Parents’ views on preparation to care for extremely premature infants at home.

Aim: To gain insight into the post-discharge experiences of parents in relation to the adequacy of preparation for caring for their extremely premature infant at home. Method: A narrative approach was drawn on to facilitate data collection, via face-to-face semi-structured interviews, with fourteen parents of extremely premature infants. Findings: Constant comparative analysis was employed to allow the emergence of five key research themes: Emotional and mental health of parents; uncertain outcomes; on-going health needs of the baby; education needs of health professionals; parental support and preparation for transition home. Conclusion: Parental experience of being discharged home with a premature baby can be emotionally challenging necessitating a range of support mechanisms to assist them to cope with this period of transition

The forgotten mothers of extremely preterm babies : A qualitative study

© 2019 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons LtdAims and objectives: To explore the experiences of mothers of extremely prematurebabies during their Neonatal Intensive Care Unit stay and transition home. Background: Mothers of extremely preterm infants (28 weeks’ gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home. Method: An interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi‐structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six‐phase thematic analysis approach. The COREQ checklist has been used. Results: Two main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events. Conclusion: The mothers were at high risk of developing post‐traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home. Relevance to Clinical Practice: This study highlights the need for nurses to include a focus on the mothers’ psychosocial needs. Supporting maternal mental health both improves maternal well‐being and enables mothers to be emotionally available and responsive to their extremely preterm infant.Peer reviewe

The transition home of extremely premature babies: An integrative review

© 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.Taking a premature baby home after an often-protracted period on the neonatal unit can be stressful for parents and they are often confronted with an unexpected reality. The transition to motherhood and parenthood has occurred in the neonatal unit, under the watchful eye of neonatal nurses. When the baby goes home, parents are expected to take on the full-time caregiving role of a baby who may require around the clock care with medications, home oxygen, feeding issues and monitoring. The level of preparation for the transition home of the premature baby can impact on how the family survives and thrives. It is not surprising that parents may find this challenging because the growth and development trajectory of extremely premature babies can be markedly different from a term infant requiring tailored support to meet. This article is an integrative review of the literature focusing on parents’ experience of transitioning home from a neonatal unit with a premature baby. Six themes were identified, and an analysis is presented: namely, transition, unique needs of premature babies, discharge preparation and readiness, Discharge learning content, maternal mental health and the role of the neonatal nurse in transition.Peer reviewe

Enhancing access to parenting services using digital technology supported practices

Background: Early parenting services (EPS) in Australia provide a range of expanding and rapidly changing services, including innovative digital technologies to improve service access for metropolitan and rural families. Aim: This research aims to provide comprehensive information required for the planning, implementation and evaluation of the use of digital technologies for service delivery with parenting/child and family services in Australia and New Zealand in metropolitan and rural settings. Methods: An interpretive descriptive approach was applied using semi-structured interviews from 23 EPS practitioners and managers in five sites. Findings: These are presented as five main themes – preparing the way, practitioner qualities, benefits of using technology, presenting challenges, and management and professional development requirements. The findings have provided recommendations for the ongoing work in this area, the recruitment of new employees, and ongoing professional development and planning of services using digital supported technologies. Conclusion: This study has explored the experiences of both practitioners and managers, with a positive response despite navigating the initial and ongoing challenges that can occur with technology and internet capabilities. The use of digital technologies has significant benefits for rural and remote families due to many not having easy access to parenting services locally

The approaches Hong Kong Chinese mothers adopt to teach their preschool children to prevent influenza: a multiple case study at household level

Abstract Background: In Hong Kong, the population is at risk of seasonal influenza infection twice a year. Seasonal influenza is significantly associated with the increased hospitalization of children. Maintaining personal hygiene and vaccination are the most effective measures to prevent influenza infection. Research demonstrates a positive relationship between the health practices applied by parents and the behaviour of their children highlighting the importance of parental heath education. However, there is minimal research that provides an understanding of how Hong Kong Chinese parents teach their children to prevent seasonal influenza. Methods: Mixed methods research was undertaken that employed a multiple-case study approach to gain an understanding of parental teaching practices regarding seasonal influenza prevention. Purposive intensity sampling was adopted to recruit twenty parents and their healthy children. A thematic analysis was employed to examine the qualitative interview data and the quantitative survey data were examined descriptively. These data were then integrated to provide a more rigorous understanding of parental teaching strategies. Comparisons were made across cases to reveal commonalities and differences. Results: Five major themes were identified: processes parents used to teach personal hygiene; parent-child interaction during teaching; approaches to managing children's health behaviours; enhancing children's healthy practices; and parents' perspective of the role of the nurse in health promotion. Conclusions: This study provided valuable insight into the approach of Hong Kong Chinese parents in teaching their children to prevent seasonal influenza. The results indicate that parents can be better supported to develop effective strategies to teach their preschool children hygiene practices for seasonal influenza prevention. Partnerships with community nurses can play a role in building effective parent-child interactions to enhance children's learning and adoption of healthy practices

Characteristics and co-admissions of mothers and babies admitted to residential parenting services in the year following birth in NSW:a linked population data study (2000-2012)

BACKGROUND: There is a tiered healthcare system in Australia to support maternal and child health, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in New South Wales [NSW]). RPS are unique to Australia, and currently there is limited information regarding the healthcare trajectory of women accessing RPS and if they are more likely to have admissions to other health facilities within the first-year post-birth. This study aimed to examine differences in hospital co-admissions for women and babies admitted to RPS in NSW in the year following birth compared to non-RPS admitted women. METHODS: A linked population data study of all women giving birth in NSW 2000-2012. Statistical differences were calculated using chi-square and student t-tests. RESULTS: Over the 12-year timeframe, 32,071 women and 33,035 babies were admitted to RPS, with 5191 of these women also having one or more hospital admissions (7607 admissions). The comparator group comprised of 99,242 women not admitted to RPS but having hospital admissions over the same timeframe (136,771 admissions). Statistically significant differences between cohorts were observed for the following parameters (p ≤ .001). Based upon calculated percentages, women who were admitted to RPS were more often older, Australian born, socially advantaged, private patients, and having their first baby. RPS admitted women also had more multiple births and labour and birth interventions (induction, instrumental birth, caesarean section, epidural, episiotomy). Their infants were also more often male and admitted to Special Care Nursery/Neonatal Intensive Care. Additionally, RPS admitted women had more admissions for mental health and behavioural disorders, which appeared to increase over time. There was no statistical difference between cohorts regarding the number of women admitted to a psychiatric facility; however, women attending RPS were more likely to have mood affective, or behavioural and personality disorder diagnoses. CONCLUSION: Women accessing RPS in the year post-birth were more socially advantaged, had higher birth intervention and more co-admissions and treatment for mental health disorders than those not accessing RPS. More research is needed into the impact of birth intervention and mental health issues on subsequent parenting difficulties

Equity-Oriented Conceptual Framework for K-12 STEM Literacy

We introduce a conceptual framework of K-12 STEM literacy that rightfully and intentionally positions each and every student, particularly minoritized groups, as belonging in STEM. In order to conceptualize the equity-based framework of STEM literacy, we conducted a systematic review of literature related to STEM literacy, which includes empirical studies that contribute to STEM literacy. The literature on the siloed literacies within STEM (i.e., science, technology, engineering, and mathematics literacy) also contributed to formulate the necessity of and what it means to develop STEM literacy. The Equity-Oriented STEM Literacy Framework illuminates the complexities of disrupting the status quo and rightfully transforming integrated STEM education in ways that provide equitable opportunities and access to all learners. The Equity-Oriented STEM Literacy Framework is a research-based, equity and access-focused framework that will guide research, inform practice, and provide a lens for the field that will ensure each and every student, especially minoritized students, develop, and are developing STEM literacy

The Patent Troll Business: An Efficient model to enforce IPR?

Patent trolls have many faces, since the media uses this expression in various ways. The patent troll phenomenon thus seems to be an ambiguous term that is discussed in several directions. This paper reveals that a patent troll as such has no distinct shape or appearance. Our analysis redeems a troll classification solely from firms’ market position, such as being non-practicing, and shows that a patent troll business can only be defined by the respective activities to enforce IPR. Using 10 cases, of which five are treated in detail, the analysis reveals a distinct typology of the troll business. This paper is furthermore able to identify troll behavior to be: a) an efficient mechanism to enforce IP rights and b) a strategy that yields excessive license fees and causes inefficient negotiation costs

EMPOWERED trial: protocol for a randomised control trial of digitally supported, highly personalised and measurement-based care to improve functional outcomes in young people with mood disorders

Objectives: Many adolescents and young adults with emerging mood disorders do not achieve substantial improvements in education, employment, or social function after receiving standard youth mental health care. We have developed a new model of care referred to as ‘highly personalised and measurement-based care’ (HP&MBC). HP&MBC involves repeated assessment of multidimensional domains of morbidity to enable continuous and personalised clinical decision-making. Although measurement-based care is common in medical disease management, it is not a standard practice in mental health. This clinical effectiveness trial tests whether HP&MBC, supported by continuous digital feedback, delivers better functional improvements than standard care and digital support. Method and analysis: This controlled implementation trial is a PROBE study (Prospective, Randomised, Open, Blinded End-point) that comprises a multisite 24-month, assessor-blinded, follow-up study of 1500 individuals aged 15–25 years who present for mental health treatment. Eligible participants will be individually randomised (1:1) to 12 months of HP&MBC or standardised clinical care. The primary outcome measure is social and occupational functioning 12 months after trial entry, assessed by the Social and Occupational Functioning Assessment Scale. Clinical and social outcomes for all participants will be monitored for a further 12 months after cessation of active care. Ethics and dissemination: This clinical trial has been reviewed and approved by the Human Research Ethics Committee of the Sydney Local Health District (HREC Approval Number: X22-0042 & 2022/ETH00725, Protocol ID: BMC-YMH-003-2018, protocol version: V.3, 03/08/2022). Research findings will be disseminated through peer-reviewed journals, presentations at scientific conferences, and to user and advocacy groups. Participant data will be deidentified. Trial registration number: ACTRN12622000882729