Supporting multiple birth families:Perceptions and experiences of health visitors

Objective: To explore the current practice and perceptions of health visitors in supporting multiple birth families. Design and sample: Practicing health visitors across the United Kingdom were invited to complete a cross-sectional, descriptive, online survey. The questionnaire covered multiple birth caseload, education received about multiples and the experience of working with families. Two-hundred and ninety health visitors completed the questionnaire. Descriptive and inferential statistics were used for analysis of the quantitative components and thematic analysis for the qualitative data. Results: Most health visitors had twins on their current workload. Most health visitors had not received any specific training or continuing professional development regarding the needs of multiple birth families. Supporting the families within the confines of reduced time and increased workload was challenging. Daily tasks of caring for multiples were the main areas that health visitors and parents wanted more information about. Conclusions: In the United Kingdom, health visitors are uniquely positioned to support multiple birth families, in particular during the more challenging early years. However, the findings of this study suggest that many health visitors are aware that the care and support that they are able to provide multiple birth families falls short of meeting their needs

Identifying individual-based injury patterns in multi-trauma road users by using an association rule mining method

In many road crashes the human body is exposed to high forces, commonly resulting in multiple injuries. This study of linked road crash data aimed to identify co-occurring injuries in multiple injured road users by using a novel application of a data mining technique commonly used in Market Basket Analysis. We expected that some injuries are statistically associated with each other and form Individual-Based Injury Patterns (IBIPs) and further that specific road users are associated with certain IBIPs. First, a new injury taxonomy was developed through a four-step process to allow the use of injury data recorded from either of the two major dictionaries used to document anatomical injury. Then data from the Swedish Traffic Accident Data Acquisition, which includes crash circumstances from the police and injury information from hospitals, was analysed for the years 2011 to 2017. The injury data was analysed using the Apriori algorithm to identify statistical association between injuries (IBIP). Each IBIP were then used as the outcome variable in logistic regression modelling to identify associations between specific road user types and IBIPs. A total of 48,544 individuals were included in the analysis of which 36,480 (75.1%) had a single injury category recorded and 12,064 (24.9%) were considered multiply injured. The data mining analysis identified 77 IBIPs in the multiply injured sample and 16 of these were associated with only one road user type. IBIPs and their relation to road user type are one step on the journey towards developing a tool to better understand and quantify injury severity and thereby improve the evidence-base supporting prioritisation of road safety countermeasures

Health impacts and economic costs of residential fires (RESFIRES study) : protocol for a population-based cohort study using linked administrative data

Introduction: Residential fires remain a significant global public health problem. It is recognised that the reported number of residential fires, fire-related injuries and deaths significantly underestimate the true number. Australian surveys show that around two-thirds of respondents who experience a residential fire are unwilling to call the fire service, and international studies highlight that many individuals who access medical treatment for fire-related injuries do not have an associated fire incident report. The objectives of this study are to quantify the incidence, health impacts, risk factors and economic costs of residential fires in New South Wales (NSW), Australia. Methods and analysis: The RESFIRE cohort will include all persons living at an NSW residential address which experienced a fire over the period 2005–2014. Nine data sources will be linked to provide a comprehensive picture of individual trajectories from fire event to first responder use (fire and ambulance services), emergency department presentations, hospital admissions, burn out-patient clinic use and death. These data will be used to describe the circumstances and characteristics of residential fires, provide a profile of fire-related injuries, examine trends over time, and explore the relationship between fire circumstance, emergency and health services utilisation, and health outcomes. Regression modelling, including multilevel modelling techniques, will be used to explore factors that impact on these relationships. Costing models will be constructed. Ethics and dissemination: Ethical approval for this study has been obtained from the NSW Population and Health Service Research Ethics Committee and Western Sydney University Human Research Ethics Committee. The study reference group comprises key stakeholders including Fire and Rescue NSW, policy agencies, health service providers and burns clinicians ensuring wide dissemination of results and translation of data to inform practice and identify areas for targeted prevention. Summary reports in formats designed for policy audiences in parallel with scientific papers will be produced

Meyouandus: Interactive in-venue displays. Research and Development Report

Arts practice MeYouAndUs will produce TILO, a hybrid display system for cultural venues. It uses digital screens situated in the public spaces of a venue, combined with live feeds and sensors to display engaging, interactive and personalised content. TILO aims to create a dialogue between the arts organisation, the building and its visitors, and will allow artists to carry out their own interventions. The system will be piloted at FACT, the popular cross-arts venue in Liverpool

Estimating the total number of residential fire-related incidents and underreported residential fire incidents in New South Wales, Australia by using linked administrative data

The rate of fires, and particularly residential fires, is a serious concern in industrialized countries. However, there is considerable uncertainty regarding the reported numbers of residential fire incidents as official figures are based on fires reported to fire response agencies only. This population-based study aims to quantify the total number of residential fire incidents regardless of reporting status. The cohort comprised linked person-level data from Fire and Rescue New South Wales (FRNSW) and health system and death records. It included all persons residing at a residential address in New South Wales, Australia, that experienced a fire between 1 January 2005 and 31 December 2014. The capture-recapture method was used to estimate the underreporting number of residential fire-related incidents. Over the study period, 43,707 residential fire incidents were reported to FRNSW, and there were 2795 residential fire-related health service utilizations, of which 2380 were not reported. Using the capture-recapture method, the total number of residential fire incidents was estimated at 267,815 to 319,719, which is more than six times the official records. This study found that 15% of residential fire incidents that were identified in health administrative dataset were reported. The residential fire incidents that were not reported occurred mainly in socio-economically disadvantaged areas among males and adults

The impact of reduced fire risk cigarettes regulation on residential fire incidents, mortality and health service utilisation in New South Wales, Australia

Smoking materials are a common ignition source for residential fires. In Australia, reduced fire risk (RFR) cigarettes regulation was implemented in 2010. However, the impact of this regulation on residential fires is unknown. This paper examines the impact of the RFR cigarettes regulation on the severity and health outcomes of fire incidents in New South Wales (NSW), Australia, from 2005 to 2014. Fire department data from 2005 to 2014 were linked with ambulance, emergency department, hospital, outpatient burns clinic and mortality datasets for NSW. Negative binomial regression analysis was performed to assess the changes to fire incidents’ severity pre- and post-RFR cigarettes regulation. There was an 8% reduction in total fire incidents caused by smokers’ materials post-RFR cigarettes regulation. Smokers’ materials fire incidents that damaged both contents and structure of the building, where fire flames extended beyond the room of fire origin, with over AUD 1000 monetary damage loss, decreased by 18, 22 and 12%, respectively. RFR cigarettes regulation as a fire risk mitigation has positively impacted the residential fire incident outcomes. This provides support for regulation of fire risk protective measures and bestows some direction for other fire safety policies and regulations

Comparison of causes, characteristics and consequences of residential fires in social and non-social housing dwellings in New South Wales, Australia

There are over 17,000 residential fire incidents in Australia annually, of which 6,500 occur in New South Wales (NSW). The number of state-provided accommodations for those on low incomes (social housing), is over 437,000 in Australia of which 34% are located in NSW. This study compared causes, characteristics and consequences of residential fires in social and non-social housing in NSW, Australia. This population-based study used linked fire brigade and health service data to identify those who experienced a residential fire incident from 2005 to 2014. Over the study period, 43,707 residential fires were reported, of which 5,073 (11.6%) occurred in social housing properties. Fires in social housing were more likely to occur in apartments (RR 1.85, 95%CI 1.75–1.96), caused by matches and lighters (RR 1.62, 95%CI 1.51–1.74) and smokers’ materials (RR 1.51, 95%CI 1.34 – 1.71). The risk of health service utilisation or hospital admission was 16% (RR 1.16, 95%CI 1.04–1.28) and 25% (RR 1.25, 95%CI 1.02–1.51) higher in social housing respectively. Those aged 25–65 were at 40% (RR 1.40, 95%CI 1.14 – 1.73) higher risk of using residential fire-related health services. Almost 88% of social housing properties did not have a functioning fire detector of any type, and 1.2% were equipped with sprinklers. Overall, the risk of residential fire incidents and associated injuries was higher for residents in social housing. Risk mitigation strategies beyond the current provision of smoke alarms are required to reduce the impact of residential fires in social and non-social housing

Reflective Diary for Professional Development of Novice Teachers

Many starting teachers of computer science have great professional skill but often lack pedagogical training. Since providing expert mentorship directly during their lessons would be quite costly, institutions usually offer separate teacher training sessions for novice instructors. However, the reflection on teaching performed with a significant delay after the taught lesson limits the possible impact on teachers. To bridge this gap, we introduced a weekly semi-structured reflective practice to supplement the teacher training sessions at our faculty. We created a paper diary that guides the starting teachers through the process of reflection. Over the course of the semester, the diary poses questions of increasing complexity while also functioning as a reference to the topics covered in teacher training. Piloting the diary on a group of 25 novice teaching assistants resulted in overwhelmingly positive responses and provided the teacher training sessions with valuable input for discussion. The diary also turned out to be applicable in a broader context: it was appreciated and used by several experienced university teachers from multiple faculties and even some high-school teachers. The diary is freely available online, including source and print versions

Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS): a 24-year clinical experience with 178 patients

BACKGROUND: Thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome (TTP-HUS) are related and uncommon disorders with a high fatality and complication rate if untreated. Plasma exchange therapy has been shown to produce high response rates and improve survival in patients with many forms of TTP-HUS. We performed a retrospective cohort study of 178 consecutively treated patients with TTP-HUS and analyzed whether clinical or laboratory characteristics could predict for important short- and long-term outcome measures. RESULTS: Overall 30-day mortality was 16% (n = 27). 171 patients (96%) received plasma exchange as the principal treatment, with a mean of 8 exchanges and a mean cumulative infused volume of 42 ± 71 L of fresh frozen plasma. The rate of complete response was 65% or 55% depending on whether this was defined by a platelet count of 100,000/μl or 150,000/μl, respectively. The rate of relapse was 18%. The Clinical Severity Score did not predict for 30-day mortality or relapse. The time to complete response did not predict for relapse. Renal insufficiency at presentation was associated with a decreased risk of relapse, with each unit increase in serum creatinine associated with a 40% decreased odds of relapse. 72% of our cohort had an idiopathic TTP-sporadic HUS, while 17% had an underlying cancer, received a solid organ transplant or were treated with a mitomycin-based therapy. The estimated overall 5-year survival was 55% and was significantly better in those without serious underlying conditions. CONCLUSION: Plasma exchange therapy produced both high response and survival rates in this large cohort of patients with TTP-HUS. The Clinical Severity Score did not predict for 30-day mortality or relapse, contrary to our previous findings. Interestingly, the presence of renal insufficiency was associated with a decreased risk of relapse. The most important predictor of mortality was the presence or absence of a serious underlying disorder