Search

Background: Parenting interventions offer an evidence-based method for the prevention and early intervention of child mental health problems, but to-date their population-level effectiveness has been limited by poor reach and engagement, particularly for fathers, working mothers, and disadvantaged families. Internationally, there has been a call for more sensitive intervention frameworks that better recognize parents’ differences and match support accordingly. Tailoring intervention content to parents’ context (i.e., to common parenting situations) offers potential to enhance parent engagement and learning by increasing relevance of content to parents’ daily experiences. However, this approach requires a detailed understanding of the common parenting situations and issues that parents face day-to-day, which is currently lacking.Objective: We sought to identify the most common parenting situations discussed by parents on parenting-specific forums of the free online discussion forum, Reddit, one of the most popular social media platforms in the world. We aimed to understand perspectives from both mothers and fathers, and therefore retrieved publicly available data from two parenting-specific ‘subreddits’ (r/Daddit; r/Mommit).Methods: We used latent Dirichlet allocation (LDA) to identify the most common topics discussed in the Reddit posts. Once topics were identified, we completed a manual text analysis of the 10 posts ranked as most relevant to each topic, and summarized the parenting situations that were described. Our pre-specified definition of a parenting situation required that the post involve a parent and their child aged 0-18 years and describe a potential or actual difficulty or issue.Results: We retrieved 340 (r/Daddit) and 578 (r/Mommit) original posts. A model with 31 LDA topics was found to be the best fitting model. Of these, 24 topics included posts that met our inclusion criteria for manual review. From these, we identified 45 unique but broadly-defined parenting situations. The majority of parenting situations were either focused on basic childcare situations relating to eating, sleeping, routines, sickness and toilet training; or related to how to respond to child negative emotions or difficult behavior. Most situations were discussed in relation to infant or toddler age children, and on the whole, there was a high level of consistency in the themes raised in r/Daddit and r/Mommit.Conclusions: Our text analysis of the r/Daddit and r/Mommit posts highlighted two overarching themes in topics commonly discussed in online parenting forums; basic childcare, and management of child emotions and behavior. Our results offer potential to tailor parenting interventions in a meaningful way, creating opportunities to develop content and resources that are directly relevant to parents’ lived experiences.

Data literacy has been defined as “the ability to read, work with, analyze and argue with data”. The United Nations has highlighted a growing risk of inequality for people excluded from the new world of data by lack of education, language, poverty, and discrimination and has called for the development of data literacy at all levels of society. Responses to data are shaped by personal, social and cultural influences, as well as by trust in the source. The arts can play an important role in regulating our responses to information and increasing accessibility, engagement and sense-making of data. However, to our knowledge, to date, there has been no comprehensive review of publications on the role of the arts in the context of data literacy. This paper presents a protocol and a methodological framework to perform a scoping review to identify and map the available evidence for the role of the arts in enhancing data literacy. The review aims to provide an overview of research over the past twenty years to develop a clearer understanding of (a) which art forms are represented in the literature (b) which population groups and settings are identified (c) and the rationale for using the arts to enhance data literacy.

Despite rising cases of COVID-19 in the United States of America, several states are easing restrictions (e.g., relaxing physical distancing requirements, reopening businesses) that were imposed to limit community transmission of the virus. Individuals hold differing opinions regarding whether restrictions should continue to be imposed or lifted, evidenced, for example, by debate and protests regarding reopening of businesses and venues. Health and social psychological research suggest that perceptions of COVID-19related risk, experiences of the virus, and individual difference factors can help explain individuals’ attitudes towards health initiatives and their tendency to be persuaded towards a specific course of action. The purpose of this study was to investigate what factors influence support or opposition to easing COVID-19-related restrictions. A sample of 350 United States citizens, responding to an anonymous survey, were asked about the extent to which they support/oppose easing of COVID-19-related restrictions, both generally and in relation to specific restrictions. Respondents completed measures of their experiences of COVID-19, individual difference factors, and demographic variables, including political affiliation and degree of social and economic conservatism. In a series of regression analyses, significant demographic predictors of support or opposition for easing restrictions were gender, age, ethnicity, and education, with political affiliation and degree of social and economic conservatism also predicting attitudes. Experiences related to COVID-19 that predicted attitudes were concerns for self and family, perceptions of threat posed by the virus, perceived ability to adhere to restrictions, willingness to take government direction, and belief in COVID-19-related conspiracy theories. At an individual differences level, uncertainty avoidance, collectivism, long-term orientation, masculinity, empathic concern, personal distress, reactance, and general conspiracy theory beliefs all significantly precited attitudes to easing restrictions. Understanding the factors that help explain attitudes towards COVID-19 restrictions can inform how best to position health messaging and initiatives going forward, particularly as states or countries open borders.

Objective Polypharmacy, defined as the concurrent use of multiple medications, is a growing concern globally. This study aimed to identify the significant factors that predict the perceived burden of medication and health-related quality of life. Methods Adults, aged 18 years and above who have used at least two regular medicines, were invited to complete the study questionnaires between June and October 2019. Multiple linear regression analysis was conducted to identify significant predictors for perceived burden of medication and health-related quality of life. Results A total of 119 participants completed this study. The average age of the participants was 63 years (SD±16 years). Factors significantly predicting perceived burden of medication were participants’ current health condition (p = 0.001), overall burden of treatment (p Conclusions This study revealed that hypertensive participants in poor health tended to experience higher perceived burden of medication, which in turn was found to be correlated with lower perceived health-related quality of life.

Background It is unclear which Early Warning System (EWS) score best predicts in-hospital deterioration of patients when applied in the Emergency Department (ED) or prehospital setting. Methods This systematic review (SR) and meta-analysis assessed the predictive abilities of five commonly used EWS scores (National Early Warning Score (NEWS) and its updated version NEWS2, Modified Early Warning Score (MEWS), Rapid Acute Physiological Score (RAPS), and Cardiac Arrest Risk Triage (CART)). Outcomes of interest included admission to intensive care unit (ICU), and 3-to-30-day mortality following hospital admission. Using DerSimonian and Laird random-effects models, pooled estimates were calculated according to the EWS score cut-off points, outcomes, and study setting. Risk of bias was evaluated using the Newcastle-Ottawa scale. Meta-regressions investigated between-study heterogeneity. Funnel plots tested for publication bias. The SR is registered in PROSPERO (CRD42020191254). Results Overall, 11,565 articles were identified, of which 20 were included. In the ED setting, MEWS, and NEWS at cut-off points of 3, 4, or 6 had similar pooled diagnostic odds ratios (DOR) to predict 30-day mortality, ranging from 4.05 (95% Confidence Interval (CI) 2.35–6.99) to 6.48 (95% CI 1.83–22.89), p = 0.757. MEWS at a cut-off point ≥3 had a similar DOR when predicting ICU admission (5.54 (95% CI 2.02–15.21)). MEWS ≥5 and NEWS ≥7 had DORs of 3.05 (95% CI 2.00–4.65) and 4.74 (95% CI 4.08–5.50), respectively, when predicting 30-day mortality in patients presenting with sepsis in the ED. In the prehospital setting, the EWS scores significantly predicted 3-day mortality but failed to predict 30-day mortality. Conclusion EWS scores’ predictability of clinical deterioration is improved when the score is applied to patients treated in the hospital setting. However, the high thresholds used and the failure of the scores to predict 30-day mortality make them less suited for use in the prehospital setting.

Introduction Outpatient care for children and adolescents with chronic conditions needs to be continuous and programmed, encompassing comprehensive care, with periodically scheduled consultations, exams, and procedures, to promote quality of life and reduce mortality. In the context of the new coronavirus pandemic, however, outpatient care for children and adolescents with chronic conditions, in person, was hampered in favor of social isolation, a necessary sanitary measure to reduce and prevent the spread of Coronavirus Disease 2019. In response to this need, studies suggest telehealth in pediatrics as a fertile and expanding field especially in times of pandemics. Here, we aimed to map the evidence related to telehealth in outpatient care for children and adolescents with chronic conditions during the COVID-19 pandemic, to identify which strategies were implemented and their impacts on the continuity of care. Methods A scoping review protocol is reported and guided by the Scoping Reviews Manual of the Joanna Briggs Institute. The search for evidence will cover the following databases: MEDLINE/PubMed, Cochrane Libary; Embase; Web of Science; Scopus; Cinahl and PsycINFO, plus additional sources, such as The British Library, Google Scholar, and Preprints [medRXiv]. No date or language restrictions will be employed in this scoping review. Two independent researchers will conduct the search strategy, study selection, data charting, and data synthesis. Results The findings will be presented through tables, charts, narrative summaries, and assessed based on the type of data charted as well as outcomes. Additionally, the meaning of these findings will be considered as they relate to the guiding question, the characterization and measurement of the impact of different telehealth modalities used in outpatient care for children and adolescents with chronic conditions during the COVID-19 pandemic, and the implications for practice and further research. Discussion To the best of our knowledge, this will be the first scoping review to look specifically at the telehealth modalities to be used in outpatient care for children and adolescents with chronic conditions during the COVID-19 pandemic. We expect that our results will be of interest to practitioners as well as researchers concerned with this particular emerging issue in the pandemic context. Also, the plans for the dissemination of this study comprise peer-reviewed publication and conference presentations. trial registration Open Science Framework Registration: osf.io/5pqgu.

Health practitioners play an important role in identifying and responding to domestic violence and abuse (DVA). Despite a large amount of evidence about barriers and facilitators influencing health practitioners' care of survivors of DVA, evidence about their readiness to address DVA has not been synthesised. This article reports a meta-synthesis of qualitative studies exploring the research question: What do health practitioners perceive enhances their readiness to address domestic violence and abuse? Multiple data bases were searched in June 2018. Inclusion criteria included: qualitative design; population of health practitioners in clinical settings; and a focus on intimate partner violence. Two reviewers independently screened articles and findings from included papers were synthesised according to the method of thematic synthesis. Forty-seven articles were included in the final sample, spanning 41 individual studies, four systematic reviews and two theses between the years of 1992 and 2018; mostly from high income countries. Five themes were identified as enhancing readiness of health practitioners to address DVA: Having a commitment; Adopting an advocacy approach; Trusting the relationship; Collaborating with a team; and Being supported by the health system. We then propose a health practitioners' readiness framework called the CATCH Model (Commitment, Advocacy, Trust, Collaboration, Health system support). Applying this model to health practitioners' different readiness for change (using Stage of Change framework) allows us to tailor facilitating strategies in the health setting to enable greater readiness to deal with intimate partner abuse.

Introduction Adverse pregnancy outcomes are more common among Aboriginal and Torres Strait Islander populations than non-Indigenous populations in Australia. Later in life, most of the difference in life expectancy between Aboriginal and Torres Strait Islander women and non-Indigenous women is due to non-communicable diseases (NCDs). Most Aboriginal and Torres Strait Islander women attend health services regularly during pregnancy. Providing high-quality care within these appointments has an important role to play in improving the current and future health of women and babies. Aim This study engaged stakeholders in a theory-informed process to use aggregated continuous quality improvement (CQI) data to identify 1) priority evidence-practice gaps in Aboriginal and Torres Strait Islander maternal health care, 2) barriers and enablers to high-quality care, and 3) strategies to address identified priorities. Methods Three phases of reporting and feedback were implemented using de-identified CQI data from 91 health services between 2007 and 2014 (4,402 client records). Stakeholders (n = 172) from a range of professions and organisations participated. Results Stakeholders identified four priority areas relating to NCDs: smoking, alcohol, psychosocial wellbeing and nutrition. Barriers or enablers to high-quality care included workforce support, professional development, teamwork, woman-centred care, decision support, equipment and community engagement. Strategies to address the priorities included upskilling staff to provide best practice care in priority areas, advocating for availability of healthy food, housing and local referral options, partnering with communities on health promotion projects, systems to facilitate continuity of care and clear referral pathways. Conclusions This novel use of large-scale aggregate CQI data facilitated stakeholder input on priority evidence-practice gaps in maternal health care in Australia. Evidence-practice gaps relating to NCD risk factors and social determinants of health were prioritised, and stakeholders suggested both healthcare-focussed initiatives and approaches involving the community and the wider health sector. The findings can inform health service planning, advocacy, inter-agency strategies, and future research.