838 research outputs found

    Health-led parenting interventions in pregnancy and early years

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    Evaluation of anuran richness in restored wetlands of central Louisiana

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    Bottomland hardwood forests and associated fauna, including frogs, are disappearing. The 1990 Farm Bill created a wetland restoration program on private lands called the Wetland Reserve Program (WRP) that has the potential to reverse the declines in species associated with bottomland hardwood forests. As of September 2005, nearly 85,000 ha had been enrolled in Louisiana, but the structure and value of these wetlands to frogs is not known. I evaluated 22 restored and 8 reference wetlands from January through May in 2004 and 2005 to determine the effects of local and landscape scale habitat characteristics on frog species richness and occurrence. I used chorus count surveys, egg mass searches, and dipnet surveys to detect frog species each season. Vegetation characteristics at each wetland were determined seasonally. I evaluated landscape influences by using aerial photography and satellite imagery of the sites to determine the surrounding land use. I used multiple linear and logistic regression analysis and t-tests to evaluate the effects of local and landscape variables on species richness and individual species occurrence. I detected 12 of the 13 species expected to occur. Frog species richness did not differ between restored and natural wetlands, but species richness was higher in 2004 than 2005 (P \u3c 0.0001), presumably due to much greater amounts of rainfall in 2004. Species richness in 2004 was positively influenced by median water depth and canopy cover (P = 0.0011). In 2005, permanent flooding, median water depth, emergent and floating vegetation, and canopy cover positively influenced species richness (P \u3c 0.0001). Species richness also increased with forest in the surrounding landscape. Bullfrogs and bronze frogs were associated with canopy closure, herbaceous vegetation, and nearby forest. Northern cricket frogs were associated with shallow wetlands with floating vegetation, litter, and nearby forest. Gray tree frogs were found in wetlands with canopy cover, low emergent vegetation, and nearby agriculture. Restored wetlands in this study provided suitable frog habitat and supported similar frog species comparable to reference wetlands; however, additional frog and vegetation monitoring should be continued to evaluate restored sites throughout maturation

    A Study of Attendance at Four Corners School in Sugarland, Texas 1946-47

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    Over a period of five years the average enrollment at Four Corners School, Sugar Land, Texas, has been 85, but the average graduating class has been two and a larger number of children has had irregular attendance than the number that has attended regularly. At the 1940 session of the Texas State Teachers Association, State Superintendent of Education, L. A. Woods pointed out that the small number of Negro high school graduates was due to the low percentage of attendance in both the elementary and secondary schools. In the light of these considerations, the writer is faced with the question: If the causes for low attendance can be found, might it not be possible to encourage and otherwise help boys and girls to remain in school long enough to graduate? Might it not be possible to revise the curriculum to meet the needs of these children who drop out of school? It is the problem of this study to find some of the underlying causes of irregular attendance in the Four Corners School of Sugar Land and to interpret them; to find if the causes can be reduced or remove entirely; to make suggestions for curricular changes that might foster better attendance. The problem involved in this study finds expression in these questions: 1. What is the status of school attendance of Negro school children in four Corners School, Sugar Land, Texas? 2. What are the causes for irregular attendance

    Improving child protection : a systematic review of training and procedural interventions

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    Aim: To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals. Methods: Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour. Results: Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of onegroup pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process. Conclusion: Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective

    A systematic review of reviews of interventions to promote mental health and prevent mental health problems in children and young people

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    Background: There is a growing policy imperative to promote positive mental health as well as preventing the development of mental health problems in children. This paper summarises the results of published systematic reviews evaluating interventions to promote mental health and prevent mental illness in children. Method: A search was undertaken of ten electronic databases using a combination of medical subject headings (MeSH) and free text searches. Systematic reviews covering mental health promotion or mental illness prevention interventions aimed at infants, children or young people up to age 19 were included. Reviews of drug and alcohol prevention programmes or programmes to prevent childhood abuse and neglect were excluded because these have been the subject of recent good quality reviews of reviews. Critical appraisal of all studies was undertaken using a standardised appraisal tool for systematic reviews. Where possible effect sizes and 95% confidence intervals are reported. A narrative summary has been provided. Results: A total of 27 systematic reviews were included and grouped pragmatically under the following headings: parenting interventions; programmes for the prevention of anxiety and depression, programmes to promote self esteem, violence and aggression prevention programmes, school-based programmes, and general reviews. Included studies targeted a range of risk and protective factors, and a range of populations (including both parents and children). While, many lacked methodological rigour, overall, the evidence is strongly suggestive of the effectiveness of a range of interventions in promoting positive mental well-being, and reducing key risk factors for mental illness in children. Conclusion: A variety of programmes have been shown to be effective in promoting children’s mental health, albeit with modest effect sizes. Based on this evidence, arguments are advanced for the preferential provision of early preventive programmes

    Leadership for knowledge translation : the case of CLAHRCs

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    Calls for successful knowledge translation (KT) in healthcare have multiplied over recent years. The NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) program is a policy initiative in the UK aimed at speeding-up the translation of research into healthcare practice. Using multiple qualitative research methods and drawing on the ongoing processes used by individuals to interpret and contextualize information, we explore how new organizational forms for KT bridge the gap between research and practice. We pay particular attention to the relationship between the organization and practices of KT and leadership. Our empirical data demonstrate how the relationship between leadership and KT shifted over time from a push model where the authoritarian top-down leadership team set outcome measures by which to judge KT performance to one which aimed to distribute leadership capacity across a wide range of stakeholders in a health and social care systems. The relationship between the organization and practices of KT and leadership is affected by local contextual influences on policies directed at increasing the uptake of research in clinical practice. Policy-makers and service leaders need to recognize that more dispersed type of leadership are needed to accommodate the idiosyncratic nature of collective action

    Impact of a general practice based group parenting programme on the mental health of children and parents 12 months post intervention : quantitative and qualitative results from a controlled trial

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    Objective To test the effectiveness at one year of the Webster Stratton Parents and Children Series group parenting programme in a population sample of parents Design multicentre block randomised controlled trial Setting 3 urban General Practices in Oxford. Participants Parents of children aged 2-8 years in 116 families who scored in the upper 50% on a behaviour inventory. Intervention Webster-Stratton’s 10-week parenting programme led by health visitors. Outcome measures. Eyberg Child Behaviour Inventory, Goodman Strengths and Difficulties Questionnaire, General Health Questionnaire, Parenting Stress Index, Rosenberg Self Esteem Scale. Qualitative interviews with volunteer parents from both intervention and control groups immediately post intervention. Results The intervention significantly reduced child behaviour problems and improved mental health at immediate and 6-month follow-ups. One-year differences between control and intervention groups were not significant. Possible methodological reasons for this are: Hawthorne effects and contamination of control group. At interview parents spoke of a need for further sessions and a desire for attendance by both parents. They also described how, as a result of the programme, they had gained in confidence, felt less stressed, shouted less and achieved more cooperation from their children. Conclusions Parenting programmes have the potential to promote mental health and reduce social inequalities, but further work is needed to improve long-term effectiveness

    Role of home visiting in improving parenting and health in families at risk of abuse and neglect : results of a multicentre randomised controlled trial and economic evaluation

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    Objectives – To evaluate the effectiveness and cost-effectiveness of an intensive home visiting programme in improving outcomes for vulnerable families. Design – Multicentre randomised controlled trial in which eligible women were allocated to receive home visiting (n=67) or standard services (n=64). Incremental cost analysis. Setting – 40 GP practices across two counties in the UK Participants – 131 vulnerable pregnant women. Intervention: Selected health visitors were trained in the Family Partnership Model to provide a weekly home visiting service from 6-months antenatally to 12 months postnatally. Main outcome measures – mother-child interaction, maternal psychological health attitudes and behaviour, infant functioning and development, and risk of neglect or abuse. Results – At 12-months differences favouring the home visited group were observed on an independent assessment of maternal sensitivity (p<0.04) and infant cooperativeness (p<0.02). No differences were identified on any other measures. There was a non-significant increase in the likelihood of intervention group infants being the subject of child protection proceedings, or being removed from the home, and one death in the control group. The mean incremental cost per infant of the home visiting intervention was £3,246 (bootstrapped 95% confidence interval for the difference: £1,645 - £4,803). Conclusion – This intervention may have the potential to improve parenting and increase the identification of infants at risk of abuse and neglect in vulnerable families. Further investigation is needed together with long term follow up to assess possible sleeper effects

    When infrastructure transition and work practice redesign collide

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    Purpose – As management innovations become more complex, infrastructure needs to change in order to accommodate new work practices. Different challenges are associated with work practice redesign and infrastructure change however; combining these presents a dual challenge and additional challenges associated with this interaction. The purpose of this paper is to ask: what are the challenges which arise from work practice redesign, infrastructure change and simultaneously attempting both in a single transformation? Design/methodology/approach – The authors present a longitudinal study of three hospitals in three different countries (UK, USA and Canada) transforming both their infrastructure and work practices. Data consists of 155 ethnographic interviews complemented by 205 documents and 36 hours of observations collected over two phases for each case study. Findings – This paper identifies that work practice redesign challenges the cognitive load of organizational members whilst infrastructure change challenges the project management and structure of the organization. Simultaneous transformation represents a disconnect between the two aspects of change resulting in a failure to understand the relationship between work and design. Practical implications – These challenges suggest that organizations need to make a distinction between the two aspects of transformation and understand the unique tensions of simultaneously tackling these dual challenges. They must ensure that they have adequate skills and resources with which to build this distinction into their change planning. Originality/value – This paper unpacks two different aspects of complex change and considers the neglected challenges associated with modern change management objectives. </jats:sec
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