Effectiveness of nurse home-visiting for disadvantaged families: results of a natural experiment

Extent: 9p.Objective: To evaluate the effects of a postnatal home-visiting programme delivered by community health nurses to socially disadvantaged mothers in South Australia. Design: The intervention group of 428 mothers lived in metropolitan Adelaide and the comparison group of 239 mothers lived in regional towns where the programme was not yet available. All participating mothers met health service eligibility criteria for enrolment in the home-visiting programme. Participants in both groups were assessed at baseline (mean child age=14.4 weeks SD=2.3), prior to programme enrolment, and again when the children were aged 9, 18 and 24 months. Setting: State-wide community child health service. Participants: 667 socially disadvantaged mothers enrolled consecutively. 487 mothers (73%) completed the 24-month assessment. Intervention: Two-year postnatal home-visiting programme based on the Family Partnership Model. Primary outcome measures: Parent Stress Index (PSI), Kessler Psychological Distress Scale and the Ages and Stages Questionnaire. Results: Mixed models adjusting for baseline differences were used to compare outcomes in the two groups. The mothers in the home-visiting group reported greater improvement on the PSI subscales assessing a mother's perceptions on the quality of their relationship with their child (1.10, 95% CI 0.06 to 2.14) and satisfaction with their role as parents (0.46, 95% CI −0.15 to 1.07) than mothers in the comparison group. With the exception of childhood sleeping problems, there were no other significant differences in the outcomes across the two groups. Conclusions: The findings suggest that home-visiting programmes delivered by community health nurses as part of routine clinical practice have the potential to improve maternal–child relationships and help mothers adjust to their role as parents.Michael Gifford Sawyer, Linda Frost, Kerrie Bowering, John Lync

Three Dimensional Structure and Energy Balance of a Coronal Mass Ejection

The Ultraviolet Coronagraph Spectrometer (UVCS) observed Doppler shifted material of a partial Halo Coronal Mass Ejection (CME) on December 13 2001. The observed ratio of [O V]/O V] is a reliable density diagnostic important for assessing the state of the plasma. Earlier UVCS observations of CMEs found evidence that the ejected plasma is heated long after the eruption. We have investigated the heating rates, which represent a significant fraction of the CME energy budget. The parameterized heating and radiative and adiabatic cooling have been used to evaluate the temperature evolution of the CME material with a time dependent ionization state model. The functional form of a flux rope model for interplanetary magnetic clouds was also used to parameterize the heating. We find that continuous heating is required to match the UVCS observations. To match the O VI-bright knots, a higher heating rate is required such that the heating energy is greater than the kinetic energy. The temperatures for the knots bright in Ly$\alpha$ and C III emission indicate that smaller heating rates are required for those regions. In the context of the flux rope model, about 75% of the magnetic energy must go into heat in order to match the O VI observations. We derive tighter constraints on the heating than earlier analyses, and we show that thermal conduction with the Spitzer conductivity is not sufficient to account for the heating at large heights.Comment: 40 pages, 16 figures, accepted for publication in ApJ For associated mpeg file, please see https://www.cora.nwra.com/~jylee/mpg/f5.mp

Setting priorities to inform assessment of care homes’ readiness to participate in healthcare innovation: a systematic mapping review and consensus process

© 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedOrganisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.Peer reviewe

Silicate Emission in the TW Hydrae Association

The TW Hydrae Association is the nearest young stellar association. Among its members are HD 98800, HR 4796A, and TW Hydrae itself, the nearest known classical T Tauri star. We have observed these three stars spectroscopically between 3 and 13 microns. In TW Hya the spectrum shows a silicate emission feature that is similar to many other young stars with protostellar disks. The 11.2 micron feature indicative of significant amounts of crystalline olivine is not as strong as in some young stars and solar system comets. In HR 4796A, the thermal emission in the silicate feature is very weak, suggesting little in the way of (small silicate) grains near the star. The silicate band of HD 98800 (observed by us but also reported by Sylvester and Skinner (1996)) is intermediate in strength between TW Hya and HR 4796.Comment: 22 pages, 11 figures, LaTeX2e and AAS LaTeX macros v5.0. Accepted for publication in A