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Background and objective Children with medical complexity (CMC) have chronic and severe conditions leading to medical fragility. CMC represent less than 1% of children but account for one-third of paediatric healthcare expenditures. Enrollment to a complex care program (CCP) decreases health care resource utilization while improving parental satisfaction. An in-depth understanding of how these changes operate in real-world setting is needed to further support CMC and their families. This study aimed at assessing the possible reasons for a decrease in emergency department (ED) visits and hospitalization length of stay related to enrollment to a CCP, based on parental perspectives. Study design Using a qualitative approach, data were collected using in-depth, semi-structured interviews with parents of CMC enrolled in a CCP from a university hospital centre in Montreal, Canada. The interview guide was co-constructed by an interdisciplinary team, including a parent partner and a clinical nurse coordinator. Themes have been identified inductively, using thematic analysis. Results Parents identified personalized care , family empowerment and guidance as enablers arising from the CCP that contributed to the decrease in hospital-delivered care utilization. Improvement in medical baseline condition was also identified as a contributing factor, while not necessarily related to program's support. Conclusions In this study, we identified personalized care, parental empowerment, and guidance as three strategies for a CCP to potentially decrease ED visits and hospital length of stay, from the parents' perspective. Parents identified the clinical nurse coordinator as playing a central role in supporting the implementation of these strategies. [ABSTRACT FROM AUTHOR]

Behavioral flexibility is important in a changing environment. Previous research suggests that systems consolidation, a long-term poststorage process that alters memory traces, may reduce behavioral flexibility. However, exactly how systems consolidation affects flexibility is unknown. Here, we tested how systems consolidation affects: (1) flexibility in response to value changes and (2) flexibility in response to changes in the optimal sequence of actions. Mice were trained to obtain food rewards in a Y-maze by switching nose pokes between three arms. During initial training, all arms were rewarded and mice simply had to switch arms in order to maximize rewards. Then, after either a 1 or 28 d delay, we either devalued one arm, or we reinforced a specific sequence of pokes. We found that after a 1 d delay mice adapted relatively easily to the changes. In contrast, mice given a 28 d delay struggled to adapt, especially for changes to the optimal sequence of actions. Immediate early gene imaging suggested that the 28 d mice were less reliant on their hippocampus and more reliant on their medial prefrontal cortex. These data suggest that systems consolidation reduces behavioral flexibility, particularly for changes to the optimal sequence of actions.

The Americans' attitudes towards U.S. conditions, president George W. Bush, the Congress are experiencing declining trends. A January 2008 survey of 1,023 adults showed that 82% are satisfied with the quality of life in the country, while 47% are dissatisfied towards the government systems and how it works. Perceptions on the the nations' health, social and economic policies are given.

The results of the telephonic survey conducted among a group of Americans to analyze the patterns of media usage, news consumption and local media networks in the United States are presented.

The results of the telephonic survey conducted among a group of Americans to examine the relation between personality and political leadership credentials to reflect a presidential candidate are presented.

A recent survey on the health of elderly adults in the United States finds that majority of Americans aged 80 and older appear to enjoy good physical as well as mental health.

A recent pre-election poll conducted among a group of Americans shows that the Democratic victory in Congressional elections is because of solid support from constituent groups and all key subgroups.

A pre-election poll for the United States Senate, conducted among a group of Americans, shows that Democratic candidates in New Jersey and Montana holding significant leads but the races are too close to call in Missouri, Rhode Island, Tennessee and Virginia.

Political conditions prevailing in the United States prior to midterm elections are described.

Results of a survey to find out public opinion on deterioration of the environment are described.

A survey on Americans views about the nation's energy supply, is discussed. It is revealed that 41 percent of Americans say that the energy supply situation in the country is 'very serious'.

The poll was conducted using a random sample of 1,510 adult Katrina victims. According to the survey 42% of people suffered during Hurricane are feeling relief but 31% are still feeling scared and they are currently feeling specific post-traumatic stress disorder symptoms like trouble sleeping, anxiety, and depression.

A survey is conducted to find out people's views on Social Security reforms. The results suggested a low level of approval of the way US President George W. Bush is handling the issue and widespread agreement that Social Security has major problems.

A survey was conducted to know the people's opinion whether they would support or oppose a plan in which people could invest some of their Social Security contributions in the stock market. The result showed that about 53% supported the plan while 44% opposed the plan.

A survey was conducted to study Americans view on President George W. Bush's intent to make federal income tax permanent. The result showed that 52% of Americans favored making Bush's federal income tax cuts permanent while 40% opposed.

George W. Bush's standing versus John Kerry on Labor Day could define his re-election prospects, as historical Gallup polling shows that candidates who are substantially ahead usually go on to win. Gallup's historical polling record provides context for what the post-convention results might mean for Bush's re-election prospects.

Ronald Reagan was the fortieth president of United States and became the most revered public figure in recent years. According to the Gallup polls his ratings improved substantially after he left office in November 1984.

The Gallup's annual and Economy and Personal Finance survey, conducted in April 2004 indicate that American public is more concerned about having enough money for retirement than about any other finance related issues. Among current retirees 83% say they have enough money to live comfortably and report fewer financial worries than non-retired population.

A research is conducted to know the attitudes of the American about the legality of abortion. The result reveals 26% American says that abortion should be legal under any circumstances and 14% says that legal under most circumstances.

Surveys were conducted to find the viewpoints of the Americans relating to civil rights attitudes with respect to race, based on different field. Most African-Americans have personally experienced racial discrimination in public life or at their place of employment.

A survey was conducted to study the views of the Americans regarding the responsibility of the fast food industry for consumers' weight problems. The results indicated that 89 percent Americans blamed consumers rather than the fast food industry for the health problems faced by the obese people.

A survey was conducted to find the degree of sympathy for Martha Stewart among Americans. According to the Gallup survey 2003, only 34% of Americans have some sympathy for her and most Americans believe that she obstructed the federal investigation and so they are left with no sympathy for her.

An analysis of non-retired households income is conducted. Households depending on the husband's earnings have a higher income level than the one depending on the wife's earnings.

The frequency of Americans dining out in a restaurant depending on their household income and age is analyzed. The people living in higher-income households eat out more often than those in lower-income households do while as per age young adults dine out more often than adults who in their peak earning years dine out more lavishly.

The result of a poll suggests that upper-income Americans are more likely to use money management tools than the rest of the public. Although it's the wealthy that have the means to manage their incomes it is the less-than-wealthy who really need it.

The Gallup's annual economy and finances poll conducted revealed that retirees are less likely than non-retired persons to indicate having financial strain in their lives. Their direct exposure to the stock market is limited, and half of retirees rely on social security as major income source.

The data of Gallup poll on the views of American on the economy and economic approval rating for the President for the year 1991 is compared with that of the year 2003. Americans are giving President George Bush higher approval rating for his handling of the economy than his father George H.W. Bush.

A Gallup survey conducted reveals that the consumer confidence was higher before the war. This is because the impact of economy affected the consumerEs attitudes at the time of national crisis.

The Gallup poll on the presidential election conducted found that the Connecticut Senator Joe Lieberman holds a slight edge over the field of nine Democratic candidates that will meet in the South Caroline. The same poll shows that U.S. president George W. Bush is in a stronger position against the Democrats in the general election.

Al-Jazeera is the predominant news station in the Arab countries that is independent of the government and employs with a wide variety of backgrounds. A Gallup poll conducted of nine predominant Islamic countries found that the attitudes of the viewers of Al-Jazeera are different from other though it is not possible to state that it is due to the type or style of news presented on Al-Jazeera.

A survey was conducted to find the public opinions about invading Iraq. The Gallup polling indicates that Americans have fairly high tolerance for U.S. casualties in a potential war with Iraq to a certain point and if the estimated number of casualties reaches 5,000 then majority of Americans would oppose invading Iraq with U.S. ground troops.

The Gallup 2002 Islamic study shows a common thread of negative feelings towards the west held by the Islamic and Arab communities as a whole. Although the conclusions cannot be drawn from the data recovered, it is clear that the perception of the West is unfair towards the entire Arab and Islamic populations.

The Gallup conducted a poll to evaluate the amount of trust the Americans have in the federal government, the media and the American public to perform its role in the democratic process. The Americans expressed a great deal of confidence in the American people whereas the media is trusted the least.

The Phi Delta Kappa/Gallup survey suggested that Americans welcome the increased federal involvement in local education. Nearly 96% of Americans believe that public school teachers should take statewide competency, before being licensed.

A nationwide survey was conducted by Gallup to find public opinion about the use of hormone replacement therapy (HRT) and their perceptions of its risks. A federally funded study of HRT was aborted when researchers determined that the therapy was associated with the risk of breast cancer.

A Gallup poll conducted to find whether the Americans understand United States considering new military action against Iraq revealed that majority of them understand while 44% are uncertain of the reasons involved. The Americans find both Iraq and Saddam Hussein quite objectionable and majority of Americans support a new military incursion in Iraq.

The poll conducted to determine the reaction of smokers to anti-smoking policies revealed that 39% of smokers feel unjustly discriminated by the regulations while 58% feel restrictions are justified. USA Today reported that at present there is 15 states that approved cigarette tax increases while the results revealed that 68% smokers feel unjustly discriminated by increase in tax.

The issue of abortion that took place in United States has withheld funding for population control programs are illustrated. Gallup's polling on abortion finds some evidence that Americans are sympathetic to the pro-choice side, with the majority saying abortion laws should remain as they are or be loosened, rather than tightened.