Nurses’ views on the implementation of Individualised Medication Administration Guides in patients with dysphagia in care homes

As conditions such as stroke, cancer, Parkinson's disease and Huntingdon's chorea are commonly found in care homes between 15% and 30% of residents in care homes have been found to have difficulties in swallowing their medicines.To address the difficulties associated with administering medicines to patients who cannot swallow (with dysphagia), Individualised Medication Administration Guides (I-MAGs) were introduced by a specialised pharmacist in Care for Elderly wards in a general hospital in East Anglia. The guides contained detailed information about how to administer each medication and they were individualised to the needs of the patient. The I-MAGs were printed in green forms and attached to the medication chart in order to be used in conjunction with it. The ward nurses reported an increase in their confidence when administering medication when I-MAGs were present in the ward. Some patients with I-MAG were discharged to care homes where the I-MAG might have been equally useful. However, the design of such guides is not known to be suitable for care homes environment where they have never been used before. This study aims to explore the opinions of nurses and carers within care homes on the relevance and acceptability of individualised medication administration guides for patients with dysphagia (PWD).

Pressure placed on paediatric haematopoietic stem cell donors: Views from health professionals

Aim Paediatric haematopoietic stem cell donors undergo non-therapeutic procedures and endure known and unknown physical and psychosocial risks for the benefit of a family member. One ethical concern is the risk they may be pressured by parents or health professionals to act as a donor. This paper adds to what is known about this topic by presenting the views of health professionals. Methods This qualitative study involved semi-structured interviews with 14 health professionals in Australasia experienced in dealing with paediatric donors. Transcripts were analysed using established qualitative methodologies. Results Health professionals considered that some paediatric donors experience pressure to donate. Situations were identified that were likely to increase the risk of pressure being placed on donors and views were expressed about the ethical ‘appropriateness’ of these practices within the family setting. Conclusions Children may be subject to pressure from family and health professionals to be tested and act as donors, Therefore, our ethical obligation to these children extends to implementing donor focused processes – including independent health professionals and the appointment of a donor advocate – to assist in detecting and addressing instances of inappropriate pressure being placed on a child.

Implementing process views in the web service environment

Web service and business process technologies are widely adopted to facilitate business automation and collaboration. Given the complexity of business processes, it is a sought-after feature to show a business process with different views to cater for the diverse interests, authority levels, etc., of different users. Aiming to implement such flexible process views in the Web service environment, this paper presents a novel framework named FlexView to support view abstraction and concretisation of WS-BPEL processes. In the FlexView framework, a rigorous view model is proposed to specify the dependency and correlation between structural components of process views with emphasis on the characteristics of WS-BPEL, and a set of rules are defined to guarantee the structural consistency between process views during transformations. A set of algorithms are developed to shift the abstraction and concretisation operations to the operational level. A prototype is also implemented for the proof-of-concept purpose. © 2010 Springer Science+Business Media, LLC.

The information experience of new mothers in social media: A grounded theory study

This constructivist grounded theory study investigated the nature of new mothers' information experience in social media. The findings provide a holistic view of the phenomenon and the resultant substantive grounded theory describes new mothers' information experience in social media as a complex, multi-layered, and highly contextualised phenomenon. It encapsulates multiple individual experiences of information, and is broader and deeper than the individual experiences it is comprised of. The theory incorporates the characteristics, dimensions and categories of experience to provide a holistic view of new mothers' information experience in social media.

Mothers' perception of the quality of childhood sibling relationships affected by disability

The quality of the sibling relationship has an important role in the development of psychosocial skills throughout childhood. While the literature suggests that the significance of sibling relationships is heightened when one sibling has a disability, empirical findings about the quality of these relationships are few and inconsistent. The present study aimed to address this gap, by investigating mothers’ perspectives about the impact of disability on the quality of the childhood sibling relationship. Forty-one mothers with a child with disability, and 48 with no children with disability completed an online questionnaire that assessed the amount of perceived warmth/closeness and conflict in their children’s sibling relationship. It was found that while there were no differences in reported conflict between the two groups, mothers with a child with disability reported significantly lower warmth/closeness in their children’s sibling relationship than mothers without a child with disability. Demographic variables such as number of children, gender grouping, target gender, target age and age order did not moderate this result. Mothers overall reported significantly more warmth/closeness for younger rather than older children, and more conflict when the sibling was younger than the target child as opposed to older than them. Clinical implications for intervention are discussed.

Varying sun protection of young children by migrant and Australian-born mothers

OBJECTIVE: To compare sun protection by Australian-born and migrant mothers of three-year-old children. METHODS: Australian-born and migrant mothers taking part in the Environments for Healthy Living prospective birth-cohort study were asked standard questions about their child's sun protection. Children were given a skin cancer susceptibility score based on grandparents' ethnic origin. Logistic regression was used to estimate odds ratios (ORs) to measure the association of sun protection of children according to mothers' migrant status adjusted for socio-demographic characteristics. RESULTS: A total of 613 Australian-born and 224 migrant mothers of three-year-old children were studied. Mothers who had migrated less than four years ago were more likely to allow their three-year-old to spend more than two hours outdoors between 10 am and 3 pm compared to Australian-born mothers (OR=2.80, 95%CI 1.20-6.57). Mothers from high latitude countries (>45 degrees) were more likely to apply sunscreen to their child than those from lower latitude countries (OR=3.15, 95%CI 1.03-9.61). CONCLUSIONS AND IMPLICATIONS: Strategies should aim to increase general awareness about the need for sun protection of young children, and recent migrants should be alerted to the harms of excessive sun exposure.

Factors influencing first-time mothers’ introduction of complementary foods: A qualitative exploration

Background Optimal infant nutrition comprises exclusive breastfeeding, with complementary foods introduced from six months of age. How parents make decisions regarding this is poorly studied. This study begins to address the dearth of research into the decision-making processes used by first-time mothers relating to the introduction of complementary foods. Methods This qualitative explorative study was conducted using interviews (13) and focus groups (3). A semi-structured interview guide based on the Theory of Planned Behaviour (TPB). The TPB, a well-validated decision-making model, identifies the key determinants of a behaviour through behavioural beliefs, subjective norms, and perceived behavioural control over the behaviour. It is purported that these beliefs predict behavioural intention to perform the behaviour, and performing the behaviour. A purposive, convenience, sample of 21 metropolitan parents recruited through advertising at local playgroups and childcare centres, and electronically through the University community email list self-selected to participate. Data were analysed thematically within the theoretical constructs: behavioural beliefs, subjective norms and perceived behavioural control. Data relating to sources of information about the introduction of complementary foods were also collected. Results Overall, first-time mothers found that waiting until six months was challenging despite knowledge of the WHO recommendations and an initial desire to comply with this guideline. Beliefs that complementary foods would assist the infants' weight gain, sleeping patterns and enjoyment at meal times were identified. Barriers preventing parents complying with the recommendations included subjective and group norms, peer influences, infant cues indicating early readiness and food labelling inconsistencies. The most valued information source was from peers who had recently introduced complementary foods. Conclusions First-time mothers in this study did not demonstrate a good understanding of the rationale behind the WHO recommendations, nor did they understand fully the signs of readiness of infants to commence solid foods. Factors that assisted waiting until six months were a trusting relationship with a health professional whose practice and advice was consistent with the recommendations and/or when their infant was developmentally ready for complementary foods at six months and accepted them with ease and enthusiasm. Barriers preventing parents complying with the recommendations included subjective and group norms, peer influences, infant cues indicating early readiness and food labelling inconsistencies.

Psychiatrists' views on pathways to care for people with schizophrenia in Vietnam

Objectives: Research about the outcomes of schizophrenia and the factors that determine them in developing countries is still limited. In this study, we interviewed experienced Vietnamese psychiatrists to examine their perspectives on outcome determinants in their country. The qualitative approach aimed to complement existing epidemiological knowledge and contribute to debate around the hypothesis that recovery is better in developing countries. Methods: Fifteen Vietnamese psychiatrists working in five leading psychiatric facilities participated in semi-structured interviews. Thematic content analysis of their expressed views identified three themes related to important outcome determinants in Vietnam: access to contemporary treatment, established patient-level prognostic indicators, and sociocultural variables. Results: The improving accessibility of modern treatment (including new medications, specialist staff and facilities) and increasing community adoption of a medical perspective on mental illness were seen as factors leading to improved outcomes, particularly in urban areas. However, some psychiatrists also identified the potentially beneficial nature of some aspects of Vietnamese society and culture being eroded by modernization, including traditional family structures, forms of employment and lifestyles. Conclusions: The perspectives of psychiatrists in this study suggest that socioeconomic change may be exerting conflicting influences on the outcomes of schizophrenia in Vietnam and other developing countries. Their views have implications in terms of how adequate treatment and support for people with severe mental illness can be provided in the context of limited resources, staffing and formal treatment options. Further research is needed to establish current recovery rates and prospectively explore the impact of modernization on outcomes.

BPMN process views construction

Process view technology is catching more attentions in modern business process management, as it enables the customisation of business process representation. This capability helps improve the privacy protection, authority control, flexible display, etc., in business process modelling. One of approaches to generate process views is to allow users to construct an aggregate on their underlying processes. However, most aggregation approaches stick to a strong assumption that business processes are always well-structured, which is over strict to BPMN. Aiming to build process views for non-well-structured BPMN processes, this paper investigates the characteristics of BPMN structures, tasks, events, gateways, etc., and proposes a formal process view aggregation approach to facilitate BPMN process view creation. A set of consistency rules and construction rules are defined to regulate the aggregation and guarantee the order preservation, structural and behaviour correctness and a novel aggregation technique, called EP-Fragment, is developed to tackle non-well-structured BPMN processes.

Driver views on safety at roadworks

Poor compliance with temporary speed limits is a common contributing factor in roadway work zone crashes. Despite the wide range of measures used to encourage compliance, speeding remains a major challenge in work zone traffic control. As part of the major study into safety at Queensland roadworks conducted by CARRS-Q and industry partners, an online survey was conducted to study the perceptions and experiences of drivers regarding roadworks, speed choice and related safety concerns. Survey participants (N=410) were asked to view photographs of 12 roadwork sites (shot from a drivers’ perspective without revealing the speed limits), to nominate the speed they thought they would drive at through work zones, and to rate from 1 to 5 separate levels of perceived risk to workers and to their own vehicles. The survey sought further information on topics including recall and effectiveness of public safety messages, perceived effectiveness of common roadwork safety measures, and demographic characteristics. Participants were also invited to express their concerns regarding any general or specific issue related to driving through roadworks. The current paper provides a descriptive summary of key findings from the survey, drawn from preliminary analyses of both quantitative and qualitative data, demonstrating the depth of data and its value for improving knowledge on driver perceptions and speed choice at roadworks. The survey is the first study of driver perceptions of roadwork risks and hazards to include an assessment of self-nominated speeds which can be compared with actual observed speeds at the same roadwork sites.

Worker views on safety at roadworks

Roadworks in live traffic environments are hazardous to workers and road users alike. In an increasing body of international research literature, roadwork risks and hazards have been comprehensively examined. As in the broader field of road safety research, much of the work rightly takes a quantitative approach to assessing risk and related issues and to addressing the identified risks appropriately. In Australia, however, limited official data constrains the ability of researchers to achieve an in-depth understanding of the situation at state/territory and national levels based on traditional quantitative analyses. One way to enhance and supplement the limited available data is to consult those who are directly involved in roadworks for qualitative information, although such an approach is rarely reported in the roadwork safety arena. As part of the major study focusing on safety at roadworks in Queensland, 66 workers were interviewed about their perceptions and experiences regarding roadwork safety. This paper thus outlines a qualitative examination of workers' perceptions of the causes of roadwork incidents and the effectiveness of hazard mitigation measures. Consistent with findings reported in the literature is the view among workers that speeding is a major hazard and that police enforcement is the most effective countermeasure. Other hazards commonly observed by workers but less frequently reported elsewhere include driver distraction and aggression toward workers, working in poor weather and working at night. Workers mostly suggested educational measures to address distraction and aggression issues, though such measures are only tentatively supported in the literature.

Breastfeeding duration and authoritative feeding practices in first-time mothers

Background Longer breastfeeding duration appears to have a protective effect against childhood obesity. This effect may be partially mediated by maternal feeding practices during the first years of life. However, the few studies that have examined links between breastfeeding duration and subsequent feeding practices have yielded conflicting results. Objective Using a large sample of first-time mothers and a newly validated, comprehensive measure of maternal feeding (the Feeding Practices and Structure Questionnaire1), this study examined associations between breastfeeding duration and maternal feeding practices at child age 24 months. Methods Mothers (n = 458) enrolled in the NOURISH trial2 provided data on breastfeeding at child age 4, 14 and 24 months, and on feeding practices at 24 months. Structural Equation Modelling was used to examine associations between breastfeeding duration and five non-responsive and four structure-related ‘authoritative’ feeding practices, adjusting for a range of maternal and child characteristics. Results The model showed acceptable fit (χ2/df = 1.68; RMSEA = .04, CFI = .91 and TLI = .89) and longer breastfeeding duration was negatively associated with four out of five non-responsive feeding practices and positively associated with three out of four structure-related feeding practices. Overall, these results suggest that mothers who breastfeed longer reported using more appropriate feeding practices. Conclusion These data demonstrate an association between longer breastfeeding duration and authoritative feeding practices characterised by responsiveness and structure, which may partly account for the apparent protective effect of breastfeeding on childhood obesity.

Australian journalism students’ professional views and news consumption: Results from a representative study

Journalism education’s role in shaping students’ professional views has been a topic of interest among scholars for the past decade in particular. Increasing numbers of studies are concerned with examining students’ backgrounds and views in order to identify what role exposure to the tertiary environment may play in socializing them into the industry. This study reports on the results of the largest survey of Australian journalism students undertaken to date, with a sample size of 1884 students. The study finds that time spent studying journalism appears to be related to changes in role perceptions and news consumption. Final-year students are significantly more likely to support journalism’s watchdog role and to reject consumer-oriented and ‘loyal’ roles. They also consume more news than first-year students. On the other hand, journalism education appears to have little impact on views of controversial practices, with only marginal differences between final- and first-year students.

Caught between a rock and a hard place: Disruptive boys’ views on mainstream and special schools in New South Wales, Australia

Students with disruptive behaviour in the Australian state of New South Wales are increasingly being educated in separate “behaviour” schools. There is however surprisingly little research on how students view these settings, or indeed the mainstream schools from which they were excluded. To better understand excluded students’ current and past educational experiences, we interviewed 33 boys, aged between 9 and 16 years of age, who were enrolled in separate special schools for students with disruptive behaviour. Analyses reveal that the majority of participants began disliking school in the early years due to difficulties with school work and teacher conflict. Interestingly, while most indicated that they preferred the behaviour school, more than half still wanted to return to their old school. It is therefore clear that separate special educational settings are not a solution to disruptive behaviour in mainstream schools. Whilst these settings do fulfil a function for some students, the preferences of the majority of boys suggest that “mainstream” school reform is of first order importance.