Key Working for Families with Young Disabled Children

For families with a disabled child, the usual challenges of family life can be further complicated by the need to access a wide range of services provided by a plethora of professionals and agencies. Key working aims to support children and their families in navigating these complexities ensuring easy access to relevant, high quality, and coordinated care. The aim of this paper is to explore the key worker role in relation to “being a key worker” and “having a key worker”. The data within this paper draw on a larger evaluation study of the Blackpool Early Support Pilot Programme. The qualitative study used an appreciative and narrative approach and utilised mixed methods (interviews, surveys and a nominal group workshop). Data were collected from 43 participants (parents, key workers, and other stakeholders). All stakeholders who had been involved with the service were invited to participate. In the paper we present and discuss the ways in which key working made a difference to the lives of children and their families. We also consider how key working transformed the perspectives of the key workers creating a deeper and richer understanding of family lives and the ways in which other disciplines and agencies worked. Key working contributed to the shift to a much more family-centred approach, and enhanced communication and information sharing between professionals and agencies improved. This resulted in families feeling more informed. Key workers acted in an entrepreneurial fashion, forging new relationships with families and between families and other stakeholders. Parents of young disabled children and their service providers benefited from key working. Much of the benefit accrued came from strong, relational, and social-professional networking which facilitated the embedding of new ways of working into everyday practice. Using an appreciative inquiry approach provided an effective and relevant way of engaging with parents, professionals, and other stakeholders to explore what was working well with key working within an Early Support Pilot Programme

Grounding perceptions: the value of otoendoscopy images in strengthening parents and children’s understanding and decision making in a paediatric ENT clinic

IntroductionIn recent years, there has been an increasing use of otoendoscopy in middle ear surgery. There is also increasing evidence of its usefulness as a diagnostic tool for clinicians. However, there is limited evidence on whether understanding their ear condition is of benefit to patients. This novel study sought to explore the perceptions, perspectives, and satisfaction of parents, children, and young people regarding the use of otoendoscope images in outpatient ENT consultations in relation to their understanding of ear symptoms, disease, and subsequent treatment. The framework for the study is child (and parent) health literacy and how visual images can play in scaffolding understanding, communication, and decision-making.MethodsThis qualitative descriptive exploratory study used semi-structured observation, a survey, short conversational interviews, and child activities.ResultsPurposive sampling of 16 children (aged 4–15 yrs, various diagnoses) and parents/carers attending an outpatient ENT clinic at a tertiary pediatric hospital. One overarching theme, “Grounding perceptions and deepening engagement,” and two sub-themes, “Strengthening understanding” and “Supporting decision-making,” were identified. The children and parents valued the opportunity to see the images and gain insight and knowledge of their child's pathology.DiscussionThe images appeared to promote child (and parent) health literacy and interaction between the child-parent-clinician and informed shared decision-making. This study suggests that the use of otoendoscopy in an out-patient setting and sharing of the images with parents, children, and young people have a largely positive impact on understanding, relationship building, and decision making in pediatric ENT consultations

Environmental DNA analysis confirms extant populations of the cryptic Irwin’s turtle within its historical range

Background Approximately 50% of freshwater turtles worldwide are currently threatened by habitat loss, rural development and altered stream flows. Paradoxically, reptiles are understudied organisms, with many species lacking basic geographic distribution and abundance data. The iconic Irwin’s turtle, Elseya irwini, belongs to a unique group of Australian endemic freshwater turtles capable of cloacal respiration. Water resource development, increased presence of saltwater crocodiles and its cryptic behaviour, have made sampling for Irwin’s turtle in parts of its range problematic, resulting in no confirmed detections across much of its known range for > 25 years. Here, we used environmental DNA (eDNA) analysis for E. irwini detection along its historical and contemporary distribution in the Burdekin, Bowen and Broken River catchments and tributaries. Five replicate water samples were collected at 37 sites across those three river catchments. Environmental DNA was extracted using a glycogen-aided precipitation method and screened for the presence of E. irwini through an eDNA assay targeting a 127 base pair-long fragment of the NADH dehydrogenase 4 (ND4) mitochondrial gene. Results Elseya irwini eDNA was detected at sites within its historic distribution in the lower Burdekin River, where the species had not been formally recorded for > 25 years, indicating the species still inhabits the lower Burdekin area. We also found higher levels of E. iriwni eDNA within its contemporary distribution in the Bowen and Broken Rivers, matching the prevailing scientific view that these areas host larger populations of E. irwini. Conclusions This study constitutes the first scientific evidence of E. irwini presence in the lower Burdekin since the original type specimens were collected as part of its formal description, shortly after the construction of the Burdekin Falls Dam. From the higher percentage of positive detections in the upper reaches of the Broken River (Urannah Creek), we conclude that this area constitutes the core habitat area for the species. Our field protocol comprises a user-friendly, time-effective sampling method. Finally, due to safety risks associated with traditional turtle sampling methods in the Burdekin River (e.g., estuarine crocodiles) we propose eDNA sampling as the most pragmatic detection method available for E. irwini

Support for Children’s Protagonism: Methodological Moves towards Critical Children Rights Research Framed from Below

With notable exceptions, there is a lack of critique in existing approaches to children’s rights based research. Where children’s rights research is also co-research with children, a critical approach requires that children are enabled to challenge assumptions about, and definitions of, rights, as well as to lead the process and to try to bring about change. This paper argues that creative methods and structured intergenerational dialogue can support critical children rights research ‘from below’. We illustrate this approach using research by disabled children and young people, who reflected on their own experiences and the provisions of three international Conventions (UNCRC, UNCRPD and ICESCR). Effectively engaging with existing international Conventions meant matching children’s claims to rights in their everyday contexts with existing rights provisions. This framework was then used to analyse qualitative research with other disabled children and their families. The young co-researchers are now using the findings in their protagonism for social change

The Forum: Summer 2005

Summer 2005 journal of the Honors Program at the University of North Dakota. The issue includes stories, poems, essays and art by undergraduate students.https://commons.und.edu/und-books/1057/thumbnail.jp

Posterior Reconstruction Before Anastomosis Improves the Anastomosis Time During Robot-Assisted Radical Prostatectomy

Posterior reconstruction prior to anastomosis decreased anastomotic time for robotic surgeons in training

Spitzer View of Massive Star Formation in the Tidally Stripped Magellanic Bridge

The Magellanic Bridge is the nearest low-metallicity, tidally stripped environment, offering a unique high-resolution view of physical conditions in merging and forming galaxies. In this paper we present analysis of candidate massive young stellar objects (YSOs), i.e., {\it in situ, current} massive star formation (MSF) in the Bridge using {\it Spitzer} mid-IR and complementary optical and near-IR photometry. While we definitely find YSOs in the Bridge, the most massive are $\sim10 M_\odot$, $\ll45 M_\odot$ found in the Large Magellanic Cloud (LMC). The intensity of MSF in the Bridge also appears decreasing, as the most massive YSOs are less massive than those formed in the past. To investigate environmental effects on MSF, we have compared properties of massive YSOs in the Bridge to those in the LMC. First, YSOs in the Bridge are apparently less embedded than in the LMC: 81% of Bridge YSOs show optical counterparts, compared to only 56% of LMC sources with the same range of mass, circumstellar dust mass, and line-of-sight extinction. Circumstellar envelopes are evidently more porous or clumpy in the Bridge's low-metallicity environment. Second, we have used whole samples of YSOs in the LMC and the Bridge to estimate the probability of finding YSOs at a given \hi\ column density, N(HI). We found that the LMC has $\sim3\times$ higher probability than the Bridge for N(HI) $>10\times10^{20}$ cm$^{-2}$, but the trend reverses at lower N(HI). Investigating whether this lower efficiency relative to HI is due to less efficient molecular cloud formation, or less efficient cloud collapse, or both, will require sensitive molecular gas observations.Comment: 41 pages, 20 figures, 6 tables; accepted for publication in ApJ; several figures are in low resolution due to the size limit here and a high resolution version can be downloaded via http://www.astro.virginia.edu/~cc5ye/ms_bridge20140215.pd