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PubMed1998

Determining factors for successful adoption of dogs from an animal shelter.

OBJECTIVE: To determine whether certain characteristics of dogs offered for adoption are associated with successful adoption. DESIGN: Retrospective cohort study. ANIMALS: 1,468 relinquished dogs offered for adoption at a local humane society. PROCEDURE: Data regarding dogs offered for adoption were obtained from surveys completed by previous owners. Data were analyzed by use of bivariate statistics and multivariable logistic regression. RESULTS: Of dogs offered for adoption, 1,073 were successfully adopted, 239 were not adopted, and 157 were returned to the shelter after adoption. Terrier, hound, toy, and nonsporting breeds were found to be significantly associated with successful adoption (P < 0.05, chi 2 analysis). Certain coat colors (gold, gray, and white), small size, and history of an indoor environment were also significant predictors of successful adoption. The correlation coefficient (0.048) indicated that only a small percentage of variance in adoption success could be explained by the multiple logistic regression model. CLINICAL IMPLICATIONS: Animal shelter managers with limited kennel capacity may wish to periodically use surveys to determine whether the type of dog being offered to the public reflects the type of dog the public will adopt.

Adoption↗
PubMed2004

Does the early adopter of drugs exist? A population-based study of general practitioners' prescribing of new drugs.

OBJECTIVE: To analyse associations between indicators for adoption of new drugs and to test the hypothesis that physicians' early adoption of new drugs is a personal trait independent of drug groups. METHODS: In a population-based cohort study using register data, we analysed the prescribing of new drugs by Danish general practitioners. Angiotensin-II antagonists, triptans, selective cyclo-oxygenase-2 antagonists and esomeprazol were used in the assessment. As indicators of new drug uptake, we used adoption time, cumulative incidence, preference proportion, incidence rate and prescription cost and volume. For each measure, we ranked the general practices. Ranks were pair-wise plotted, and Pearson's correlation coefficient ( r) was calculated. Next, we analysed the correlation between ranks across different drug classes. RESULTS: For all indicators, the general practitioners' adoption of one group of drugs was poorly associated with adoption of others ( r</=0.49), indicating that early adoption of one type of drugs is not associated with early adoption of another. For all drug groups, adoption time adjusted for practice size was only weakly associated with other indicators ( r: -0.56 to -0.27). Indicators, based on cost and volume of drugs, were highly correlated ( r: 0.96-0.99), and the others correlated reasonably well ( r: 0.51-0.91). CONCLUSIONS: Within drug groups, indicators of drug adoption, except for adoption time, correlate reasonably well. However, the theory that physicians' early adoption of new drugs is a personal trait independent of the type of drug could not be confirmed. The notion of the early-drug-adopting general practitioner may be mistaken.

Cohort Studies↗
PubMed2006

Adoption of a sedation scoring system and sedation guideline in an intensive care unit.

AIM: The paper presents a study assessing the rate of adoption of a sedation scoring system and sedation guideline. BACKGROUND: Clinical practice guidelines including sedation guidelines have been shown to improve patient outcomes by standardizing care. In particular sedation guidelines have been shown to be beneficial for intensive care patients by reducing the duration of ventilation. Despite the acceptance that clinical practice guidelines are beneficial, adoption rates are rarely measured. Adoption data may reveal other factors which contribute to improved outcomes. Therefore, the usefulness of the guideline may be more appropriately assessed by collecting adoption data. METHOD: A quasi-experimental pre-intervention and postintervention quality improvement design was used. Adoption was operationalized as documentation of sedation score every 4 hours and use of the sedation and analgesic medications suggested in the guideline. Adoption data were collected from patients' charts on a random day of the month; all patients in the intensive care unit on that day were assigned an adoption category. Sedation scoring system adoption data were collected before implementation of a sedation guideline, which was implemented using an intensive information-giving strategy, and guideline adoption data were fed back to bedside nurses. After implementation of the guideline, adoption data were collected for both the sedation scoring system and the guideline. The data were collected in the years 2002-2004. FINDINGS: The sedation scoring system was not used extensively in the pre-intervention phase of the study; however, this improved in the postintervention phase. The findings suggest that the sedation guideline was gradually adopted following implementation in the postintervention phase of the study. Field notes taken during the implementation of the sedation scoring system and the guideline reveal widespread acceptance of both. CONCLUSION: Measurement of adoption is a complex process. Appropriate operationalization contributes to greater accuracy. Further investigation is warranted to establish the intensity and extent of implementation required to positively affect patient outcomes.

Adolescent↗
PubMed2006

Assessing the level of healthcare information technology adoption in the United States: a snapshot.

BACKGROUND: Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap. METHODS: We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages. RESULTS: Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity. CONCLUSION: Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss.

Attitude of Health Personnel↗
PubMed1979

Does adoption affect subsequent fertility?

A hypothesis derived from the old wives' tale that adoption increases subsequent fertility was tested by analysis of follow-up data obtained from 895 couples who were "at risk" of pregnancy and of adoption after they had registered in the Stanford Infertility Clinic between 1963 and 1977. Of the 767 couples who did not adopt, 329 later conceived; of the 128 who did adopt, 41 later conceived. Simple comparison of the percentages or, indeed, of the life tables suggests reduced fertility after adoption. However, this is probably a spurious effect related to a number of factors which differ between two groups. These differences were controlled in the statistical analysis by methods which take into account the length of time each couple was at risk of either conception or adoption and the presence or absence of explanatory variables. The relative risk of conception estimated by the Cox model was not significantly different from 1 and the Mantel-Haenszel statistic (m = 0.208) indicates no significant difference in subsequent conception rates between adoptive and not-adoptive couples. The same methods were used to control for seven covariates, including age and duration of infertility, which could affect conception rates. In each instance, the estimate of relative risk of conception for adoptive versus not-adoptive couples was not significantly different from 1. Therefore, our data do not support the hypothesis that adoption affects subsequent fertility.

Adoption↗
PubMed1976

Nature-nurture and intelligence: the twin and adoption studies agree.

A large-scale adoption study is underway at the University of Texas where IQ test scores are available for over 1200 women who gave up their children for adoption immediately following delivery. The adopted children and their adoptive families are now being located and tested and, if current trends continue, complete data should eventually be available on over 400 families. About half of these families will contain two or more adopted children or both adopted and natural children. At present, data are available for 89 families. The results are consistent with twin data and support a genetic hypothesis. The biological mother-adopted child correlation is 0.37 whereas the adoptive mother-adopted child and adoptive father-adopted child correlations are only 0.22 and 0.04 respectively. There are 59 pairs of unrelated children reared together in this sample and the IQ correlation for these children is only 0.13.

Adoption↗
PubMed1999

[Adoption and/or reproductive medicine].

Adoption and medically assisted reproduction are alternative options for childless parents to fulfill their wish for having a child. In both situations, there is a necessity for the future parents to mourn the loss of their imagined child, which could have been conceived without a third party (adoption agency or medically assisted reproduction). Adoption always represents for the child a loss of emotional ties with birthparents and the development of new attachments with adoptive parents. Adoption can be considered as a lifetime process of the members involved in the adoption triangle, that is birth parents, adoptive parents and the child. The article discusses the loss of emotional bonds from primary caretakers as a psychological trauma and addresses mourning difficulties in adoptees. Problems with the development of new attachments with adoptive parents such as loyalty conflicts and the revelation of the adoption are described. Family romance fantasy in adoption and aspects of family dynamics as well as the specific difficulties adoptive parents encounter are explored.

Adoption↗
PubMed1975

[Adoption and its psychiatric aspects].

Adoption has changed in history, in different cultures, in law, in its goals, its functions, its modalities. The study of the adoptive condition is worthwhile for theoretical research (psychopathology, genetics, etc.) and for clinical practice (prevention, selection and motivation analysis of adopting parents). It is dangerous and too simple to explain pathology by adoption. However, there is a specific psychopathology of adoptees : 1. by maternal deprivation and abandonnement pathology (more frequent and more important), 2. by the adoptive situation condition itself. We review some hypotheses, particularly the concept of "Family romance". The adopted child undergoes more frequent examinations, both pediatric and psychiatric, than the ordinary child (this may be explained by parental anxiety and child acting out behavior). Certain American statistics on this appear to be significant. On the other hand, there is a silent pathology (the majority ?) : we found it frequently in the youngest children in France. We discuss the problem of psychiatric selection of adoptive parents and adoptive children, its legitimacy, its methodes ; psychopathology and motivations of the adoptive patents ; the problem of the revelation of adoption to the child ; the problem of sterility (it is often incompletely explored and treated). Adoption may not be the best solution for most of the abandonned children and sterile couples.

Adolescent↗
PubMed2003

Pre-placement screening in international adoption.

BACKGROUND: The number of child adoptions from abroad is increasing, but the adverse living conditions of these children prior to the adoption raise questions on their medical and neurodevelopmental status, particularly since there are no guidelines for pre- or post-adoption medical evaluation. OBJECTIVES: To describe the condition of a cohort of young children who were candidates for adoption in East European orphanages and foster homes, and to determine those attributes associated with a family's decision to adopt or refuse a particular child. METHODS: Eighty-two young children, median age 11 months, were evaluated by Israeli pediatricians in Eastern Europe between 3 weeks and 6 months prior to their adoption. The evaluation consisted of comprehensive medical and neurodevelopmental testing on site using a battery of standardized assessment tools, and observation of free play and social interactive behaviors recorded on videotape. Laboratory tests included complete blood count, chemistries, serology screening, and metabolic and genetic testing. RESULTS: The children were growth-retarded. Medical problems were classified as resolved (pneumonia and diarrhea) in 32.8%; or ongoing, such as hepatitis B and C, failure to thrive, organomegaly, and visual and hearing disorders, in 14.8%. Neuromotor status was grossly abnormal in 13.4%. Twenty-two percent of the children were rejected for adoption by families in Israel. Factors associated with the adoption decision were performance skills on developmental testing (P = 0.0001), present medical status (P = 0.002), and weight (P = 0.016). CONCLUSIONS: Pre-placement comprehensive screening of children eligible for foreign adoption, which includes developmental screening, helps to identify a wide variety of strengths and impairments in a child's background before the adoption procedure is finalized. A family's decision to adopt or not was associated with the child's performance on Bayley Scales, weight, and current medical status, but not with language delays, serious past medical history or suspect family background.

Adoption↗
PubMed1989

[Adoption in terms of current regulations].

Legal decisions concerning adoption taken over the last thirty years have usually followed changes in public opinion. For instance, the July 11 1966 Act has practically put an end to conflicts between adopting parents and biologic mothers (or parents) and has specified adoption eligibility criteria. At present, because most adoptions are successful and numbers of children eligible for adoption are falling steadily, efforts are being made to allow the adoption of the greatest possible number of children at a young age; some handicapped children as well as older children are also considered as adoptable. Older children who were neglected in their former environment occasionally experience psychologic problems; for them, decisions can be taken only individually and foster home placement with the potential adoptive parents can be used as a first step. Today, the practitioner's role is mainly to inform the adoptive parents on the impact of a given somatic or (if possible) psychologic handicap. The current tendency is to maintain the greatest possible number of children within their family environment by supporting the family and allowing the child and parents to participate in all the decisions concerning them. Adoption of French children is becoming more and more difficult, explaining why foreign-born children are being increasingly adopted.

Adoption↗
PubMed2006

Outcome of cats adopted from a biomedical research program.

Adoption of companion animals retired from biomedical research projects can provide an alternative, humane method for their disposition. For more than a decade, the University of Florida College of Veterinary Medicine has allowed investigators to arrange for the adoption of nonhuman animals used in their research. This report directed a survey to caregivers (owners) of 458 cats adopted over a 6-year period. The survey determined (a) retention rate of adopted cats in their original homes, (b) characteristics of adopters and cats, (c) adopters' initial expectations and subsequent experiences with the cats, (d) quality of the humananimal bond, and (e) adopters' perceptions of the adoption process. Completed surveys totaled 275 (60.0% response rate) with a median follow-up interval of 38 months. Of cats surveyed, 91.3% were still in their original homes, 91.0% had seen a veterinarian following adoption, and 80.4% were highly valued family members. The procedures followed to place cats in appropriate homes satisfied the vast majority of adopters surveyed. These results suggest that adoption into private homes is a viable alternative for cats who have completed research studies.

Animal Experimentation↗
PubMed2003

Determinants of adoption and euthanasia of shelter dogs spayed or neutered in the university of california veterinary student surgery program compared to other shelter dogs.

Limited economic resources and pet overpopulation force animals shelters to consider euthanasia of adoptable animals every day. Veterinary medical schools can play a positive role in increasing pet adoption and combating overpopulation by providing free neutering for shelter animals. This retrospective cohort study illustrated that the cooperative efforts of a veterinary medicine surgical teaching program and local animal shelters decreases euthanasia of adoptable pets. At the University of California, Davis (UCD), shelter dogs are neutered by veterinary students and then returned to the shelter for adoption. The rates of adoption and euthanasia of the dogs neutered at UCD were contrasted with a comparison shelter group to determine the effect of pre-adoption neutering. The UCD-neutered dogs had a lower rate of euthanasia than the comparison shelter group at the shelters investigated. At Sacramento County Animal Care and Regulation, 73% of the UCD group but only 36% of the comparison group were adopted. At Yolo County Animal Services, 71% of the UCD group and 45% of the comparison group were adopted. The sex of an animal did not significantly affect the rate of euthanasia. Dogs that were predominantly pit bull, rottweiler, or chow chow breeds had higher rates of euthanasia than other breeds, independent of neuter status. Also, juveniles (less than one year old) had lower rates of euthanasia than adults, independent of neuter status. UCD adult dogs had lower rates of euthanasia than comparison adults. Post-surgical UCD dogs spent a longer average time in the shelter before adoption (15 days at Sacramento; 16 days at Yolo) than the comparison dogs (11 and 12 days, respectively). UCD dogs also spent a longer average time in the shelter before euthanasia (18 and 25 days, respectively) than the comparison dogs (13 days at both shelters). Lower probabilities of euthanasia for behavioral or medical reasons were found for UCD dogs than for the comparison dogs. The probability of euthanasia for reasons of space limitations increased with time in shelter for both groups. In this study, pre-adoption neutering increased adoptions without increasing the probability of medical or behavioral euthanasia.

Animals↗
PubMed1999

Adopted children's behavior problems: a review of five explanatory models.

Although the majority of adopted children are well-adjusted, adopted children evidence proportionately more behavior problems when compared to nonadopted children in both clinic and nonclinic populations. An extensive literature examining behavioral, diagnostic, and demographic characteristics of adopted children has provided several plausible explanations for the high rate of behavior problems among adopted children. In this review, the existing literature is organized into five explanatory models: (a) genetic or "biosocial" factors, (b) pathogenesis of the adoption process, (c) long-term effects of impaired preadoption childrearing, (d) referral bias in adoptive parents, and (e) impaired adoptive parent-adoptee relations. We conclude that evidence for each model is mixed at best. Especially noteworthy is the mixed results for genetic or biosocial studies and the relative absence of studies focused on identifying factors associated with disruptions in the adoptive parent-adoptee relationship. We propose that a psychosocial model to explain the high rate of behavior problems among adopted children is highly plausible and further suggest that it may be time for a new awareness and appreciation for the normative aspects of adoption. An overview of parenting and family characteristics associated with risk factors for antisocial behavior is provided as a guide for future research.

Adolescent↗
PubMed2003

Adoption as a natural experiment.

Adoption provides a unique opportunity for the study of child development. Because adopted children are raised in families in which they have no genetic relationship with their parents, and possibly none with their siblings, they provide a rare opportunity to study the relative importance of genetic, shared environmental, and nonshared environmental influences on the development of child characteristics and behaviors. Because children are adopted from a variety of circumstances and at a wide range of ages, studies of adopted children and their families provide researchers the opportunity to examine the short- and long-term influences of a wide range of environments on children's development. Because children are adopted into homes with a range of characteristics (e.g., multiracial homes), adoption provides the opportunity to study the range of influences of these homes on child development. Adoption research that focuses on each of these areas is reviewed in this article. We present conclusions about the value of adoption in psychological research and some reasons why many psychologists ignore the opportunities presented by studying adoptive families, as well as potential useful directions for future research with adopted children and their families.

Adoption↗
PubMed2006

Maternal secure-base scripts and children's attachment security in an adopted sample.

Studies of families with adopted children are of special interest to attachment theorists because they afford opportunities to probe assumptions of attachment theory with regard to the developmental timing of interactions necessary to form primary attachments and also with regard to effects of shared genes on child attachment quality. In Bowlby's model, attachment-relevant behaviors and interactions are observable from the moment of birth, but for adoptive families, these interactions cannot begin until the child enters the family, sometimes several months or even years post-partum. Furthermore, because adoptive parents and adopted children do not usually share genes by common descent, any correspondence between attachment representations of the parent and secure base behavior of the child must arise as a consequence of dyadic interaction histories. The objectives of this study were to evaluate whether the child's age at the time of adoption or at the time of attachment assessment predicted child attachment security in adoptive families and also whether the adoptive mother's internal attachment representation predicted the child's attachment security. The participants were 106 mother - child dyads selected from the 406 adoptions carried out through the Lisbon Department of Adoption Services over a period of 3 years. The Attachment Behavior Q-Set (AQS; Waters, 1995) was used to assess secure base behavior and an attachment script representation task was used to assess the maternal attachment representations. Neither child's age at the time of adoption, nor age of the child at assessment significantly predicted the AQS security score; however, scores reflecting the presence and quality of maternal secure base scripts did predict AQS security. These findings support the notion that the transmission of attachment security across generations involves mutual exchanges and learning by the child and that the exchanges leading to secure attachment need not begin at birth. These results complement the findings and conceptual arguments offered by Bowlby and Ainsworth concerning the critical influence of maternal representations of attachment to the quality of attachment security in children.

Adoption↗
PubMed1998

Promoting same-race adoption for children of color.

Opponents of policies that protect same-race adoption assert that children of color are languishing in out-of-home care because they are being restricted from entering transracial adoption arrangements. This article argues that transracial adoption is not necessary to ensure that children of color are adopted in a timely manner and sets forth alternative arguments around six issues: (1) policies favoring adoption by foster parents, (2) the availability of same-race families to adopt children of color, (3) the abundance of children in out-of-home care unavailable for adoption or with special needs, (4) disparities in child welfare services related to ethnicity, (5) misleading data on the numbers of children of color who are in foster care, and (6) poverty as an underlying cause of out-of-home placements. This article briefly presents the history of the transracial adoption controversy and discusses its current status; counters assertions typically used to oppose same-race adoption policies for children of color; summarizes the positions of several social work organizations regarding adoption and race; and makes recommendations for education, policy, research, and practice.

Adoption↗
PubMedDate not supplied

Legal issues in nonrelated infant adoption: nursing implications.

PURPOSE: To highlight the legal issues surrounding nonrelated infant adoptions. POPULATION: Parties in the adoption triad--the infant, the biological parent(s), and the adoptive parent(s). CONCLUSIONS: Current adoption laws have been influenced by a historical stigmatization of adoption by society, states' sovereignty rights, and individual's constitutional rights. Controversies surrounding nonrelated infant adoptions have highlighted the inadequacies of the present system of adoption laws and regulations. Nurses can take a proactive role in their practice by acquiring a clear understanding of the legal issues surrounding adoption. PRACTICE IMPLICATIONS: Knowledge about state adoption laws, regulations, and resources, as well as the legal issues surrounding infant adoption, will allow the nurse to take a proactive role in formulating and providing supportive interventions that assist all parties through the process.

Adoption↗
PubMed2003

The predictive accuracy of pre-adoption video review in adoptees from Russian and Eastern European orphanages.

Many internationally adopted children have a pre-adoption video for prospective adoptive parents to review before their commitment to adopt. No published report to date has examined the value of the pre-adoption video evaluation (PreAVE) as a predictor of post-adoption developmental status. The present study was designed to determine whether PreAVE can predict the post-adoption developmental status of internationally adopted children. In this retrospective chart review, children who presented to the Yale International Adoption Clinic between December 1998 and September 2000, and had both a PreAVE and a post-adoption developmental evaluation (PosADE) were selected (N = 20) PreAVE was done using the Denver II and PosADE was done using the Bayley Scales of Infant Development, 2nd edition. The Pearson r coefficient between the two ratings was determined and sensitivity and specificity were calculated. There was a significant correlation between the PreAVE and the PosADEs (r = 0.53, p = 0.01).The sensitivity of PreAVE to detect moderate to severe developmental delay was 43% and the specificity was 85%. Although ratings of development on PreAVE are similar to PosADE, the ability to detect moderate to severe developmental delay by video review is limited.

Adoption↗