Protecting my injured child: a qualitative study of parents' experience of caring for a child with a displaced distal radius fracture

BACKGROUND: Childhood fractures can have a significant impact on the daily lives of families affecting children’s normal activities and parent’s work. Wrist fractures are the most common childhood fracture. The more serious wrist fractures, that can look visibly bent, are often treated with surgery to realign the bones; but this may not be necessary as bent bones straighten in growing children. The children’s radius acute fracture fixation trial (CRAFFT) is a multicentre randomised trial of surgery versus a cast without surgery for displaced wrist fractures. Little is known about how families experience these wrist fractures and how they manage treatment uncertainty. This study aimed to understand families’ experience of this injury and what it is like to be asked to include their child in a clinical trial. METHODS: Nineteen families (13 mothers, 7 fathers, 2 children) from across the UK participated in telephone interviews. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. RESULTS: Our findings highlight parents’ desire to be a good parent through the overarching theme “protecting my injured child”. To protect their child after injury, parents endeavoured to make the right decisions about treatment and provide comfort to their child but they experienced ongoing worry about their child’s recovery. Our findings show that parents felt responsible for the decision about their child’s treatment and their child’s recovery. They also reveal the extent to which parents worried about the look of their child’s wrist and their need for reassurance that the wrist was healing. CONCLUSION: Our findings show that protecting their child after injury can be challenging for parents who need support to make decisions about treatment and confidently facilitate their child’s recovery. They also highlight the importance of providing information about treatments, acknowledging parents’ concerns and their desire to do the right thing for their child, reassuring parents that their child’s wrist will heal and ensuring parents understand what to expect as their child recovers

Abundance estimates for sperm whales in the Mediterranean Sea from acoustic line-transect surveys

Open access journal. This is the author accepted manuscript. The final version is available from the International Whaling Commission via the URLs in this record.The Mediterranean sub-population of sperm whales is believed to be isolated and is classified as Endangered on the IUCN Red List. Although there is evidence to suggest the population is declining, there is a lack of abundance data. A series of acoustic line-transect surveys to estimate abundance were conducted between 2004 and 2013. In 2004, 3,946km of acoustic effort was conducted in the southern Western Mediterranean basin, resulting in the detection of 159 sperm whales. While in 2007 and 2013, 10,276km of acoustic effort was conducted in the Eastern Mediterranean basin, resulting in the detection of 24 sperm whales. A pooled detection function gave an effective strip half-width of 9.8km. A correction for availability bias was made for each block based on published simulations using data on sperm whale acoustic behaviour: estimates of g(0) were 0.95-0.96. Estimated abundances were: Southern Western Mediterranean block 634 animals [374-1,077] (95% log-normal confidence interval), Hellenic Trench block 41 [17-100], Central Aegean Sea block 33 [5-203], Herodotus Rise block 5 [1-28] and Southern Adriatic Sea block 2 [0-12], estimates for all other blocks were zero. The density of sperm whales in the surveyed Southern Western Mediterranean block was over 17 times higher than for the surveyed Eastern Mediterranean (2.12 and 0.12 whales per 1,000km² respectively). These results, combined with an acoustic survey of the northern Ionian Sea in 2003 and aerial surveys in the northern Western Mediterranean basin in 2010-11, covered approximately 57% of the likely sperm whale habitat in the Western Mediterranean and 75% in the Eastern Mediterranean. Approximate total estimates of sperm whale abundance in the Western and Eastern Mediterranean basins based on extrapolation to the unsurveyed areas are 1,678 and 164 whales respectively. This gives an estimate for the whole Mediterranean Sea of 1,842 animals.The research presented in this paper was conducted and funded by the International Fund for Animal Welfare

Challenges to concordance: theories that explain variations in patient responses

Failing to establish a collaborative relationship between patient and health professional can be a significant obstacle to recovery. Julie Green and Rebecca Jester delve into the psychology behind patient responses and present methods to empower patients.This article was first published in the British Journal of Community Nursing, volume 24, issue 10.Published versio

Analytical nonlinear reluctance model of a single-phase saturated core fault current limiter

A saturated core fault current limiter (FCL) is a device that is designed to limit the fault currents in electrical energy networks and consequently, protect existing network equipment from damage. Due to complex nonlinear magnetic properties, the performance of saturated core FCLs has largely been characterized through experimentation and finite-element analysis simulations. Although both of these techniques are quite accurate, they are time consuming and do not describe the behavior of FCLs in actual electrical networks. This has led to an increasing demand for an accurate analytical model that is suitable for transient network analyses. This paper presents the development of an analytical model of a single-phase open-core FCL, which accurately describes the nonlinear magnetic properties of the FCL through a reduced reluctance approach. The extension of this model to other saturated core FCL arrangements (such as closed core) is also discussed. © 1986-2012 IEEE

Don’t forget the humanitarian paradox at home

van Tulleken talks of the humanitarian paradox, but let’s not overstate it—the efforts of healthcare providers do not always exacerbate the problem of refugee camps. The basic healthcare provided in refugee camps in Europe is unlikely to have attracted many of the 1.2 million people who arrived in 2015, most fleeing conflict zones.2 Nor has healthcare provision been the motive for other European states to refuse refugees; their borders closed efore healthcare arrived. Healthcare is not the solution to Europe’s collective failure to adequately accommodate refugees, but neither is it part of the problem. Medical humanitarian organisations working in the field are well attuned to their dual role in healthcare and advocacy. Doctors considering donating time or funds to organisations working for Europe’s refugees should not be put off by fear of paradox

Don’t forget the humanitarian paradox at home

van Tulleken talks of the humanitarian paradox, but let’s not overstate it—the efforts of healthcare providers do not always exacerbate the problem of refugee camps. The basic healthcare provided in refugee camps in Europe is unlikely to have attracted many of the 1.2 million people who arrived in 2015, most fleeing conflict zones.2 Nor has healthcare provision been the motive for other European states to refuse refugees; their borders closed efore healthcare arrived. Healthcare is not the solution to Europe’s collective failure to adequately accommodate refugees, but neither is it part of the problem. Medical humanitarian organisations working in the field are well attuned to their dual role in healthcare and advocacy. Doctors considering donating time or funds to organisations working for Europe’s refugees should not be put off by fear of paradox