Responding to parents’ well-being needs throughout the COVID-19 pandemic – a critical reflection on the experiences of vulnerable parents and frontline service providers

In March 2020, a range of public health measures were introduced to curb the spread of COVID-19 in Ireland, including the closure of non-essential services and schools, and restricting the movements and social interactions of the majority of the population. The social and economic upheaval caused by these measures led to increased stress, strain and worry for parents, significantly heightening the risk for detrimental effects on well-being. Barnardos, Irelands leading children’s charity, responded quickly to the crisis by adapting its existing therapeutic services and creating a range of new services to support the needs of parents and families. This paper uses the lens of parental well-being to review the situation in Ireland experienced by vulnerable families during the COVID-19 pandemic as a result of the disruptions and the service response. We explore the research background to parental well-being and detail the specific challenges faced by parents as reported in organisational surveys during the pandemic and in feedback from our frontline services. We also outline the complexities for services in responding innovatively and urgently to evolving family needs, and demonstrate facilitators and barriers to engagement. The paper concludes with a summary of the current and anticipated future context for families, and some recommendations for key actions around promoting and sustaining parental well-being

Provision of artificial shelter on beaches is associated with improved shorebird fledging success

Artificial chick shelters might improve productivity of beach-nesting birds threatened by anthropogenic disturbance. We investigated the efficacy of three different chick shelter designs against four criteria: accessibility to chicks over time, thermal insulation, conspicuousness to beach-goers, and practicality (cost and ease of transport). One design (‘A-frame’) was selected because it offered the greatest thermal insulation, was the least conspicuous, most cost effective, and performed equally well in terms of accessibility. We deployed these artificial shelters on Hooded Plover Thinornis rubricollis territories where broods were present (n 5 11), and compared the behaviour and survival rate of chicks to that at control sites (n 5 10). We were unable to discern any difference in the behaviour of broods when artificial shelters were available. However, the survival rate of chicks to fledging was 71.8% higher where an artificial shelter was provided (n 5 21 broods). This was validated by analysing data from a larger sample of broods monitored as part of an active volunteer-based management programme; shelters conferred a 42.8%increase in survival to fledging (n 5 81 broods). Thus, artificial shelters have the potential to increase survival rates of threatened shorebird chicks, though the mechanisms through which survival is increased require further investigation

Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2):a multicentre observational cohort study

Background: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. Methods: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death. We excluded patients if they could not undergo MRI, had a definite contraindication to anticoagulation, or had previously received therapeutic anticoagulation. The primary outcome was symptomatic intracranial haemorrhage occurring at any time before the final follow-up at 24 months. The log-rank test was used to compare rates of intracranial haemorrhage between those with and without cerebral microbleeds. We developed two prediction models using Cox regression: first, including all predictors associated with intracranial haemorrhage at the 20% level in univariable analysis; and second, including cerebral microbleed presence and HAS-BLED score. We then compared these with the HAS-BLED score alone. This study is registered with ClinicalTrials.gov, number NCT02513316. Findings: Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0·53), models including cerebral microbleeds and HAS-BLED (0·66, 0·53–0·80) and cerebral microbleeds, diabetes, anticoagulant type, and HAS-BLED (0·74, 0·60–0·88) predicted symptomatic intracranial haemorrhage significantly better (difference in C-index 0·25, 95% CI 0·07–0·43, p=0·0065; and 0·33, 0·14–0·51, p=0·00059, respectively). Interpretation: In patients with atrial fibrillation anticoagulated after recent ischaemic stroke or transient ischaemic attack, cerebral microbleed presence is independently associated with symptomatic intracranial haemorrhage risk and could be used to inform anticoagulation decisions. Large-scale collaborative observational cohort analyses are needed to refine and validate intracranial haemorrhage risk scores incorporating cerebral microbleeds to identify patients at risk of net harm from oral anticoagulation. Funding: The Stroke Association and the British Heart Foundation

Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study

Summary Background: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. Methods: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death. We excluded patients if they could not undergo MRI, had a definite contraindication to anticoagulation, or had previously received therapeutic anticoagulation. The primary outcome was symptomatic intracranial haemorrhage occurring at any time before the final follow-up at 24 months. The log-rank test was used to compare rates of intracranial haemorrhage between those with and without cerebral microbleeds. We developed two prediction models using Cox regression: first, including all predictors associated with intracranial haemorrhage at the 20% level in univariable analysis; and second, including cerebral microbleed presence and HAS-BLED score. We then compared these with the HAS-BLED score alone. This study is registered with ClinicalTrials.gov, number NCT02513316. Findings: Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0·53), models including cerebral microbleeds and HAS-BLED (0·66, 0·53–0·80) and cerebral microbleeds, diabetes, anticoagulant type, and HAS-BLED (0·74, 0·60–0·88) predicted symptomatic intracranial haemorrhage significantly better (difference in C-index 0·25, 95% CI 0·07–0·43, p=0·0065; and 0·33, 0·14–0·51, p=0·00059, respectively). Interpretation In patients with atrial fibrillation anticoagulated after recent ischaemic stroke or transient ischaemic attack, cerebral microbleed presence is independently associated with symptomatic intracranial haemorrhage risk and could be used to inform anticoagulation decisions. Large-scale collaborative observational cohort analyses are needed to refine and validate intracranial haemorrhage risk scores incorporating cerebral microbleeds to identify patients at risk of net harm from oral anticoagulation. Funding The Stroke Association and the British Heart Foundation

Stakeholder Perceptions of Threatened Species and Their Management on Urban Beaches

We surveyed 579 recreationists regarding management of the threatened, beach-dwelling Hooded Plover Thinornis rubricollis. We postulated that: (1) lower awareness of the species and higher ‘inconvenience’ of management would engender less favourable perceptions of conservation and management; and (2) that frequency of beach use and dog ownership may mediate perceptions and levels of awareness and inconvenience. Overall, inconvenience was low while awareness and support for plover conservation were high. Education and awareness strategies were considered less effective than regulations; exclusion and regulations were considered less desirable than on-ground protective measures. Awareness, frequency of beach use and dog walking did not influence the perceived effectiveness of different managements. More frequent beach users had greater awareness of the species and their plight but reported greater inconvenience associated with management. Respondents with high awareness rated the severity of human-related threats higher; low awareness was associated with more inconvenience associated with on-ground protection, and exclusion and regulations. Dog walkers reported more inconvenience associated with exclusions and regulations than non-dog walkers. Dog walkers who used the beach infrequently rated threats significantly higher than frequent beach users. Conservation and education strategies could usefully be tailored to beach users’ level of use and pet ownership

Behavioural ecology of the southern emu-wren (Stipiturus malachurus)

© 2005 Grainne S. Maguire.In this thesis, I describe the behavioural ecology of an Australian passerine, the Southern Emuwren Stipiturus malachurus (Maluridae). The southern emu-wren is threatened in several parts of its range, and yet information on the species’ breeding biology, habitat use and mating system is lacking. These data are fundamental to effective conservation management. My research investigated the breeding behaviour and habitat ecology of a population of southern emu-wrens in Portland, Victoria, Australia, over three breeding seasons (2000/01, 2001/02 and 2002/03). also collected data pertaining to habitat use from populations located in Anglesea and Lower Glenelg National Park (Victoria, Australia). Southern emu-wrens commonly formed socially monogamous pair bonds, although cooperative breeding was observed for the first time in this species, where male offspring within several families delayed breeding to help raise younger siblings. Successful nests produced 1.8 fledglings on average, however, a nest had only a 56% chance of success during incubation and nestling phases. Nest failure was mainly attributed to depredation and snakes were identified as major nest predators. The slow breeding rate of the southern emu-wren is typical of a small passerine in the Southern Hemisphere. Nevertheless, adult mortality was unusually high. In one breeding season the adult population was reduced by 50%. The population recovered when individuals dispersed from the adjacent coastal heathland to fill territory vacancies. This highlights the vulnerability of populations to local catastrophe, and potential extinction if spatial separation of populations exceeds the species’ dispersal capacity

An Exploration of Practitioners’ Experiences of Delivering Digital Social Care Interventions to Children and Families During the COVID-19 Pandemic: Mixed Methods Study

BackgroundDigital technology is an increasing feature of social care practice, and its use has accelerated greatly in response to the COVID-19 pandemic. ObjectiveThis study aimed to assess social care practitioners’ experiences of delivering digital interventions to vulnerable children and families during the pandemic. MethodsA mixed methods study combining survey and qualitative research was conducted. In total, 102 social care practitioners working in the Republic of Ireland who delivered a range of digital social care support took part in a web-based survey. This survey captured practitioners’ engagement and experiences of delivering digital social care interventions to children and families as well as training and capacity building needs. Subsequently, 19 focus groups with 106 social care practitioners working with children and families were also conducted. These focus groups were directed by a topic guide and explored in more depth practitioners’ perceptions of digital social care practice, the perceived impact of digital technology on their work with children and families, and the future application of digital social care interventions. ResultsThe survey findings revealed that 52.9% (54/102) and 45.1% (46/102) of practitioners, respectively, felt “confident” and “comfortable” engaging in digital service delivery. The vast majority of practitioners (93/102, 91.2%) identified maintaining connection during the pandemic as a benefit of digital social care practice; approximately three-quarters of practitioners (74/102, 72.5%) felt that digital social care practice offered service users “increased access and flexibility”; however, a similar proportion of practitioners (70/102, 68.6%) identified inadequate home environments (eg, lack of privacy) during service provision as a barrier to digital social care practice. More than half of the practitioners (54/102, 52.9%) identified poor Wi-Fi or device access as a challenge to child and family engagement with digital social care. In total, 68.6% (70/102) of practitioners felt that they needed further training on the use of digital platforms for service delivery. Thematic analysis of qualitative (focus group) data revealed 3 overarching themes: perceived advantages and disadvantages for service users, practitioners’ challenges in working with children and families through digital technologies, and practitioners’ personal challenges and training needs. ConclusionsThese findings shed light on practitioners’ experiences of delivering digital child and family social care services during the COVID-19 pandemic. Both benefits and challenges within the delivery of digital social care support as well as conflicting findings across the experiences of practitioners were identified. The implications of these findings for the development of therapeutic practitioner–service user relationships through digital practice as well as confidentiality and safeguarding are discussed. Training and support needs for the future implementation of digital social care interventions are also outlined