Oʼmalley Donna M
Children's Mercy Hospitals and Clinics, Emergency and Urgent Care Services, Kansas City, Missouri 64108, USA.
Nurs Adm Q. 2013 Jul-Sep;37(3):216-21. doi: 10.1097/NAQ.0b013e318295f5d8.
The Patient Protection and Affordable Care Act aims to increase access to many who were previously uninsured, to increase the quality of health care, and to decrease costs. Accountable Care Organizations are a manifestation of these new health care reforms. A proactive approach focused on primary prevention to address modifiable determinants of health holds the promise of a healthier population while being cost-effective. Exposure to toxic stress in childhood places many children on a trajectory for poor immediate and long-term health outcomes. A lifecourse approach to disease prevention offers opportunities at every age and stage to build resilience, which buffers and protects children from the effects of adversity and toxic stress. The American Academy of Pediatrics, recognizing that many adult diseases are rooted in experiences in early childhood, has proposed an ecobiodevelopmental framework that expands the role of pediatricians and embraces a preventive lifecourse approach to health and well-being. Exposure to adversity and toxic stress in childhood is a serious public health problem. A new kind of leadership is required to address these issues. Pediatric nurses and physicians are trusted healers and in a position to seek solutions skillfully and intentionally.
《患者保护与平价医疗法案》旨在让更多此前未参保的人能够获得医保，提高医疗保健质量，并降低成本。 accountable care organizations是这些新的医疗改革的一种体现。一种专注于初级预防以解决健康方面可改变的决定因素的积极方法，有望在具有成本效益的同时使人口更健康。童年时期暴露于有毒压力会使许多儿童走上即时和长期健康状况不佳的道路。疾病预防的生命历程方法在每个年龄和阶段都提供了建立复原力的机会，这种复原力可以缓冲和保护儿童免受逆境和有毒压力的影响。美国儿科学会认识到许多成人疾病都源于童年早期的经历，因此提出了一个生态生物发展框架，该框架扩大了儿科医生的作用，并采用预防性生命历程方法来促进健康和福祉。童年时期暴露于逆境和有毒压力是一个严重的公共卫生问题。需要一种新型的领导力来解决这些问题。儿科护士和医生是值得信赖的治疗者，有能力巧妙而有目的地寻求解决方案。
