Training community health nurses to measure parent–child interaction: a mixed-methods study

Background This study aims to determine whether the Parental Responsiveness Rating Scale (PaRRiS) completed at child age 24–30 months can be used by community child health nurses (CCHNs) to reliably measure the quality of parent–child interactions in practice. Methods A mixed-methods design was used involving CCHNs working in public health settings. Five CCHNs recruited from the North-East of England were trained to use PaRRiS. Thirty parent–child dyads attending their routine 24–30-month check were observed. Nurses rated parent–child dyads during 5 min of free-play using PaRRiS. The free-play sessions were video recorded and rated blind by the first author to the nurse observation. Semi-structured phone interviews were conducted with the five CCHNs once observations of parent–child interactions were complete. Interviews were audio-recorded, transcribed, anonymized and thematically analyzed. Results Two-thirds of participating parents were mothers. Half the families (15/30) were from the 10% most deprived areas based on the English Index of Multiple Deprivation. The average PaRRiS score was 3.03 [standard deviation (SD) = 0.8; all ratings were <5.0]. Reliability between the first author (‘gold standard’) and CCHNs was excellent [Intra-class correlation coefficient (ICC): 0.85; 95% confidence interval (CI): 0.67–0.93]. CCHNs found PaRRiS aligned well with current practice and was acceptable to parents. There was no evidence of a relationship between social disadvantage and PaRRiS scores. Conclusions With further development and evaluation work, PaRRiS could potentially be incorporated into existing universal health services to provide child health nurses with an additional tool for identifying families most likely to be in need of parent–child interaction interventions

Men, chronic illness and healthwork: accounts from male partners of women with endometriosis

Currently dominant in medical discourse, the concept of self‐management sees the responsibility for health and illness shift from the state to the individual. However, while this emphasis on individual responsibility and management has burgeoned, the role and status of partners and other family members in the management of chronic illness remains under‐theorised. While self‐management privileges individual responsibility for the management of chronic illness, the role of partners remains unclear. This paper utilises data from a study of heterosexual couples’ experiences of living with the chronic gynaecological condition endometriosis to explore how male partners engage in its day‐to‐day management. In all, 22 couples participated in in‐depth, semi‐structured interviews with each partner interviewed separately (n = 44). Data were analysed thematically and dyadically, informed by an interpretivist relational approach. The paper utilises the concept of healthwork to describe the illness work, everyday life work, biographical work and emotion work men engaged in. The paper demonstrates how the conceptual value of healthwork is enhanced by incorporating an analysis of the emotional effort required in managing chronic illness. The paper illustrates the value of investigating the role of partners in managing chronic illness to provide a fuller account of the distributed and relational nature of healthwork

A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer

Background Accurate preoperative staging is important in determining the appropriate treatment of gastric cancer. Recently, endoscopic ultrasound (EUS) has been introduced as a staging modality. However, reported test characteristics for EUS in gastric cancer vary. Our purpose in this study was to identify, synthesize, and evaluate findings from all articles on the performance of EUS in the preoperative staging of gastric cancer.Methods Electronic literature searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1 January 1998 to 1 December 2009. All search titles and abstracts were independently rated for relevance by a minimum of two reviewers. Meta-analysis for the performance of EUS was analyzed by calculating agreement (Kappa statistic), and pooled estimates of accuracy, sensitivity, and specificity for all EUS examinations, using histopathology as the reference standard. Subgroup analyses were also performed.Results Twenty-two articles met our inclusion criteria and were included in the review. EUS pooled accuracy for T staging was 75% with a moderate Kappa (0.52). EUS was most accurate for T3 disease, followed by T4, T1, and T2. EUS pooled accuracy for N staging was 64%, sensitivity was 74%, and specificity was 80%. There was significant heterogeneity between the included studies. Subgroup analyses found that annual EUS volume was not associated with EUS T and N staging accuracy (P = 0.836, 0.99, respectively).Conclusion EUS is a moderately accurate technique that seems to describe advanced T stage (T3 and T4) better than N or less advanced T stage. Stratifying by EUS annual volume did not affect EUS performance in staging gastric cancer.Canadian Cancer SocietyMinistry of Health and Long Term CareCIHRHanna Family Chair in Surgical OncologySunnybrook Hlth Sci Ctr, Sunnybrook Res Inst, Toronto, ON M4N 3M5, CanadaSunnybrook Hlth Sci Ctr, Div Surg Oncol, Toronto, ON M4N 3M5, CanadaOdette Canc Ctr, Toronto, ON M4N 3M5, CanadaInst Clin Evaluat Sci, Toronto, ON, CanadaUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilSunnybrook Hlth Sci Ctr, Div Gastroenterol, Dept Med, Toronto, ON M4N 3M5, CanadaUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilCanadian Cancer Society: 019325Web of Scienc

Characteristics of effective peer mentorship for primiparous mothers: Qualitative findings from a peer support program

The early days of motherhood can be challenging, especially for first-time mothers. These challenges can predispose women to maternal distress, and social support—such as that offered by peers—can be important in assisting mothers to manage such distress. While existing research has identified that first time mothers often seek for and value peer support programs (e.g., practical advice, not feeling alone), few researchers have investigated factors that contribute to successful peer support and mentorship for primiparous women. Insight into these factors can be key to enhancing the success of future peer support interventions. Thematic analysis was applied to thirty-six semi structured interviews conducted with fourteen primiparous mothers and seventeen peer mentors in a peer support program. Four key factors were identified and included: expectations about the peer mentor relationship, independence of peer mentor (i.e., not part of the mother’s immediate circle of friend or family), nature of contact between primiparous mothers and peer mentors (e.g., frequency, content of conversation), and similarities between primiparous mothers and peer mentors (e.g., pregnancy and parenting experience, personality, beliefs). This study adds to existing research on factors that contribute to building successful peer mentor relationships for primiparous women. The identification of additional factors that influence peer mentor relationships, and the interplay between those factors appear important in the formulation of support networks for first time mothers. To encourage successful peer support relationships, future intervention developers need to understand the dynamics between these factors and their influence on successful relationships in a peer support context

An experience sensitive approach to care with and for autistic children and young people in clinical services

Many support schemes in current autism clinical services for children and young people are based on notions of neuro-normativity with a behavioural emphasis. Such neuro-disorder approaches gradually undermine a person, restrain authentic self-expression, and fail to address the impact of a hostile world on autistic wellbeing. Furthermore, such approaches obscure attention from a fundamental challenge to conceptualise an alternative humanistic informed framework of care for staff working with diagnosed or undiagnosed autistic children and young people. In this paper, we offer an appreciation of the lifeworld-led model of care by Todres, Galvin, & Holloway, (2009). We discuss how mental health practitioners can adopt an experience sensitive framework of healthcare by incorporating the eight dimensions of care into practice. This neuroinclusive approach creates a culture of respect, honours the sovereignty of the person, prioritises personalisation of care based on collaborative decision-making, and enables practitioners to support wellbeing from an existential, humanistic view, grounded in acceptance of autistic diversity of being. Without a fundamental shift towards such neurodivergence-affirming support with practitioners being willing to transform their understanding, real progress cannot happen to prevent poor mental health outcomes for autistic people across the lifespan. This shift is needed to change practice across research, clinical, and educational contexts

Microscopic View on Short-Range Wetting at the Free Surface of the Binary Metallic Liquid Gallium-Bismuth: An X-ray Reflectivity and Square Gradient Theory Study

We present an x-ray reflectivity study of wetting at the free surface of the binary liquid metal gallium-bismuth (Ga-Bi) in the region where the bulk phase separates into Bi-rich and Ga-rich liquid phases. The measurements reveal the evolution of the microscopic structure of wetting films of the Bi-rich, low-surface-tension phase along different paths in the bulk phase diagram. A balance between the surface potential preferring the Bi-rich phase and the gravitational potential which favors the Ga-rich phase at the surface pins the interface of the two demixed liquid metallic phases close to the free surface. This enables us to resolve it on an Angstrom level and to apply a mean-field, square gradient model extended by thermally activated capillary waves as dominant thermal fluctuations. The sole free parameter of the gradient model, i.e. the so-called influence parameter, $\kappa$, is determined from our measurements. Relying on a calculation of the liquid/liquid interfacial tension that makes it possible to distinguish between intrinsic and capillary wave contributions to the interfacial structure we estimate that fluctuations affect the observed short-range, complete wetting phenomena only marginally. A critical wetting transition that should be sensitive to thermal fluctuations seems to be absent in this binary metallic alloy.Comment: RevTex4, twocolumn, 15 pages, 10 figure

Randomized controlled trial of Vitamin D supplementation in older people to optimize bone health

Background: Vitamin D insufficiency is common in older people and may lead to increased bone resorption, bone loss, and increased falls and fractures. However, clinical trials assessing the effect of vitamin D supplementation on bone mineral density (BMD) have yielded conflicting results. Objectives This study examined the effect of vitamin D supplementation on BMD at the hip, using dual-energy X-ray absorptiometry. Methods: A total of 379 adults aged ≥70 y (48% women; mean age: 75 y) from the northeast of England were randomly allocated to 1 of 3 doses of vitamin D 3 [12,000 international units (IU), 24,000 IU, or 48,000 IU] given once a month. The primary outcome was change in BMD (δBMD) at the hip. Secondary endpoints comprised the dose effects on femoral neck BMD, falls, circulating calciotropic hormones, bone turnover markers, and adverse events. Results: The mean ± SD baseline plasma 25-hydroxyvitamin D [25(OH)D] concentration was 40.0 ± 20.1 nmol/L, which increased after 12 mo to a mean 25(OH)D of 55.9, 64.6, or 79.0 nmol/L for participants receiving a monthly dose of 12,000, 24,000, or 48,000 IU, respectively (P < 0.01 for difference). There was no between-group difference in δBMD. However, parathyroid hormone concentrations decreased in all 3 groups, with a significantly greater decrease in the 48,000-IU group compared with the 12,000-IU group (P < 0.01). There were no differences in any adverse events between groups, with 3 cases of hypercalcemia, none of nephrolithiasis, and 249 falls observed. Conclusions: There was no difference in change in BMD over 12 mo between the 3 doses of vitamin D, suggesting no effect of the intervention or a similar attenuation of the anticipated decrease in BMD over 12 mo. The treatment was safe and effective in increasing plasma 25(OH)D concentrations, with no dose-related adverse events. This trial was registered at the EU Clinical Trials Register (EudraCT 2011-004890-10) and the ISRCTN Registry (ISRCTN35648481)

Host Galaxy Properties and Offset Distributions of Fast Radio Bursts: Implications for Their Progenitors

We present observations and detailed characterizations of five new host galaxies of fast radio bursts (FRBs) discovered with the Australian Square Kilometre Array Pathfinder (ASKAP) and localized to ≾ 1". Combining these galaxies with FRB hosts from the literature, we introduce criteria based on the probability of chance coincidence to define a subsample of 10 highly confident associations (at z = 0.03–0.52), 3 of which correspond to known repeating FRBs. Overall, the FRB-host galaxies exhibit a broad, continuous range of color (M_u − M_r = 0.9–2.0), stellar mass (M_★ = 10⁸ − 6 × 10¹⁰ M_⊙), and star formation rate (SFR = 0.05–10 M_⊙ yr⁻¹) spanning the full parameter space occupied by z 99% c.l.). We measure a median offset of 3.3 kpc from the FRB to the estimated center of the host galaxies and compare the host-burst offset distribution and other properties with the distributions of long- and short-duration gamma-ray bursts (LGRBs and SGRBs), core-collapse supernovae (CC-SNe), and SNe Ia. This analysis rules out galaxies hosting LGRBs (faint, star-forming galaxies) as common hosts for FRBs (>95% c.l.). Other transient channels (SGRBs, CC-, and SNe Ia) have host-galaxy properties and offsets consistent with the FRB distributions. All of the data and derived quantities are made publicly available on a dedicated website and repository