Preventing child pedestrian injuries and deaths arising from vehicle-child accidents in domestic driveways: An action research project

This research was a three-fold investigation into the viability of previous recommendations for vehicle-related child driveway accident safety . Firstly, the groups most at risk of these types of accidents were determined in order that they could be specifically considered when reviewing the practicalities of previous recommendations . Secondly, the feasibility of previous recommendations was systematically examined through both an extensive literature review and key and expert informant interviews . Based on these, the likelihood of implementation of previous safety recommendations for the identified high risk groups was ascertained, providing a basis on which to abandon some previous recommendations, remove obstacles to others which would enhance practicability and generate further recommendations that would be tenable for the at-risk groups in particular. The key findings of this research were, foremost, that there is a noticeable lack of specific reference to vehicle-related child driveway accidents in any legislation or safety guidelines, as well as a shortage of official data that deal expressly with this type of accident. Further, it was found that the major obstacles to the implementation of previous recommendations - particularly the environmental ones - were cost, autonomy, and spatial constraints. While several recommendations were abandoned due to factors such as unproven or dubious effectiveness and/or prohibitive cost, it was found that the most viable recommendations were characterised by their relatively low cost for the families involved. These recommendations were typically environmental or educational in nature. Thus, the recommendations in this report include some moderate regulatory changes to facilitate greater uptake of environmental and behaviour-modifying recommendations as well as practical ideas that all need to be part of a cohesive campaign to address the issue of vehicle-related child driveway accidents in New Zealand

Breast-feeding in a UK urban context: who breast-feeds, for how long and does it matter?

Objective: To investigate what factors relate most strongly to breast-feeding duration in order to successfully support breast-feeding mothers. Design: Prospective birth cohort study using questionnaires, routinely collected weights and health check at age 13 months. Setting: Gateshead, UK. Subjects: Parents of 923 term infants born in a defined geographical area and recruited shortly after birth, 50% of whom were breast-feeding initially. Results: Only 225 (24%) infants were still breast-fed at 6 weeks, although 136 (15%) continued beyond 4 months. Infants in the most affluent quintile were three times more likely to be initially breast-fed (P , 0.001) and five times more likely to still be feeding at 4 months (P ¼ 0.001) compared with infants in the most deprived quintile. A third of breast-fed infants were given supplementary feeds in the maternity unit and this was associated with a 10-fold increase in odds of giving up breast-feeding by discharge (P ¼ 0.001). Frequent feeding was reported as a reason for giving up in 70% of mothers at 6 weeks and 55% at 4 months. Those infants who stopped breastfeeding earliest showed the most rapid weight gain and were tallest at age 13 months. Non-breast-fed infants had 50% more family doctor contacts up to age 4 months (P ¼ 0.005). Conclusions: Initiation of breast-feeding in urban Britain remains strongly determined by socio-economic background and early cessation seems to be related to frequent feeding and rapid growth as well as a continuing failure to eradicate health practices that undermine breast-feeding. Those infants not receiving breast milk suffered increased morbidity, but the apparent association between breast-feeding duration and growth probably reflects reverse causation

Power in periods: a Foucauldian-feminist exploration of menstruation in an all-girls’ secondary school in South Africa

Absenteeism from school among girls due to a lack of menstrual health management (MHM) products has increasingly attracted attention from researchers and activists in recent years. Having highlighted the challenges caused by a lack of MHM products, the focus has been on the available facilities at schools to ensure MHM. Many schools in South Africa lack water, sanitation and hygiene (WASH) to ensure hygiene standards for the removal of bodily excre-ment, which further causes distress to girls needing MHM while at school. To investigate fur-ther the MHM challenges girls face, apart from access to products and WASH, this qualita-tive study purposively selected an all-girls’ school with access to good sanitation facilities. This research uses Foucauldian Discourse Analysis and Feminist Theory to explore the forms of discipline and control that girls experience at school to contain their bodily functioning and fluids, and the forms of resistance and support that girls encounter with MHM at school. I will argue that the ambivalent meanings girls acquire about menstruation at home and in soci-ety persist at school despite their own views that menstruation is normal. While MHM prod-ucts and WASH facilities need to be freely available, the problematic social response to men-struation is what needs to be addressed in order to emancipate women from the social patriar-chal power that informs their understanding that menstruation is shameful. MHM cannot only encompass products and facilities but needs to encompass a change in societal views of sex-ual and reproductive health.Thesis (MA) -- Faculty of Humanities, Psychology, 202

Nasal fentanyl alone plus buccal midazolam: an open-label, randomised, controlled feasibility study in the dying

Introduction: Many patients want to stay at home to die. They invariably become unable to take oral medication during their terminal phase. Symptoms are usually controlled by subcutaneous medications. There have been no studies on nasal fentanyl (NF) or buccal midazolam (BM) to control symptoms in the dying.Objective: To establish how best to conduct a definitive, randomised controlled trial (RCT) to determine whether NF and BM administered by families, for patients dying at home, lead to faster and better symptom control and fewer community nursing visits than standard breakthrough medication by healthcare professionals.Methods: This open-label mixed-method feasibility RCT compared the efficacy of NF and BM by family members to standard breakthrough medication by nurses for the terminally ill in a specialist palliative care unit. Partway through the study, a third observational arm was introduced where BM alone was used. The primary outcomes were whether recruitment and randomisation were possible, assessment of withdrawal and drop-out, and whether the methods were acceptable and appropriate.Results: Administration of NF and BM was acceptable to patients and families. Both were well tolerated. We were unable to obtain quality of life data consistently but did get time period data for dose-controlled symptoms.Conclusions: Study participation in a hospice population of the dying was acceptable. The results will help guide future community study planning

Soil formation on Holocene moraines in the cirque de Troumouse, Pyrenees

Factors affecting rates and degree of soil formation on Holocene moraines are discussed with reference to moraine sequences in the Cirque de Troumouse, French Pyrenees. In particular, the role of time, slope position and post-depositional history are evaluated for three moraines ranging in age from c. 5000 to c. 1000 yr BP. Soil profile development, as determined by visual criteria, indicates differences in soil development between moraines of different age as well as between soils developed on the same moraine but occupying different slope positions. Particle size analysis and soil chemical analyses confirm that microtopography exerts a strong control on the extent and rate of soil formation, and must therefore be considered when sampling and describing soil chronosequences on glacial moraines.[es] Se discuten los factores que afectan a las tasas y al grado de formación del suelo en morrenas Holocenas, con referencia a la secuencia de morrenas en el Circo de Troumouse, Pirineo francés. En particular, se evalúa el papel del tiempo, la posición de la pendiente y la historia postdeposicional para tres morrenas ordenadas en edad desde c. 5000 a c. 1000 años BP. El desarrollo del perfil del suelo, determinado por criterios visuales, indica diferencias de desarrollo del suelo entre morrenas de diferente edad así como entre suelos desarrollados en la misma morrena, pero ocupando diferentes posiciones de la pendiente. Análisis granulométricos y químicos del suelo confirman que la microtopografía ejerce un fuerte control en la extensión y en la tasa de formación del suelo y, por tanto, deberla ser tenida en cuenta en los muéstreos y descripciones de las cronosecuencias del suelo en morrenas glaciares. [fr] On discute les facteurs qui affectent les taux et le degré de formation du sol en moraines Holocènes, avec référence à la séquence de moraines du Cirque de Troumouse, Pyrénées français. En particulier, on évalue le rôle du temps, la position de la pente et l'histoire postdépositionelle pour trois moraines ordonnées chronologiquement de c. 5000 à 1000 ans av. J.C.. Le développement du profil du sol, déterminé selon des critères visuels, ' signale des différences de développement du sol entre des moraines d'âge différent de même qu'entre des sols formés dans la même moraine, mais qui occupent différentes positions de la pente. Des analyses granulométriques et chimiques du sol confirment que la microtopographie exerce une forte influence sur l'étendue et les taux de formation du sol et par conséquent, elle devrait entrer en ligne de compte dans les échantillonnages et les descriptions des chronoséquences du sol en moraines glaciaires

Does acupressure help reduce nausea and vomiting in palliative care patients? A double blind randomised controlled trial

Introduction: Nausea and vomiting are common symptoms for patients with advanced cancer. While there is evidence for acupuncture point stimulation for treatment of these symptoms for patients having anticancer treatment, there is little for when they are not related to such treatment.Objective: To determine whether acupressure at the pericardium 6 site can help in the treatment of nausea and vomiting suffered by palliative care patients with advanced cancer.Materials and methods: Double blind randomised controlled trial—active versus placebo acupressure wristbands. In-patients with advanced cancer in two specialist palliative care units who fitted either or both of the following criteria were approached: Nausea that was at least moderate; Vomiting daily on average for the prior 3 days.Results: 57 patients were randomised to have either active or placebo acupressure wristbands. There was no difference in any of the outcome measures between the two groups: change from baseline number of vomits; Visual Analogue Scale for ‘did acupressure wristbands help you to feel better?’; total number of as needed doses of antiemetic medication; need for escalation of antiemetics.Conclusions: In contrast to a previously published feasibility study, active acupressure wristbands were no better than placebo for specialist palliative care in-patients with advanced cancer and nausea and vomiting

Accuracy of self-reported medicines use compared to pharmaceutical claims data amongst a national sample of older Australian women

This study assessed agreement between two measures of medicine use, self-report by mail and pharmaceutical claims data, for a national sample (N = 4687) of older women aged 79 to84 in2005, from the Australian Longitudinal Study on Women’s Health. Medicines used for common chronic diseases in older people were selected, with pharmaceutical claims data retrieval periods of three and six months. For six month retrieval, Kappa’s ranged between 0.44 (nervous system medicines) and 0.94 (glucose lowering medicines). For three month retrieval, aspirin (Kappa: 0.35) and folic acid (Kappa = 0.48) had lowest agreement. Women were least able to accurately report use of nervous system medicines (sensitivity < 50%), and most accurately report glucose lowering medicines use (sensitivity > 80%). Specificity was consistently high across all classes, suggesting women could accurately report using a medicine. Pharmaceutical claims data can assist evaluation of judicious medicines use, changes to availability and uptake of medicines, and track medicine expenditure for chronic conditions. Over-the-counter medicines, medicines not covered by pharmaceutical subsidies and those used on an as needed basis may be best measured by self-report, as use may be underestimated using pharmaceutical claims data

Exploring the Reactions of Peer Learners to a New Model of Peer-Assisted Simulation-Based Learning Clinical Placement

In response to the paucity of clinical placements available in 2020 due to the COVID-19 pandemic, alternate options for prelicensure students were necessary in order for them to complete the fieldwork required for graduation. In response, Curtin University replaced a faculty-led fully-simulated placement with a peer-assisted learning model. This incorporated final-year students acting as peer teachers to penultimate-year students, thus creating new learning and teaching placements for the final-year students. To our knowledge, this had never been done on such a scale before. Considering the importance of meeting learner expectations in the tertiary setting, the perceptions of peer learners around the innovation were important but unknown. This study used a prospective qualitative observational design that utilized feedback from peer learners relating to learning using the peer-assisted model. Peer learners provided written reflections that were analysed thematically. During November and December 2020, 171 penultimate-year physiotherapy students participated in one of two three-week placements, and 170 consented to participate in data collection. Qualitative data reflected several enablers and barriers to learning during the experience. These related to the peer teacher attributes, the provision of performance feedback, the learning environment, and the facilitation of clinical reasoning. Peer learners enjoyed the peer-assisted model, found peer teachers able to facilitate learning, and provided useful insights that will shape future placements. The success of the model supports repeating it in the future. This will maintain a bilateral exchange of peer-led clinical learning and teaching with diminished faculty supervisory workload

Rockfalls and glacier contraction: Cirque de Troumouse, French Pyrenees

The incidence of rockfalls within the Cirque de Troumouse appears to have been triggered by ice wastage and the resultant geomorphological pattern of rockfall deposits affords an insight into the migration of headwall weathering zones. Observations of the rockfall deposits indicate clear geological controls which maybe directly related to the exposure of the headwall zone during phases of glacier wastage[es] Las caldas de piedras en el Circo de Troumouse parecen haber sido desencadenadas por la acción del hielo, y el modelo geomorfológico de depósitos de bloques resultante proporciona una idea sobre la migración de las zonas de meteorización en las paredes. Las observaciones de tales depósitos indican la existencia de claros controles geológicos que pueden relacionarse directamente con la exposición de la pared durante las fases de fusión glaciar. [fr] Les chutes des pierres dans le cirque de Troumouse paraissent avoir été déclenchées par l'action de la glace, et le modèle géomorphologique des dépôts de blocs résultant donne une idée de la migration des zones de météorisation dans les parois. Les observations de ces dépôts indiquent l'existence de contrôles géologiques très clairs qui peuvent être directement liés à l'exposition de la paroi durant les phases de fusion glaciaire

Experiencing integration: A pilot study of consumer and provider experiences of integrated primary health care

This study will provide important insights into if and how integrated primary health care works from the perspectives of both consumers and providers. It will pilot test methods of qualitative and quantitative research into consumer experiences of integrated primary health care in a single-site health care service.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy