This paper reports on the findings from a study exploring the efficacy of a training program for child protection practitioners. The training aimed to improve understanding of the sociohistorical ...context that underpins interactions between the welfare system and Aboriginal communities, the impact of past and present child protection laws, and the importance of trauma theory to guide practice when working with Aboriginal families. A pre-post survey design study was conducted. Findings demonstrated the preferred theoretical approach to practice was guided by attachment theory. No participant listed trauma theory as guiding their work with Aboriginal families. The study found the lack of skills and knowledge deficit of trauma-informed principles and the limited understanding of trauma theories can be and should be addressed in vocational training. As a result of the training, participants' knowledge about trauma significantly improved, as did their understanding of key concepts such as the difference between past and current welfare laws, assimilation, intergenerational trauma and trauma-related behaviours. Findings point to the need for high quality training in entry-level and professional development for welfare practitioners to support best practice in working with Aboriginal families, and the importance of rigorous evaluation of training to ensure that it is impactful.
IMPLICATIONS
Welfare practitioners do not necessarily understand trauma theory and trauma-informed practice and do not understand the impact of trauma on Indigenous Australians.
Mandatory in-service training about the past and ongoing traumatic impact of previous child welfare system laws, must be provided to welfare practitioners.
Trauma theory needs to guide child protection practice when working with Aboriginal families.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children.
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.
Integrative review.
PubMed/Medline, CINAHL, Embase, and PsycINFO.
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.
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.
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.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To analyse variations in the n-butanol threshold and odour identification scores of the Connecticut Chemosensory Clinical Research Centre test in various grades of olfactory dysfunction and in ...different nasal conditions leading to olfactory loss.
Retrospective observational study.
All grades of olfactory dysfunction were predominantly noted among males. In chronic rhinosinusitis, anosmia or severe hyposmia was seen in 87.5 per cent of patients without polyps in comparison with 68 per cent of patients with polyps. In addition, 90 per cent of patients with atrophic rhinitis and post-traumatic loss had anosmia, but only 30.7 per cent of patients with allergic rhinitis had anosmia. Pepper was the most affected smell for all the nasal diseases except atrophic rhinitis, in which asafoetida and baby powder smells were affected more.
In most inflammatory sinonasal conditions, odour identification is relatively preserved even when the threshold is maximally affected. In patients with comparable olfactory dysfunction based on the Connecticut Chemosensory Clinical Research Centre test score, a relatively preserved suprathreshold odour identification score may predict better prognosis.
In the economy of therapeutic monitoring, an affordable viral marker is essential in the era of direct-acting antivirals (DAAs). We elucidated the kinetics of HCVcAg to delineate its precise role in ...monitoring therapeutic response.
In this longitudinal study, 3208 patients were tested for HCV RNA. A total of 423 patients were started on DAAs. Treatment response and kinetics of HCVcAg/RNA were assessed in treatment-naïve (n = 383) and previously treated (n = 40) patients with follow-up for 2 years.
After the initiation of DAAs, the rate of relapse was significantly higher in the previously treated group than naive group 12.5% (5/40) Vs 2% (7/383), p<0.0001. The response rate at RVR was significantly higher with HCVcAg than RNA in both groups (p<0.02). The kinetics of HCVcAg and RNA were significantly different at ETR and SVR12 in the naïve (p<0.04), but similar at all therapeutic points in the previously treated group. The correlation between HCVcAg and RNA was good at baseline, ETR and SVR, except RVR in both groups (r>0.6; p<0.0001). Furthermore, HCV genotypes, treatment regimen, CTP (<7/≥7) and MELD (<15/≥15) did not influence the therapeutic response and the viral replication kinetics (p>0.05).
It is the first longitudinal study from India shows that the response rate and kinetics of HCVcAg are comparable to HCV RNA for an extended duration, except at RVR, irrespective of the HCV genotypes, treatment regimen, and liver disease severity. Hence, HCVcAg can be considered as a pragmatic marker to monitor therapeutic response and predict relapse in the era of DAAs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cell-based therapy for articular hyaline cartilage regeneration predominantly involves the use of mesenchymal stem cells and chondrocytes. However, the regenerated repair tissue is suboptimal due to ...the formation of mixed hyaline and fibrocartilage, resulting in inferior long-term functional outcomes. Current preclinical research points towards the potential use of cartilage-derived chondroprogenitors as a viable option for cartilage healing. Fibronectin adhesion assay-derived chondroprogenitors (FAA-CP) and migratory chondroprogenitors (MCP) exhibit features suitable for neocartilage formation but are isolated using distinct protocols. In order to assess superiority between the two cell groups, this study was the first attempt to compare human FAA-CPs with MCPs in normoxic and hypoxic culture conditions, investigating their growth characteristics, surface marker profile and trilineage potency. Their chondrogenic potential was assessed using mRNA expression for markers of chondrogenesis and hypertrophy, glycosaminoglycan content (GAG), and histological staining. MCPs displayed lower levels of hypertrophy markers (RUNX2 and COL1A1), with normoxia-MCP exhibiting significantly higher levels of chondrogenic markers (Aggrecan and COL2A1/COL1A1 ratio), thus showing superior potential towards cartilage repair. Upon chondrogenic induction, normoxia-MCPs also showed significantly higher levels of GAG/DNA with stronger staining. Focused research using MCPs is required as they can be suitable contenders for the generation of hyaline-like repair tissue.
Obtaining regeneration-competent cells and generating high-quality neocartilage are still challenges in articular cartilage tissue engineering. Although chondroprogenitor cells are a resident ...subpopulation of native cartilage and possess a high capacity for proliferation and cartilage formation, their potential for regenerative medicine has not been adequately explored. Fetal cartilage, another potential source with greater cellularity and a higher cell-matrix ratio than adult tissue, has been evaluated for sourcing cells to treat articular disorders. This study aimed to compare cartilage resident cells, namely chondrocytes, fibronectin adhesion assay-derived chondroprogenitors (FAA-CPCs) and migratory chondroprogenitors (MCPs) isolated from fetal and adult cartilage, to evaluate differences in their biological properties and their potential for cartilage repair. Following informed consent, three human fetal and three adult osteoarthritic knee joints were used to harvest the cartilage samples, from which the three cell types a) chondrocytes, b) FAA-CPCs, and MCPs were isolated. Assessment parameters consisted of flow cytometry analysis for percentage expression of cell surface markers, population doubling time and cell cycle analyses, qRT-PCR for markers of chondrogenesis and hypertrophy, trilineage differentiation potential and biochemical analysis of differentiated chondrogenic pellets for total GAG/DNA content. Compared to their adult counterparts, fetal cartilage-derived cells displayed significantly lower CD106 and higher levels of CD146 expression, indicative of their superior chondrogenic capacity. Moreover, all fetal groups demonstrated significantly higher levels of GAG/DNA ratio with enhanced uptake of collagen type 2 and GAG stains on histology. It was also noted that fetal FAA CPCs had a greater proliferative ability with significantly higher levels of the primary transcription factor SOX-9. Fetal chondrocytes and chondroprogenitors displayed a superior propensity for chondrogenesis when compared to their adult counterparts. To understand their therapeutic potential and provide an important solution to long-standing challenges in cartilage tissue engineering, focused research into its regenerative properties using in-vivo models is warranted.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
The Maternal Early Childhood Sustained Home-visiting program (MECSH) is a structured nurse-delivered program designed to address health inequities experienced by families ...experiencing significant adversity. There is strong evidence for the effectiveness of this program, but limited research exploring the practice and process elements that are core to positive parent outcomes. This study aimed to examine the relationship between customised care related to the mother’s risk factors and parent satisfaction and enablement in the delivery of a MECSH-based program.
Methods
A cross-sectional study design was used. Program delivery data collected as part of a large randomised controlled trial of a MECSH-based sustained nurse home visiting program in Australia (right@home) were analysed. This study used the data collected from the intervention arm in the trial (
n
= 352 women). Parent satisfaction was measured at child age 24 months using the modified short-form Patient Satisfaction Questionnaire. Parent enablement was measured at child age 24 months by a modified Parent Enablement Index. Customised care was defined as appropriate provision of care content in response to four maternal risks: smoking, mental health, domestic violence and alcohol and drugs. Logistic analysis was performed to assess the impact of customised care on parent satisfaction and enablement while adjusting for covariates such as sociodemographic factors. A significance level of 95% was applied for analysis.
Results
Our results indicated high levels of satisfaction with the care provided and positive enablement. There were several sociodemographic factors associated with satisfaction and enablement, such as language spoken at home and employment experience. The mothers who received customised care in response to mental health risk and domestic violence had significantly greater satisfaction with the care provided and experienced an increase in enablement compared to those who did not receive such care.
Conclusion
This study contributes to the existing body of empirical research that examines the relationship between care processes and client outcomes in the delivery of home visiting services. It is essential for the sustained nurse home visiting service model to be flexible enough to cater for variations according to family circumstances and needs while maintaining a core of evidence-based practice.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this book review, I compare three timely ethnographies that critically explore the topics of human–poultry relationships, avian influenza, and global health. I start the review by considering how ...the three authors, each located in a different context, approach these topics by drawing upon distinct methodological and theoretical frameworks. I then show how these approaches shape the way in which the authors discuss three separate concepts: preparedness, experiments, and viruses. I conclude that, whether read independently or together, these books illustrate the power of ethnographic research in exposing the distinctive ways that people envisage the relationships between human and non-human lives and the implications of such distinctions for disease control.
Abstract
We aimed to evaluate the predictive accuracy of InsuTAG index against
M
value of the hyperinsulinaemic-Euglycaemic clamp (HEC) procedure and fasting surrogate indices of insulin ...sensitivity/resistance in young, normoglycaemic, Asian Indian males. HEC studies were done in young (mean age 19.7 ± 1 years), non-obese (mean BMI 19.2 ± 2.6 kg/m
2
), normoglycemic Asian Indian males (n = 110) and the
M
value was calculated. Surrogate indices namely InsuTAG index, HOMA-IR, FG-IR, QUICKI and McAuley index were calculated. Pearson’s correlation and ROC-AUC at 95% CI were applied. Significant negative correlation was observed for InsuTAG index with the
M
value (
r
− 0.23,
p
= 0.01), McAuley index (
r
− 0.65,
p
< 0.01), QUICKI (
r
− 0.34,
p
< 0.01) and FGIR (
r
− 0.35,
p
< 0.01). Significant positive correlations of InsuTAG index were observed for BMI and waist circumference. The ROC-AUC was higher for InsuTAG index (0.75) than FGIR (0.30), QUICKI (0.31), and McAuley index (0.20). The InsuTAG cut-off value ≥ 19.13 showed 66.7% sensitivity and 69.2% specificity in this study group.
BACKGROUND: The aim of this study is to compare the clinical efficacy of a single intraoperative posterior sub-Tenon's capsule triamcinolone acetonide injection with postoperative topical steroids in ...controlling intraocular inflammation in uncomplicated pediatric cataract surgery.
MATERIALS AND METHODS: A prospective comparative study of children (<13 years of age) undergoing cataract surgery in a tertiary care eye center in South India. Preoperative evaluation was similar in both groups. The surgical procedure was the same for both groups except at the end of surgery only Group 1 (right eye of bilateral cataracts and all unilateral cataracts) received intraoperative 0.5 ml (40 mg/ml) posterior sub-Tenon's injection of triamcinolone acetonide. Postoperatively, Group 1 was administered only topical antibiotic and Group 2 was put on topical antibiotic, mydriatic, and steroids. Intraocular inflammation and intraocular pressure (IOP) were assessed clinically on day 1, 1st week, 1st month, and 3 months, postoperatively.
RESULTS: A total of 30 eyes were included in the study. Age ranged between 1 month and 132 months, with 18 eyes included in Group 1 and 12 eyes in Group 2. The mean postoperative IOP at the 3 months follow-up was not significantly different between groups (P = 0.4). The presence of intraocular lens had no role in postoperative inflammation (P = 1). Group 2 showed more anterior segment inflammation with six eyes (50%) developing posterior synechiae and distortion of the pupil 3 months postoperatively.
CONCLUSION: In pediatric cataracts, a single intraoperative sub-Tenon's capsule injection of triamcinolone acetonide appears to be safe and effective in controlling postcataract surgery inflammation.
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