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IntroductionDirectors of Head Start (HS) and non–Head Start (non-HS) child care centers were surveyed to compare health consultation and screening for and prevalence of health risks among enrolled children.MethodsDirectors of licensed centers from five states were surveyed from 2004 to 2005. Data were analyzed using cross-tabulation and logistic regression techniques.ResultsA total of 2753 surveys were completed. HS centers were more likely than non-HS centers to consult health professionals (P < .0001). More than 90% of HS centers screened for health problems compared with 64.9% of non-HS centers (P < .0001). Almost all HS centers provided parents with child health information. Children at HS centers were at high risk for dental problems. Less than 3% of HS center directors, versus 11.3% of non-HS directors (P < .0002), reported TV viewing for more than an hour a day.DiscussionChildren in HS centers were more likely to receive health consultations and screenings, were at higher risk for dental problems, and watched less TV compared with children in non-HS centers. HS centers promoted health significantly more frequently than did non-HS centers.  相似文献   

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Keeping a child healthy is the most important priority of every parent. The child can be kept healthy by ensuring exclusive breastfeeding for first 6 mo of life, maintaining healthy weight throughout the childhood, providing adequate and balanced diet, promoting regular physical activity and adequate sleep, keeping a watch on all the parameters of development and referring the child to the specialist whenever deviation from normal is suspected. Proper and timely immunization as per the prevailing guidelines must be done to prevent serious infections. Stress should also be given on promoting oral as well as mental health besides other important general measures to improve the health of the child.  相似文献   

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From mid ′50s onwards, we witness a change of paradigm in the Western world: the expression of a historical shift from modernity to postmodernity. This new era includes a strong influence of the media on the population, a change from a lineal sense of time to a virtual, punctual one, and a flooding of overwhelming amount of information, mostly irrelevant, broadcasted in a de-contextualized, synchronic, fragmented and senseless fashion. This new age is characterized, above all, by the destitution of the State, the meta- institution source of legitimacy of all modern institutions: citizenship, factory, and mainly, School, an essential determinant this last one in the construction process of child subjectivity. Having lost its modeling power, the School loses its modern meaning, becoming thus a mere physical space in which pupils meet, but where general, transcendent rules, norms and values cannot be built, as in fact happened in modern times. According to Corea and Lewkowicz, school becomes an empty shed in which rules have to be built all the time, and become valid only for a particular occasion. These changes necessarily influence child subjectivity, the way they feel, they behave, and they "live" in contemporary society. Pediatricians have to be aware and try to understand these changes, so that we can help children, and, in doing so, to build a better world for them.  相似文献   

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This article examines the relationship between child poverty and children’s subjective well-being on the range of domains identified by Rees et al. (2010) in the Good Childhood Index. Data are taken from a school-based survey of children in England. Child poverty is measured using a child-derived index of material deprivation (proposed by Main and Bradshaw in Child Indicators Research 5(3): 503–521, 2012) and indicators of children living in households likely to qualify for minimum income benefits. After a review of relevant literature to provide background to the study, the relationship between material deprivation, qualification for minimum income benefits and various domains of children’s subjective well-being are examined. Finally, a more detailed analysis is performed on the relationship between poverty and children’s subjective well-being in the domains of family and choice, as relationships were found to be strongest in these domains. Findings show that poverty is an important predictor of subjective well-being and that the child-derived index is more successful than household qualification for minimum income benefits in explaining variation in Rees et al’s (2010) Good Childhood Index domains. This lends support to Cummins’s (Journal of Happiness Studies 1(2):133–158, 2000) argument that the relationship between income and subjective well-being exists but is confounded by mediating factors. The domains in which the association to material deprivation is especially strong – family and choice - are identified by Rees et al. (2010) as amongst the most strongly associated with overall subjective well-being.  相似文献   

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The assessment of a child is quite different from that of adults and requires knowledge of normal variations in anatomy and physiology with growth and development. An important part of initial assessment includes triage and recognizing children with emergency signs so that they can be managed at the earliest to prevent death and referred timely to the specialist. After ruling out emergency signs, the children with priority signs require prompt assessment, management and referral to the specialist. In addition to normal history as in adults, prenatal and birth history, developmental history, immunization history, feeding history and social history are important for complete assessment of the child. The approach to physical examination should consider age and developmental level. It is important to make the child comfortable with pleasant surroundings and playful behavior to yield maximum information from the examination. In addition to diagnosing disease, pediatric assessment should involve identification of malnutrition, immunization status, level of development, screening for 4 Ds (Defects at birth, Deficiencies, Diseases and Developmental Delay including Disability), hearing and visual assessment and detection of child abuse. Tanner staging and psychosocial assessment should be done in adolescents.  相似文献   

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This article discusses a 4-year-old girl who displayed behavioral symptoms consistent with posttraumatic stress disorder. She was recently placed in foster care due to emotional and physical neglect. During her clinic visit, she disclosed being sexually abused by her father with a knife. Results of her general and anogenital physical examinations were normal. The case discussion proposes an explanation for how a maltreated child (1) develops behavioral problems, (2) has a normal genital examination despite the history of sexual abuse, and (3) has an implausible disclosure of her father hurting her with a knife. As part of the Integrating Basic Science into Clinical Teaching Initiative series, basic science principles are the method of explanation. The case discussion is an attempt to understand the science responsible for the disease that is present and make that understanding useful for future clinical problem solving.  相似文献   

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AIM: To study the validity of the decision not to investigate mandatory reports of suspected child maltreatment. METHODS: Written files of 220 reports indicating possible child maltreatment were analysed and re-evaluated. As a measure of the justification for the decisions, a 5-y follow-up study was done. RESULTS: We determined that 76% of the reports still indicated child maltreatment after the initial assessment was done. In the follow-up study, 45% of the children had been investigated. The social worker used the family as the only source of information in 74% of the cases, in 6% someone outside the family was contacted, and in 11% no further information in addition to the report was collected. In 9%, data on information sources were missing. CONCLUSION: The findings are rather discouraging, as they challenge the belief that a report is a means of ensuring that maltreatment does not continue. The study shows that, depending upon the way in which the initial assessments are made, maltreated children may run a risk of not being identified, even though the maltreatment has been reported. This suggests that there may be a need for national guidelines concerning the reporting of maltreatment.  相似文献   

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Infants under one account for up to 13% of child protection registrations in the UK with neglect (55%) and emotional abuse (17%) accounting for nearly two-thirds of these. Infants are highly dependent on their caregivers to enable them to optimize their rapidly developing nervous system, and also to promote their ability for affect regulation via the attachment relationship. As a result, maltreatment that occurs during this period has a disproportionate effect on the child's development.  相似文献   

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The diagnosis of nonbacterial thrombotic endocarditis (NTBE) is rarely made during life. This report describes a child who had high-grade non-Hodgkin's lymphoma with NTBE and multiple systemic embolism. The transthoracic echocardiographic findings of mitral valve leaflet vegetations and progressive regurgitation led to surgical resection of the vegetations. A high index of suspicion is needed when a clinician is faced with a patient who has malignancy, systemic embolic phenomena, and persistent negative blood cultures.  相似文献   

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