Research Priorities for Children's Nursing in Ireland: A Delphi Study

This paper is a report of a study which identified research priorities for children's nursing in an acute care setting in Ireland. A limited number of studies have examined research priorities for children's nursing. This study was undertaken against the backdrop of significant proposed changes to the delivery of of children's healthcare. A three round Delphi survey design was used to identify and rate the importance of research priorities for children's nursing. In round 1 participants were asked to identify five of the most important research priorities for children's nursing. Participants in round 2 were asked to rate the importance of each of each research priority on a seven point Likert scale. In round 3 participants were presented with the mean scoreof each research priority from the second questionaire, and again asked to consider the importance of each topic on a 7 point Likert scale. The aim was to reach a consensus on the priorities. The top three priorities identified were recognition and care of the deteriorating child, safe transfer of the critically ill child between acute health care facilities, and the child and families perceptions of care at end-of life. The wide variation of priorities reflects the scope of care delivery of children's nurses and mirrors many global care concerns in caring for children

Tackling health inequalities: moving theory to action

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Anaemia in pregnancy among Aboriginal and Torres Strait Islander women of Far North Queensland: a retrospective cohort study

Aim: Anaemia during pregnancy is common worldwide. In Australia between 7.1% and 11% of mothers have been reported to have anaemia in pregnancy. Higher rates are reported for Aboriginal and Torres Strait Islander women (Townsville: 34.2%, remote Northern Territory: 50%). The present study describes anaemia in pregnancy among Aboriginal and Torres Strait Islander women of Far North Queensland. Methods: Health service information was analysed for 2076 Aboriginal and Torres Strait Islander women who gave birth between 2006 and 2010. The prevalence of anaemia in pregnancy, characteristics of the mothers and pregnancy outcomes were described. Logistic regression for bivariate analyses and multivariable linear modelling with and without imputed data were used to compare those mothers who had anaemia in pregnancy with those who did not. Results: More than half of Aboriginal and Torres Strait Islander women (54.5% (95% CI: 52.4%, 56.7%)) had anaemia in pregnancy. For mothers who gave birth in 2009 and 2010 (n = 1796) with more complete data, those who were iron deficient during pregnancy were more likely to be anaemic (RR: 1.40, P = <0.001). Mothers (29.0%) from localities of relative socioeconomic advantage had lower risk of anaemia in pregnancy (RR: 0.86, P = 0.003), as did mothers (31.9%) who were obese (RR: 0.87, P = 0.013). Conclusions: The prevalence of anaemia in pregnancy among Aboriginal and Torres Strait Islander women of Far North Queensland is high. Prevention and treatment of anaemia will improve the health of these mothers, and possibly the health and early development of their children

AIDS epidemic at age 25 and control efforts in China

In the first 10 years of AIDS epidemic in China, intravenous drug users (IDUs) and Former Plasma Donors (FPDs) were hardly hit in the late 1980s and mid 1990s respectively. In the last 10 years, while IDU epidemic keeps at a fast pace, sexual transmitted cases of HIV have been steadily increasing. All signs indicate that the HIV epidemic in China is at a turning point, spreading from high risk groups to the general population. Learning from the SARS epidemic, China has recently launched an impressive AIDS campaign by making serious political commitments, and by strengthening the public health system and implementing an aggressive Four Free One Care Policy. There remains huge challenges both at the societal level which form the roots of the AIDS epidemic and at increasing the capabilities of the implementation teams. In addition to other needed efforts, enhancing AIDS research through international collaborations will strengthen China's ability to conduct her huge control program efficiently. Only with a scientific approach and evidence-based strategy, can China seize the opportunity to stop AIDS at an early stage

Growing old in England: economic and social issues

This paper examines the economic and social impact of changes in the duration of working life for the 80 per cent of older adults living in urban England. While some people are experiencing extended retirement because of moving out of paid work in their fifties, a growing minority of those beyond the state retirement age continue in paid employment. This paper highlights the considerable challenges for urban policy makers in addressing the economic and social inclusion of all older adults

Suicide in an ageing UK population: problems and prevention

Purpose Suicide can be an emotive, and at times, controversial subject. The purpose of this paper is to reflect on the social, health, personal, and cultural issues that can arise in later life and the potential reasons for suicide. It will analyse already recognised risk factors of suicide in older adults and focus on improving knowledge about the social meaning and causation of suicide for older people. It will also consider suicide prevention policies, their practice implications, and whether they are successful in protecting this potentially vulnerable cohort. Design/methodology/approach A synopsis of available literature in the form of a general review paper of suicide of older adults. Findings There is evidence that the ageing process often leads to a set of co-morbidities and a complex and diverse set of individual challenges. This in turn equates to an increased risk of suicide. There is no easy answer to why there is evidence of a growing number of older adults deciding that suicide is there only option, and even fewer suggestions on how to manage this risk. Social implications The entry of the “baby boom” generation into retirement will lead to the potential of an increase in both suicide risk factors and older adults completing suicide. This is on the background of a demographic surge which is likely to place additional pressures on already under-resourced, and undervalued, statutory and non-statutory services. Originality/value A literature search found very little information regarding older adults and suicide risk, assessment, treatment or prevention. </jats:sec

Cost-effectiveness of interventions for increasing the possession of functioning smoke alarms in households with pre-school children: a modelling study

Background The UK has one of the highest rates for deaths from fire and flames in children aged 0-14 years compared to other high income countries. Evidence shows that smoke alarms can reduce the risk of fire-related injury but little exists on their cost-effectiveness. We aimed to compare the cost effectiveness of different interventions for the uptake of 'functioning' smoke alarms and consequently for the prevention of fire-related injuries in children in the UK. Methods We carried out a decision model-based probabilistic cost-effectiveness analysis. We used a hypothetical population of newborns and evaluated the impact of living in a household with or without a functioning smoke alarm during the first 5 years of their life on overall lifetime costs and quality of life from a public health perspective. We compared seven interventions, ranging from usual care to more complex interventions comprising of education, free/low cost equipment giveaway, equipment fitting and/or home safety inspection. Results Education and free/low cost equipment was the most cost-effective intervention with an estimated incremental cost-effectiveness ratio of [pound sign]34,200 per QALY gained compared to usual care. This was reduced to approximately £4,500 per QALY gained when 1.8 children under the age of 5 were assumed per household. Conclusions Assessing cost-effectiveness, as well as effectiveness, is important in a public sector system operating under a fixed budget restraint. As highlighted in this study, the more effective interventions (in this case the more complex interventions) may not necessarily be the ones considered the most cost-effective

Regional Variations in Emergency Service Performance: Does Social Capital Matter?

Regional variations in emergency service performance: does social capital matter?, Regional Studies. The relationship between social capital and the performance of public organizations is currently at the top of the UK policy agenda and elsewhere. This paper examines whether social capital is associated with improved regional emergency service performance by exploring its relationship with the achievements of ambulance trusts in England. Drawing on a six-year panel dataset, ambulance response times are modelled using an index of social capital, incorporating measures of community organizational life, political efficacy and social trust, in the regions served by National Health Service (NHS) ambulance trusts. Theoretical and practical implications are discussed