Category Archives: Early childhood
Sunny G. Hallowell, PhD, APRN, is a postdoctoral fellow, and Danielle Altares Sarik, MSN, APRN, a predoctoral fellow, at the Robert Wood Johnson Foundation-funded Center for Health Outcomes and Policy Research at the School of Nursing at the University of Pennsylvania. Hallowell is also a Leonard Davis Institute Fellow. Both are pediatric nurse practitioners serving on the executive board of the National Association of Pediatric Nurse Practitioners, Pennsylvania Delaware Valley Chapter. Monday, October 6, is National Child Health Day.
Many Americans may not know that children born in the United States are less likely to survive to their fifth birthday than children born in other high-income peer countries. The United States falls at the bottom of the Commonwealth Fund’s recently released “Mirror, Mirror” report, ranking last out of 11 countries for infant mortality.
As children hold the greatest potential to achieve good health, high infant and child mortality may be particularly surprising. Early lifestyle and health care decisions can set children on a trajectory that determines their health for a lifetime.
As a country, we can do more to ensure the health of our youngest and most vulnerable population. Using nurses and nurse practitioners (NP) to the highest level of their education and training is one strategy. Robust use of nurses and NPs can offer solutions to improve infant and child survival rates through prenatal, postnatal and early childhood health surveillance.
Quick thinking and a lucky coincidence saved a toddler’s life, and the incident is serving as a powerful reminder about the need to train parents and other caregivers about what to do when children choke.
Maja Djukic, PhD, RN, a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar and assistant professor at the New York University College of Nursing, was rollerblading near her home in Connecticut this fall when she heard screaming. Djukic raced to the scene to find a one-year-old boy limp and turning blue. The boy’s father was calling 9-1-1 while him mother tried, unsuccessfully, to clear his air passages. Djukic was able to do so; she had the child breathing by the time an ambulance arrived. He has fully recovered.
In “Keeping Little Breaths Flowing,” Jane E. Brody of the New York Times wrote about the incident, noting that “few parents of newborns are taught how to prevent choking and what to do if it occurs.” Brody’s two-part piece on cardiopulmonary resuscitation (CPR) concludes with “How CPR Can Save a Life,” in which she focuses on resuscitating adult victims of cardiac arrest.
Human Capital News Roundup: Electronic health records, the widow effect, child safety restraint laws, and more.
Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:
Race and economic status are not as important as social network in predicting whether a person will become a victim of a fatal shooting in Chicago, according to a study from Andrew Papachristos, PhD, an RWJF Health & Society Scholars alumnus. “Generally, you can’t catch a bullet from just anyone,” Papachristos told the Chicago Sun Times. “Your relationship with the people involved matters.” The study was also covered by NPR, U.S. News & World Report, and Psych Central, among other outlets.
Most organizations across the United States are in the middle stages of implementing electronic health records, Ann O’Brien, RN, told NurseZone.com. O’Brien is senior director of clinical informatics for Kaiser Permanente and an RWJF Executive Nurse Fellow. “At Kaiser … we have almost three years now of electronic health record data and the ability to actually optimize data and technology to improve care,” she said.
Sheryl Magzamen, PhD, MPH, is an assistant professor in the College of Veterinary Medicine and Biomedical Sciences at Colorado State University and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2007-2009). She recently published two studies exploring the link between early childhood lead exposure and behavioral and academic outcomes in Environmental Research and the Annals of Epidemiology. She discusses both below.
Human Capital Blog: What are the main findings of your study on childhood lead exposure and discipline?
Sheryl Magzamen: We found that children who had moderate but elevated exposure lead in early childhood were more than two times as likely as unexposed children to be suspended from school, and that’s controlling for race, socioeconomic status, and other covariates. We’re particularly concerned about this because of what it means for barriers to school success and achievement due to behavioral issues.
We are also concerned about the fact that there‘s a strong possibility, based on animal models, that neurological effects of lead exposure predispose children to an array of disruptive or anti-social behavior in schools. The environmental exposures that children have prior to going to school have been largely ignored in debates about quality public education.
David Olds, PhD, is founder of the Nurse-Family Partnership, a Robert Wood Johnson Foundation 40th Anniversary Force Multiplier that provides maternal and early childhood health programs for at-risk, first-time mothers. He is a professor of pediatrics at the University of Colorado School of Medicine, where he directs the Prevention Research Center for Family and Child Health.
When I finished my undergraduate degree in Baltimore in 1970, I went to work at an inner-city day care center, hoping that I might help poor preschoolers get off to a great start and have a better chance of succeeding in school and becoming productive, healthy citizens. But I soon realized that for many children in my classroom, it was already too little, too late. One little boy had been exposed to alcohol during pregnancy and was pretty profoundly developmentally compromised—he couldn’t communicate with words. Other children were being abused or neglected, so it was clear to me that parents’ prenatal health and parenting behaviors were part of the solution for low-income children.
I would have been out of touch, however, to think that all that was needed was for parents to do a better job of caring for their children. Our center was in a poor, inner-city neighborhood, where poverty, crime and a lack of adequate housing were undeniable influences for families. It was clear that parents wanted the best for their children, but their own personal histories and the social and material stressors weighing on them often made it really hard for them to protect themselves and their children. And this was happening in countless communities across the country.
By Deepa Camenga, MD, Robert Wood Johnson Foundation Clinical Scholar
When I was pregnant with my first child, my husband and I diligently prepared for our new baby. We studiously researched the safest car seats, cribs and strollers, we took labor classes to prepare for the birth, and we ate a healthy diet. My husband accompanied me to every OB/GYN visit, and we both listened closely when the doctor recommended that we should both receive the flu and Tdap (Tetanus, diphtheria, and pertussis) vaccine.
Tdap protects against pertussis, or whooping cough, a debilitating respiratory infection that can be fatal in young infants. I had received Tdap during my pediatric residency as recommended by the hospital, and my OB/GYN provided the flu vaccine, but my husband, an overall healthy guy, had not seen a doctor in years and had not received Tdap. He went to our local pharmacy for a flu shot, so I could check that off our list, but as the months moved forward, still no Tdap.
Fast forward to the delivery, when upon discharge our nurse again reminded us about Tdap. I’m sure it sank in somewhere, but it was quickly forgotten when we pulled into our driveway and realized we didn’t know how to remove our son from the car seat. The weeks that followed quickly turned into months…and years. Ultimately, it took a full two years—and the birth of our second son—before my husband was finally vaccinated.
I’m sure this experience is shared by many new parents. It was no surprise to me when I learned that few eligible adults in the United States receive the Tdap vaccine.