Randomised controlled trial of a multimedia-based parenting intervention for the prevention of burn injuries in pre-school children

Childhood burn injuries are a leading cause of death and disability worldwide and a major public health concern. Children younger than five years of age are more at risk. Majority of burn incidents occur as accidents within the home. Poor parental burn hazard perception and knowledge of burns first aid have been reported. This PhD project aimed to determine whether a targeted preventative parenting intervention ‘Toddler-safe’ improved parental burns safety and first aid knowledge and behaviour in the home, and reduced the risk of future childhood burns. A systematic review of the literature was undertaken to assess the effectiveness of parenting interventions at preventing unintentional injuries in pre-school children. The review found that parenting interventions that provided home visitation, education, and free/discounted safety devices, delivered on a one-to-one basis, during the perinatal or early postnatal period, were associated with significantly fewer childhood injuries, and improvements in parental safety knowledge and practices. However, there was a lack of prevention intervention research specifically for burn injuries in children under the age of five. Findings from the systematic review informed the design and methodology of the Toddler-Safe study. Toddler-Safe was conducted as a randomised controlled trial. One hundred and fifty six parents allocated to the intervention arm of the trial received an intervention consisting of a burns safety and first aid video, and an injury safety leaflet. An equal number of controls received only the injury safety leaflet. The study was evaluated using pre- and post-test questionnaires. Outcome measures included first aid knowledge and burns prevention, knowledge, attitude, and practices; and parent-reported or medically attended injuries. Just over half of the study participants were available for follow-up at six months. Non-responders were found to be younger and from lower socioeconomic backgrounds. Toddler-Safe was not effective at improving parental burns prevention and first aid knowledge, attitudes, and practices at ii follow-up. Burn injuries were reported in four children living with participating families. Participant attrition and omission of key knowledge and attitude topics from the intervention were major limitations of the study

Development of Tendering Duration Models for Federal Government Building Projects in Nigeria

The Study sought to fundamentally generate information on the relationship between tendering duration and project complexity/determinants of cost and duration in order to determine via a scientific model, realistic tendering durations of various types of federal building projects in Nigeria.  To achieve this, historical data on project cost, project duration and tendering duration were obtained for 78 federal building projects.  They were subjected to correlation and regression analysis to test for statistical significance and the relationship between tendering duration and cost variables. Results of the regression analysis revealed that there is a significant relationship between tendering duration and project cost, which can be seen from the strong statistical correlation; R square value = 0.53 and the P(significant) values of 0.00 < alpha value ? (0.05)adopted in the study. Furthermore, a significant relationship between tendering duration and project duration was revealed. The statistical correlation was however observed to be higher; with R square value = 0.80 and P(sig) values < ? (0.05). Hence, the following models were developed which proved significant for the sampled projects based on the quadratic regression equation: First, the tendering duration – project cost model which is in the form; TD = 2.574 + 1.137E-9C – 5.245E-20C2, where TD is the tendering duration in weeks and C, project cost.  Second, the tendering duration-project duration model expressed as TD = 1.299 + 0.073D + 0.000D2, where D is the project duration in weeks. The study recommends that the Federal Government should formulate bidding deadlines for different categories of building projects based on complexity factors of cost and duration, via adoption of the models proposed by the study. This will promote standards, efficiency in project planning, achievement of fairness and transparency in the public tendering system. Key Words: Building Projects, Development, Federal Government, Models, Nigeria, Tendering Duration

The effectiveness and cost-effectiveness of of community diagnostic centres: a rapid review

Objectives: To examine the effectiveness of community diagnostic centres as a potential solution to increasing capacity and reducing pressure on secondary care in the UK.Methods: A comprehensive search for relevant primary studies was conducted in a range of electronic sources in August 2022. Screening and critical appraisal were undertaken by two independent reviewers. There were no geographical restrictions or limits to year of publication. A narrative synthesis approach was used to analyse data and present findings.Results: Twenty primary studies evaluating twelve individual diagnostic centres were included. Most studies were specific to cancer diagnosis and evaluated diagnostic centres located within hospitals. The evidence of effectiveness appeared mixed. There is evidence to suggest diagnostic centres can reduce various waiting times and reduce pressure on secondary care. However, cost-effectiveness may depend on whether the diagnostic centre is running at full capacity. Most included studies used weak methodologies that may be inadequate to infer effectiveness.Conclusion: Further well-designed, quality research is needed to better understand the effectiveness and cost-effectiveness of community diagnostic centres

Living alone, loneliness and lack of emotional support as predictors of suicide and self-harm: A nine-year follow up of the UK Biobank cohort

Background: The association between loneliness and suicide is poorly understood. We investigated how living alone, loneliness and emotional support were related to suicide and self-harm in a longitudinal design. Methods: Between 2006 and 2010 UK Biobank recruited and assessed in detail over 0.5 million people in middle age. Data were linked to prospective hospital admission and mortality records. Adjusted Cox regression models were used to investigate relationships between living arrangements, loneliness and emotional support, and both suicide and self-harm as outcomes. Results: For men, both living alone (Hazard Ratio (HR) 2.16, 95%CI 1.51-3.09) and living with non-partners (HR 1.80, 95%CI 1.08-3.00) were associated with death by suicide, independently of loneliness, which had a modest relationship with suicide (HR 1.43, 95%CI 0.1.01-2.03). For women, there was no evidence that living arrangements, loneliness or emotional support were associated with death by suicide. Associations between living alone and self-harm were explained by health for women, and by health, loneliness and emotional support for men. In fully adjusted models, loneliness was associated with hospital admissions for self-harm in both women (HR 1.89, 95%CI 1.57-2.28) and men (HR 1.74, 95%CI 1.40-2.16). Limitations: Loneliness and emotional support were operationalized using single item measures. Conclusions: For men - but not for women - living alone or living with a non-partner increased the risk of suicide, a finding not explained by subjective loneliness. Overall, loneliness may be more important as a risk factor for self-harm than for suicide. Loneliness also appears to lessen the protective associations of cohabitation