Search

Background: Baby walkers are commonly used items of nursery equipment, but cause more than 3000 injuries each year in the UK. There is currently little evidence regarding the effectiveness of interventions in primary care to reduce walker use., Aim: To evaluate the effectiveness of an educational package provided by midwives and health visitors to reduce baby walker possession and use., Design of Study: Cluster randomised controlled trial., Setting: Sixty-four general practices in Nottingham and North Nottinghamshire, UK., Method: An educational package aimed at discouraging mothers-to-be from obtaining and using a walker was delivered by midwives and health visitors to 1174 mothers-to-be of at least 28 weeks gestation. The control arm received usual care. Primary outcome measures were the possession and use of a walker. Secondary outcome measures included the frequency and duration of walker use, knowledge and attitudes towards walkers, plans to use a walker with future children, recommending a walker to a friend, and use of stair gates and fire guards., Results: Intervention arm participants were significantly less likely to own (odds ratio [OR] = 0.63, 95% confidence interval [CI] = 0.43 to 0.93) or to use a walker (OR = 0.26, 95% CI = 0.08 to 0.84). They were significantly less likely to plan to use a walker with their next child (OR = 0.52, 95% CI = 0.31 to 0.86) or to agree that walkers keep children safe (OR = 0.35, 95% CI = 0.16 to 0.78). There was some evidence that they were less likely to recommend a walker to a friend (OR = 0.51, 95% CI = 0.28 to 0.91) or to agree that they help children to walk more quickly (OR = 0.53, 95% CI = 0.29 to 0.95)., Conclusion: An educational package delivered by midwives and health visitors was effective in reducing baby walker possession and use. Providers of primary healthcare services should include baby walker education in their injury prevention strategy and child health promotion programme.

Deixis -- a fundamental part of communication -- involves combinations of speech, gesture and eye-gaze, yet little is known about the temporal dynamics of this coordination. The authors analysed eye-gaze, pointing gestures and verbal productions in 514 deictic episodes during triadic, semi-naturalistic, book-reading sessions performed by Italian children (1;08--2;07) and their caregivers. Results show three new findings. First, deictic communication is overwhelmingly preceded and accompanied by shared attention (of consistent duration) on an object, and only sometimes by disjoint attention. Second, children are synchronously multimodal (conveying information via speech, pointing gesture and eye-gaze) in their deictic communications. Third, the form of deictic communication used is not related to the complexity of the linguistic structures of the sample. Deictic communication is remarkably consistent in children ranging from approximately 1;08 to 2;07 years of age.

Objective: The objective of these analyses was to explore maternal antenatal decisions about baby walker use, factors associated with these decisions and the relationship between antenatal plans to use a walker and postnatal walker use. Design: Cross sectional study. Setting: Mothers-to-be (n = 1174) participating in a cluster randomised controlled trial of an educational package to reduce walker use in 64 general practices in the East Midlands of the United Kingdom. Method: Data on plans to use a walker, socio-demographic and economic characteristics, partner's views on walker use, knowledge of walker-related injury and attitudes towards walkers were collected at entry to the trial by means of a self-completion questionnaire. Data on post-natal walker use was collected by postal questionnaire nine months after delivery. Results: The majority of mothers-to-be (74 per cent) had already decided whether or not to use a walker prior to the birth of their baby and one-third were planning to do so. Several factors were identified which may be useful for identifying mothers-to-be who are undecided about walker use antenatally; these include partner's views on walkers, parity, housing tenure and attitudes towards walkers. Antenatal plans about walker use had high positive and negative predictive values for predicting postnatal walker use. Conclusion: Education regarding walker use will be an important method for reducing walker use until walkers are no longer available to purchase first or second hand. The results of this study will assist health professionals in identifying which mothers-to-be are likely to be undecided about walker use and this group may be more receptive to health education than those who have already made a decision. (Contains 5 tables and 1 figure.)

Abstract Background Most studies report that being parents of a child with cancer is a stressful experience, but these have tended to focus on mothers and few have included both parents. Moreover, studies have focussed on families in Western countries and none have been published examining the psychological outcomes for parents living in an Arabic country. This research explores the stress levels of Jordanian parents caring for a child with cancer in order to identify the psychological needs of parents in this environment and to explore how mothers and fathers stress levels might differ. Methods The study was carried out in Jordan using the Perceived Stress Scale 10-items (PSS10). The questionnaire was completed by 300 couples with a child who has cancer and a comparison group of 528 couples where the children do not have any serious illness. Multivariate backward regression analysis was carried out. Results Analysis adjusting for spousal stress and sociodemographic predictors revealed that stress levels of mothers with a child who had cancer remained significantly higher than mothers whose children did not have any serious illness (p Parental stress was analysed for those with a child who has cancer and in models which included spouse’s stress scores, sociodemographic and cancer-related predictors 64 % of the variance was explained for mothers (adjusted R2 = 0.64, p 2 = 0.64, p Conclusions This is the first study into the psychological outcomes for parents living in an Arabic country who care for a child with cancer. Both mothers and fathers with a child diagnosed with cancer reported higher stress levels than those from the normal Jordanian parent population. Mothers and fathers of children with cancer reported significantly different levels of stress to each other but models reveal significant contributions of the stress score of fathers upon mothers, and vice versa. The findings provide evidence of the need for psychological support to be developed for families caring for a child with cancer in Jordan.

Background: Most studies report that being parents of a child with cancer is a stressful experience, but these have tended to focus on mothers and few have included both parents. Moreover, studies have focussed on families in Western countries and none have been published examining the psychological outcomes for parents living in an Arabic country. This research explores the stress levels of Jordanian parents caring for a child with cancer in order to identify the psychological needs of parents in this environment and to explore how mothers and fathers stress levels might differ. Methods: The study was carried out in Jordan using the Perceived Stress Scale 10-items (PSS10). The questionnaire was completed by 300 couples with a child who has cancer and a comparison group of 528 couples where the children do not have any serious illness. Multivariate backward regression analysis was carried out. Results: Analysis adjusting for spousal stress and sociodemographic predictors revealed that stress levels of mothers with a child who had cancer remained significantly higher than mothers whose children did not have any serious illness (p<0.001). However, having a child with cancer did not show a significant association with the fathers’ reported stress scores (p = 0.476) when spousal stress was in the model, but was highly significant once that was removed (p<0.001). Parental stress was analysed for those with a child who has cancer and in models which included spouse’s stress scores, sociodemographic and cancer-related predictors 64 % of the variance was explained for mothers (adjusted R2 = 0.64, p<0.001) and fathers (adjusted R2 = 0.64, p<0.001). Models excluding spousal stress scores explained just 26 % of the variance for fathers and 22 % for mothers. Conclusions: This is the first study into the psychological outcomes for parents living in an Arabic country who care for a child with cancer. Both mothers and fathers with a child diagnosed with cancer reported higher stress levels than those from the normal Jordanian parent population. Mothers and fathers of children with cancer reported significantly different levels of stress to each other but models reveal significant contributions of the stress score of fathers upon mothers, and vice versa. The findings provide evidence of the need for psychological support to be developed for families caring for a child with cancer in Jordan. [ABSTRACT FROM AUTHOR]