111 research outputs found

    “Before I was like a Tarzan. But now, I take a pause”: mixed methods feasibility study of the Naungan Kasih parenting program to prevent violence against children in Malaysia

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    Background: Despite impressive strides in health, social protection, and education, children continue to experience high rates of child maltreatment in Malaysia. This mixed-methods study assessed the feasibility of a five-session, social learning-based parenting program delivered by government staff in a community setting to reduce violence against children. Methods: Parents of children from birth to 17 years were recruited from two communities near Kuala Lumpur to participate in the government-run program called the Naungan Kasih Positive Parenting Program (“Protecting through Love” in Bahasa Melayu). Quantitative data from female caregivers (N = 74) and children ages 10–17 (N = 26) were collected along with qualitative interviews and focus groups with parents, children, and facilitators. The primary outcome was child maltreatment with secondary outcomes including neglect, positive parenting, acceptability of corporal punishment, harsh parenting, positive discipline, and child behavior problems. Multilevel Poisson regression and multilevel linear regression were conducted to compare baseline and post-test outcomes. Qualitative interviews and focus groups examined how participants experienced the program utilizing a thematic analysis approach. Results: Quantitative analyses found pre-post reductions in overall child maltreatment, physical abuse, emotional abuse, attitudes supporting corporal punishment, parent sense of inefficacy, and child behavior problems. There were no reported changes on positive and harsh parenting, parental mental health, and marital satisfaction, nor were there any other significant changes reported by children. Qualitative findings suggested that the program had tangible benefits for female caregivers involved in the program, with the benefits extending to their family members. Conclusions: This feasibility study is one of the few studies in Southeast Asia that examined the feasibility and initial program impact of a parenting program delivered by government staff to families with children across the developmental spectrum from birth to 17 years. Promising results suggest that the program may reduce child maltreatment across a range of child ages. Findings also indicate areas for program improvement prior to further delivery and testing, including additional training and content on sexual and reproductive health, parenting children with disabilities, and online child protection

    Impact of anti-inflammatories, beta-blockers and antibiotics on leaf litter breakdown in freshwaters

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    Pharmaceuticals are now recognised as important pollutants in freshwater systems but a shortcoming of effects studies is that they have focused on structural endpoints and impacts on ecosystem functioning are poorly understood. The decomposition of organic matter is an important functional process in aquatic systems and it is known that this can be impacted by the presence of pollutants. Previous studies on leaf litter breakdown have only considered the effects of antibiotics and not other groups of drugs though. The current study investigated the effects of anti-inflammatories, a beta-blocker and an antibiotic on microbially mediated breakdown of leaf litter in the laboratory, colonisation of leaf packs by benthic macroinvertebrates when placed in a stream and shredding of leaf litter by these organisms. Furthermore, the effects of single compounds relative to their mixture were assessed. It was found that exposure of leaf litter to the study compounds did not influence its breakdown by microbes in the laboratory or macroinvertebrates in a stream. Exposure of leaf litter to pharmaceuticals also had no effect on its colonisation by macroinvertebrates in this study. Many unknowns remain, however, and further studies of the effects of pharmaceuticals on structural and functional endpoints are needed to aid aquatic conservation

    Flemish network on rare connective tissue diseases (CTD): patient pathways in systemic sclerosis. First steps taken.

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    peer reviewedDespite the low prevalence of each rare disease, the total burden is high. Patients with rare diseases encounter numerous barriers, including delayed diagnosis and limited access to high-quality treatments. In order to tackle these challenges, the European Commission launched the European Reference Networks (ERNs), cross-border networks of healthcare providers and patients representatives. In parallel, the aims and structure of these ERNs were translated at the federal and regional levels, resulting in the creation of the Flemish Network of Rare Diseases. In line with the mission of the ERNs and to ensure equal access to care, we describe as first patient pathways for systemic sclerosis (SSc), as a pilot model for other rare connective and musculoskeletal diseases. Consensus was reached on following key messages: 1. Patients with SSc should have multidisciplinary clinical and investigational evaluations in a tertiary reference expert centre at baseline, and subsequently every three to 5 years. Intermediately, a yearly clinical evaluation should be provided in the reference centre, whilst SSc technical evaluations are permissionably executed in a centre that follows SSc-specific clinical practice guidelines. In between, monitoring can take place in secondary care units, under the condition that qualitative examinations and care including interactive multidisciplinary consultations can be provided. 2. Patients with early diffuse cutaneous SSc, (progressive) interstitial lung disease and/or pulmonary arterial hypertension should undergo regular evaluations in specialised tertiary care reference institutions. 3. Monitoring of patients with progressive interstitial lung disease and/or pulmonary (arterial) hypertension will be done in agreement with experts of ERN LUNG
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