Research Review: In a rush to permanency: preventing adoption disruptionJennifer Coakley, Jill Duerr Berrick|Child & Family Social Work|2007 ABSTRACT Since the late 1990s, US, UK and Canadian policy have increasingly focused on improving permanency outcomes for looked‐after children. Although the ideal permanency outcome of reunification is attained for about half of the children entering out‐of‐home care, an increasing number of children are adopted each year. The vast majority of adoptions are stable and secure, but concerns about adoption disruption haunt child welfare workers when making this important permanency decision. Despite a variety of definitions employed in the literature, adoption disruption is a general term used to describe the failure or breakdown of an adoptive child’s placement. Studies dating back to the 1970s have reported adoption disruption rates and the characteristics associated with those involved in such cases. This paper reviews available research, principally from the United States, and offers possible explanations for the wide range of reported disruption rates in the literature. After reviewing the research, practice implications for improving adoption outcomes and suggestions for future research are presented.
Potential role for extracorporeal membrane oxygenation cardiopulmonary resuscitation (E-CPR) during in-hospital cardiac arrest in Australia: A nested cohort studyGemma Pound, Glenn M. Eastwood, Daryl Jones et al.|Critical Care and Resuscitation|2023 Objective: This study aims to evaluate the characteristics and outcomes of patients who fulfilled extracorporeal membrane oxygenation cardiopulmonary resuscitation (E-CPR) selection criteria during in-hospital cardiac arrest (IHCA). Design: This is a nested cohort study. Setting: Code blue data were collected across seven hospitals in Australia between July 2017 and August 2018. Participants: Participants who fulfilled E-CPR selection criteria during IHCA were included. Main outcome measures: Return of spontaneous circulation and survival and functional outcome at hospital discharge. Functional outcome was measured using the modified Rankin scale, with scores dichotomised into good and poor functional outcome. Results: < 0.001) compared to those with a good outcome. The majority of patients (18/19 [94.7%]) achieved sustained return of spontaneous circulation within 15 minutes of CPR. All five patients who had CPR >15 minutes had a poor outcome. Conclusion: Approximately one in six IHCA patients fulfilled E-CPR selection criteria during IHCA, half of whom had a poor outcome. Non-shockable rhythm and longer duration of CPR were associated with poor outcome. Patients who had CPR for >15 minutes and a poor outcome may have benefited from E-CPR. The feasibility, effectiveness and risks of commencing E-CPR earlier in IHCA and among those with non-shockable rhythms requires further investigation.