Comprehensive Child Health Care Research Articles

Repercussões da pandemia no desenvolvimento infantil e nas ações dos visitadores do Programa Criança Feliz

Abstract Objective to apprehend the repercussions of the COVID-19 pandemic on child development and on the actions of the Happy Child Program visitors. Method qualitative research, anchored in Bronfenbrenner's Bioecological Theory of Human Development, with eight visitors from the aforementioned program, in a city in Paraíba. Data were collected from January to June 2021, using a semi-structured script, with interviews recorded and processed by IRAMUTEQ, which were later analyzed according to the Descending Hierarchical Classification (Reinert's method), and the Bardin's Content Analysis framework. Results the repercussions of the pandemic limit the actions to promote child development by visitors, by hindering interaction with families surrounded by the fear of contracting the disease, incurring a break in the connection between visitors and family, a delay or absence of return of activities by families, feelings such as fear, discouragement, frustration, aggressiveness and attachment to screens as barriers to the continuity of child monitoring. Final considerations and implications for practice learning about the repercussions of the COVID-19 pandemic on the development of children assisted by the Happy Child Program, provided an opportunity to reflect upon the strategies necessary to enhance Nursing practice in development surveillance and stimulation actions for comprehensive child health care.

Epidemiology of eye diseases among children with disability in rural Bangladesh: a population‐based cohort study

To describe the epidemiology of eye diseases among children with disability in rural Bangladesh. We established a population-based cohort of children with disability using the key informant method. Children younger than 18 years with disability (i.e. physical, visual, hearing, speech, epilepsy) were included. We used detailed ophthalmological assessments following World Health Organization (WHO) protocols by a multidisciplinary team including an ophthalmologist, optometrist, physician, and physiotherapist. Visual impairment, blindness, and severe visual impairment (SVI) were defined by following WHO categories. Between October 2017 and February 2018, 1274 children were assessed (43.6% female; median [interquartile range] age 9y 10mo [6y -13y 7mo]). Overall, 6.5% (n=83) had blindness/SVI, and 5.6% (n=71) had visual impairment. In the group with blindness/SVI, 47% (n=39) had cortical blindness; of those, 79.5% (n=31) had cerebral palsy (CP). The other main anatomical sites of abnormalities in this group included lens (13.3%, n=11), cornea (10.8%, n=9), and optic nerve (9.6%, n=8). In the group with visual impairment, 90.1% (n=64) had refractive error. Overall, 83.1% (n=69) and 78.8% (n=56) of those with blindness/SVI and visual impairment had avoidable causes. Most children with blindness/SVI and visual impairment lacked access to education. The burden of blindness/SVI/visual impairment is high among children with disability in rural Bangladesh, mostly due to avoidable causes. Overrepresentation of CP and cortical blindness in the group with blindness/SVI and refractive error in the group with visual impairment highlights the need for integration of ophthalmology assessment, eye care, and refraction services in comprehensive health care for children with disability including CP in rural Bangladesh.

Indications and challenges of limb amputation in children; Experience in a tertiary hospital in Enugu Nigeria

Background: Limb amputations in children are generally an uncommon procedure and are usually associated with significant emotional implications for the patients and their caregivers. Apart from emotional issues, this surgical procedure, which is often life-saving is fraught with challenges in a developing country. The aim of the study was to review indications and challenges posed by presentation and consent time in managing children who need amputation. It is hoped that highlighting the challenges will be helpful in improving care for children who may be involved. Patients and Methods: This was a retrospective study of all children 16 years and below who had limb amputation in Enugu State University of Technology Teaching hospital between January 2015 and December 2019. Results: They were 22 amputations involving 13 (59.0%) males and 9 (41.0%) females, giving a ratio of 1.4:1. Amputations of the lower limb occurred in 15 (68.2%) cases, while the upper limb was involved in 7 (31.8%) cases. Road traffic accident (RTA) 6 (27.3%) and sequalae of Traditional bone setter's (TBS) intervention 6 (27.3%) after trauma were the most common indications for amputation. Delayed wound healing was the most common complication seen. No mortality was recorded, and consent for surgery was the most common challenge encountered. None of the patients was able to acquire prosthesis due to financial constraints. Conclusion: RTA and bone setter's intervention in trauma management leading to gangrene are the most common indications for amputation in children. Comprehensive Child health care plan addressing observed challenges could bring a better outcome in children who may need amputation.

Impact of infant & young child feeding & caring practices on morbidity

Background: Around 5.9 million children still die every year before reaching their fifth birthday. Child morbidity and mortality due to preventable causes remains high in developing countries. Aim & Objective: To find out the relationship of morbidity with child rearing practices and sociodemographic characteristic. Material and Methods: To cover a sample size of 400 in urban health center area population under 5 children every alternate family was selected by systematic random sampling from the total of 1867 registered families at urban health center. The data was obtained by the interview of mothers and examination of children using predesigned and pretested Questionnaire. The data thus collected, was first coded and then transferred to a master chart on Microsoft Excel sheet, from which distribution as well as co-relation tables were prepared, analyzed and statistically evaluated by SPSS version 20.0.Result: In the present study, the overall fortnightly incidence of morbidity among under 5 children was found to be 65.3% (boys – 64.2%, girls – 66.5%). Exclusive breastfeeding (p < 0.001); time of initiation of breastfeeding (p < 0.001); complementary feeding (p < 0.05) and hand washing practices (p < 0.001) are statistically significant predictors of child morbidity Conclusion: We need comprehensive child health care programme having all three promotive, preventive and curative services.

A promoção da saúde da criança: a participação da Fisioterapia

This article seeks to analyze the state-of-the-art physiotherapeutic actions geared to children, with a focus on health promotion, in the available literature. Thus, by questioning ideas present in the production of knowledge, the intention is to contribute with input for the formulation of principles for physiotherapy to promote actions of comprehensive health care for children. In terms of methodology, the study consisted of a bibliographical review of a qualitative nature, focusing on articles available in national and international virtual libraries and databases. Four pivotal themes that permeate the discussion were singled out, namely: physiotherapy from the perspective of promoting the health of children; bodily practices at different levels of care; physiotherapy for children on a community basis; and cooperation between sectors. The discussions of the literature consulted made it possible to establish parameters for the development of physiotherapy geared to children from a health promotion standpoint.

Pediatric nursing consultation in the perspective of nurses from the family health strategy

Qualitative study that analyzed conceptions and experiences of nurses about the pediatric nursing consultation and its systematization in the Family Health Strategy. Semi-structured interviews were recorded with ten nurses from four cities of the countryside of São Paulo, in 2011. The interviews were analyzed according to the method of Thematic Content Analysis, based on current assumptions of the systematization of nursing care and the comprehensive child health care. Generally, nursing consultations, and specifically, pediatric ones were defined as the nurses’ activity that allows them to know the life/health story, current needs and prevent future problems, having recognized the importance of its implementation and systematization. The experiences reported the paucity and lack of systematization in the pediatric nursing consultation in the context studied. Processes of ongoing health education are necessary to ensure quality and completeness to children's health.

Daily immunization services: A moral duty, not an empty slogan

BackgroundImmunization services in Armed Forces hospitals are provided once or twice a week leading to children missing important vaccines. Vaccines offered are restricted to vaccines provided under the Universal Immunization Programme (UIP). This system is inadequate to meet the challenge of providing 100% immunization to children in a station. Two large service hospitals were selected for provision of daily immunizations under the ‘CHOICE’ banner (Comprehensive child Healthcare, OPD services and Immunization Clinic Everyday), which was conducted under the supervision of the Pediatrician. The immunization delivery before and after institution of the daily immunization program was compared. MethodThis retrospective study compares the vaccine delivery rate of two systems, namely a restricted approach providing UIP vaccines on a weekly basis and a comprehensive approach providing both UIP as well as optional vaccines on a daily basis. ResultsThere was a significant increase in attendance at the immunization clinic, which was progressive over the years with the comprehensive approach. The delivery rates of all vaccines increased, in particular the combination vaccines. The workload per immunization session showed a concomitant decrease. ConclusionDaily immunization is a better method of vaccine delivery to children, leading to a marked increase in attendance at the immunization clinic and utilization of hospital services.

AIDS in Brazilian Children: History, Surveillance, Antiretroviral Therapy, and Epidemiologic Transition, 1984–2008

We present a systematic review of historical, political, and epidemiologic aspects of AIDS in Brazilian children. Over 25 years, Brazil has developed different strategies to control AIDS in children. Three revisions of criteria for defining AIDS cases in children and nine national guidelines on antiretroviral therapy administration for management of HIV infection were published. These guidelines represent important progress, including aspects of HIV/AIDS surveillance, antiretroviral treatment, opportunistic conditions, prophylaxis, and laboratory testing. Brazil has significantly expanded access to free therapy with different classes of antiretroviral drugs. Initially focusing on treatment for HIV and opportunistic conditions, the scope of treatment guidelines gradually expanded to comprehensive health care for children and adolescents. From 1996 to 2008, the number of AIDS cases and deaths in children has been reduced by 67% and 65%, respectively, as a result of different strategies to prevent mother-to-child transmission of HIV and highly active antiretroviral therapy administration to infected children. Improved morbidity, mortality, and survival of Brazilian children with AIDS demonstrate clear benefits of adopting a policy of free and universal access to antiretroviral drugs associated with comprehensive care. However, important issues remain to be resolved, mainly concerning social, operational, and regional inequalities in coverage and quality of care, and epidemiological surveillance in different regions of the country. This broad review shows that the overall situation of pediatric AIDS in Brazil represents an incomplete process of epidemiologic and demographic transition, with the coexistence of old and new clinical and epidemiologic challenges.

Child health care centres: an academic model for comprehensive child health care in the community

The challenge of the discipline of paediatrics in the 21st century is to promote health and development of children in a way that will enable them to maximize their biological and social potential. The community child health centre (CHC) in Israel is a model of community health care service built to provide comprehensive health care to children and adolescents, as well as an academic setting for under- and postgraduate paediatric training. Today there are 34 CHCs in Israel, serving a population of 220 000 children from birth to 18 years of age. The CHC combines the advantages of group practice with those of an academic medical centre and enables flexibility and mutual learning. Further expansion and development are required to realize the CHC's mission of a true comprehensive academic centre for paediatric community health.

NAPNAP updates

Leadership development & association managementBest wishes from the board & staffHere's wishing you a safe, healthy, and happy holiday season from the NAPNAP Executive Board and National Office staff. May 2005 be a year of progress in our work to improve the health and lives of children and families!New technology to personalize membershipsAs of the deadline for this column, NAPNAP's Communication Technology Work Group was reviewing proposals to redevelop NAPNAP's website. By the time you read this, work likely will be underway to create a new online experience for members and visitors that will be built on a blueprint intended to enhance services, foster a sense of community, and promote growth. While it's too early to bring you a preview of the look and feel of the new NAPNAP website, please visit www.napnap.org often to experience these exciting developments.Strategic planning processAt the Fall 2004 Executive Board Meeting in San Francisco, the Executive Board members and National Office staff participated in a day-long session to create the framework for NAPNAP's 2005-2008 Strategic Plan. Facilitator Deborah Mullen of Captus Communications worked with Strategic Planning Chair Juanita Dale to set the agenda and create a lively discussion regarding NAPNAP's Strategic Plan. Details of the planning document will be communicated to members in a number of ways once finalized.Mark those calendars!Please remember that December 31, 2004, is the deadline to nominate candidates for the 2004-2005 Loretta C. Ford Distinguished Fellow Award and the Henry K. Silver Memorial Award. Also, please recall that the week of March 27-April 3, 2005, is “Pediatric Nurse Practitioner Week.” Work with your chapters to plan celebrations and publicize PNP excellence that week. Please contact Joe Casey at [email protected] to let us know of your PNP Week activities so that we can acknowledge your contributions to increasing recognition of the role of the PNP.AdvocacyNAPNAP health policy agenda 2004-2005NAPNAP's Health Policy Chair Karen Duderstadt, MS, CPNP, announced the priorities for NAPNAP's advocacy initiatives that were developed and approved by NAPNAP's Legislative Work Group. The agenda includes the following items:IAdvocate to protect and promote child health•Promote understanding of factors leading to the increase of childhood overweight and obesity and advocate for strategies to promote healthy nutrition and physical activity levels throughout childhood.•Increase awareness and recognition of mental health and emotional problems in children and adolescents in all health care settings and in the community. Support legislation for improved access to mental health services.•Support legislation and initiatives for prevention of tobacco use, underage drinking, and alcohol- related morbidities and mortalities.•Support legislation and initiatives for improved injury surveillance and prevention of injury due to violence.•Advocate for legislation supporting the goals of NAPNAP's Special Interest Groups in Child Care, Child Maltreatment & Neglect, HIV, Immunization, School-Based Health Clinics, Breastfeeding, Global Health Care, and Acute Care.IIAdvocate for access to comprehensive health care for children•Support legislation and policies affecting access to quality pediatric health care for all children and families and improve access to comprehensive preventive health care services.•Support sustained and improved funding for Maternal Child Health initiatives including programs for children with special health care needs.IIIPromote access to Advanced Practice Nurses•Ensure access to Advanced Practice Nurses for all children across health care settings.•Promote funding for Advanced Practice Nursing education development of graduate nursing faculty.EducationRoundtables set“Grand Challenges in Children's Health & Fitness,” NAPNAP's 26th Annual Conference is scheduled for March 31-April 3, 2005, in Phoenix, AZ. The roundtable luncheon is scheduled for Saturday, April 2, 2005 from 12:00 noon to 1:30 pm.Please consider serving as a discussion leader at the luncheon roundtable session. You do not need to be an expert in the topic to participate; just have an interest in learning and sharing information with your colleagues. ($10.00 registration fee for the roundtable luncheon is waived for facilitators). If interested, please contact Susan Van Cleve via NAPNAP's National Office ( [email protected] ). Please indicate your choice of topic and include a brief biographical statement (1 paragraph maximum) of your background.2005 roundtable topics•Chronic Illness: Management at Home and in Primary Care•Assessing Parenting and Gui- ding Parents•Preceptor Challenges•Environmental Health: Issues for Children•The Evolving Acute Care PNP Role•Putting Evidence Into Practice: Clinical Guidelines and Standards•Pediatric End of Life IssuesVIPs (volunteers: interested and participating) neededGet more involved in the conference, meet new people, and network by serving as a VIP. VIPs are needed to assist with monitoring educational sessions, audiovisual assistance, speaker introductions, and other responsibilities. If interested, please check the space on the registration or contact NAPNAP's National Office at [email protected] .Research/scholarshipWhat's hot with NAPNAP's HEAT© initiativeMembers of the HEAT© Steering Work Group have represented NAPNAP and the initiative at several meetings since the beginning of the 2004-05 fiscal year. Among them: Lynn Gilbert, PhD, MSN, RN, CS, gave a HEAT© presentation at the 2004 Keystone Conference in Colorado; Lisa Frost, MSN, RN, CPNP, spoke to two sessions at the Contemporary Forums Obesity Conference in Seattle, Washington. Christina Calamaro, MSN, CRNP, was a presenter of a seminar on “Understanding Childhood Obesity and How to Help Those at Risk for Overweight” at Nursing Spectrum's Career Fitness Expo in Cherry Hill, NJ; Carolyn Montoya, MSN, CPNP, spoke about obesity and pediatric hypertension at the Utah Chapter's annual conference; and Mary Margaret Gottesman, PhD, RN, CPNP, was selected for a poster presentation at the American Academy of Nursing 31st Annual Meeting and Conference in Washington, DC.NAPNAP KySS© program updateWe thank all the chapters who agreed to participate in the first KySS© Across America Walk-a-thon. Chapters who signed up included: Arizona, Indiana, Missouri: Greater Kansas City, Michigan, New York: Upstate, Ohio, and Oregon.The KySS Institute Proceedings are now available on CD-ROM. To receive a complimentary copy, please call the National Office at (856) 857-9700.Collaboration & partnershipsStinchfield appointed to ACIPPatsy Stinchfield, MSN, RN, CPNP, of Minnesota was appointed to the Advisory Committee on Immunization Practices by U.S. Health and Human Services Secretary Tommy Thompson. Patsy is the first advanced practice nurse or nurse ever appointed to the 15-member ACIP. ACIP brings together the nation's leading experts on vaccine-preventable disease to guide U.S. policy on immunization. Patsy is the director of the infectious disease service line at Children's Hospitals and Clinics of Minneapolis/St. Paul. Leadership development & association managementBest wishes from the board & staffHere's wishing you a safe, healthy, and happy holiday season from the NAPNAP Executive Board and National Office staff. May 2005 be a year of progress in our work to improve the health and lives of children and families!New technology to personalize membershipsAs of the deadline for this column, NAPNAP's Communication Technology Work Group was reviewing proposals to redevelop NAPNAP's website. By the time you read this, work likely will be underway to create a new online experience for members and visitors that will be built on a blueprint intended to enhance services, foster a sense of community, and promote growth. While it's too early to bring you a preview of the look and feel of the new NAPNAP website, please visit www.napnap.org often to experience these exciting developments.Strategic planning processAt the Fall 2004 Executive Board Meeting in San Francisco, the Executive Board members and National Office staff participated in a day-long session to create the framework for NAPNAP's 2005-2008 Strategic Plan. Facilitator Deborah Mullen of Captus Communications worked with Strategic Planning Chair Juanita Dale to set the agenda and create a lively discussion regarding NAPNAP's Strategic Plan. Details of the planning document will be communicated to members in a number of ways once finalized.Mark those calendars!Please remember that December 31, 2004, is the deadline to nominate candidates for the 2004-2005 Loretta C. Ford Distinguished Fellow Award and the Henry K. Silver Memorial Award. Also, please recall that the week of March 27-April 3, 2005, is “Pediatric Nurse Practitioner Week.” Work with your chapters to plan celebrations and publicize PNP excellence that week. Please contact Joe Casey at [email protected] to let us know of your PNP Week activities so that we can acknowledge your contributions to increasing recognition of the role of the PNP. Best wishes from the board & staffHere's wishing you a safe, healthy, and happy holiday season from the NAPNAP Executive Board and National Office staff. May 2005 be a year of progress in our work to improve the health and lives of children and families! Here's wishing you a safe, healthy, and happy holiday season from the NAPNAP Executive Board and National Office staff. May 2005 be a year of progress in our work to improve the health and lives of children and families! New technology to personalize membershipsAs of the deadline for this column, NAPNAP's Communication Technology Work Group was reviewing proposals to redevelop NAPNAP's website. By the time you read this, work likely will be underway to create a new online experience for members and visitors that will be built on a blueprint intended to enhance services, foster a sense of community, and promote growth. While it's too early to bring you a preview of the look and feel of the new NAPNAP website, please visit www.napnap.org often to experience these exciting developments. As of the deadline for this column, NAPNAP's Communication Technology Work Group was reviewing proposals to redevelop NAPNAP's website. By the time you read this, work likely will be underway to create a new online experience for members and visitors that will be built on a blueprint intended to enhance services, foster a sense of community, and promote growth. While it's too early to bring you a preview of the look and feel of the new NAPNAP website, please visit www.napnap.org often to experience these exciting developments. Strategic planning processAt the Fall 2004 Executive Board Meeting in San Francisco, the Executive Board members and National Office staff participated in a day-long session to create the framework for NAPNAP's 2005-2008 Strategic Plan. Facilitator Deborah Mullen of Captus Communications worked with Strategic Planning Chair Juanita Dale to set the agenda and create a lively discussion regarding NAPNAP's Strategic Plan. Details of the planning document will be communicated to members in a number of ways once finalized. At the Fall 2004 Executive Board Meeting in San Francisco, the Executive Board members and National Office staff participated in a day-long session to create the framework for NAPNAP's 2005-2008 Strategic Plan. Facilitator Deborah Mullen of Captus Communications worked with Strategic Planning Chair Juanita Dale to set the agenda and create a lively discussion regarding NAPNAP's Strategic Plan. Details of the planning document will be communicated to members in a number of ways once finalized. Mark those calendars!Please remember that December 31, 2004, is the deadline to nominate candidates for the 2004-2005 Loretta C. Ford Distinguished Fellow Award and the Henry K. Silver Memorial Award. Also, please recall that the week of March 27-April 3, 2005, is “Pediatric Nurse Practitioner Week.” Work with your chapters to plan celebrations and publicize PNP excellence that week. Please contact Joe Casey at [email protected] to let us know of your PNP Week activities so that we can acknowledge your contributions to increasing recognition of the role of the PNP. Please remember that December 31, 2004, is the deadline to nominate candidates for the 2004-2005 Loretta C. Ford Distinguished Fellow Award and the Henry K. Silver Memorial Award. Also, please recall that the week of March 27-April 3, 2005, is “Pediatric Nurse Practitioner Week.” Work with your chapters to plan celebrations and publicize PNP excellence that week. Please contact Joe Casey at [email protected] to let us know of your PNP Week activities so that we can acknowledge your contributions to increasing recognition of the role of the PNP. AdvocacyNAPNAP health policy agenda 2004-2005NAPNAP's Health Policy Chair Karen Duderstadt, MS, CPNP, announced the priorities for NAPNAP's advocacy initiatives that were developed and approved by NAPNAP's Legislative Work Group. The agenda includes the following items:IAdvocate to protect and promote child health•Promote understanding of factors leading to the increase of childhood overweight and obesity and advocate for strategies to promote healthy nutrition and physical activity levels throughout childhood.•Increase awareness and recognition of mental health and emotional problems in children and adolescents in all health care settings and in the community. Support legislation for improved access to mental health services.•Support legislation and initiatives for prevention of tobacco use, underage drinking, and alcohol- related morbidities and mortalities.•Support legislation and initiatives for improved injury surveillance and prevention of injury due to violence.•Advocate for legislation supporting the goals of NAPNAP's Special Interest Groups in Child Care, Child Maltreatment & Neglect, HIV, Immunization, School-Based Health Clinics, Breastfeeding, Global Health Care, and Acute Care.IIAdvocate for access to comprehensive health care for children•Support legislation and policies affecting access to quality pediatric health care for all children and families and improve access to comprehensive preventive health care services.•Support sustained and improved funding for Maternal Child Health initiatives including programs for children with special health care needs.IIIPromote access to Advanced Practice Nurses•Ensure access to Advanced Practice Nurses for all children across health care settings.•Promote funding for Advanced Practice Nursing education development of graduate nursing faculty. NAPNAP health policy agenda 2004-2005NAPNAP's Health Policy Chair Karen Duderstadt, MS, CPNP, announced the priorities for NAPNAP's advocacy initiatives that were developed and approved by NAPNAP's Legislative Work Group. The agenda includes the following items:IAdvocate to protect and promote child health•Promote understanding of factors leading to the increase of childhood overweight and obesity and advocate for strategies to promote healthy nutrition and physical activity levels throughout childhood.•Increase awareness and recognition of mental health and emotional problems in children and adolescents in all health care settings and in the community. Support legislation for improved access to mental health services.•Support legislation and initiatives for prevention of tobacco use, underage drinking, and alcohol- related morbidities and mortalities.•Support legislation and initiatives for improved injury surveillance and prevention of injury due to violence.•Advocate for legislation supporting the goals of NAPNAP's Special Interest Groups in Child Care, Child Maltreatment & Neglect, HIV, Immunization, School-Based Health Clinics, Breastfeeding, Global Health Care, and Acute Care.IIAdvocate for access to comprehensive health care for children•Support legislation and policies affecting access to quality pediatric health care for all children and families and improve access to comprehensive preventive health care services.•Support sustained and improved funding for Maternal Child Health initiatives including programs for children with special health care needs.IIIPromote access to Advanced Practice Nurses•Ensure access to Advanced Practice Nurses for all children across health care settings.•Promote funding for Advanced Practice Nursing education development of graduate nursing faculty. NAPNAP's Health Policy Chair Karen Duderstadt, MS, CPNP, announced the priorities for NAPNAP's advocacy initiatives that were developed and approved by NAPNAP's Legislative Work Group. The agenda includes the following items:IAdvocate to protect and promote child health•Promote understanding of factors leading to the increase of childhood overweight and obesity and advocate for strategies to promote healthy nutrition and physical activity levels throughout childhood.•Increase awareness and recognition of mental health and emotional problems in children and adolescents in all health care settings and in the community. Support legislation for improved access to mental health services.•Support legislation and initiatives for prevention of tobacco use, underage drinking, and alcohol- related morbidities and mortalities.•Support legislation and initiatives for improved injury surveillance and prevention of injury due to violence.•Advocate for legislation supporting the goals of NAPNAP's Special Interest Groups in Child Care, Child Maltreatment & Neglect, HIV, Immunization, School-Based Health Clinics, Breastfeeding, Global Health Care, and Acute Care.IIAdvocate for access to comprehensive health care for children•Support legislation and policies affecting access to quality pediatric health care for all children and families and improve access to comprehensive preventive health care services.•Support sustained and improved funding for Maternal Child Health initiatives including programs for children with special health care needs.IIIPromote access to Advanced Practice Nurses•Ensure access to Advanced Practice Nurses for all children across health care settings.•Promote funding for Advanced Practice Nursing education development of graduate nursing faculty. EducationRoundtables set“Grand Challenges in Children's Health & Fitness,” NAPNAP's 26th Annual Conference is scheduled for March 31-April 3, 2005, in Phoenix, AZ. The roundtable luncheon is scheduled for Saturday, April 2, 2005 from 12:00 noon to 1:30 pm.Please consider serving as a discussion leader at the luncheon roundtable session. You do not need to be an expert in the topic to participate; just have an interest in learning and sharing information with your colleagues. ($10.00 registration fee for the roundtable luncheon is waived for facilitators). If interested, please contact Susan Van Cleve via NAPNAP's National Office ( [email protected] ). Please indicate your choice of topic and include a brief biographical statement (1 paragraph maximum) of your background.2005 roundtable topics•Chronic Illness: Management at Home and in Primary Care•Assessing Parenting and Gui- ding Parents•Preceptor Challenges•Environmental Health: Issues for Children•The Evolving Acute Care PNP Role•Putting Evidence Into Practice: Clinical Guidelines and Standards•Pediatric End of Life IssuesVIPs (volunteers: interested and participating) neededGet more involved in the conference, meet new people, and network by serving as a VIP. VIPs are needed to assist with monitoring educational sessions, audiovisual assistance, speaker introductions, and other responsibilities. If interested, please check the space on the registration or contact NAPNAP's National Office at [email protected] . Roundtables set“Grand Challenges in Children's Health & Fitness,” NAPNAP's 26th Annual Conference is scheduled for March 31-April 3, 2005, in Phoenix, AZ. The roundtable luncheon is scheduled for Saturday, April 2, 2005 from 12:00 noon to 1:30 pm.Please consider serving as a discussion leader at the luncheon roundtable session. You do not need to be an expert in the topic to participate; just have an interest in learning and sharing information with your colleagues. ($10.00 registration fee for the roundtable luncheon is waived for facilitators). If interested, please contact Susan Van Cleve via NAPNAP's National Office ( [email protected] ). Please indicate your choice of topic and include a brief biographical statement (1 paragraph maximum) of your background. “Grand Challenges in Children's Health & Fitness,” NAPNAP's 26th Annual Conference is scheduled for March 31-April 3, 2005, in Phoenix, AZ. The roundtable luncheon is scheduled for Saturday, April 2, 2005 from 12:00 noon to 1:30 pm. Please consider serving as a discussion leader at the luncheon roundtable session. You do not need to be an expert in the topic to participate; just have an interest in learning and sharing information with your colleagues. ($10.00 registration fee for the roundtable luncheon is waived for facilitators). If interested, please contact Susan Van Cleve via NAPNAP's National Office ( [email protected] ). Please indicate your choice of topic and include a brief biographical statement (1 paragraph maximum) of your background. 2005 roundtable topics•Chronic Illness: Management at Home and in Primary Care•Assessing Parenting and Gui- ding Parents•Preceptor Challenges•Environmental Health: Issues for Children•The Evolving Acute Care PNP Role•Putting Evidence Into Practice: Clinical Guidelines and Standards•Pediatric End of Life Issues •Chronic Illness: Management at Home and in Primary Care•Assessing Parenting and Gui- ding Parents•Preceptor Challenges•Environmental Health: Issues for Children•The Evolving Acute Care PNP Role•Putting Evidence Into Practice: Clinical Guidelines and Standards•Pediatric End of Life Issues VIPs (volunteers: interested and participating) neededGet more involved in the conference, meet new people, and network by serving as a VIP. VIPs are needed to assist with monitoring educational sessions, audiovisual assistance, speaker introductions, and other responsibilities. If interested, please check the space on the registration or contact NAPNAP's National Office at [email protected] . Get more involved in the conference, meet new people, and network by serving as a VIP. VIPs are needed to assist with monitoring educational sessions, audiovisual assistance, speaker introductions, and other responsibilities. If interested, please check the space on the registration or contact NAPNAP's National Office at [email protected] . Research/scholarshipWhat's hot with NAPNAP's HEAT© initiativeMembers of the HEAT© Steering Work Group have represented NAPNAP and the initiative at several meetings since the beginning of the 2004-05 fiscal year. Among them: Lynn Gilbert, PhD, MSN, RN, CS, gave a HEAT© presentation at the 2004 Keystone Conference in Colorado; Lisa Frost, MSN, RN, CPNP, spoke to two sessions at the Contemporary Forums Obesity Conference in Seattle, Washington. Christina Calamaro, MSN, CRNP, was a presenter of a seminar on “Understanding Childhood Obesity and How to Help Those at Risk for Overweight” at Nursing Spectrum's Career Fitness Expo in Cherry Hill, NJ; Carolyn Montoya, MSN, CPNP, spoke about obesity and pediatric hypertension at the Utah Chapter's annual conference; and Mary Margaret Gottesman, PhD, RN, CPNP, was selected for a poster presentation at the American Academy of Nursing 31st Annual Meeting and Conference in Washington, DC.NAPNAP KySS© program updateWe thank all the chapters who agreed to participate in the first KySS© Across America Walk-a-thon. Chapters who signed up included: Arizona, Indiana, Missouri: Greater Kansas City, Michigan, New York: Upstate, Ohio, and Oregon.The KySS Institute Proceedings are now available on CD-ROM. To receive a complimentary copy, please call the National Office at (856) 857-9700. What's hot with NAPNAP's HEAT© initiativeMembers of the HEAT© Steering Work Group have represented NAPNAP and the initiative at several meetings since the beginning of the 2004-05 fiscal year. Among them: Lynn Gilbert, PhD, MSN, RN, CS, gave a HEAT© presentation at the 2004 Keystone Conference in Colorado; Lisa Frost, MSN, RN, CPNP, spoke to two sessions at the Contemporary Forums Obesity Conference in Seattle, Washington. Christina Calamaro, MSN, CRNP, was a presenter of a seminar on “Understanding Childhood Obesity and How to Help Those at Risk for Overweight” at Nursing Spectrum's Career Fitness Expo in Cherry Hill, NJ; Carolyn Montoya, MSN, CPNP, spoke about obesity and pediatric hypertension at the Utah Chapter's annual conference; and Mary Margaret Gottesman, PhD, RN, CPNP, was selected for a poster presentation at the American Academy of Nursing 31st Annual Meeting and Conference in Washington, DC. Members of the HEAT© Steering Work Group have represented NAPNAP and the initiative at several meetings since the beginning of the 2004-05 fiscal year. Among them: Lynn Gilbert, PhD, MSN, RN, CS, gave a HEAT© presentation at the 2004 Keystone Conference in Colorado; Lisa Frost, MSN, RN, CPNP, spoke to two sessions at the Contemporary Forums Obesity Conference in Seattle, Washington. Christina Calamaro, MSN, CRNP, was a presenter of a seminar on “Understanding Childhood Obesity and How to Help Those at Risk for Overweight” at Nursing Spectrum's Career Fitness Expo in Cherry Hill, NJ; Carolyn Montoya, MSN, CPNP, spoke about obesity and pediatric hypertension at the Utah Chapter's annual conference; and Mary Margaret Gottesman, PhD, RN, CPNP, was selected for a poster presentation at the American Academy of Nursing 31st Annual Meeting and Conference in Washington, DC. NAPNAP KySS© program updateWe thank all the chapters who agreed to participate in the first KySS© Across America Walk-a-thon. Chapters who signed up included: Arizona, Indiana, Missouri: Greater Kansas City, Michigan, New York: Upstate, Ohio, and Oregon.The KySS Institute Proceedings are now available on CD-ROM. To receive a complimentary copy, please call the National Office at (856) 857-9700. We thank all the chapters who agreed to participate in the first KySS© Across America Walk-a-thon. Chapters who signed up included: Arizona, Indiana, Missouri: Greater Kansas City, Michigan, New York: Upstate, Ohio, and Oregon. The KySS Institute Proceedings are now available on CD-ROM. To receive a complimentary copy, please call the National Office at (856) 857-9700. Collaboration & partnershipsStinchfield appointed to ACIPPatsy Stinchfield, MSN, RN, CPNP, of Minnesota was appointed to the Advisory Committee on Immunization Practices by U.S. Health and Human Services Secretary Tommy Thompson. Patsy is the first advanced practice nurse or nurse ever appointed to the 15-member ACIP. ACIP brings together the nation's leading experts on vaccine-preventable disease to guide U.S. policy on immunization. Patsy is the director of the infectious disease service line at Children's Hospitals and Clinics of Minneapolis/St. Paul. Stinchfield appointed to ACIPPatsy Stinchfield, MSN, RN, CPNP, of Minnesota was appointed to the Advisory Committee on Immunization Practices by U.S. Health and Human Services Secretary Tommy Thompson. Patsy is the first advanced practice nurse or nurse ever appointed to the 15-member ACIP. ACIP brings together the nation's leading experts on vaccine-preventable disease to guide U.S. policy on immunization. Patsy is the director of the infectious disease service line at Children's Hospitals and Clinics of Minneapolis/St. Paul. Patsy Stinchfield, MSN, RN, CPNP, of Minnesota was appointed to the Advisory Committee on Immunization Practices by U.S. Health and Human Services Secretary Tommy Thompson. Patsy is the first advanced practice nurse or nurse ever appointed to the 15-member ACIP. ACIP brings together the nation's leading experts on vaccine-preventable disease to guide U.S. policy on immunization. Patsy is the director of the infectious disease service line at Children's Hospitals and Clinics of Minneapolis/St. Paul.

Implementation of the Immunization Policy (S94-26)

Prevention of disease through immunization always has been a priority for pediatricians and a major goal of comprehensive pediatric health care. Before 1994, the recommendation of the American Academy of Pediatrics (AAP) was that children should be completely immunized against diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b disease, measles, mumps, and rubella. Universal hepatitis B immunization of all infants and adolescents was recommended in the 1994 Red Book,1 adding a ninth disease to the previous list. Only those children with specific contraindications to one or more of the immunizations should be excluded. Childhood immunizations, per the AAP recommended schedule, must continue to be an essential component of continuous, comprehensive child health care. Furthermore, a child's immunization status warrants evaluation at every health care visit. In recent years, inadequate immunization rates attributed to multiple causes have indicated that the Academy's original immunization policy (1977) calling for universal immunization of all children has not been fulfilled. From data collected in the National Health Interview Survey in 1993 and 1994, the Centers for Disease Control and Prevention (CDC)2 currently estimates that only about two thirds of 2-year-old children in the United States have received all appropriate immunizations. Vaccine coverage levels include the following ranges: 67% coverage for four doses of diphtheria, tetanus, and pertussis (DPT) vaccine; 76% for three doses of oral polio vaccine (OPV); 90% for one dose of measles, mumps, and rubella vaccine (MMR), and 71% for age-appropriate doses of H influenzae type b vaccine. Recent outbreaks of measles, particularly in preschool children but also in adolescents and young adults, attest to inadequate protection and demonstrate a continuing need for surveillance and modification of current immunization recommendations.

Health Care for Children of Farmworker Families

Migrant and seasonal farmworkers constitute a major portion of the labor force in the American agricultural industry. By harvesting and processing farm crops, they contribute positively to farm communities and the American economy. In 1988, the Office of Migrant Health estimated that nationwide migrant and seasonal farmworkers and their dependents numbered between 3 and 5 million.1 The majority of farmworkers are married and/or have children. Only 10% to 25% of farmworkers are estimated to be unauthorized workers. The average annual income for migrant and seasonal farmworkers is well below the poverty level despite the prevalence of families with two wage earners. Although most farmworker families qualify for some type of public assistance, only 18% actually receive it.2 Because health care insurance is invariably beyond the reach of farmworker family budgets, and employers of farmworkers rarely provide health care benefits for their employees, these families are usually uninsured. In some cases, these families lack US citizenship or are in this country illegally, further limiting access to health care for their children. Medicaid eligibility is complicated by migration, because different eligibility requirements must be met in each state. Because of their income level, lack of insurance, and mobile lifestyle, families of farmworkers often find that comprehensive child health care (health maintenance, anticipatory guidance, and preventive medicine) is essentially unavailable. Additionally, recent changes in immigration policy and economic developments have resulted in a rapid growth of population that is not parallelled by the growth of health care facilities. Other problems that delay or prevent access to health care for the children of farmworker families include language barriers and differences in culture.

Providing Comprehensive Health Care to Children With Chronic Illness

To test whether a program of outreach and comprehensive health care for children with chronic disorders provides more complete care and reduces unmet health needs compared with traditional care. A pretest-posttest randomized control trial. An inner-city municipal teaching hospital. Two hundred nineteen systematically enrolled mothers of children with diverse chronic physical health conditions. A comprehensive outreach program, Pediatric Home Care (PHC), contrasted with Standard Care. Nine elements of comprehensive care established in the literature as components of a basic package of care for those with chronic conditions. The PHC intervention addressed gaps in services and improved both the acquisition and maintenance of elements of comprehensive care. These data suggest mechanisms through which comprehensive care programs may contribute to the improvement in psychological and social outcomes previously reported for those in the PHC intervention.

The Measles Epidemic

The nation has experienced a marked increase in measles cases during 1989 and 1990. Almost one half of all cases have occurred in unvaccinated preschool children, mostly minorities. The principal cause for the epidemic is failure to provide vaccine to vulnerable children on schedule. Major reasons for the low vaccine coverage exist within the health care system itself, which creates barriers to obtaining immunization and fails to take advantage of many opportunities to provide vaccines to children. Ideally, immunizations should be given as part of a comprehensive child health care program. However, immunization cannot await the development of such an ideal system. Essential changes can and should be made now. Specific recommendations include improved availability of immunization; improved management of immunization services; improved capacity to measure childhood immunization status; implementation of the two-dose measles vaccine strategy; and laboratory, epidemiologic, and operational studies to further define the determinants of decreased vaccine coverage and to develop new combinations of vaccines that can be administered earlier in life. The measles epidemic may be a warning flag of problems with our system of primary health care. (JAMA. 1991;266:1547-1552)

The measles epidemic. The problems, barriers, and recommendations. The National Vaccine Advisory Committee

The nation has experienced a marked increase in measles cases during 1989 and 1990. Almost one half of all cases have occurred in unvaccinated preschool children, mostly minorities. The principal cause for the epidemic is failure to provide vaccine to vulnerable children on schedule. Major reasons for the low vaccine coverage exist within the health care system itself, which creates barriers to obtaining immunization and fails to take advantage of many opportunities to provide vaccines to children. Ideally, immunizations should be given as part of a comprehensive child health care program. However, immunization cannot await the development of such an ideal system. Essential changes can and should be made now. Specific recommendations include improved availability of immunization; improved management of immunization services; improved capacity to measure childhood immunization status; implementation of the two-dose measles vaccine strategy; and laboratory, epidemiologic, and operational studies to further define the determinants of decreased vaccine coverage and to develop new combinations of vaccines that can be administered earlier in life. The measles epidemic may be a warning flag of problems with our system of primary health care.

NATIONAL DAY OF PRAYER

A national day of prayer has been recognized as a part of our country's heritage since it was declared by the Continental Congress in 1775.... Officially it is the first Thursday of every May; this year it falls on May 5. We could trust the spirit of President Abraham Lincoln who, in despair, said, "I have been driven many times upon my knees by the overwhelming conviction that I had nowhere else to go." This is the anxiety felt by 13-million American children who are "Poorest in a Land of Plenty," title given a film produced by the National Council of Churces, to be introduced on Mother's Day, May 14 (NBC, 1 pm). The NCC's statistics show that "One out of every five children in America is poor; among 20 industrialized nations the USA has the third highest infant mortality rate; among industrialized nations only the USA and South Africa fail to provide comprehensive health care for children and pregnant women.

Health Care for Children of Migrant Families

Migrant and seasonal/farm workers constitute a major portion of the labor force in the American food industry. By harvesting and processing farm crops, they contribute positively to agricultural communities and the American economy. Currently, the office of Migrant Health estimates that nationwide there are between 3 and 5 million migrant and seasonal farm workers and dependents. The average annual income for migrant and seasonal farm workers is well below the poverty level (US Dept of Health and Human Services, unpublished data, 1988). Because health care insurance is invariably beyond the reach of migrant family budgets, and employers of farm workers rarely provide health care benefits for their employees, these families are usually uninsured. In some cases, these families lack US citizenship or are in this country illegally, which complicates obtaining health care for their children. Medicaid enrollment is also complicated by migration because aliens must meet eligibility requirements in each state to which they migrate, and only US citizens are eligible. Because of their income and mobile life-style, migrant worker families often find that comprehensive child health care (health maintenance, anticipatory guidance, and preventive medicine) essentially is not available. Migrating families must seek health care whenever it is available. This results in a pattern of service that usually is fragmented and ad hoc. Migration not only interrupts continuity of care but it also contributes to a lack of knowledge about a community's health services and/or jeopardizes eligibility for these services by conflicting with residency requirements. Other problems that delay or prevent access to health care for the children of migrant families include language barriers and differences in culture.

Essentials of Comprehensive Health Care for Children and Their Families

Journal of Developmental & Behavioral Pediatrics: February 1987 - Volume 8 - Issue 1 - p 1-2

McATEE WINS HENRY K. SILVER AWARD

Patricia Rooney McAtee, Ph.D., was the recipient of the Henry K. Silver Award of the National Association of Pediatric Nurse Associates and Practitioners. The award, presented on October 22, 1978, was given for significant contributions to child health care and for the furtherance of the nurse practitioner movement's goals and objectives. Dr. McAtee has been a member of the faculty of the School of Nursing and the School of Medicine of the University of Colorado. She was one of the co-developers of the school nurse practitioner program, and is president of the National Board of Nurse Practitioners and Associates, which she was instrumental in developing. Patricia McAtee has been widely recognized for her contributions in the field of child health care. She was one of the first nurses to be elected to the Institute of Medicine of the National Academy of Sciences and served on its committee to develop manpower policy for primary health care. She has been selected as a member of Who's Who of American Women and of Who's Who in America. She is a member of the Editorial Board of Pediatric Nursing and is the author of numerous articles which have appeared in nursing, medical, and school health journals. Dr. McAtee has been a pioneer in the development of the role of the Pediatric Nurse Practitioner/Associate in the delivery of primary child health care. She has been a major contributor to the concept of team delivery service and has been instrumental in promoting collaboration between medicine and nursing to provide more comprehensive child health care.

The comprehensive child health centres in the Sudan

In 1963, Morley initiated the concept of clinics for children under five years old. This paper describes our experience in applying that concept in Omdurman town (Sudan) where existing maternity and child health centres and hospitals in the area were involved in the scheme. It was found necessary to establish a main centre to develop methodology and to provide specialized training of staff. The medical problems were similar to those described by Morley. The approach to their solution was essentially the same except that we used more professional staff and placed more emphasis on nutrition education than hitherto advocated. It is concluded that, in theory, Morley's concept provides a system of comprehensive child health care which suits the needs of developing countries. But our adaptation of Morley's ideas to existing health structures, even on the small scale we achieved in Omdurman, was difficult because of the high initial and running costs and in view of the long established dichotomy between curative and preventive medicine.