Children and the Fly-in/Fly-out lifestyle : employment-related paternal absence and the implications for children

There has been growing interest in the implications of paternal fly-in/fly-out employment (FIFO) for families and children. The current research had a dual aim, first to investigate children’s well-being in relation to family functioning and paternal FIFO employment characteristics and, second, to access children’s own experience, perceptions and attitudes about the FIFO lifestyle and employment-related paternal absence. The research was multi-method in design, with a quantitative study measuring child, parent and family functioning and a two-stepped qualitative component consisting of a content analysis of written responses and a thematic analysis of semi-structured interviews with children.Forty-eight children, aged between 8 and 16 years, and their parents (i.e., 48 mothers, 47 fathers) from 49 families completed the quantitative questionnaires. Overall, the children’s emotional-behavioural functioning was healthy and not significantly related to paternal FIFO employment characteristics. The boys reported more emotionalbehavioural difficulties than girls, in particular hyperactivity. The children’s well-being was associated with several maternal-reported variables but none of the paternalreported variables. However, the children’s level of emotional-behavioural functioning was predicted by their self-report of paternal care and nurturance. Addressing parental well-being, the participating women reported more emotional difficulties than the men, with over one third of the women reporting stress symptoms in the moderate to severe clinical range. While the majority of children and their parents reported healthy family functioning and the parents reported healthy relationship quality, over 50% of the mothers and fathers in the study reported parenting conflict in the clinical range.Participating children endorsed the extended, quality time with their fathers and the financial remuneration of paternal FIFO employment as the key benefits of the FIFO lifestyle. The adolescents in the study viewed employment-related paternal absences as a respite from fathering as well as a loss of paternal support. The main costs of the FIFO lifestyle for the children were the negative emotions related to paternal absence, the loss of physical and emotional paternal support, and the restriction to their lifestyle and activities. A subset of 15 children from the original study and 12 of their siblings (n = 27) were interviewed. The majority of the children demonstrated successful adaptation to paternal FIFO employment. The key themes to emerge from these interviews were the children’s emotional and personal changes (e.g., increased responsibility, greater independence) and family changes (e.g., alternating household systems, family selfreliance). The children demonstrated knowledge of their father’s work and were also aware of the potential impact of FIFO employment on family and personal relationships.The overall findings suggest that paternal FIFO employment does not act as a discreet homogeneous risk factor for children. However, there was some evidence that boys negotiate employment-related paternal absences differently from girls, with boys expressing more ambivalence toward paternal absences. The significant finding of high maternal stress in the study indicates that mothers may “buffer” the strains of regular family disruption from the other family members. The participating children’s ability to balance the benefits of the FIFO lifestyle with the costs of paternal absences, to understand parental employment decisions, and to demonstrate resilience to family changes was positive news for FIFO families and those families considering the FIFO option

Six aspects of female genital mutilation education (SAFE) model:findings from a qualitative study

Objectives: Recent figures show that over 200 million women and girls, globally, live with the consequences of female genital mutilation (FGM). Complex debilitating physical, psychological and social problems result from the practice. Health education interventions have proven to be essential in both preventing the practice and informing support of survivors. In this study, we aimed to explore factors that affect the effectiveness of health education interventions.Design: A generic qualitative approach was applied using semistructured individual and focus group interviews with women and men from communities with a history of FGM in Birmingham, UK. Framework analysis was used to group recurring themes from the data. Intersectionality was used as a theoretical lens to synthesise findings.Participants: Twenty-one individuals (18 women and 3 men) participated in semistructured individual and focus group interviews about their views and experiences of health and well-being intervention programmes related to FGM.Results: Six themes emerged from the data and were developed into a model of issues relating to FGM education. These six themes are (1) active communication, (2) attitudes and beliefs, (3) knowledge about FGM, (4) social structures, (5) programme approach and (6) the better future. A combined discussion of all these issues was compressed into three groupings: social structures, culture and media.Conclusion: The results of this study depict aspects associated with FGM education that should be considered by future interventions aiming to prevent the practice and inform support services for survivors in a holistic way

Accidental Needlestick Exposures linked to the Administration of Local Anesthesia by Healthcare Workers

The Massachusetts Department of Public Health mandates that all Massachusetts hospitals maintain an active log to track sharps injuries due to the health risks related to such injuries. These logs are used to guide continuous quality improvement activities aimed at preventing sharps injuries. A review of sharps injuries at UMass Memorial Medical Center (UMMMC) in 2013 showed a seemingly high incidence occurring among healthcare workers who were administering local anesthesia. We undertook an investigation of the relative rate of needlesticks associated with local anesthesia administration compared to the rate of all sharps injuries over a 10-year period

Factors associated with non-attendance in a general practice super clinic population in regional Australia: a retrospective cohort study

BackgroundNon-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance.AimsTo explore factors associated with non-attendance in a regional primary care setting.MethodA retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week.  ResultsThe overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208,

Evaluation of the performance of Ortho T. cruzi ELISA test system for the detection of antibodies to Trypanosoma cruzi

The serologic diagnosis of chronic Chagas disease, caused by infection with the parasite Trypanosoma cruzi, is challenging and lacks a gold-standard assay. To overcome the problem, CDC uses an algorithm that uses two tests on different platforms and applies a third test as a tiebreaker. The Ortho T. cruzi ELISA Test System from Ortho Diagnostics was cleared by FDA for clinical diagnosis usage. We evaluated this test against the CDC algorithm for chronic Chagas disease. We tested several sets of serum specimens: 104 specimens tested positive for T. cruzi specific antibody and 283 (including 30 specimens positive for antibody to Leishmania spp.) tested negative based on the current CDC chronic T. cruzi infection diagnostic testing algorithm. Concordance of the Ortho T. cruzi ELISA Test System with the CDC algorithm result was 90% (95% CI 87 to 93%) overall and 92% (95% CI 89 to 95%) when excluding Leishmania spp. antibody positive specimens. The cross-reactivity of the Ortho T. cruzi ELISA Test System was 37% to Leishmania spp. serologically positive specimens, 1% to specimens from patients diagnosed with other parasitic infections, and 0% against specimens from a US noninfected population. In conclusion, the Ortho T. cruzi ELISA Test System compares well against the CDC diagnostic algorithm for chronic Chagas disease. The availability of this FDA-cleared assay will improve the chronic Chagas disease diagnosis. © 2022 American Society for Microbiology. All rights reserved

Six aspects of female genital mutilation education (SAFE) model: findings from a qualitative study.

ObjectivesRecent figures show that over 200 million women and girls, globally, live with the consequences of female genital mutilation (FGM). Complex debilitating physical, psychological and social problems result from the practice. Health education interventions have proven to be essential in both preventing the practice and informing support of survivors. In this study, we aimed to explore factors that affect the effectiveness of health education interventions.DesignA generic qualitative approach was applied using semistructured individual and focus group interviews with women and men from communities with a history of FGM in Birmingham, UK. Framework analysis was used to group recurring themes from the data. Intersectionality was used as a theoretical lens to synthesise findings.ParticipantsTwenty-one individuals (18 women and 3 men) participated in semistructured individual and focus group interviews about their views and experiences of health and well-being intervention programmes related to FGM.ResultsSix themes emerged from the data and were developed into a model of issues relating to FGM education. These six themes are (1) active communication, (2) attitudes and beliefs, (3) knowledge about FGM, (4) social structures, (5) programme approach and (6) the better future. A combined discussion of all these issues was compressed into three groupings: social structures, culture and media.ConclusionThe results of this study depict aspects associated with FGM education that should be considered by future interventions aiming to prevent the practice and inform support services for survivors in a holistic way

Describing a new food group classification system for UK biobank: analysis of food groups and sources of macro- and micronutrients in 208,200 participants.

PURPOSE: The UK Biobank study collected detailed dietary data using a web-based self-administered 24 h assessment tool, the Oxford WebQ. We aimed to describe a comprehensive food grouping system for this questionnaire and to report dietary intakes and key sources of selected nutrients by sex and education. METHODS: Participants with at least one valid 24-h questionnaire were included (n = 208,200). Dietary data were grouped based on the presence of nutrients as well as culinary use, processing, and plant/animal origin. For each food group, we calculated the contribution to energy intake, key macronutrients, and micronutrients. We also identified the top contributors to energy intake, free sugars and saturated fat by sex and education. RESULTS: From the 93 food groups, the top five contributors to energy intake (in descending order) were: desserts/cakes/pastries; white bread; white pasta/rice; bananas/other fruit; semi-skimmed milk. Wine, beer, and fruit juices were the top beverage contributors to overall energy intake. Biscuits, and desserts/cakes/pastries were the highest contributors to free sugars, total fat, and saturated fat intakes, but also contributed to the calcium and iron intakes. Top contributors to energy, saturated fat, and free sugars were broadly similar by sex and education category, with small differences in average nutrient intakes across the population. CONCLUSION: This new food classification system will support the growing interest in the associations between food groups and health outcomes and the development of food-based dietary guidelines. Food group variables will be available to all users of the UK Biobank WebQ questionnaire

Dynamics of cinacalcet use and biochemical control in hemodialysis patients: a retrospective New-user cohort design

Abstract Background Cinacalcet is used to treat secondary hyperparathyroidism among hemodialysis patients. Large-scale epidemiologic studies describing patterns of cinacalcet use, effects on parathyroid hormone (PTH), calcium, and phosphorous levels, and predictors of discontinuation have not been previously reported. Methods This retrospective cohort study used a clinical database of a large U.S. dialysis provider (2007–2010) merged with administrative data from the United States Renal Data System. Among new users of cinacalcet with Medicare coverage, trends in PTH, calcium, and phosphorus were measured in 30-day intervals following cinacalcet initiation. Results Seventeen thousand seven hundred sixty-three eligible initiators contributed 111,047 30-day follow-up intervals. Of these, 56 % discontinued cinacalcet by month 4. Of those discontinuing, 76.3 % reinitiated. Mean values of PTH, calcium, and phosphorus decreased to recommended levels within 4 months following initiation. Proximal PTH levels <150 pg/mL were associated with discontinuation: HR = 1.23 (95 % CI: 1.12, 1.36), whereas low calcium (<7.5 mg/dL) was suggestive of an association, HR = 1.09 (95 % CI 0.91, 1.32). Being in the Part D gap period increased discontinuation risk: HR = 1.09 (95 % CI: 1.03, 1.16). Low-income subsidy status decreased discontinuation risk: HR = 0.77 (95 % CI 0.69, 0.86). Predictors of reinitiation included low-income subsidy, HR = 1.32 (95 % CI 1.22, 1.43); higher albumin level, HR = 1.23 (95 % CI 1.10, 1.36) and higher calcium level, HR = 1.26 (95 % CI 1.19, 1.33). Conclusions Substantial and expected declines in laboratory values occurred following cinacalcet initiation. Early discontinuation and reinitiation of cinacalcet were common and may have occurred for clinical and economic reasons

Does fish larval dispersal differ between high and low latitudes?

Author Posting. © The Author(s), 2013. This is the author's version of the work. It is posted here by permission of The Royal Society for personal use, not for redistribution. The definitive version was published in Proceedings of the Royal Society B Biological Sciences 280 (2013): 20130327, doi:10.1098/rspb.2013.0327.Several factors lead to expectations that the scale of larval dispersal and population connectivity of marine animals differs with latitude. We examine this expectation for demersal shorefishes, including relevant mechanisms, assumptions, and evidence. We explore latitudinal differences in: 1) biological (e.g., species composition, spawning mode, pelagic larval duration (PLD)), 2) physical (e.g., water movement, habitat fragmentation), and 3) biophysical factors (primarily temperature, which could strongly affect development, swimming ability, or feeding). Latitudinal differences exist in taxonomic composition, habitat fragmentation, temperature, and larval swimming, and each could influence larval dispersal. Nevertheless, clear evidence for latitudinal differences in larval dispersal at the level of broad faunas is lacking. For example, PLD is strongly influenced by taxon, habitat, and geographic region, but no independent latitudinal trend is present in published PLD values. Any trends in larval dispersal may be obscured by a lack of appropriate information, or use of ‘off the shelf’ information that is biased with regard to the species assemblages in areas of concern. Biases may also be introduced from latitudinal differences in taxa or spawning modes, as well as limited latitudinal sampling. We suggest research to make progress on the question of latitudinal trends in larval dispersal.TK was supported by the Norwegian Research Council through project MENUII #190286. JML was supported by ARC Discovery Grant DP110100695. JEC and RRW were supported by the Partnership for the Interdisciplinary Study of Coastal Oceans, funded by The David and Lucille Packard Foundation and the Gordon and Betty Moore Foundation.2014-03-2