Family adaptation following paediatric acquired brain injury

© 2017 Dr Lyndal Catherine HickeyObjective: This thesis aims to address the lack of evidence based research in interventions that promote family adaptation following paediatric acquired brain injury (ABI). It reports on the first social work clinical intervention trial designed to measure the effectiveness of a new family intervention titled ‘Family Forward’. This intervention was compared with ‘Usual Care’ social work practice to assess its efficacy in assisting families to make early adaptations during their child’s inpatient rehabilitation phase of care. Method: Participants were parents, caregivers and siblings of 47 children diagnosed with ABI and admitted to an inpatient rehabilitation service. Families were recruited prospectively and sequentially as their child was admitted to an inpatient rehabilitation ward at a statewide tertiary paediatric hospital. The ‘Usual Care’ group (n=22) recruitment, intervention and data collection was completed before the second phase of the intervention, ‘Family Forward’ (n=25) commenced. Patient characteristics were obtained from the child’s medical record. Families provided family demographic and psychosocial risk information using the Psychosocial Assessment Tool (PAT 2.0). Family adaptation outcomes were assessed using family functioning outcomes (Family Assessment Device – General Functioning: FAD-GF) and family management of the injured child’s care at home (Family Management Measure: FAMM). Family members’ appraisal of the child’s injury was also examined in relation to trauma, grief, emotional experience and injury perceptions (Impact of Event Scale – Revised: IES-R; Parent Experience of Childhood Illness: PECI; Brief Illness Perception Questionnaire: Brief-IPQ). Measures were completed at the child’s inpatient rehabilitation admission (pre-intervention), inpatient rehabilitation discharge (post-intervention) and six weeks post inpatient rehabilitation discharge (follow-up). Parents/caregivers and siblings also completed open-ended questions relating to the impact of the child’s injury on family relationships at follow-up. Social workers delivered the ‘Usual Care’ and ‘Family Forward’ interventions and completed the Social Work Activity Form (SWAF) measure at post-intervention and at follow-up. The SWAF measured the social work activity and the level of intensity of the interventions delivered to the families in the two groups. Results: Family adaptation outcomes (FAD-GF and FAMM) were similar for both groups at follow-up. The ‘Family Forward’ group had poorer family functioning pre-intervention (FAD-GF Family Forward mean = 1.626 SD = 0.391; Usual Care mean = 1.491 SD 0.394) and endured longer hospital admissions (Family Forward mean =56.4 days SD 46.1; Usual Care mean = 37.5 days SD 16.4) and inpatient rehabilitation admissions (Family Forward mean = 33.3 SD 29.0; Usual Care mean = 21.4 SD 13.5) than the Usual Care group. There were significant differences in relation to the social work activity and intensity of the interventions delivered to the two groups. The Family Forward group received more services in all areas of service delivery measured by the SWAF and there was an association between poorer family functioning and increased social work activity and level of intensity of the interventions delivered to this group. No significant group differences were found for family appraisal outcomes (IES-R, PECI and Brief IPQ) at any of the three time-points. Both groups reported more adaptive grief responses compared with the PECI normative sample. Trauma responses (IES-R) suggest adaptive family appraisal for both groups. However, the two groups continued to have depleted emotional resources (PECI scale) at follow-up. Parents and siblings also reflected on changes to family relationships at six weeks post discharge. Thematic analysis of free text identified themes common in both groups: ‘negative changes in sibling interactions’ and ‘sibling protectiveness of the injured child’. In addition to these themes, the families in the ‘Family Forward’ group described ‘increased expectation on sibling’; ‘family system challenges’; ‘balancing needs within the sibling subsystem’; and ‘adjustment to parenting’. Conclusions: As this is the first study of its kind, the results can begin to inform social work and rehabilitation clinicians alike about the early family adaptation experience and important foci for psychosocial interventions during a child’s inpatient rehabilitation

Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala

Infectious diseases have contributed to the decline in the health of koala ( Phascolarctos cinereus) populations in the wild in some regions of Australia. Herein we report the development and validation of 2 multiplex real-time PCR (rtPCR) panels for the simultaneous detection of Mycoplasma spp., Ureaplasma spp., Bordetella bronchiseptica, and Chlamydia, including speciation and quantification of Chlamydia, in ocular, reproductive, and nasal swab samples in addition to semen and male urogenital and reproductive tissues, from koalas. Each rtPCR panel was developed for use as a single-tube reaction using pathogen-specific primers and fluorescently labeled probe sets. DNA extracted from reference strains and isolates was used for validation of sequence gene targets for the multiplex rtPCR panels. Each panel was shown to be sensitive and specific in detecting and differentiating the bacterial pathogens. The multiplex rtPCR panels were used to screen clinical samples from free-ranging and hospitalized koalas for multiple pathogens simultaneously. The multiplex rtPCR will improve turnaround time compared to individual-pathogen rtPCR methods used, to date, for confirmation of diagnosis and will provide the wildlife clinician with the ability to make treatment decisions more rapidly

SF6_JVDI_10.1177_1040638718770490 – Supplemental material for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala

<p>Supplemental material, SF6_JVDI_10.1177_1040638718770490 for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala by Lyndal S. Hulse, Danica Hickey, Jessica M. Mitchell, Kenneth W. Beagley, William Ellis, Stephen D. Johnston in Journal of Veterinary Diagnostic Investigation</p

SF5_JVDI_10.1177_1040638718770490 – Supplemental material for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala

<p>Supplemental material, SF5_JVDI_10.1177_1040638718770490 for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala by Lyndal S. Hulse, Danica Hickey, Jessica M. Mitchell, Kenneth W. Beagley, William Ellis, Stephen D. Johnston in Journal of Veterinary Diagnostic Investigation</p

SF4_JVDI_10.1177_1040638718770490 – Supplemental material for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala

<p>Supplemental material, SF4_JVDI_10.1177_1040638718770490 for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala by Lyndal S. Hulse, Danica Hickey, Jessica M. Mitchell, Kenneth W. Beagley, William Ellis, Stephen D. Johnston in Journal of Veterinary Diagnostic Investigation</p

Tables_S1-S3_JVDI_10.1177_1040638718770490 – Supplemental material for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala

<p>Supplemental material, Tables_S1-S3_JVDI_10.1177_1040638718770490 for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala by Lyndal S. Hulse, Danica Hickey, Jessica M. Mitchell, Kenneth W. Beagley, William Ellis, Stephen D. Johnston in Journal of Veterinary Diagnostic Investigation</p

Post-disaster social work research: A scoping review of the evidence for practice

The Author(s) 2020. The aim of this study was to understand the extent, range and nature of social work research activity after natural disasters and to identify the implications for future research and practice. A Scoping review methodology framework was used search of three databases: Web of Science, ProQuest and Informit was conducted to identify relevant studies between 2000 and 2018. Selection of studies was based on empirical research about social work and natural disasters and/or authored by social workers. Study selection found a total of 38 relevant articles. Charting the data was conducted and the following areas of focus were summarised: (1) interventions relating to psychosocial care, aid work and community work; (2) the effects of disasters on people and mediators of these effects; (3) social work education and challenges in disaster relief; and (4) measuring mental health outcomes of people who have experienced a disaster event. This scoping review has established that there is a range of social work literature focused on natural disasters that primarily examines social work interventions, the effects of disasters and social work education. Future social work research and practice needs to focus on the types and timing of interventions that promote positive recovery following natural disasters

SF1_JVDI_10.1177_1040638718770490 – Supplemental material for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala

<p>Supplemental material, SF1_JVDI_10.1177_1040638718770490 for Development and application of two multiplex real-time PCR assays for detection and speciation of bacterial pathogens in the koala by Lyndal S. Hulse, Danica Hickey, Jessica M. Mitchell, Kenneth W. Beagley, William Ellis, Stephen D. Johnston in Journal of Veterinary Diagnostic Investigation</p