Latino Disparities in Child Mental Health Services

TOPIC:  Access and utilization of mental health services for Latino children.
PURPOSE:  As Latino children may experience higher rates of unmet needs, this article examines the current literature for the reasons for the disparity and the barriers to the utilization of mental health services for Latino children.
SOURCES:  An integrative literature review was undertaken from child psychiatry and nursing.
CONCLUSIONS:  The literature confirmed a pattern of underutilization of mental health services by Latino children, but did not completely address the reasons for the disparity. Suggested barriers were language and cultural issues. Gaps in the literature include a lack of agreement for definition of a mental health problem and the tools to identify these, insufficient studies into the barriers for Latino children in the access and utilization of mental health services, and cultural and language issues related to Latino research.     

Record Keeping and Health Service Mirrored by Data from Swedish Child Health Care Records

Abstract. In order to study the completeness and accuracy of the recording of Child Health Care data, 212 randomly sampled records from all of Sweden were collected. The degree of completeness and accuracy was determined by scoring information from the records. The results showed that the recorded data lacked accuracy to a large extent, and completeness to a somewhat lesser extent. Information on the development of the child, especially speech and language development, but also psychomotor development, were the main areas lacking completeness. Health information, environmental conditions, behaviour, illnesses, accidents and evaluation of the neonatal period were also very poorly recorded. The results indicate that the records of the Child Health Care service do not constitute, in the respects studied, a complete and secure basis for clinical work, research, planning or evaluation of the quality of the health services.     

Fluoride mouthrinses for preventing dental caries in children and adolescents

The Mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and related health care professionals involved in delivering, leading, or researching nursing care. The CNCF produces “Cochrane Corner” columns (summaries of recent nursing‐care‐relevant Cochrane Reviews) that are regularly published in collaborating nursing‐care‐related journals. Information on the processes this Field has developed can be accessed at: http://cncf.cochrane.org/evidence-transfer-program-review-summaries .     

Health and Safety Needs in Early Care and Education Programs: What do Directors,Child Health Records,and National Standards Tell Us?

ABSTRACT Objective: To identify the overlapping and unique health and safety needs and concerns identified by early care and education (ECE) directors, health records, and observed compliance with national health and safety (NHS) standards. Design and Sample: Cross‐sectional study. 127 ECE programs from 5 California counties participated in the study, including 118 directors and 2,498 children's health records. Measures: Qualitative data were collected using standardized ECE directors' interviews to identify their health and safety concerns; and objective, quantitative data were collected using child health record reviews to assess regular health care, immunizations, health insurance, special health care needs, and screening tests and an observation Checklist of 66 key NHS standards collected by research assistants. Results: The overlapping health and safety needs and concerns identified by the directors and through observations were hygiene and handwashing, sanitation and disinfection, supervision, and the safety of indoor and outdoor equipment. Some of the health and safety needs identified by only one assessment method were health and safety staff training, medical plans for children with special health care needs and follow‐up on positive screening tests. Conclusions: Comprehensive, multimethod assessments are useful to identify health and safety needs and develop public health nursing interventions for ECE programs.     

PRACTICE REPORTS

Edwina Thomas, BA, MM, RN, Clinical Nurse Specialist (Midwifery) Nepean Hospital, Sidney, NSW, Australia
The responsibility of caring for pregnant women and both their unborn and newly born babies falls directly and squarely upon the shoulders of midwives in whatever setting in which they work. In small peripheral hospitals midwives often fulfil much of the role played by registrars and residents in larger institutions. This certainly helps enable these midwives to provide holistic care, and truly function as midwives, but in doing so increases both the responsibility undertaken by, and the public's expectations of the midwife. Similarly, in all midwife-led antenatal clinics the responsibility of recognising deviations from normal and implementing timely, effective intervention is great. To protect ourselves we tend to engage in a lot of ritualistic practices that do little to ensure maternal and fetal well-being, but which serve to 'prove' we 'did everything possible' for a good outcome.     

UNITED KINGDOM: CARING DIFFERENTLY: INTERMEDIATE CARE - AN ALTERNATIVE APPROACH TO SERVICE PROVISION IN RESPONSE TO CLIENT NEED AND WORKFORCE CHANGES IN THE NHS

The King's Fund is an independant organisation whose prime function is to support development of health and social services. The following paper outlines one aspect of its work which is concerned with the introduction of so called ‘intermediate care’ services for people who need help during the transition between medical dependance and personal independance, but who do not require the specialist medical expertise provided in an acute hospital setting. It is argued that currently there are few services specifically designed to meet this group of patients needs and a ‘black hole’ exists in service provision. The purpose of such a service is to provide intensive therapy in order to maximise their ability to live independently, improve the quality of their lives, and provide the opportunity for them to learn greater self-care skills in order that they can manage their own health more effectively in the longer term.     

School nurse assessment of primary school children: Analysis of data from the school entrant health questionnaire

Edgecombe GA, Avant KC, Griffin P, Corneille K. International Journal of Nursing Practice 1998; 4: 40–50
School nurse assessment of primary school children: Analysis of data from the school entrant health questionnaire
The School Entrant Health Questionnaire (SEHQ) has been used by the School Nursing Program in Victoria since April, 1997. The SEHQ assists school nurses in developing a health profile of primary grade children and in discriminating between children with problems and children without problems. The SEHQ assesses children in 11 domains: general health, medications, immunisations, dental health, speech/language, hearing, vision, disabilities, general development, behaviour and emotional well-being, and family stress. The SEHQ was found to be reliable and valid, and to provide an excellent means of distinguishing between students who had problems and needed intervention and those who did not. This paper presents an analysis of data from the first testing of the SEHQ.     

Policy and practice for preventing skin cancer in children

This paper identifies what is known and what is not known about the link between sun exposure and skin cancer and what can be done to reduce sun exposure in children. There is evidence for the use of sun protective clothing and of the effectiveness of sunscreens for some, but not all, forms of skin cancer. While there is some evidence to support interventions in schools, there is insufficient evidence to support other interventions aimed at children or their caregivers. There is no clear means of assessing the "trade-off" between the benefits and harms of sunlight exposure, and the impact of sun protection strategies on other health promotion messages aimed at children is unknown. Reliance on educational interventions in schools may benefit from a broader approach that includes more emphasis on protective clothing and structural changes in the school day. Sun protection messages should be linked with other health promotion messages targeting children.     

Utilization of parenting groups and consultation services as parenting support services by Japanese mothers of 18 month old children

Aim: To clarify the factors related to the utilization of parenting groups and consultation services by mothers with children aged 18 months. Methods: This was a cross‐sectional study using a self‐report questionnaire survey at health examinations in five health centers of an urban city in Tokyo, Japan, from July to September 2003. The final study population was comprised of the 371 mothers who provided information on both demographics and the utilization of services. Results: Of these 371 mothers, 166 participated in parenting groups since the birth of their 18 month old child. Logistic regression analyses indicated the following factors related to such participation: past experience in the use of services provided by the local government, trust in the specific group, and worries about their children. Participation in the parenting groups was not related to child‐rearing anxiety or mental health status. The participants indicated that the groups provided friends and child‐rearing information and alleviated stress. Worries about children and past experience in the use of public services would enhance the utilization of services. Conclusion: It is essential for service‐providers to offer services specific to the situation or desires of mothers. Mothers might need both consultation services and support groups to reinforce the mother–child relationship, for social support, and to freely discuss worries with both professionals and peers.     

Games,Gambling, and Children: Applying the Precautionary Principle for Child Health

TOPIC: We were compelled by the trends of Internet gambling, state‐initiated gambling outlets, and of having gambling social events in middle schools and high schools in the United States to examine gambling and its health effects on children and adolescents. PURPOSE AND SOURCES: We researched trends in adolescent gambling as well as its association with negative health and sociological outcomes through the literature for child and adolescent gambling studies. CONCLUSION: The literature shows gambling to be associated with many negative health and socioeconomic effects. The increasing participation of children and adolescents is of particular concern, for the earlier a person starts gambling, the more likely that person is to develop serious gambling problems. We propose the application of the precautionary principle in this situation. Until it is proven that adolescents will not be negatively affected by exposure to gambling, the exposure of adolescents to gambling must be carefully restricted.     

Bad news: Families’ experiences and feelings surrounding the diagnosis of Zika‐related microcephaly

The rapidly increasing number of cases of Zika virus and limited understanding of its congenital sequelae (e.g., microcephaly) led to stories of fear and uncertainty across social media and other mass communication networks. In this study, we used techniques generic to netnography, a form of ethnography, using Internet‐based computer‐mediated communications as a source of data to understand the experience and perceptions of families with infants diagnosed with Zika‐related microcephaly. We screened 27 YouTube? videos published online between October 2015 and July 2016, during which the Zika epidemic started, peaked, and declined. We identified three themes: (a) experiencing the news of a diagnosis of Zika‐associated microcephaly; (b) experiencing feelings and expectations of the ‘imperfect’ child; and (c) seeking to understand microcephaly to care for the child. We found that families experienced distressing feelings of shock, sadness, hopelessness, and pain, while dealing with emerging and sometimes conflicting information being transmitted by news outlets, uncertainty about the child's health, and healthcare providers’ lack of clarity to guide the family members. The ‘unknown’ factor of ZIKA was an additional stressful factor in the experience of the families.     

Assessing the need for child-care health consultants

This study surveyed health and safety needs of child-care programs; examined the perceptions of directors, the person identified as being responsible for a program, concerning health consultation; and determined how directors would secure funds to pay for consultative services. The survey was conducted in a state without mandates for child-care health consultation and minimal access to consultants. The researchers designed and pilot-tested a Child Care Health and Safety Survey. Working with a task group of statewide child health experts, the researchers revised the survey and mailed it to a random sample of child-care programs. Twenty-two Head Start Programs, 122 licensed child-care centers, and 116 family child-care homes participated, representing a return rate of 73, 36, and 30%, respectively. The majority of programs expressed interest in child-care health consultation offered for free or fee-based. Directors identified reasonable means of obtaining funds to support consultation. All programs had needs related to supporting health practices in their settings, provision of health services for staff, and health screening for children. Public health nurses, specially trained to advise child care, are well positioned to offer consultation. Systems of health consultation may be accepted as fee-for-service arrangements, supporting sustainability.     

Health Systems and Maternal and Child Survival in Central Asian Republics

Purpose: To describe the status of health care systems in five Central Asian Republics (CAR): Kyrgzstan, Kazakhstan, Uzbekistan, Turkmenistan, and Tajikistan, with particular attention to women's and children's health.
Organizing construct: Changing mortality profiles are investigated using the "protractedpolarized" model of epidemiologic transition.
Sources: Empirical evidence was drawn from the World Health Organization (WHO) database for the region, along with additional evidence presented at a maternal-child health conference held in Bishkek, Kyrgyzstan, on November 11–14, 1998. The conference was sponsored by the Albert Schweitzer Institute and the Soros Foundation. This evidence is evaluated for completeness, validity, and reliability. Trends are identified using the 1998 and 1999 World Health Reports and 1999/2000 World Bank Development Report.
Findings: Incomplete data prohibited comprehensive analysis. Available data indicated high but variable rates of maternal and child mortality and overall declines in health status and the health care infrastructure in the 1990s.
Conclusions: Data collection and analysis from this part of the world are often incomplete and unreliable. Future research should focus on improving maternal and child health indicators by enhancing resource sharing and opportunities for international collaboration.     

Nurses' first encounters with parents of new-born children--public health nurses' views of a good meeting

? The nurse’s view of the first meeting with parents of new‐born children may have consequences for the quality of future contact. A good start will lay a solid foundation for a lasting relationship, and have an affect on the nurse’s work to support parents and children and to promote health. We do not know what nurses mean by a ‘good meeting’. ? The aim of this study was to discover how nurses view the first meeting as a general preventive measure aimed at all parents and their new‐born children. ? Four focus groups interviews were held with nurses from different primary health care areas in the county of Skåne, southernmost Sweden. ? Analysis of the content in the transcribed interview texts disclosed eight subcategories: good contact/reciprocal relationship; willingness to listen; guest/equal roles; time/peace and quiet; the family in its environment; socio‐cultural aspects; confirmation/support; and individual advice. ? Three categories were established: creating trust; creating a supportive climate; and creating a picture of the family’s life situation. ? The home visit was seen as an important way to establish trust and obtain a picture of the family’s life situation, which was in turn essential for creating a supportive climate.