A study into the effectiveness of an education programme for parents and teachers

Introduction: Parents and teachers lack knowledge and self-efficacy when providing postural care to physically disabled children. This can act as a barrier to the successful implementation of therapy. An intervention was developed to improve knowledge and confidence in providing postural care. The aim is to determine whether this intervention improves parents’ and teachers’ knowledge and confidence. Participants and Methods: The intervention includes a 2-hour interactive workshop and follow-up home/school visits delivered in three localities across the south-east of England. The UKC-PostCarD scale, which assesses levels of knowledge and confidence in providing postural care, was used to evaluate the intervention. It is completed at baseline and after the intervention is completed. Focus groups with participants will provide insight into elements that were effective/ineffective.Interviews with children will provide their perspective. Interviews with therapists will consider the feasibility and acceptability of delivery. Results: A mixed-design ANOVA 2 (Time: before vs. after) 9 3 (Area:Kent, Sussex, Surrey) will be used to determine whether knowledge and confidence improved following the intervention. Framework analysis will be used for the focus group and interview data. Qualitative findings will be fed into the overall evaluation. Results will be available by September 2013. Conclusion: If shown to improve confidence and knowledge, we will make this education programme available nationally

POSTED - general questionnaire

This questionnaire is concerned with carers experiences of daytime postural care. This questionnaire may be completed by anyone with experience of providing postural care to a child with a physical disability in a school and/or home environment. This includes parents, teachers and teaching assistants. It is likely that information, training and support needs vary considerably from one person to the next – due to the needs of the child, the type of equipment used, or the environment in which postural care is provided. This questionnaire was developed to enable parents, teachers, and teaching assistants to highlight specific aspects of postural care that they find challenging in order that information, training and support may be appropriately targeted. The questionnaire was originally designed for use in research commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (grant reference number PB‐PG‐ 0110‐21045). When using/referring to this questionnaire please acknowledge authorship as appropriate. Details of the development of the questionnaire can be found in the following publication. Hotham, S., Hutton, E. & Hamilton‐West, K. E. (2015) Development of a reliable, valid measure to assess parents' and teachers' understanding of postural care for children with physical disabilities: the (UKC‐PostCarD) questionnaire. Child: Care, Health and Development, 41, 1172– 1178

A study into the effectiveness of a postural care education programme aimed at improving self-efficacy in carers of children with physical disabilities

Background & Aim: Parents and teachers lack knowledge and self-efficacy when providing postural care to physically disabled children. This can act acts as a barrier to the successful implementation of therapy. An intervention was developed to improve knowledge and confidence in providing postural care. The aim is to determine whether this intervention improves parents’ & teachers’ knowledge & confidence. Methods. The intervention includes a 2-hour interactive workshop and follow-up home/school visits delivered in three localities across the South-East. The UKC-PostCarD scale assesses levels of knowledge and confidence in providing postural care was utilised to evaluate the intervention. This will be completed at baseline and after the intervention is completed. Focus groups with participants will provide insight into elements that were effective/ineffective. Interviews with children will provide an end user perspective. Interviews with therapists will consider the feasibility and acceptability of delivery. Analysis: A mixed-design ANOVA 2 (Time: before vs. after) x 3 (Area: Kent, Sussex, Surrey) will be used to determine whether knowledge and confidence improved following the intervention. Framework analysis will be used for the focus group and interview data. Qualitative findings will be fed into the overall evaluation. Findings: Analysis of data will begin in June 2013 and findings will be available in September 2013. Discussion. If shown to improve confidence and knowledge, we hope to make this education programme available regionally and nationally. As more physically disabled children attend mainstream schools this will be a timely and useful resource

Understanding the support needs of disabled children and their families in East Kent

Objective: Explore the support needs of parents and carers of children with physical disabilities (< 18 years) within a therapy service in the South East of England. Method: Qualitative methods were used including focus groups and interviews with 9 parents/carers of children with a physical disability. Framework analysis approach was used to analyse the data. Results: Data was organised into the following themes. • Parent and carer experiences of using services including direct experience of therapy services • Education • Organisation of services and access to information • Impact of disability on family and carer life • Experiences and views of personalised care. Conclusions: Parents and carers had varied experiences of therapy services. Parents and carers valued close relationships established over time when therapists had knowledge and understanding of their child and family situation. Families experienced most difficulty over the provision of equipment and poor liaison between different parts of the care system added to stress and frustration. Few parents and carers had knowledge or awareness of personal health budgets and were unsure about whether a personal budget would improve their access to or experience of therapy

Impact of a community-based pilot intervention to tackle childhood obesity: a ‘whole-system approach’ case study

Background Go-Golborne was a three-year pilot programme to test an innovative, community-based ‘whole system’ approach to preventing overweight in children in Golborne ward, London. Whilst there is a growing interest in local whole systems approaches to obesity, understandings of what they look like in practice are newly emerging. Go-Golborne was designed, implemented and evaluated within this context. Methods The evaluation used a case-study design and theory of change approach to assess the effectiveness of the intervention. Height/weight measurements of children in the six participating primary schools were recorded annually for 4 years. For behavioural outcomes, children aged six-11 completed four annual on-line surveys (total 4331 responses). Parents were surveyed in year one and year four (177 responses). Three focus group discussions were held with children aged 10–11 (N = 21); interviews were conducted with parents (N = 11), and school representatives (N = 4). Stakeholders were surveyed twice (37 responses), and interviews were conducted with key stakeholders (N = 11). An extensive range of programme documents were reviewed and additional process data was collected from the programme team. The RE-AIM framework was used to synthesise findings and examine public health impact. Results Go-Golborne reached a diverse range of partners across Golborne. Events were attended by over 3360 local children and families and all six primary schools in the ward actively engaged in activities. The proportion of children in the above healthy weight categories remained stable over time. A number of changes in home, school and neighbourhood environments to support healthy behaviour change were evidenced. There was some qualitative evidence of positive changes in children’s behaviours, though significant or sustained changes were not evidenced by the quantitative data. Conclusions Go-Golborne helped stakeholders and parents to develop a shared commitment to improving healthy weight in children, to identify barriers to a healthy lifestyle, and to start to make changes in their services/behaviours. The campaigns and changes made at micro-level appeared to be insufficient, in the face of counteracting forces and personal factors, to achieve significant behaviour change within 3 years. This highlights the need for local initiatives to be reinforced by supporting action at regional, national and global levels

Experience of care for Parkinson's disease in European countries: A survey by the European Parkinson's Disease Association

Background: Few studies report on experience of care for Parkinson’s disease (PD) from patients’ own point of view. Methods: Analysis of a survey in 11 European countries on self-reported access to services and satisfaction with different aspects of care. Results: 1,775 people with PD (PwP) participated with disease duration ranging from <1 to 42 years. Initial referral to specialists had taken <3 months in most but medication reviews occurred every 3 months in only 10%, every 6 months in 37%, once a year in 40%, and every two years or less frequently in 13%. Waiting times to therapists were usually at ?4 months. Satisfaction with care was highest for involvement of PwP in decisions (63% of respondents satisfied) and involvement of family/carer (62%) followed by communication with PwP (57%), information received (54%), frequency of treatment reviews (52%), suitability of treatment for the individual condition and circumstances (52%), but lowest for availability and accessibility of treatment when needed (48%) and collaborations between healthcare professionals in delivering care (41% satisfied). The main factors associated with overall satisfaction scores with care were the overall satisfaction with initial consultation (r=0.26, p<0.0001), the sensitivity with which the diagnosis was communicated, the quantity of information provided (both r=0.24, p<0.0001) and the frequency of medication review (r=0.17, p<0.0001). Conclusion: More coordinated and responsive care, tailored to the individual, with regular and timely medication reviews and treatment referrals, is likely to improve satisfaction with care in current health care pathways

Vomocytosis of live pathogens from macrophages is regulated by the atypical MAP kinase ERK5

Vomocytosis, or non-lytic extrusion, is a poorly understood process through which macrophages release live pathogens that they have failed to kill back into the extracellular environment. Vomocytosis is conserved across vertebrates and occurs with a diverse range of pathogens, but to date the host signaling events that underpin expulsion remain entirely unknown. Here we use a targeted inhibitor screen to identify the MAP-kinase ERK5 as a critical suppressor of vomocytosis. Pharmacological inhibition or genetic manipulation of ERK5 activity significantly raises vomocytosis rates in human macrophages whilst stimulation of the ERK5 signaling pathway inhibits vomocytosis. Lastly, using a zebrafish model of cryptococcal disease, we show that reducing ERK5 activity in vivo stimulates vomocytosis and results in reduced dissemination of infection. ERK5 therefore represents the first host regulator of vomocytosis to be identified and a potential target for the future development of vomocytosis-modulating therapies

What influences people's responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations

BACKGROUND: Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond. OBJECTIVE: To synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people's responses to messages. DESIGN: A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704. DATA SOURCES: Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020. STUDY SELECTION: All study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded. SYNTHESIS: Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging. RESULTS: Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility. DISCUSSION: There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics

Naturopaths practice behaviour: provision and access to information on complementary and alternative medicines

BACKGROUND: The increasing use of complementary and alternative medicines in Australia has generated concern regarding the information on these products available to both healthcare providers and the public. The aim of this study was to examine the practice behaviours of naturopaths in relation to both the provision of and access to information on complementary and alternative medicines (CAM). METHODS: A representative sample of 300 practicing naturopaths located nationally were sent a comprehensive survey which gathered data on self reported practice behaviour in relation to the provision of information on oral CAM to clients and the information needs of the practitioners themselves RESULTS: A response rate of 35% was achieved. Most practitioners (98%) have a dispensary within their clinic and the majority of practitioners perform the dispensing themselves. Practitioners reported they provided information to clients, usually in the form of verbal information (96%), handwritten notes (83%) and printed information (75%). The majority of practitioners (over 75%) reported always giving information on the full name of the product, reason for prescribing, expected response, possible interactions and contraindications and actions of the product. Information resources most often used by practitioners included professional newsletters, seminars run by manufacturers, patient feedback and personal observation of patients. Most practitioners were positive about the information they could access but felt that more information was required in areas such as adverse reactions and safe use of CAM in children, pregnancy and breastfeeding. Most naturopaths (over 96%) were informed about adverse events through manufacturer or distributor newsletters. The barriers in the provision of information to clients were misleading or incorrect information in the media, time constraints, information overload and complex language used in printed information. The main barrier to the practitioner in information access was seen as the perceived division between orthodox and complementary medicine practitioners. CONCLUSION: Our data suggest most naturopaths were concerned about possible interaction between pharmaceuticals and CAM, and explore this area with their patients. There is scope to improve practitioners' access to information of adverse events including an increased awareness of sources of information such as the Australian Therapeutic Goods Administration (TGA) website