Comparison of family centered care with family integrated care and mobile technology (mFICare) on preterm infant and family outcomes: a multi-site quasi-experimental clinical trial protocol.

BackgroundFamily Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes.MethodsThis exploratory multi-site quasi-experimental study will compare usual FCC with mobile enhanced FICare (mFICare) on growth and clinical outcomes of preterm infants born at or before 33 weeks gestational age, as well as the stress, competence and self-efficacy of their parents. The feasibility and acceptability of using mobile technology to gather data about parent involvement in the care of preterm infants receiving FCC or mFICare as well as of the mFICare intervention will be evaluated (Aim 1). The effect sizes for infant growth (primary outcome) and for secondary infant and parent outcomes at NICU discharge and three months after discharge will be estimated (Aim 2).DiscussionThis study will provide new data about the implementation of FICare in the US context within various hospital settings and identify important barriers, facilitators and key processes that may contribute to the effectiveness of FICare. It will also offer insights to clinicians on the feasibility of a new mobile application to support parent-focused research and promote integration of parents into the NICU care team in US hospital settings.Trial registrationClinicalTrials.gov, ID NCT03418870. Retrospectively registered on December 18, 2017

Evaluating the implementation of a mental health referral service "Connect to Wellbeing": a quality improvement approach

There is increasing demand for mental health services to be accessible to diverse populations in flexible, yet, cost-effective ways. This article presents the findings from a study that evaluated the process of implementing Connect to Wellbeing (CTW), a new mental health intake, assessment and referral service in regional Australia, to determine how well it improved access to services, and to identify potential measures that could be used to evaluate value for money. The study used a hybrid study design to conduct a process evaluation to better understand: the process of implementing CTW; and the barriers and factors enabling implementation of CTW. In addition, to better understand how to measure the cost-effectiveness of such services, the hybrid study design included an assessment of potential outcome measures suitable for ascertaining both the effectiveness of CTW in client health outcomes, and conducting a value for money analysis. The process evaluation found evidence that by improving processes, and removing waitlists CTW had created an opportunity to broadened the scope and type of psychological services offered which improved accessibility. The assessment of potential outcome measures provided insight into suitable measures for future evaluation into service effectiveness, client health outcomes and value for money

Living bioethics, theories and children’s consent to heart surgery

Background: This analysis is about practical living bioethics and how law, ethics and sociology understand and respect children’s consent to, or refusal of, elective heart surgery. Analysis of underlying theories and influences will contrast legalistic bioethics with living bioethics. In-depth philosophical analysis compares social science traditions of positivism, interpretivism, critical theory and functionalism and applies them to bioethics and childhood, to examine how living bioethics may be encouraged or discouraged. Illustrative examples are drawn from research interviews and observations in two London paediatric cardiac units. This paper is one of a series on how the multidisciplinary cardiac team members all contribute to the complex mosaic of care when preparing and supporting families’ informed consent to surgery. Results: The living bioethics of justice, care and respect for children and their consent depends on theories and practices, contexts and relationships. These can all be undermined by unseen influences: the history of adult-centric ethics; developmental psychology theories; legal and financial pressures that require consent to be defined as an adult contract; management systems and daily routines in healthcare that can intimidate families and staff; social inequalities. Mainstream theories in the clinical ethics literature markedly differ from the living bioethics in clinical practices. Conclusion: We aim to contribute to raising standards of respectful paediatric bioethics and to showing the relevance of virtue and feminist ethics, childhood studies and children’s rights

Reviews

Tolkien, Race and Cultural History: From Fairies to Hobbits. Dimitra Fimi. Reviewed by Jason Fisher. Charles Williams and his Contemporaries. Suzanne Bray and Richard Sturch, eds. Reviewed by Joe R. Christopher. In the Land of Invented Languages: Esperanto Rock Stars, Klingon Poets, Loglan Lovers, and the Mad Dreamers who Tried to Build a Perfect Language. Arika Okrent. Reviewed by Harley J. Sims. Millennial Mythmaking: Essays on the Power of Science Fiction and Fantasy Literature, Films and Games. John Perlich & David Whitt, eds. Reviewed by Priscilla Hobbs Middle-earth Minstrel: Essays on Music in Tolkien. Bradford Lee Eden, ed. Reviewed by Emily A. Moniz. Harry Potter & Imagination: The Way Between Two Worlds. Travis Prinzi. Reviewed by David D. Oberhelman. Fastitocalon: Studies in Fantasticism Ancient to Modern: Immortals and the Undead. Eds. Thomas Honneger and Fanfan Chen. Reviewed by Janet Brennan Croft. Theodor Seuss Geisel [sic]. Donald E. Pease. Reviewed by Joe R. Christopher

Balance and harmony in the Gallup World Poll: The development of the Global Wellbeing Initiative module

Over recent decades, scholarship on wellbeing has flourished. However, this has been critiqued as Western-centric, firstly in terms of the location of research participants and scholars, and moreover in terms of the very ideas and values through which wellbeing is understood. In response to such issues, the Global Wellbeing Initiative – a partnership between Gallup and the Wellbeing for Planet Earth foundation – was created to look at wellbeing from a more global perspective. The centrepiece of this initiative is a survey module in the Gallup World Poll. This paper charts the evolution of this module to date, from its initial incarnation in the 2020 poll (featuring items on various aspects of wellbeing) to a finalized 2022 iteration (which focuses specifically on balance and harmony). With the 2022 version now intended to stay consistent longitudinally, this paper establishes a valuable baseline for this important project which will contribute to a more inclusive and comprehensive understanding of wellbeing

Identifying predictors of translocation success in rare plant species

The fundamental goal of a rare plant translocation is to create self-sustaining populations with the evolutionary resilience to persist in the long term. Yet, most plant translocation syntheses focus on a few factors influencing short-term benchmarks of success (e.g., survival and reproduction). Short-term benchmarks can be misleading when trying to infer future growth and viability because the factors that promote establishment may differ from those required for long-term persistence. We assembled a large (n = 275) and broadly representative data set of well-documented and monitored (7.9 years on average) at-risk plant translocations to identify the most important site attributes, management techniques, and species' traits for six life-cycle benchmarks and population metrics of translocation success. We used the random forest algorithm to quantify the relative importance of 29 predictor variables for each metric of success. Drivers of translocation outcomes varied across time frames and success metrics. Management techniques had the greatest relative influence on the attainment of life-cycle benchmarks and short-term population trends, whereas site attributes and species' traits were more important for population persistence and long-term trends. Specifically, large founder sizes increased the potential for reproduction and recruitment into the next generation, whereas declining habitat quality and the outplanting of species with low seed production led to increased extinction risks and a reduction in potential reproductive output in the long-term, respectively. We also detected novel interactions between some of the most important drivers, such as an increased probability of next-generation recruitment in species with greater seed production rates, but only when coupled with large founder sizes. Because most significant barriers to plant translocation success can be overcome by improving techniques or resolving site-level issues through early intervention and management, we suggest that by combining long-term monitoring with adaptive management, translocation programs can enhance the prospects of achieving long-term success

Silta mill-"Antigone" ta’ Sofokle

Ġabra ta’ poeżiji u proża li tinkludi: Ħajki ta’ Josette Attard – Din l-għanja tiegħi ta’ Rena Balzan – Fl-irdum fejn jidwi ta’ Charles Bezzina – Naqa’ biss ta’ Ġorġ Borg – Gambrinu, 7.45 a.m. ta’ Norbert Bugeja – Għadam ta’ Joseph Buttigieg – Tħarisx biss fil-wiċċ ta’ John Caruana – Petra ta’ Priscilla Cassar – Mhux iżjed dan il-pajjiż tiegħi ta’ Victor Fenech – Twieqi magħluqa ta’ Maria Grech Ganado – Joseph quddiem ir-ritratt ta’ sieħbu jitfarrak ta’ Adrian Grima – Ta’ l-ilma l-fruntieri tiegħek ta’ Simone Inguanez – Għall-kaċċa tal-grejtwajt ta’ Daniel Massa – Ftit weraq mis-Slovenja ta’ Immanuel Mifsud – Dak li kien ta’ Achille Mizzi – Wassalni ta’ Anna Pullicino – Tamiet fiergħa ta’ Patrick Sammut – Fost l-isbaħ jiem ta’ Lillian Sciberras – Kelma ta’ Marcel Zammit Marmarà – Lill-Imdina żagħżugħa ta’ Joe Zammit Tabona – Sodda ta’ l-ilma ta’ Clare Azzopardi – Kurċifiss ta’ Paul P. Borg – Mera mkissra ta’ Lina Brockdorff – No(ra)vella ta’ Joe Friggieri – L-abbati ta’ Henry Holland – L-eħrex ġurnata tal-gwerra ta’ Maurice Mifsud Bonnici – Marija ta’ Lino Spiteri – Ikla ta’ Trevor Żahra – Il-mara midinba ta’ Albert Camus, traduzzjoni ta’ Toni Aquilina – Silta mill-"Antigone" ta’ Sofokle, traduzzjoni ta’ Victor Xuereb.peer-reviewe

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited