Evaluation of the Parent Centre's positive parenting skills training programme: a randomised controlled trial

Includes bibliographical referencesThis dissertation is both an assessment of the fidelity, and outcomes, of a parenting programme. The programme is implemented by The Parent Centre, a non-profit organisation (NPO) which provides a range of support services for caregivers of children. The primary audience for this dissertation includes programme stakeholders such as the organisation's director, programme manager and programme facilitators. The programme theory underpinning this intervention was created in collaboration with programme stakeholders and expert opinion. Briefly, this theory assumes that by participating in the parenting programme, caregivers are likely to benefit from learning positive parenting techniques which, when used, will catalyse improvements in the relationship they have with their children, and their children's behaviour. A literature review of similar programmes' effectiveness was conducted to assess its plausibility. This review found evidence which largely supported the programme's theory. This programme theory helped guide the focus of the evaluation. A total of nine evaluation questions were formulated. Two of these aimed to determine whether the programme was implemented with fidelity. The remaining seven aimed to determine the extent to which the programme was effective in improving its intended parent and child outcomes. A range of measures were employed to answer these questions. Implementation fidelity was assessed through asking programme facilitators to complete sessional checklists, collect programme attendance and participant homework checklists for each session. A randomised controlled trial design was used to assess programme outcomes; pre and post-test interviews were conducted in people's homes which utilised a range of measures. The programme was found to be implemented with high levels of fidelity. Despite high levels of engagement also being demonstrated by those who attended, attendance rates were overall quite low. Limited evidence for programme effectiveness was found using both an intention to treat analysis, and after conducting a second analysis which took into consideration a moderator of programme effectiveness i.e., programme attendance. Poor levels of programme attendance, as well as ceiling effects on some measures at pre-test , changes in the control group over time due to control group participants accessing other parenting assistance, reactivity to the questionnaire, and finally having the post-test conducted immediately after the programme was completed , are all factors which likely contributed to one finding limited evidence for programme effectiveness. Despite these factors hindering one's ability to determine programme effectiveness, further analyses are tentatively recommended based on the results that were found. Once participants have been allowed further time to practice programme skills, it is possible that programme effects may be found. Therefore, a long-term follow-up will likely allow one to come to a stronger conclusion regarding programme effectiveness. Finally, a few recommendations are made with regards to programme design, content, delivery and monitoring of outcomes. Continued emphasis on praise, and some coverage of consistent discipline may increase the programme's effectiveness. Keeping group sizes smaller and including only parents of children of the specified ages will help ensure it is relevant to programme participants. Introducing a basic pre and post programme completion questionnaire will allow The Parent Centre to track outcome achievement over time and facilitate an understanding of participant demographics. More recommendations will be able to be made once the one-year follow-up is completed. This dissertation addresses the gaps in the literature regarding parenting programme effectiveness in South Africa, and low and middle-income countries in general

What do we know about preventing school violence? A systematic review of systematic reviews

Many children across the world are exposed to school violence, which undermines their right to education and adversely affects their development. Studies of interventions for school violence suggest that it can be prevented. However, this evidence base is challenging to navigate. We completed a systematic review of interventions to reduce four types of school violence: (a) peer violence; (b) corporal punishment; (c) student-on-teacher violence and (d) teacher-on-student violence. Reviewers independently searched databases and journals. Included studies were published between 2005 and 2015; in English; considered school-based interventions for children and measured violence as an outcome. Many systematic reviews were found, thus we completed a systematic review of systematic reviews. Only systematic reviews on interventions for intimate partner violence (IPV) and peer aggression were found. These reviews were generally of moderate quality. Research on both types of violence was largely completed in North America. Only a handful of programmes demonstrate promise in preventing IPV. Cognitive behavioral, social-emotional and peer mentoring/mediation programmes showed promise in reducing the levels of perpetration of peer aggression. Further research needs to determine the long-term effects of interventions, potential moderators and mediators of program effects, program effects across different contexts and key intervention components

Engagement in parenting programmes: exploring facilitators of and barriers to participation

The large-scale delivery of evidence-based parenting programmes is key to nation building in South Africa. In order to achieve change, parents must participate in these programmes. This policy brief aims to contribute to an understanding of participation by exploring the barriers and facilitators encountered by a sample of parents who were invited to take part in one of two local parenting programmes. Recommendations to improve recruitment and retention strategies are provided

Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening

The COVID-19 pandemic has created a public health crisis. Because SARS-CoV-2 can spread from individuals with presymptomatic, symptomatic, and asymptomatic infections, the reopening of societies and the control of virus spread will be facilitated by robust population screening, for which virus testing will often be central. After infection, individuals undergo a period of incubation during which viral titers are too low to detect, followed by exponential viral growth, leading to peak viral load and infectiousness and ending with declining titers and clearance. Given the pattern of viral load kinetics, we model the effectiveness of repeated population screening considering test sensitivities, frequency, and sample-to-answer reporting time. These results demonstrate that effective screening depends largely on frequency of testing and speed of reporting and is only marginally improved by high test sensitivity. We therefore conclude that screening should prioritize accessibility, frequency, and sample-to-answer time; analytical limits of detection should be secondary. &nbsp;</p

UCT ERT Student Experience Survey 2020

Final report of the UCT Emergency Remote Teaching Student Experience Survey 2020, an online survey of student experiences of emergency remote teaching (ERT) during the 2nd term of 2020 (April to July 2020). The purpose of the survey was to inform and improve the design of courses taught online during the second semester of 2020 (August to November), and improve support for students where possible. The survey was thus a form of institutional research and followed an exploratory research design rather than setting out to confirm or disprove specific hypotheses. The report presents key concerns of students during this time period, including mental health, course workload in relation to available time, and challenges relating to course site design, assessments, social connectedness, Internet access and mobile data and preferences relating to video material and synchronous teaching. While most students experienced some difficulties arising from ERT and the COVID-19 lockdown conditions, students who no longer had access to UCT residences after the start of ERT were particularly adversely affected

International consensus on mitotane treatment in pediatric patients with adrenal cortical tumors: indications, therapy, and management of adverse effects.

OBJECTIVE: Mitotane is an important cornerstone in the treatment of pediatric adrenal cortical tumors (pACC), but experience with the drug in the pediatric age group is still limited and current practice is not guided by robust evidence. Therefore, we have compiled international consensus statements from pACC experts on mitotane indications, therapy, and management of adverse effects. METHODS: A Delphi method with 3 rounds of questionnaires within the pACC expert consortium of the international network groups European Network for the Study of Adrenal Tumors pediatric working group (ENSAT-PACT) and International Consortium of pediatric adrenocortical tumors (ICPACT) was used to create 21 final consensus statements. RESULTS: We divided the statements into 4 groups: environment, indications, therapy, and adverse effects. We reached a clear consensus for mitotane treatment for advanced pACC with stages III and IV and with incomplete resection/tumor spillage. For stage II patients, mitotane is not generally indicated. The timing of initiating mitotane therapy depends on the clinical condition of the patient and the setting of the planned therapy. We recommend a starting dose of 50 mg/kg/d (1500 mg/m²/d) which can be increased up to 4000 mg/m2/d. Blood levels should range between 14 and 20 mg/L. Duration of mitotane treatment depends on the clinical risk profile and tolerability. Mitotane treatment causes adrenal insufficiency in virtually all patients requiring glucocorticoid replacement shortly after beginning. As the spectrum of adverse effects of mitotane is wide-ranging and can be life-threatening, frequent clinical and neurological examinations (every 2-4 weeks), along with evaluation and assessment of laboratory values, are required. CONCLUSIONS: The Delphi method enabled us to propose an expert consensus statement, which may guide clinicians, further adapted by local norms and the individual patient setting. In order to generate evidence, well-constructed studies should be the focus of future efforts

Alirocumab and cardiovascular outcomes after acute coronary syndrome

BACKGROUN