Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ADOPTION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Foster care and adoption policy in Romania: suggestions for international intervention.

Building an effective child welfare system is a monumental task facing postrevolution Romania. Following revelations on American and Western European television about the large number of "orphans" in Romania, many couples flocked to that country to adopt children. A significant number of adopted Romanian children were brought to the United States. Some of these children are now evidencing problems that are bringing them to the attention of health and social service agencies. This article examines the macroeconomic policies that led to the institutionalization of a large number of children in Romania. Although institutional care is the current norm, a legal basis exists for building family foster care as an alternative. Romania's new adoption law replaces private adoptions with agency-based work. International adoption agencies are involved in developing community-based foster care and permanency planning as part of their work. This article challenges international adoption agencies to use clinical assessments of developmental delays and more rigorous health examinations for children released for adoption.

Adolescent↗
PubMed1998

Clinical vicissitudes of adoption.

Many interacting forces shape the unique experience of adoption. The adoptive parents' fantasies, fears, and perceived lack of entitlement to the child can detrimentally influence their parenting abilities. The adopted child's often powerful need to master early abandonment may lead to maladaptive behaviors that feed the adoptive parents' fears and fantasies regarding the child's past and future. The therapist familiar with the challenges of adoption can take an empathic stance with the adoptive parents and the adoptive child that can contain their anxieties and conflicts and pave the way toward a better resolution of their individual and shared experience.

Adoption↗
PubMed1987

The inability of adoptive immunotherapy to eradicate tumor cells in radiation-induced chimeric mice: the possible down-regulation of intratumor immune amplification.

Tumors were eradicated following adoptive immunotherapy of (C57BL/6J X DBA/2J) F1 (B6D2F1) hybrid mice bearing the C57B1/6J (B6) sarcoma, MCA/76-9, by treatment with cyclophosphamide (CY) and adoptively transferred tumor-sensitized B6D2F1 T cells. Identical treatment of B6----B6D2F1 or DBA----B6D2F1 chimeric tumor-bearing mice resulted in temporary tumor regression only. Immunotherapy in both systems resulted in the appearance at the tumor site of large numbers of T lymphocytes and macrophages, which were shown to be derived from the adoptively transferred donor immune B6D2F1 cells or from the original reconstituting bone marrow respectively. The TAC and TAL isolated from either B6D2F1 or chimeric mice expressed potent toxicity in vitro towards tumor target cells. In addition, TAC from both systems inhibited tumor growth in a Winn assay in an immunologically specific manner. Suppressor cells detected in spleens 8 days after CY injection of normal B6, DBA, B6D2F1 hybrid and chimeric mice and also after adoptive immunotherapy of tumor-bearing B6, B6D2F1 and chimeric mice and were shown to persist in the spleens of chimeric mice for at least 31 days after adoptive immunotherapy. In contrast, spleen cells taken 31 days after therapy of B6D2F1 mice did not contain detectable suppressor cells and were able to induce tumor eradication when adoptively transferred to CY-treated tumor-bearing B6D2F1 mice. The possibility is discussed that two forms of suppressor mechanisms are induced after adoptive immunotherapy of chimeric mice and that they may down-regulate donor T cell responses at the tumor site.

Animals↗
PubMed2004

Changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after the adoption of a computerized order communication system.

OBJECTIVES: Order communication system (OCS) is a real-time computerized hospital information system that supports communication of orders from the ward users to the service departments. The adoption of an OCS may profoundly alter the service patterns of healthcare workers. As a result, job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions can be expected to increase. This study investigated changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after an OCS had been adopted and whether adoption of the system affected the changes. METHODS: A group of nurses employed in a university hospital in Korea was surveyed 1 month before and 3 months after the OCS had been adopted. We used Karasek's job contents questionnaire (JCQ) to evaluate job stress. The cumulative trauma disorder (CTD) questionnaire was used to assess the presence of musculoskeletal symptoms. The presence of unfavorable working conditions was also assessed. Next, we evaluated whether non-work factors (such as demographic factors and life events) had influence on job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions after adoption of the OCS. RESULTS: One hundred thirty nurses from the hospital (51.2%) responded to both surveys. Several JCQ scales were notably altered after OCS adoption; psychological job demand was significantly decreased (P < 0.01), although subjective assessment for hazardous conditions was significantly increased (P < 0.01). There was a significant increase in back complaints (P < 0.05). There was considerable decrease in the number of nurses who complained of 'increase in work intensity' (P < 0.05), 'increase of staying time to deal with remaining duties' (P < 0.05), and 'abrupt change of duties' (P < 0.01). According to the analysis for the associations between non-work factors and significantly changed variables, only two non-work factors, 'tenure' and 'conflicts with friend(s)', showed statistical significance with complaints of 'increase in work intensity' (P < 0.05) CONCLUSIONS. This study suggests that a newly adopted computerized system might have provoked changes in job stress, musculoskeletal symptoms, and the complaints of unfavorable working conditions. It was found that, despite the overall favorable changes, complaints of hazardous conditions and back symptoms increased.

Adult↗
PubMed1990

Patterns of preference for information sources in the adoption of new drugs by specialists.

The present study investigated the adoption of new prescription drugs by specialists who treat serious disorders using relatively high risk drugs with potentially serious side effects. One-hundred and fifty-six specialists, primarily practicing in medical specialties, evaluated a number of drug information sources and reported their use of these sources both in their general drug adoption procedures and in the adoption of one of a number of target drugs. As predicted, the pattern of drug adoption among specialists is substantially different from that generally reported in earlier studies, which are usually based on samples of general practitioners or of general practitioners and specialists combined. Professional sources of information predominate throughout the process, both in adoption procedures generally used and in the adoption of target drugs. The majority of specialists reported contact with commercial sources at some stage in the adoption process for the target drugs, but these sources were not, as is often reported in the literature, the main sources of first news of a new drug, nor did they exert much influence at the prescribing stage. It is clear from these results that in future research on drug innovation, different classes of medical practitioners, such as specialists vs general practitioners, will need to be distinguished.

Attitude of Health Personnel↗
PubMed2006

The economics of adoption and management of alley cropping in Haiti.

The Haitian people are facing serious problems of environmental degradation that threaten the economic livelihoods of many resource-poor farmers. Structures to retard the process of soil loss have been adopted reluctantly and, even when adopted, the management and maintenance have been less than desirable. We evaluate the factors that influence the adoption and management of alley cropping in Haiti. Results of the adoption model show that institutional factors, such as membership in a local peasant organization and training in soil conservation practices, favorably influence adoption. Socio-economic factors such as gender, per capita income, and interaction between education and per capita income also significantly influence adoption of alley cropping in Gaita and Bannate. The management of alley cropping is influenced by demographic, socio-economic, institutional, and physical factors. The relative importance of each factor on the probability of adoption and management of alley cropping varies from one variable to another. The study generates important information for resource allocation in the establishment of alley cropping as a soil conservation structure.

Adolescent↗
PubMed2001

Timing of adoption of laparoscopic cholecystectomy in Denmark and in The Netherlands: a comparative study.

Laparoscopic cholecystectomy (LC) has diffused rapidly in most industrialised countries. The aim of this study has been to analyse the impact of different hospital characteristics on the hospital adoption of LC in Denmark and The Netherlands. Data on the timing of the adoption of LC and hospital characteristics (hospital size, teaching status and location) were retrieved in both countries. Proportional hazard regression was used to analyse different multivariate models. A total of 59 Danish and 109 Dutch hospitals adopting LC were identified. The multivariate analyses showed that increased hospital size was associated with relatively early adoption of LC in Denmark. Neither this nor other hospital characteristics influenced the timing of adoption in The Netherlands. As in other countries studied, hospital size is identified as an important factor in hospital adoption, whereas teaching status and location play a more limited role. The study shows that a multivariate method, such as the proportional hazard regression, can be used to elucidate differences among countries of the impact of different factors on the adoption of medium-ticket technologies like LC. Such multinational comparisons provide valuable information for health policy and planning.

Cholecystectomy, Laparoscopic↗
PubMed2000

Adoption of a health education intervention for family members of breast cancer patients.

BACKGROUND: Relatives of breast cancer patients often face substantial uncertainty and psychological stress regarding their own health risks and optimal strategies for prevention and early detection. Efficacious educational and counseling interventions are rarely evaluated for their potential adoption and use in medical practice settings. This study evaluates a health education program for first-degree relatives of breast cancer patients based on the program's potential for being adopted and used by medical practices affiliated with cancer centers. METHODS: A randomized, controlled trial was implemented in four community hospital-based medical practices. After 9 months, clinical and administrative staff at each practice were given self-administered surveys. Of 90 staff members recruited to respond, useable responses were received from 60 (67%), including 13 physicians (31%), 43 nurses (98%), and four program managers (100%). Participants made self-reports of program awareness, program support, perceived program performance, likelihood of program adoption and use, and barriers to adoption. RESULTS: A strong majority of respondents (80%) reported that all or most staff agreed with the need for the program. Perceived program performance in meeting goals was generally favorable but varied across sites and across staff types. Overall, 56% of respondents indicated that their practices were likely or highly likely to adopt the program in full. The likelihood of adoption varied substantially across sites and across program components. CONCLUSIONS: Evaluating the potential for program adoption offers insight for tailoring preventive health interventions and their implementation strategies to improve diffusion in the field of practice.

Adult↗
PubMed2000

The adoption of eating behaviors conducive to weight loss.

Given the plethora of eating behavior techniques that obese individuals might adopt for weight loss, it is not likely that they could, or would be willing to, adopt all of them. Therefore, the purpose of this study was to identify the specific eating behaviors conducive to weight loss adopted during the behavioral treatment of obesity, and to distinguish those that were deemed beneficial from the ones that were not. Fifty obese (BMI 32+/-4 kg/m(2), mean+/-SD), postmenopausal women (60+/-6 years old) participated in a 6-month behavior modification, dietary, low-intensity walking weight loss program. For analysis, they were divided into two groups: "no weight loss" ( 5 kg, n=32). At pre- and posttreatment women completed the Eating Behavior Inventory (EBI) that measures specific strategies conducive to weight loss. Women who lost weight increased their total eating behavior score by 20% (p<0.001) and improved the adoption of 14 eating behaviors, which was more than twice that of the non-weight losers. Topping the list of most strongly adopted behaviors were carefully watching and recording the type and quantity of food consumed. Maintaining a weight graph and weighing daily also were important to these women. Neither group of women adopted potentially helpful eating behaviors such as leaving food uneaten, refusing food offered by others, or shopping from a list. In studies of obesity treatment, attendance at class sessions is one marker of program adherence. More definitively, implementing the EBI in clinical and research obesity treatment programs will provide its leaders with insight into whether participants adopt, ignore, or fight the essential behaviors that will facilitate success toward their personal weight loss goals.

Journal Article↗
PubMed2005

Drivers of electronic medical record adoption among medical groups.

BACKGROUND: Use of electronic medical records (EMRs) in health care organizations can reduce medical errors and improve quality of care through physicians' increased use of evidence-based patient care processes. However, only 20%-25% of physician organizations have adopted EMRs. A study was undertaken to determine the characteristics of primary care medical groups that distinguish EMR adopter from nonadopter organizations. METHODS: A quantitative nationwide survey was undertaken of all primary care medical groups in the United States with 20 or more physicians; data were collected on 738 medical groups (70% response rate). RESULTS: Fewer than one-third of the medical groups reported having either patients' medical records or progress notes in an EMR. Large organizations with relatively fewer practice locations were more likely to adopt an EMR. DISCUSSION: Large medical groups are more likely to have the financial and human resources necessary to overcome barriers to the adoption of an EMR. Knowing the influence of the other organizational characteristics on EMR adoption will help prepare organizational leaders for the complicated process of achieving consensus among physicians and others in medical groups on the expenditure of funds and other resources to acquire an EMR. Financial incentives for all medical groups will help drive EMR adoption, but financial and technical assistance aimed specifically at smaller groups is particularly warranted. Widespread adoption of EMR among medical groups will take time.

Data Collection↗
PubMed2003

Reasons for adopting technological innovations reducing physical workload in bricklaying.

In this paper the adoption of technological innovations to improve the work of bricklayers and bricklayers' assistants is evaluated. Two studies were performed among 323 subjects to determine the adoption of the working methods, the perceived workload, experiences with the working methods, and the reasons for adopting the working methods. Furthermore, a comparison of the results of the studies was made with those of two similar studies in the literature. The results show that more than half of the sector adopted the innovations. The perceived workload was reduced. The employees and employers are satisfied with the working methods and important reasons for adoption were cost/benefit advantages, improvement of work and health, and increase in productivity. Problems preventing the adoption were the use of the working methods at specific sites, for instance in renovation work. The adoption of the new working methods could perhaps have been higher or faster if more attention had been paid to the active participation of bricklayers and bricklayers' assistants during the development of the new working methods and to the use of modern media techniques, such as the Internet and CD/DVD.

Construction Materials↗
PubMed2001

Innovation in nursing homes: which facilities are the early adopters?

PURPOSE: This study examined organizational and market factors associated with nursing homes that are most likely to be early adopters of innovations. Early adopter institutions, defined as the first 20% of facilities to adopt an innovation, are important because they subsequently facilitate the diffusion of innovations to others in the industry. DESIGN AND METHODS: Two groups of innovations were examined, special care units and subacute care services. I used discrete-time logistic regression analysis and nationally representative data from 13,162 facilities at risk of being early adopters of innovations during twelve 6-month intervals from 1992 to 1997. RESULTS: Organizational factors that increase the likelihood of early innovation adoption are larger bed size, chain membership, and high levels of private-pay residents. Four market factors that increase the likelihood of early innovation adoption are: a retrospective Medicaid reimbursement methodology, a more competitive environment, higher average income in the county, and a higher number of hospital beds in the county. IMPLICATIONS: This analysis shows that organizational and market characteristics of nursing homes affect their propensity toward early adoption of innovations. Some of the results may be useful for nursing home administrators and policy makers attempting to promote innovation.

Aged↗
PubMed1996

Specialist and generalist physicians' adoption of antibiotic therapy to eradicate Helicobacter pylori infection.

OBJECTIVES: The authors examine how specialist and generalist physicians adapted their practice patterns to emerging information on the role of Helicobacter pylori in peptic ulcer disease (PUD). METHODS: Data were collected via a mail survey sent to national random samples of gastroenterologists, family practitioners, and general internists in April 1994. A Cox proportional hazards regression was used to evaluate the determinants of the timing of adoption of antibiotic therapy for suspected or confirmed PUD. RESULTS: Most respondents (99.1% of specialists and 64.6% of generalists) had prescribed antibiotic therapy to eradicate Helicobacter pylori at least once. The median specialist adopted 21 months before the medical generalist. Timing of adoption also was related to gender, board certification, PUD case load, and practice setting. CONCLUSIONS: Gastroenterologists were more likely than primary care physicians to adopt antibiotic therapy for PUD, even before the evidence of this therapy's effectiveness was conclusive. Primary care physicians remained less likely to adopt after efficacy was established. The slower adoption by primary care physicians appeared to be related both to having less information than specialists about the new therapy and to more conservative practice styles. Measures to facilitate the flow of information about new technologies to primary care physicians may be warranted. Research on interspecialty differences in adoption of new therapies can contribute to understanding the consequences of the current shift from specialist- to generalist-driven care.

Adult↗
PubMed1994

Sleeping positions adopted by pregnant women of more than 30 weeks gestation.

The position adopted during sleep by 52 pregnant women and 31 age-matched nonpregnant control subjects was studied. The pregnant group were all beyond the 30th week of gestation. In the pregnant group, 40 (77%) adopted a left tilt, 11 (21%) a right tilt and one (2%) was supine. In the control group, eight (26%) adopted a left tilt, 10 (32%) a right tilt, 12 (39%) were supine and one (3%) was prone. Closer analysis of the position adopted by the pregnant group showed: 33 adopted a full left 90 degrees tilt, five a left 60 degrees tilt, two a left 30 degrees tilt, 11 adopted a full 90 degrees right tilt and only one was supine. There was a significant difference between the sleeping positions of the pregnant and the control groups (p < 0.001). The majority of the pregnant group adopted a sleeping position that reduced the likelihood of aortocaval compression syndrome.

Female↗
PubMed1988

Adoption of fluoride-based caries preventive innovations in a public dental service.

In dentistry comparative studies of diffusion of disease preventive innovations are rare and usually atheoretical. For these reasons the present study was designed 1) to determine whether or not normal distribution assumptions applied to decisions to adopt caries preventive fluoride programs in a public dental service; 2) to compare rates of adoption of two school-based and one clinic-based fluoride program, and 3) to look for evidence indicating which type of decision-making may have been involved. The programs studied were school-based fluoride brushing 4-5 times per year, fluoride mouthrinsing at least once a month, and professional topical fluoride applications at least once a year. Data were collected by postal questionnaires from public dental officers in Norway in 1972, 1977 and 1982. To determine the length of time which had elapsed from the time of innovation of the technologies to adoption, the dental literature was reviewed. The adoption curves for school-based fluoride brushing and rinsing, as well as for clinic-based topical fluoride application did not comply with the normal distribution assumption. The time lapse from innovation to adoption was in excess of 10 yr and the rates of adoption differed between programs. Decision-making would appear to have been primarily individual or collective. It was concluded that generalization beyond the innovations studied and the social and organizational setting of this particular investigation is inadmissible. Consequently, there is a need for more and larger scale comparative analytical studies to increase our understanding of diffusion and adoption of innovations in dentistry.

Adolescent↗
PubMed2002

Prediction of adoption versus euthanasia among dogs and cats in a California animal shelter.

The purpose of this retrospective cohort study was to investigate determinants of adoption of cats and dogs from a large municipal animal shelter. The subjects were 4,813 cats and 3,301 dogs impounded by the Sacramento County Department of Animal Care and Regulation and offered for adoption September 9, 1994 to May 26, 1995. The study constructed models predicting the conditional probability of adoption using logistic regression and a final multiple logistic regression model from variables found to be important predictors of adoption. Age, sex, coat color, and reason for relinquishment were major determinants of adoption in cats. Age, sex, coat color, reason for relinquishment, breed, purebred status, and injury status were major determinants of adoption in dogs. Shelter personnel could utilize this information to increase the adoption of frequently overlooked animals. Alternatively, shelters could use this to focus their resources on animals with characteristics the public prefers.

Age Factors↗
PubMed2005

Adoption of shelter dogs in a Brazilian community: assessing the caretaker profile.

A survey in Ibiúna, Sao Paulo, Brazil, of caregivers (owners) who adopted shelter dogs assessed length of ownership, proportion of male and female dogs adopted, and owners' characteristics. It addressed breeding, neutering, vaccination, and veterinary care. It used no testing to provide a good "match" between dog and future owner. Of adopted dogs, 58% were male. Only 36% of owners were located. Mean ownership length was 14.8 months (95% confidence interval = 12.4 to 17.2 months), estimated through a survival analysis method. Of adopted dogs, 40.9% lived with their owners; 34.9% had died (some had lived on the streets); 15.0% were donated; 4.3% ran away; 3.2% were returned to the city shelter. Of interviewees, 57% reported no difficulties with the adoption; 23.1% cited the animal's illness and death as the main difficulty. For contraception, 87 owners (46.7%) chained dogs to prevent contact with other animals; 56.5% were against neutering. Reasons given were compassion (58.1%), unnecessary procedure (11.4%), cost (9.5%), and behavior change (4.8%). This research motivated a design for Ibiúna shelter dog adoption to improve the proportion of successful adoptions.

Animal Welfare↗
PubMed2004

Organizational factors affecting the adoption of diabetes care management processes in physician organizations.

OBJECTIVE: To describe the extent of adoption of diabetes care management processes in physician organizations in the U.S. and to investigate the organizational factors that affect the adoption of diabetes care management processes. RESEARCH DESIGN AND METHODS: Data are derived from the National Survey of Physician Organizations and the Management of Chronic Illness, conducted in 2000-2001. A total of 1,104 of the 1,590 physician organizations identified responded to the survey. The extent of adoption of four diabetes care management processes is measured by an index consisting of the organization's use of diabetic patient registries, clinical practice guidelines, case management, and physician feedback. The ordinary least-squares model is used to determine the association of organizational characteristics with the adoption of diabetes care management processes in physician organizations. A logistic regression model is used to determine the association of organizational characteristics with the adoption of individual diabetes care management processes. RESULTS: Of the 987 physician organizations studied that treat patients with diabetes, 48% either do not use any or use only one of the four diabetes care management processes. A total of 20% use two care management processes, and 32% use three or four processes. External incentives to improve quality, computerized clinical information systems, and ownership by hospitals or health maintenance organizations are strongly associated with the diabetes care management index and the adoption of individual diabetes care management processes. CONCLUSIONS: Policies to encourage external incentives to improve quality and to facilitate the adoption of computerized clinical information technology may promote greater use of diabetes care management processes.

Chronic Disease↗