Review of early childhood parenting, education and health intervention programs for Indigenous children and families in Australia

This paper provides a review of prevention and early intervention research literature that is focused on improving outcomes for Australian Indigenous children in the early childhood years. For the purposes of this paper, early childhood is defined as the years from conception to school entry. The included literature was drawn from 3 key areas of early childhood research: parenting, early childhood education, and early childhood health. Aims One aim of this paper is to bring together up-to-date information about the range of evaluated intervention programs for Indigenous children and their families, where the information is targeted at the early childhood years. A second aim is to review research on the programs’ effectiveness in bringing about positive change in the lives of Indigenous children and their parents. The third and primary aim of the paper is to assess the quality of published or publicly available research and evaluation of early intervention programs for Indigenous children and families in Australia: the intent is to assist practitioners and policy makers in their choice of intervention programs for use in Indigenous communities. In doing so, the paper omits discussion of programs that have not yet been evaluated or whose evaluations are not publicly available. Such programs may well be as effective, or even more effective, than those reviewed here. It also needs to be kept in mind that using the quality of research design as a primary criterion for program adoption can be problematic in Australia, where research funding is difficult to obtain and often inadequate to conduct the randomised controlled trials and longitudinal research designs that are the ‘gold standard’ for a high-quality evidence base

Food Intake of Hospitalized Older Adults after Exposure to Volunteer Feeding Program

Context: Malnutrition proves to be a significant issue for hospitalized older adults. The number of physiological, social, and psychological problems they experience increases their risk for malnourishment, only worsening their admitting diagnoses. Research shows that social interaction is crucial to food intake. Many geriatric patients do not receive the interaction or encouragement they need while they eat. A hospital in Northwest Arkansas desired to prevent this negative cycle by implementing a volunteer program assisting older adults during meals. Objective: The purpose of this study was to evaluate this type of program for its effectiveness, determining if food intake increases with volunteer assistance. Design: A non-experimental, descriptive exploratory study design using a retrospective medical chart review was conducted to look at the differences in food intake of patients before and after their exposure to the program, as well as differences in food intake between patients receiving volunteer aid and those who did not. Setting: The study was conducted in a unit of a hospital specifically designed to care for older adults. Participants: The study utilized a convenience sample of all patients admitted to the same unit at the hospital. All were at least 65 years of age with no known swallowing difficulties and had the ability to cognitively interact with volunteers. Interventions: In this program, volunteers spent one uninterrupted hour with the patient providing any assistance needed and providing verbal encouragement to eat that is usually not received. Outcome Measures: Data was examined using descriptive statistics, specifically means. The data used in this study was nurse estimation of food intake in percentages. Since data was an estimate and because the sample size was expected to be small, a qualitative approach to exploring differences was utilized in lieu of quantitative data analysis. Results: Descriptive statistics showed an average increase of patient food intake by 15% after exposure to the program. Unaided patients average intake percentage only increased by 10%. These results show that not only do patients increase their food intake with a volunteer, but they also consumed more food on average than those who did not receive assistance. Conclusion: The results of this study support previous research showing the increase of food intake with socialization provided by volunteers. Further study should be conducted utilizing a larger sample size and multiple clinical settings to extend the research, making it applicable to a larger body of people. In the meantime, medical professionals should support the process of assisting older adults during their mealtimes, and they should take steps to provide this kind of assistance to their patients

Benefits of Music Therapy When Used Collaboratively with Language Therapy

Music is a large aspect of every culture. Music can calm a child in distress, create friendships, give people a way to express themselves, and even define the differences between generations and cultures. Famous Danish author, Hans Christian Andersen once said, “Where words fail, music speaks.” Researchers have studied how music can influence a person’s ability to absorb knowledge, as well as induce fluent speech for a stutterer. However, the effects of music therapy in combination with language therapy for children with language delays have not been studied to their fullest extent. For the past year and a half, I have been studying the existing research, as well as interviewing speech language pathologists who have utilized music therapy. In this thesis paper, I will summarize the existing research, explain what I learned in my interviews, conclude how the information I gathered is useful, and formulate a plan for the next steps in my research. These will all show the benefits of using music therapy in combination with language therapy

The Impact of Coordination by a Child Abuse Committee on Community Services to Battered Children

The Child Abuse Committee at the University of Oregon Medical School has assumed a coordinating role as an attempt to provide more effective service to abused children and their families. This research report is a follow up to a 1970 study by Matusak which evaluated the effectiveness of the Committee. The Matusak study seemed to indicate that, because of Committee action resulting in appropriate intervention and services, definite improvement in the situation of the children in the study was seen. This study follows the children from the 1970 study one year later and makes further comparisons of child abuse cases seen at the hospital in 1971. The results of this study fail to support the Matusak findings. A decreased percentage of children in the 1970 study group have maintained their level of improvement one year later and an even lower percentage of the 1971 study group are improved. More children have been left in their own homes than in 1970 but there is little to indicate that the family functions any more adequately than at the time of abuse. The findings seem to reflect a need for reevaluation of management and treatment practices in child abuse cases. It appears that responsibility and authority for coordination should be placed with a single agency and that more specialized services be provided by experienced staff

Pigs, people, pathogens: health and multispecies relations in Central Uganda

This thesis describes the convergence of health and sickness in pigs and people in central Uganda. Drawing on thirteen months of ethnographic research, the chapters of this thesis trace diseases along the pig supply chain as they move from pig bodies on farms, into carcasses in slaughterhouses, meat in pork joints, and into human bodies in clinics and hospitals. Throughout this thesis, I argue that while the health of people was often dependent upon the lives of pigs, the development of beneficial relationships between pigs and people masked the emergence of pathogens which had the potential to threaten lives. One such pathogen was the neglected zoonotic parasite, Taenia solium taeniasis/cysticercosis (TSTC). With a focus on TSTC, I show how people along the supply chain did not always understand pig and human sickness in terms of pathogens. I suggest, therefore, that the visibility of pathogens along the supply chain is contingent upon networks that create and sustain their existence. Central to my argument is the concept of enactment, or the notion that objects, diseases, and bodies are not fixed, stable entities but are instead made through practices. While previous studies have considered enactments of objects, diseases, and species in specific locations, I ask whether it is possible to coordinate enactments across different species bodies and across vastly different spaces. This question has significance for the ‘One Health’ agenda – an interdisciplinary response to diseases shared between humans, animals and the environment. My findings suggest that the current ‘One Health’ framework in Uganda works on an assumption that pathogens are ontologically singular and made visible in the same way by pig supply chain actors, veterinarians, and doctors. I argue that if different enactments are not coordinated in order to make the same disease visible, then ‘One Health’ interventions could continue to neglect an array of neglected zoonotic diseases

Fragile dreams: exploring narratives of support, widowhood & caring in later life migration

My ethnographic work in the Costa del Sol region of Spain explores the complex social relationships that constitute and shape the daily lives of older British migrants. Through individual narratives and ethnographic encounters, I show how the often aspired to ‘migration dream’ is more fragile than anticipated. I examine how social relationships – friendships, acquaintanceships, family and others – shape how these older migrants manage unanticipated changes and challenges such as widowhood. By paying attention to how older migrants create, develop, transform and confront their relationships, I show how they are a central feature of both their experiences of later life and their migration dream. I show how older British migrants value and practice various forms of informal social and emotional support, help, and caring. Through my ascribed role as an adopted granddaughter, my research explores the importance of friendships between older people as they decide how and who to ask for help in different contexts. I also address the absence of widowhood within human geography through my multi-dimensional conceptualisation of this process, showing how it can be transformative for social relationships. I consider how the emotionally and socially complex questions of where to die and how to manage the presence of death shape these relationships. Moreover, I build towards understanding the caring community within which these migrants situate themselves. My thesis contributes to understanding how older migrants navigate social relationships, both proximately and transnationally. Moreover, through my empirical contributions I develop new understandings about how these migrants negotiate and contend with experiences that have traditionally received limited attention across human geography

What is Good Evidence?

In recent years, there has been a shift in the way that researchers and practitioners have thought about evidence, from a rigid commitment to the strict implementation of rigorously assessed EBPs only, to an understanding of the importance of program adaption in response to local context and the importance of flexibility to address challenges as they arise. Comparing the relative value, quality, and strength of different types of evidence is not straightforward. Although randomised controlled trials (RCTs), focus groups, and observational studies all produce valid forms of evidence, they are not all equally suited to answer the wide range of questions that are of interest to human services organisations. The aim of this report is to provide organisations with a practical guide on how to engage with research evidence in the assessment of their services

Parent satisfaction with sustained home visiting care for mothers and children : an integrative review

Aim: To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children. Background: Sustained home visiting is a service delivery mechanism of both prevention and intervention, in which people receive structured support services within their home environment over an extended period of months or years. For the purposes of this paper, sustained home visiting refers to in-home nursing support to address health inequities for mothers and young children. Sustained home visiting programs have been found to support improved health, wellbeing, and developmental outcomes for children and families. However, there is limited knowledge with regards to the level of parent satisfaction with care provided at home, and the factors and elements of care parents perceive to be critical to their satisfaction. It is important for healthcare practitioners to understand what practices and process parents consider to be a priority in securing their ongoing engagement. Design: Integrative review. Data sources: PubMed/Medline, CINAHL, Embase, and PsycINFO. Methods: A multi-step approach was used to search and retrieve peer-reviewed studies from the databases. Study selection, data extraction, data synthesis and critical appraisal were undertaken by two independent researchers. Results: A total of 13 studies met the inclusion criteria, including nine quantitative and four qualitative studies. The review found that parents provided with home visiting interventions had higher levels of satisfaction with care than those who received routine or facility-based care. Service dose was a factor associated with parent satisfaction, however, the direction of impact on parent satisfaction was mixed. Other elements of care parents perceived as important to service satisfaction included the nurse-client relationship, being treated with respect, empowerment, and emotional support. Conclusion: While it is critically important that home visiting practitioners provide evidence-based care and interventions, it is equally important that services are delivered in the context of positive and empowering relationships. Further research is recommended to understand the care process and mechanisms that enhance parent satisfaction and positive experiences, providing optimal quality of care

Community volunteer support for families with young children: Protocol for the volunteer family connect randomized controlled trial

Background: Use of community volunteers to support vulnerable families is a widely employed strategy with a long history. However, there has been minimal formal scientific investigation into the effectiveness of volunteer home visiting programs for families. There is also a need for research examining whether volunteer home visiting leads to improved outcomes for volunteers. Objective: The objective of this paper is to describe the research protocol for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home visiting program designed to support families of young children who experience social isolation or a lack of parenting confidence and skills. The project is being conducted in partnership with 3 leading not-for-profit organizations, designed to contribute to the body of evidence that informs decisions about appropriate family support services according to the level of need. It is the first study to examine outcomes for both the families and the volunteers who deliver the service. Methods: The RCT is being conducted in 7 sites across Australia. We aim to recruit 300 families to the study: 150 control (services as usual) and 150 intervention (services as usual + volunteer home visiting) families. Intervention families will receive the service for 3-12 months according to their needs, and all participants will complete 6 data collection points over 15 months. A minimum of 80 volunteers will also be recruited, along with a matched community comparison group. The volunteers will complete 3 data collection points over 12 months. Primary outcomes include community connectedness and parenting competence. Secondary outcomes include parent physical and mental health; general parent well-being; parent empowerment; the child-parent relationship; sustainability of family routines; child immunization; child nutrition or breastfeeding; number of accidental injury reports; and volunteer health, well-being, and community connectedness. Results: This effectiveness trial was funded in 2016, and we aim to complete data collection by the end of 2018. The first results are expected to be submitted early in 2019. Conclusions: There is a need to rigorously assess volunteer home visiting and whether it has a unique and important role on the service landscape, complementary to professional services. This research is the first trial of a volunteer home visiting program to be conducted in Australia and one of the largest of its kind worldwide