Assessing the overuse of antibiotics in children in Saudi Arabia : validation of the parental perception on antibiotics scale (PAPA scale)

Background Antibiotics overuse is a global public health issue influenced by several factors, of which some are parent-related psychosocial factors that can only be measured using valid and reliable psychosocial measurement instruments. The PAPA scale was developed to measure these factors and the content validity of this instrument was assessed. Aim This study further validated the recently developed instrument in terms of (1) face validity and (2) construct validity including: deciding the number and nature of factors, and item selection. Methods Questionnaires were self-administered to parents of children between the ages of 0 and 12 years old. Parents were conveniently recruited from schools’ parental meetings in the Eastern Province, Saudi Arabia. Face validity was assessed with regards to questionnaire clarity and unambiguity. Construct validity and item selection processes were conducted using Exploratory factor analysis. Results Parallel analysis and Exploratory factor analysis using principal axis factoring produced six factors in the developed instrument: knowledge and beliefs, behaviours, sources of information, adherence, awareness about antibiotics resistance, and parents’ perception regarding doctors’ prescribing behaviours. Reliability was assessed (Cronbach’s alpha = 0.78) which demonstrates the instrument as being reliable. Conclusion The ‘factors’ produced in this study coincide with the constructs contextually identified in the development phase of other instruments used to study antibiotic use. However, no other study considering perceptions of antibiotic use had gone beyond content validation of such instruments. This study is the first to constructively validate the factors underlying perceptions regarding antibiotic use in any population and in parents in particular.

Attitudes, Ideologies and Self-Organisation : Information Load Minimisation in Multi-Agent Decision Making

Sophisticated models of human social behaviour are fast becoming highly desirable in an increasingly complex and interrelated world. Here, we propose that rather than taking established theories from the physical sciences and naively mapping them into the social world, the advanced concepts and theories of social psychology should be taken as a starting point, and used to develop a new modelling methodology. In order to illustrate how such an approach might be carried out, we attempt to model the low elaboration attitude changes of a society of agents in an evolving social context. We propose a geometric model of an agent in context, where individual agent attitudes are seen to self-organise to form ideologies, which then serve to guide further agent-based attitude changes. A computational implementation of the model is shown to exhibit a number of interesting phenomena, including a tendency for a measure of the entropy in the system to decrease, and a potential for externally guiding a population of agents towards a new desired ideology.

Child mental health after parental separation: The impact of resident/non-resident parenting, parent mental health, conflict and socioeconomics

Children of separated parents tend to have poorer mental health than children of intact families. Explanations to date have tended to focus on resident mothers, neglecting the potential importance of non-resident fathers. Using recent data from the Longitudinal Study of Australian Children, and independent teacher-reports of child mental health, this study 1) compares the mental health of children with resident and non-resident fathers and 2) explores predictors of poor mental health among children with a non-resident father. Children with a non-resident father had poorer mental health than those with a resident father, but this difference was explained fully by exposure to parental conflict, and to a lesser extent by socioeconomic status, parenting, and parent mental health. For children with a non-resident father, the strongest predictors of child mental health were mothers' employment and maternal parenting consistency. Policy implications are discussed.

Perceptions and attitudes of nursing students’ towards electronic health records

Introduction The onset of Personally Controlled Electronic Health Records in Australia demand healthcare decision making processes to comprise, understand and accept electronic health records (EHR). Nurses play a key, central role in the healthcare decision making process and their perceptions and attitudes of EHRs are significant [1], which develop during their academic life. However, studies aimed at nursing students’ attitudes of EHRs are very limited [2-4]. A proper understanding of these attitudes and how they evolve with academic progress is important. This paper presents results from a survey conducted at a leading University in Queensland, Australia as a first step to filling this gap.

The Select Committee Report on Obesity (2004): The significant omission of parental views of their children's eating

Many studies have reported increasing levels of obesity and overweight in children. Recent policy developments have examined a range of influences on children's eating habits but have left largely unexamined the role of parents in general and mothers in particular. In this study we examined mothers’ understandings of healthy eating and of their influence on their children's eating patterns. Semi-structured interviews were conducted with nine mothers of children aged between 4 and 12 years of age. Interviewees displayed knowledge of recommended eating practices for their children but distinguished this knowledge from actual eating practices. Avoidance of negative social perceptions, pleasure in eating and opportunities for fast food were regarded as more important than eating in accordance with recommended nutritional guidelines. Moreover, the food choices made were viewed as positive alternatives to eating based on nutritional balance. These views pose a challenge for policy initiatives to address obesity and excess weight in children. Future initiatives should have increased regard for the everyday contexts within which children's eating patterns are understood and justified.

Attitudes of future special education teachers toward gifted students and their education

Saudi Arabian education is undergoing substantial reform in the context of a nation transitioning from a resource-rich economy to a knowledge economy. Gifted students are important human resources for such developing countries. However, there are some concerns emanating from the international literature that gifted students have been neglected in many schools due to teachers’ attitudes toward them. The literature shows that future teachers also hold similar negative attitudes, especially those in Special Education courses who, as practicing teachers, are often responsible for supporting the gifted education process. The purpose of this study was to explore whether these attitudes are held by future special education teachers in Saudi Arabia, and how the standard gifted education course, delivered as part of their program, impacts on their attitudes toward gifted students. The study was strongly influenced by the Theory of Reasoned Action (Ajzen, 1980, 2012) and the Theory of Personal Knowledge (Polanyi, 1966), which both suggest that attitudes are related to people’s (i.e. teachers’) beliefs. A mixed methods design was used to collect quantitative and qualitative data from a cohort of students enrolled in a teacher education program at a Saudi Arabian university. The program was designed for students majoring in special education. The quantitative component of the study involved an investigation of a cohort of future special education teachers taking a semester-long course in gifted education. The data were primarily sourced from a standard questionnaire instrument modified in the Arabic language, and supplemented with questions that probed the future teachers’ attitudes toward gifted children. The participants, 90 special education future teachers, were enrolled in an introductory course about gifted education. The questionnaire contained 34 items from the "Opinions about the Gifted and Their Education" (Gagné, 1991) questionnaire, utilising a five-point Likert scale. The quantitative data were analysed through the use of descriptive statistics, Spearman correlation Coefficients, Paired Samples t-test, and Multiple Linear Regression. The qualitative component focussed on eight participants enrolled in the gifted education course. The primary source of the qualitative data was informed by individual semi-structured interviews with each of these participants. The findings, based on both the quantitative and qualitative data, indicated that the majority of future special education teachers held, overall, slightly positive attitudes toward gifted students and their education. However, the participants were resistant to offering special services for the gifted within the regular classroom, even when a comparison was made on equity grounds with disabled students. While the participants held ambivalent attitudes toward ability grouping, their attitudes were positive toward grade acceleration. Further, the majority agreed that gifted students are likely to be rejected by their teachers. Despite such judgments, they considered the gifted to be a valuable resource for Saudi society. Differences within the cohort were found when two variables emerged as potential predictors of attitude: age, experience, and participants’ hometown. The younger (under 25 years old) future special education teachers, with no internship or school practice experience, held more positive attitudes toward the gifted students, with respect to their general needs, than did the older participants with previous school experiences. Additionally, participants from a rural region were more resistant toward gifted education than future teachers from urban areas. The findings also indicated that the attitudes of most of the participants were significantly improved, as a result of the course, toward ability grouping such as special classes and schools, but remained highly concerned about differentiation within regular classrooms with either elitism or time pressure. From the findings, it can be confirmed that a lectured-based course can serve as a starting point from which to focus future teachers’ attention on the varied needs of the gifted, and as a conduit for learning about special services for the gifted. However, by itself, the course appears to have minimal influence on attitudes toward differentiation. As a consequence, there is merit in its redevelopment, and the incorporation of more practical opportunities for future teachers to experience the teaching of the gifted.

Australian adolescent perceptions of parental support: Can it predict self-esteem among high and low SES groups?

Aims Physical activity has been shown to increase adolescent self-esteem. The aim of this investigation was to assess adolescent perceptions of parental support for physical activity endeavours, and its relationship with self-esteem among high and low SES groups. Methods Perceptions of parental support, and Rosenberg’s self-esteem (1965) were derived from the Children’s Physical Activity Correlates questionnaire, with scores ranging from 1 (lowest) to 4 (highest). Independent sample t-tests were conducted and Levene’s test indicated homogenous group variance, while Pearson’s r was employed to assess relationships between perceptions of parental support, and self-esteem. Results Overall, 111 (89%) and 64 (55%) high and low SES participants had complete data and were included in the analysis. The high SES differed for self-esteem (M = 3.39, SE = .05) from the low SES group (M = 2.75, SE = .08), t (173) = 6.82, p < .05, with a medium effect size (ES) r = .46. The high SES group scored higher for perceptions of parental support (M = 2.95, SE = .06) than the low SES group (M = 2.71, SE = .07), t (173) = 2.58, p < .05, with a low ES r = .04. Self-esteem was significantly correlated with parental support in both high (r = .34) and low (r = .47) SES groups. Conclusion Results indicate that perceptions of parental support may be a stronger indicator of self-esteem for low, than for high SES adolescents. Future physical activity strategies to promote self-esteem should involve parents as active facilitators.

Early childhood teachers' pedagogical practice : what they know, think and do with young children experiencing parental separation and divorce

This grounded theory study examined the practices of twenty-one Australian early childhood teachers who work with children experiencing parental separation and divorce. Findings showed that teachers constructed personalised support for these children. Teachers’ pedagogical decision-making processes had five phases: constructing their knowledge, applying their knowledge, applying decision-making schema, taking action, and monitoring action and evaluating. This study contributes new understandings about teachers’ work with young children experiencing parental separation and divorce, and extends existing theoretical frameworks related to the provision of support. It adds to scholarship by applying grounded theory methodology in a new context. Recommendations are made for school policies and procedures within and across schools and school systems.

Self-reported likelihood of speeding : the effects of attitudes, personality, and perceived legitimacy of enforcement

The positive relationship between speed and crash risk and severity is robust and well-established. While excessive speeding is typically regarded by the public as a common contributing factor in road crashes, speeding remains a common traffic infringement and an arguably socially acceptable behaviour, particularly at low levels over the speed limit. This suggests that other factors potentially contribute to this disparity between crash perceptions and actual behaviours. Previous work has described associations between perceptions of the legitimacy of speed enforcement, attitudes, and how they relate to the likelihood of speeding. This study sought to more closely examine the nature of the relationships between these variables. In total, 293 Queensland drivers participated in a study that examined how demographics, personality variables, attitudes, and perceptions of the legitimacy of enforcement contributed to drivers’ self-reported likelihood of speeding. Results suggested that positive attitudes towards speeding had the greatest impact on likelihood of speeding behaviours. Being younger and higher levels of the personality trait of extraversion were also associated with greater levels of self-reported likelihood of speeding. Attitudes were found to mediate the relationship between perceived legitimacy of speed enforcement and self-reported likelihood of speeding. A subgroup analysis of participants with positive and negative attitudes towards speeding revealed that a differential set of variables were predictive of self-reported likelihood of speeding for the two subgroups. This highlights the potential importance of attitudes in understanding the influence of perceptions of legitimacy of speed enforcement on speeding behaviour, and the need for targeted rather than a ‘one size fits all’ approach to changing attitudes and ultimately behaviour. The findings of the current study help to further understand why some drivers continue to speed.

Impact of a school-based food garden on attitudes and identification skills regarding vegetables and fruit : a 12-month intervention trial

Objective To determine changes in ability to identify specific vegetables and fruits, and attitudes towards vegetables and fruit, associated with the introduction of a school-based food garden. Design A 12-month intervention trial using a historical control (control n 132, intervention n 120), class-based, self-administered questionnaires requiring one-word answers and 3-point Likert scale responses. Setting A state primary school (grades 4 to 7) in a low socio-economic area of Brisbane, Australia. Intervention The introduction of a school-based food garden, including the funding of a teacher coordinator for 11 h/week to facilitate integration of garden activities into the curriculum. Main outcome measures Ability to identify a series of vegetables and fruits, attitudes towards vegetables and fruit. Analysis Frequency distributions for each item were generated and χ2 analyses were used to determine statistical significance. Exploratory factor analysis was employed to detect major trends in data. Results The intervention led to enhanced ability to identify individual vegetables and fruits, greater attention to origins of produce (garden-grown and fresh), changes to perceived consumption of vegetables and fruits, and enhanced confidence in preparing fruit and vegetable snacks, but decreased interest in trying new fruits. Conclusions The introduction of this school-based food garden was associated with skill and attitudinal changes conducive to enhancing vegetable and fruit consumption. The ways in which such changes might impact on dietary behaviours and intake require further analysis.

Changing parental high risk behaviour in the reduction of SIDS : the imperative of translational research

Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting South west region of England (population 4.9 million, 184 800 births). Participants 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa.

Defining the parental burden of acute cough in children

Despite the prevalence of acute cough in children (<2 weeks duration), the burden to parents and families is largely unknown. The objectives of this study were to determine the parental burden of children’s acute cough, and to evaluate psychological and other infl uences on the reported burden of acute cough in children. Methods Parents of children with a current acute cough (<2 weeks) at enrolment completed 4 questionnaires (state trait anxiety inventory (STAI); short form health survey (SF-8); depression, anxiety and stress 21-item scale (DASS21); and our preliminary 48-item parent acute cough specifi c quality of life (PAC-QOL48) questionnaire). In PAC-QOL48, lower scores refl ect worse QOL. Results Median age of the 104 children enrolled was 2.63 (IQR 1.42, 4.79) years, 54 were boys. Median length of cough at enrolment was 3 (IQR 2, 5) days. Median total PAC-QOL48 score of parents enrolled at presentation to the emergency department (n = 70) was signifi cantly worse than of parents enrolled through the community (n = 24) (p < 0.01). More than half (n = 55) had sought medical assistance more than once for the current acute coughing illness. PAC-QOL48 score was signifi cantly negatively correlated to verbal category descriptive and visual analogue scale cough scores (Spearman r = −0.26, p = 0.05 and r = −0.46, p = 0.01 respectively) and DASS21 total score (r = −0.36, p = 0.01), but not to child’s age. Conclusions Consistent with data on chronic cough, stress was the predominant factor of parental burden. This study highlights the ongoing need for clinicians to be cognizant of parental worries and concerns when their children are coughing, and for further research into safe and effective therapies for acute cough in children.