Center Care (center + care)

Distribution by Scientific Domains


Selected Abstracts


Swedish Women's Interest in Home Birth and In-Hospital Birth Center Care

BIRTH, Issue 1 2003
Ingegerd Hildingsson RN
ABSTRACT:Background: In Sweden, few alternatives to a hospital birth are available, and little is known about consumer interest in alternative birth care. The aim of this study was to determine women's interest in home birth and in-hospital birth center care in Sweden, and to describe the characteristics of these women. Methods: All Swedish-speaking women booked for antenatal care during 3 weeks during 1 year were invited to participate in the study. Three questionnaires, completed after the first booking visit in early pregnancy, at 2 months, and 1 year after the birth, asked about the women's interest in two alternative birth options and a wide range of possible explanatory variables. Results: Consent to participate in the study was given by 3283 women (71% of all women eligible). The rates of response to the three questionnaires were 94, 88, and 88 percent, respectively. One percent of participants consistently expressed an interest in home birth on all three occasions, and 8 percent expressed an interest in birth center care. A regression analysis showed five factors that were associated with an interest in home birth: a wish to have the baby's siblings (OR 20.2; 95% CI 6.2,66.5) and a female friend (OR 15.2; 95% CI 6.2,37.4) present at the birth, not wanting pharmacological pain relief during labor and birth (OR 4.7; 95% CI 1.4,15.3), low level of education (OR 4.5; 95% CI 1.8,11.4), and dissatisfaction with medical aspects of intrapartum care (OR 3.6; 95% CI 1.4,9.2). An interest in birth center care was associated with experience of being in control during labor and birth (OR 8.3; 95% CI 3.2,21.6), not wanting pharmacological pain relief (OR 2.3; 95% CI 1.3,4.1), and a preference to have a known midwife at the birth (OR 2.2; 95% CI 1.6,2.9). Conclusion: If Swedish women were offered free choice of place of birth, the home birth rate would be 10 times higher, and the 20 largest hospitals would need to have a birth center. Women interested in alternative models of care view childbirth as a social and natural event, and their needs should be considered. (BIRTH 30:1 March 2003) [source]


Interview with a Quality Leader,Karen Davis, Executive Director of The Commonwealth Fund

JOURNAL FOR HEALTHCARE QUALITY, Issue 2 2009
Lecia A. Albright
Dr. Davis is a nationally recognized economist, with a distinguished career in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977 to 1980, and was the first woman to head a U.S. Public Health Service agency. Before her government career, Ms. Davis was a senior fellow at the Brookings Institution in Washington, DC; a visiting lecturer at Harvard University; and an assistant professor of economics at Rice University. A native of Oklahoma, she received her PhD in economics from Rice University, which recognized her achievements with a Distinguished Alumna Award in 1991. Ms. Davis is the recipient of the 2000 Baxter-Allegiance Foundation Prize for Health Services Research. In the spring of 2001, Ms. Davis received an honorary doctorate in human letters from John Hopkins University. In 2006, she was selected for the Academy Health Distinguished Investigator Award for significant and lasting contributions to the field of health services research in addition to the Picker Award for Excellence in the Advancement of Patient Centered Care. Ms. Davis has published a number of significant books, monographs, and articles on health and social policy issues, including the landmark books HealthCare Cost Containment, Medicare Policy, National Health Insurance: Benefits, Costs, and Consequences, and Health and the War on Poverty. She serves on the Board of Visitors of Columbia University, School of Nursing, and is on the Board of Directors of the Geisinger Health System. She was elected to the Institute of Medicine (IOM) in 1975; has served two terms on the IOM governing Council (1986,90 and 1997,2000); was a member of the IOM Committee on Redesigning Health Insurance Benefits, Payment and Performance Improvement Programs; and was awarded the Adam Yarmolinsky medal in 2007 for her contributions to the mission of the Institute of Medicine. She is a past president of the Academy Health (formerly AHSRHP) and an Academy Health distinguished fellow, a member of the Kaiser Commission on Medicaid and the Uninsured, and a former member of the Agency for Healthcare Quality and Research National Advisory Committee. She also serves on the Panel of Health Advisors for the Congressional Budget Office. [source]


The emotional quality of childcare centers in Israel: The Haifa study of early childcare

INFANT MENTAL HEALTH JOURNAL, Issue 2 2005
Nina Koren-Karie
Data from an Israeli project shows higher proportion of insecurely attached infants in center care as compared with noncenter care (Sagi, Koren-Karie, Gini, Ziv, & Joels, 2002). The present study was designed to assess structural and emotional aspects characterizing infants' experiences in center care, aiming to explain, in part, the high incidence of attachment insecurity among center-care infants. In the present study, we focus on 151 center-care infants who were observed in the Ainsworth Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978) with their mothers. Sixty-one percent of them were coded as securely attached to their mothers while 39% were coded as insecurely attached. In addition, 56 directors and 120 caregivers in 56 centers were videotaped throughout a full-day observation. The Assessment Profile of Early Childhood Program (Abbott-Shim & Sibley, 1987) was also employed. Results indicated that the centers in Israel are of low standards: Large group size, high caregiver,infants ratio, inadequate professional training, and minimal attention to individual emotional needs. No associations were found between infants' attachment and various aspects of the settings. The low quality of the Israeli settings may explain the higher rate of attachment insecurity in center-care infants. 2005 Michigan Association for Infant Mental Health. [source]


On Estimation of the Survivor Average Causal Effect in Observational Studies When Important Confounders Are Missing Due to Death

BIOMETRICS, Issue 2 2009
Brian L. Egleston
Summary We focus on estimation of the causal effect of treatment on the functional status of individuals at a fixed point in time t* after they have experienced a catastrophic event, from observational data with the following features: (i) treatment is imposed shortly after the event and is nonrandomized, (ii) individuals who survive to t* are scheduled to be interviewed, (iii) there is interview nonresponse, (iv) individuals who die prior to t* are missing information on preevent confounders, and (v) medical records are abstracted on all individuals to obtain information on postevent, pretreatment confounding factors. To address the issue of survivor bias, we seek to estimate the survivor average causal effect (SACE), the effect of treatment on functional status among the cohort of individuals who would survive to t* regardless of whether or not assigned to treatment. To estimate this effect from observational data, we need to impose untestable assumptions, which depend on the collection of all confounding factors. Because preevent information is missing on those who die prior to t*, it is unlikely that these data are missing at random. We introduce a sensitivity analysis methodology to evaluate the robustness of SACE inferences to deviations from the missing at random assumption. We apply our methodology to the evaluation of the effect of trauma center care on vitality outcomes using data from the National Study on Costs and Outcomes of Trauma Care. [source]


Swedish Women's Interest in Home Birth and In-Hospital Birth Center Care

BIRTH, Issue 1 2003
Ingegerd Hildingsson RN
ABSTRACT:Background: In Sweden, few alternatives to a hospital birth are available, and little is known about consumer interest in alternative birth care. The aim of this study was to determine women's interest in home birth and in-hospital birth center care in Sweden, and to describe the characteristics of these women. Methods: All Swedish-speaking women booked for antenatal care during 3 weeks during 1 year were invited to participate in the study. Three questionnaires, completed after the first booking visit in early pregnancy, at 2 months, and 1 year after the birth, asked about the women's interest in two alternative birth options and a wide range of possible explanatory variables. Results: Consent to participate in the study was given by 3283 women (71% of all women eligible). The rates of response to the three questionnaires were 94, 88, and 88 percent, respectively. One percent of participants consistently expressed an interest in home birth on all three occasions, and 8 percent expressed an interest in birth center care. A regression analysis showed five factors that were associated with an interest in home birth: a wish to have the baby's siblings (OR 20.2; 95% CI 6.2,66.5) and a female friend (OR 15.2; 95% CI 6.2,37.4) present at the birth, not wanting pharmacological pain relief during labor and birth (OR 4.7; 95% CI 1.4,15.3), low level of education (OR 4.5; 95% CI 1.8,11.4), and dissatisfaction with medical aspects of intrapartum care (OR 3.6; 95% CI 1.4,9.2). An interest in birth center care was associated with experience of being in control during labor and birth (OR 8.3; 95% CI 3.2,21.6), not wanting pharmacological pain relief (OR 2.3; 95% CI 1.3,4.1), and a preference to have a known midwife at the birth (OR 2.2; 95% CI 1.6,2.9). Conclusion: If Swedish women were offered free choice of place of birth, the home birth rate would be 10 times higher, and the 20 largest hospitals would need to have a birth center. Women interested in alternative models of care view childbirth as a social and natural event, and their needs should be considered. (BIRTH 30:1 March 2003) [source]


Child Care in Poor Communities: Early Learning Effects of Type, Quality, and Stability

CHILD DEVELOPMENT, Issue 1 2004
Susanna Loeb
Young children in poor communities are spending more hours in nonparental care because of policy reforms and expansion of early childhood programs. Studies show positive effects of high-quality center-based care on children's cognitive growth. Yet, little is known about the effects of center care typically available in poor communities or the effects of home-based care. Using a sample of children who were between 12 and 42 months when their mothers entered welfare-to-work programs, this paper finds positive cognitive effects for children in center care. Children also display stronger cognitive growth when caregivers are more sensitive and responsive, and stronger social development when providers have education beyond high school. Children in family child care homes show more behavioral problems but no cognitive differences. [source]