scholarly journals Violence While in Utero: The Impact of Assaults during Pregnancy on Birth Outcomes

2020 ◽  
pp. 1-46
Author(s):  
Janet Currie ◽  
Michael Mueller-Smith ◽  
Maya Rossin-Slater
Keyword(s):  
New York ◽  
Birth Outcomes ◽  
Infant Health ◽  
In Utero ◽  
Adverse Birth Outcomes ◽  
Disadvantaged Women ◽  
The Us ◽  
Birth Records ◽  
The Impact

We study the effects of prenatal exposure to violent crime on infant health, using New York City crime records linked to mothers' addresses in birth records data. We address endogeneity of assault exposure with three strategies and find that in utero assault exposure significantly increases the incidence of adverse birth outcomes. We calculate that the annual social cost of assault during pregnancy in the US is more than $3.8 billion. Since infant health predicts long-term wellbeing and disadvantaged women are disproportionately likely to be domestic abuse victims, violence in utero may be an important channel for intergenerational transmission of inequality.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

scholarly journals Adverse Birth Outcomes in Colorado: Assessing the Impact of a Statewide Initiative to Prevent Unintended Pregnancy

2015 ◽  
Vol 105 (9) ◽  
pp. e60-e66 ◽  
Author(s):  
Lisa M. Goldthwaite ◽  
Lindsey Duca ◽  
Randi K. Johnson ◽  
Danielle Ostendorf ◽  
Jeanelle Sheeder
Keyword(s):  
Birth Outcomes ◽  
Unintended Pregnancy ◽  
Adverse Birth Outcomes ◽  
The Impact

scholarly journals In Utero ART Exposure and Birth and Early Growth Outcomes Among HIV-Exposed Uninfected Infants Attending Immunization Services: Results From National PMTCT Surveillance, South Africa

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Vundli Ramokolo ◽  
Ameena E Goga ◽  
Carl Lombard ◽  
Tanya Doherty ◽  
Debra J Jackson ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Odds Ratio ◽  
In Utero ◽  
Early Growth ◽  
Adverse Birth Outcomes ◽  
Growth Outcomes ◽  
Immunization Services ◽  
Future Policy ◽  
Hiv Exposed ◽  
Exposed Uninfected

Abstract Background Despite the recognized benefit of antiretroviral therapy (ART) for preventing and treating HIV, some studies have reported adverse birth outcomes with in utero ART exposure. We evaluated the effect of infant in utero HIV and ART exposure on preterm delivery (PTD), low birth weight (LBW), small for gestational age (SGA), and underweight for age (UFA) at 6 weeks. Methods We surveyed 6179 HIV-unexposed-uninfected (HUU) and 2599 HIV-exposed-uninfected (HEU) infants. HEU infants were stratified into 3 groups: ART, Zidovudine alone, and no antiretrovirals (None). The ART group was further stratified to explore pre- or postconception exposure. Multivariable logistic regression evaluated effects of HIV and ARV exposure on the outcomes. Results We found higher odds of PTD, LBW, SGA, and UFA in HEU than HUU infants. HEU in the None group (adjusted odds ratio [AOR], 1.9; 95% confidence interval [CI], 1.2–3.0) or those whose mothers initiated ART preconception (AOR, 1.7; 95% CI, 1.1–2.5) had almost twice the odds of PTD than infants whose mothers started ART postconception, but no increased odds for other outcomes. Conclusions There was an association between preconception ART and PTD. As ART access increases, pregnancy registers or similar surveillance should be in place to monitor outcomes to inform future policy.

The Rise of Managerialism in the US: Whither Worker Control?

2020 ◽  
pp. 193-216
Author(s):  
Mimi Abramovitz ◽  
Jennifer Zelnick
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Human Service ◽  
Service Workers ◽  
Human Service Workers ◽  
Non Profit ◽  
The Us ◽  
Democratic Control ◽  
The Impact

This chapter investigates the impact of managerialism on the work of non-profit human-service workers in New York City, drawing on survey data to paint a portrait of a sector that has been deeply restructured to emulate private-market relations and processes. It uses the Social Structure of Accumulation (SSA) theory to explain the rise of neoliberal austerity and identify five neoliberal strategies designed to dismantle the US welfare state. The chapter also focuses on the impact of privatization, a key neoliberal strategy; shows how privatization has transformed the organization of work in public and non-profit human-service agencies; and details the experience of nearly 3,000 front-line, mostly female, human-service workers in New York City. It argues that austerity and managerialism generate the perfect storm in which austerity cuts resources and managerialism promotes 'doing more with less' through performance and outcome metrics and close management control of the labour-process. Closely analysing practices for resistance, the chapter concludes that in lower-managerial workplaces, workers had fewer problems with autonomy, a greater say in decision making, less work stress, and more sustainable employment, suggesting that democratic control of the workplace is an alternative route to quality, worker engagement, and successful outcomes.

scholarly journals Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Qiguo Lian ◽  
Jiaying Ni ◽  
Jun Zhang ◽  
Julian Little ◽  
Shan Luo ◽  
...  
Keyword(s):  
Wenchuan Earthquake ◽  
Birth Outcomes ◽  
Low Birthweight ◽  
Maternal Exposure ◽  
Adverse Birth Outcomes ◽  
Reproductive Outcomes ◽  
2008 Wenchuan Earthquake ◽  
The 2008 Wenchuan Earthquake ◽  
Stratified Analysis

Abstract Background The prolonged effects of disasters on reproductive outcomes among the survivors are less studied, and the findings are inconsistent. We examined the associations of maternal exposure to the 2008 Wenchuan earthquake years before conception with adverse birth outcomes. Methods We included 73,493 women who delivered in 96 hospitals in 24 provinces and autonomous regions from the 2015/16 China Labor and Delivery Survey. We weighted the multivariable logistic models based on the combination of coarsened exact matching (CEM) weight and survey weight, and performed sex-stratified analysis to test whether associations of maternal earthquake exposure with adverse birth outcomes (Stillbirth, preterm birth [PTB], low birthweight [LBW], and small for gestational age [SGA]) varied by sex. Results The bivariate models showed that the weighted incidence of each adverse birth outcome was higher in exposed group than unexposed group: stillbirth (2.00% vs. 1.33%), PTB (14.14% vs. 7.32%), LBW (10.82% vs. 5.76%), and SGA (11.32% vs. 9.52%). The multivariable models showed maternal earthquake exposure was only associated significantly with a higher risk of PTB in offspring among all births (adjusted risk ratio [aRR](95%CI):1.25(1.06–1.48), P = 0.010). The sex-stratified analysis showed the association was significant among male births (aRR (95%CI): 1.40(1.12–1.75),P = 0.002),but unsignificant among female births. The sensitivity analysis reported similar findings. Conclusions The 2008 Wenchuan earthquake exposure has a long-term effect on PTB. Maternal acute exposure to disasters could be a major monitor for long-term reproductive outcomes. More attention should be paid to the underlining reasons for disaster-related adverse birth outcomes.

scholarly journals “We just get paid for 12 hours a day, but we work 24”: home health aide restrictions and work related stress

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jillian L. Shotwell ◽  
Eve Wool ◽  
Andrzej Kozikowski ◽  
Renee Pekmezaris ◽  
Jill Slaboda ◽  
...  
Keyword(s):  
New York ◽  
Long Term Care ◽  
Care Program ◽  
Home Health ◽  
Term Care ◽  
Home Based ◽  
Primary Care Program ◽  
Related Stress ◽  
The Impact

Abstract Background Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored. Methods Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (n = 13) caring for patients in a home-based primary care program in the New York City metropolitan area. HHAs were asked about their satisfaction with the home based primary care program, their own job satisfaction, and whether HHA restrictions affect their work in any way. Interviews were audio-recorded, transcribed, and analyzed. Results Two main themes emerged: (1) Pay, benefits and hours worked and (2) Concerns about patient well-being afterhours. HHAs are working more hours than they are compensated for, experience wage stagnation and loss of benefits, and experience stress related to leaving frail clients alone after their shifts end. Conclusions HHAs experience significant job-related stress when caring for frail elderly patients at home, which may have implications for both patient care and HHA turnover. As government bodies contemplate new policy directions for long-term care programs which rely on HHAs the impact of these changes on this vulnerable workforce must be considered.

scholarly journals Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women

2012 ◽  
Vol 21 (6) ◽  
pp. 634-642 ◽  
Author(s):  
Amelia R. Gavin ◽  
Paula Nurius ◽  
Patricia Logan-Greene
Keyword(s):  
Birth Outcomes ◽  
Adverse Birth Outcomes ◽  
Socially Disadvantaged ◽  
Disadvantaged Women
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