Increasing Participation and Improving Engagement in Home Visitation: A Qualitative Study of Early Head Start Parent Perspectives

Home visitation programs are designed to provide comprehensive services that promote parents’ abilities to create stable, nurturing care environments for their children. In order for program goals to be met, parents must participate actively and be engaged with the programs’ mission. However, promoting engagement and participation are complex processes that have been understudied in research on home visitation. The current qualitative study examined how a national, federally funded home visitation program, Early Head Start (EHS), engaged and retained families so that potentially helpful preventative interventions could be delivered. The study also identified barriers to active engagement. Semistructured interviews were conducted with 10 parents of children enrolled in EHS. Findings suggest that engagement increased when EHS reduced social isolation by forming connections among parents and when the program focused on involving parents in fostering their children’s meeting of important developmental milestones. Barriers to engagement identified included logistical and organizational challenges as well as parental biases and differences in values and attitudes. Practice and policy recommendations for improving EHS and other programs that serve similar populations to increase engagement are discussed

Child-friendly participatory research tools

Tips for trainers: Field-based action research on community-based adaptation to climate change needs to engage with all different sections of communities. Children form a significant group that is often overlooked by research and practice at community level, in part because of a lack of appropriate action research tools. In this short piece, we describe some tools for child-friendly participatory research that were used in the Philippines

Parents talking everyday science with young children

This report is the evaluation of an early years project which was developed by members of the Cass Early Childhood Studies Research Group with funding from the 2015 UEL Civic Engagement Fund. The project aimed to encourage parents‟ confidence in their own ability to support emergent scientific thinking among their young children. The project was modelled on an early years initiative undertaken a few years ago in rural Bangladesh. The original Bangladeshi project was pioneered by Dr Sue Dale Tunnicliffe, Reader in Science Education at University College London‟s Institute of Education, and chair of CASTME, the Commonwealth Association of Science, Technology and Mathematics Educator

Economic evaluation of the OSAC randomised controlled trial:oral corticosteroids for non-asthmatic adults with acute lower respiratory tract infection in primary care

ObjectiveTo estimate the costs and outcomes associated with treating non-asthmatic adults (nor suffering from other lung-disease) presenting to primary care with acute lower respiratory tract infection (ALRTI) with oral corticosteroids compared with placebo.DesignCost-consequence analysis alongside a randomised controlled trial. Perspectives included the healthcare provider, patients and productivity losses associated with time off work.SettingFifty-four National Health Service (NHS) general practices in England.Participants398 adults attending NHS primary practices with ALRTI but no asthma or other chronic lung disease, followed up for 28 days.Interventions2× 20 mg oral prednisolone per day for 5 days versus matching placebo tablets.Outcome measuresQuality-adjusted life years using the 5-level EuroQol-5D version measured weekly; duration and severity of symptom. Direct and indirect resources related to the disease and its treatment were also collected. Outcomes were measured for the 28-day follow-up.Results198 (50%) patients received the intervention (prednisolone) and 200 (50%) received placebo. NHS costs were dominated by primary care contacts, higher with placebo than with prednisolone (£13.11 vs £10.38) but without evidence of a difference (95% CI £3.05 to £8.52). The trial medication cost of £1.96 per patient would have been recouped in prescription charges of £4.30 per patient overall (55% participants would have paid £7.85), giving an overall mean ‘profit’ to the NHS of £7.00 (95% CI £0.50 to £17.08) per patient. There was a quality adjusted life years gain of 0.03 (95% CI 0.01 to 0.05) equating to half a day of perfect health favouring the prednisolone patients; there was no difference in duration of cough or severity of symptoms.ConclusionsThe use of prednisolone for non-asthmatic adults with ALRTI, provided small gains in quality of life and cost savings driven by prescription charges. Considering the results of the economic evaluation and possible side effects of corticosteroids, the short-term benefits may not outweigh the long-term harms.Trial registration numbersEudraCT 2012-000851-15 and ISRCTN57309858; Pre-results

Children's participation in community-based disaster risk reduction and adaptation to climate change

As an emerging field, reflection and learning on community-based adaptation to climate change (CBA) and disaster risk reduction (DRR) are crucial. However, there is a danger that a focus on ‘the community’ fails to look within and understand the community itself. Children under 18 are often considered the vulnerable, passive victims of disaster events. Yet children have unique perceptions of the world in which they live, and they have the capacity to act as agents of change. In this article, we argue that widening community participation to include children is crucial for successfully tackling development issues in a changing climate. We show how child-friendly participatory methodologies and processes can enable children to take an active role in communicating their perspectives to other members of the community, tackling climate change impacts, and preventing disasters

The Pan African Thoracic Society Methods in Epidemiologic, Clinical and Operations Research Program: A story of success told through a history of publications

Objectives: Despite bearing a substantial burden of respiratory diseases, low- and middle-income countries in Africa contribute little to the research literature. Since 2007, the Pan African Thoracic Society’s Methods in Epidemiologic, Clinical, and Operations Research (PATS-MECOR) program has been working to strengthen capacity in lung health research in Africa. The aim of this study was to assess the research productivity of previous PATS-MECOR participants.Materials and Methods: A systematic review of publications attributed to past PATS-MECOR participants up until 2018 was carried out using a systematic search strategy based on their names on PubMed database.Results: A total of 210 participants drawn from 21 African countries attended PATS-MECOR between 2007 and 2016, of which more than three-quarters (76.7%) had ever published. Of the total 1673 included publications, 303 (12.7%) had multiple course attendees as coauthors. The median publication per published participant was 5 (IQR 2–13) articles. The percentages of the first author, second authors, or last authors publications were 371 (22.2%), 239 (14.3%), and 99 (5.9%), respectively. The top three journals published in were PLOS One 108 (6.6%), Lancet 80 (4.9%), and the International Journal of Tuberculosis and Lung Disease 52 (3.2%). The median citation of their publications was 11 (4–26). There was approximately a double-fold rise in the publication output of participants in their 1st year following attendance to PATS-MECOR compared to the year before the course (123, 68.0% vs. 58, 32.0%).Conclusion: The PATS-MECOR training program has been successful in research capacity building for African investigators as evidenced by a growing publication track record. There is a need to ensure sustainability and for increased collaboration and networking among the trained critical mass of researchers in the continent

Effect of oral prednisolone on symptom duration and severity in nonasthmatic adults with acute lower respiratory tract infection: a randomized clinical trial

Importance: Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence. Objective: To assess the effects of oral corticosteroids for acute lower respiratory tract infection in adults without asthma. Design, Setting, and Participants: Multicenter, placebo-controlled, randomized trial (July 2013 to final follow-up October 2014) conducted in 54 family practices in England among 401 adults with acute cough and at least 1 lower respiratory tract symptom not requiring immediate antibiotic treatment and with no history of chronic pulmonary disease or use of asthma medication in the past 5 years. Interventions: Two 20-mg prednisolone tablets (n = 199) or matched placebo (n = 202) once daily for 5 days. Main Outcomes and Measures: The primary outcomes were duration of moderately bad or worse cough (0 to 28 days; minimal clinically important difference, 3.79 days) and mean severity of symptoms on days 2 to 4 (scored from 0 [not affected] to 6 [as bad as it could be]; minimal clinically important difference, 1.66 units). Secondary outcomes were duration and severity of acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, and adverse events. Results: Among 401 randomized patients, 2 withdrew immediately after randomization, and 1 duplicate patient was identified. Among the 398 patients with baseline data (mean age, 47 [SD, 16.0] years; 63% women; 17% smokers; 77% phlegm; 70% shortness of breath; 47% wheezing; 46% chest pain; 42% abnormal peak flow), 334 (84%) provided cough duration and 369 (93%) symptom severity data. Median cough duration was 5 days (interquartile range [IQR], 3-8 days) in the prednisolone group and 5 days (IQR, 3-10 days) in the placebo group (adjusted hazard ratio, 1.11; 95% CI, 0.89-1.39; P = .36 at an α = .05). Mean symptom severity was 1.99 points in the prednisolone group and 2.16 points in the placebo group (adjusted difference, −0.20; 95% CI, −0.40 to 0.00; P = .05 at an α = .001). No significant treatment effects were observed for duration or severity of other acute lower respiratory tract infection symptoms, duration of abnormal peak flow, antibiotic use, or nonserious adverse events. There were no serious adverse events. Conclusions and Relevance: Oral corticosteroids should not be used for acute lower respiratory tract infection symptoms in adults without asthma because they do not reduce symptom duration or severity

StrategyNZ: mapping our future strategy maps - from Te Papa to the Legislative Council Chamber

This report explains the inputs, processes and outputs of the StrategyNZ workshop held in March 2011. The aim was to encourage a conversation about our long-term future. Consensus emerged that New Zealand should work to ‘create a place where talent wants to live’. See Report 12 and the workshop booklet

The politicisation of science in the Murray-Darling Basin, Australia:discussion of ‘Scientific integrity, public policy and water governance’

Many water scientists aim for their work to inform water policy and management, and in pursuit of this objective, they often work alongside government water agencies to ensure their research is relevant, timely and communicated effectively. A paper in this issue, examining 'Science integrity, public policy and water governance in the Murray-Darling Basin, Australia’, suggests that a large group of scientists, who work on water management in the Murray-Darling Basin (MDB) including the Basin Plan, have been subject to possible ‘administrative capture'. Specifically, it is suggested that they have advocated for policies favoured by government agencies with the objective of gaining personal benefit, such as increased research funding. We examine evidence for this claim and conclude that it is not justified. The efforts of scientists working alongside government water agencies appear to have been misinterpreted as possible administrative capture. Although unsubstantiated, this claim does indicate that the science used in basin water planning is increasingly caught up in the politics of water management. We suggest actions to improve science-policy engagement in basin planning, to promote constructive debate over contested views and avoid the over-politicisation of basin science

The Pan African Thoracic Society Methods in Epidemiologic, Clinical and Operations Research Program: A story of success told through a history of publications

Objectives: Despite bearing a substantial burden of respiratory diseases, low- and middle-income countries in Africa contribute little to the research literature. Since 2007, the Pan African Thoracic Society’s Methods in Epidemiologic, Clinical, and Operations Research (PATS-MECOR) program has been working to strengthen capacity in lung health research in Africa. The aim of this study was to assess the research productivity of previous PATS-MECOR participants. Materials and Methods: A systematic review of publications attributed to past PATS-MECOR participants up until 2018 was carried out using a systematic search strategy based on their names on PubMed database. Results: A total of 210 participants drawn from 21 African countries attended PATS-MECOR between 2007 and 2016, of which more than three-quarters (76.7%) had ever published. Of the total 1673 included publications, 303 (12.7%) had multiple course attendees as coauthors. The median publication per published participant was 5 (IQR 2–13) articles. The percentages of the first author, second authors, or last authors publications were 371 (22.2%), 239 (14.3%), and 99 (5.9%), respectively. The top three journals published in were PLOS One 108 (6.6%), Lancet 80 (4.9%), and the International Journal of Tuberculosis and Lung Disease 52 (3.2%). The median citation of their publications was 11 (4–26). There was approximately a double-fold rise in the publication output of participants in their 1st year following attendance to PATS-MECOR compared to the year before the course (123, 68.0% vs. 58, 32.0%). Conclusion: The PATS-MECOR training program has been successful in research capacity building for African investigators as evidenced by a growing publication track record. There is a need to ensure sustainability and for increased collaboration and networking among the trained critical mass of researchers in the continent