Home-based child development interventions for preschool children from socially disadvantaged families

BACKGROUND
Social disadvantage can have a significant impact on early child development, health and wellbeing. What happens during this critical period is important for all aspects of development. Caregiving competence and the quality of the environment play an important role in supporting development in young children and parents have an important role to play in optimising child development and mitigating the negative effects of social disadvantage. Home-based child development programmes aim to optimise children's developmental outcomes through educating, training and supporting parents in their own home to provide a more nurturing and stimulating environment for their child.

OBJECTIVES
To determine the effects of home-based programmes aimed specifically at improving developmental outcomes for preschool children from socially disadvantaged families.

SEARCH STRATEGY
We searched the following databases between 7 October and 12 October 2010: Cochrane Central Register of Controlled Trials (CENTRAL) (2010, Issue 4), MEDLINE (1950 to week 4, September 2010), EMBASE (1980 to Week 39, 2010), CINAHL (1937 to current), PsycINFO (1887 to current), ERIC (1966 to current), ASSIA (1987 to current), Sociological Abstracts (1952 to current), Social Science Citation Index (1970 to current). We also searched reference lists of articles.

SELECTION CRITERIA
Randomised controlled trials comparing home-based preschool child development interventions with a 'standard care' control. Participants were parents with children up to the age of school entry who were socially disadvantaged in respect of poverty, lone parenthood or ethnic minority status.

DATA COLLECTION AND ANALYSIS
Two authors independently selected studies, assessed the trials' risk of bias and extracted data.

RESULTS
We included seven studies, which involved 723 participants. We assessed four of the seven studies as being at high risk of bias and three had an unclear risk of bias; the quality of the evidence was difficult to assess as there was often insufficient detail reported to enable any conclusions to be drawn about the methodological rigour of the studies. Four trials involving 285 participants measured cognitive development and we synthesised these data in a meta-analysis. Compared to the control group, there was no statistically significant impact of the intervention on cognitive development (standardised mean difference (SMD) 0.30; 95% confidence interval -0.18 to 0.78). Only three studies reported socioemotional outcomes and there was insufficient data to combine into a meta-analysis. No study reported on adverse effects.

AUTHORS’ CONCLUSIONS
This review does not provide evidence of the effectiveness of home-based interventions that are specifically targeted at improving developmental outcomes for preschool children from socially disadvantaged families. Future studies should endeavour to better document and report their methodological processes.

Reducing the psychological distress of family caregivers of home based palliative care patients: Longer term effects from a randomised controlled trial.

Background: Palliative care incorporates comprehensive support of family caregivers because many of them experience burden and distress. However, evidence-based support initiatives are few.

Purpose: We evaluated a one-to-one psychoeducational intervention aimed at mitigating the distress of caregivers of patients with advanced cancer receiving home-based palliative care. We hypothesised that caregivers would report decreased distress as assessed by the General Health Questionnaire (GHQ).

Method: A randomised controlled trial comparing two versions of the delivery of the intervention (one face-to-face home visit plus telephone calls versus two visits) plus standard care to a control group (standard care only) across four sites in Australia.

Results: Recruitment to the one visit condition was 57, the two visit condition 93, and the control 148. We previously reported non-significant changes in distress between times 1 (baseline) and 2 (1-week post-intervention) but significant gains in competence and preparedness. We report here changes in distress between times 1 and 3 (8-week post-death). There was significantly less worsening in distress between times 1 and 3 in the one visit intervention group than in the control group; however, no significant difference was found between the two visit intervention and the control group.

Conclusions: These results are consistent with the aim of the intervention, and they support existing evidence demonstrating that relatively short psychoeducational interventions can help family caregivers who are supporting a dying relative. The sustained benefit during the bereavement period may also have positive resource implications, which should be the subject of future inquiry. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

Improving the educational achievement of young people in out-of-home care

A strong link between research and practice is essential to ensure
that the best available evidence gets into the hands of child welfare
practitioners, who are faced with the daunting task of making decisions
about vulnerable children on a daily basis. In 2007, a group of
senior child welfare leaders in the province of Ontario (Canada) created
a research dissemination model that replicated the worldrenowned
UK program, Research in Practice (http://www.rip.org.
uk). Practice and Research Together (PART; www.partontario.org) is
an Ontario consortium of 45 child welfare organizations whose mandate
is to disseminate research to its member agencies, which include
85% of the local child welfare organizations in the province. Each
member pays an annual membership-fee that is based on its size
(Dill & Shera, 2011). A key factor in PART's success has been its ability
to link its program offerings (i.e., webinars, literature reviews, conferences,
and publications) to issues of real-world relevance to child
welfare practitioners and senior leaders. A central and highly anticipated
program offering is PART's annual conference (learning
event). These conferences bring evidence to bear on practice in priority
areas in child welfare.
On May 31 and June 1 and 2, 2011, PART, in collaboration with the
Centre for Research on Educational and Community Services (CRECS)
at the University of Ottawa, co-hosted an international conference in
Ottawa that was focused on improving the educational achievement
of young people in out-of-home care (hereafter, in care). Speakers
from five countries – Canada, USA, Germany, Sweden, and UK – presented
the results of their research at the conference. The speakers
addressed three main topic areas: the disadvantaged socio-political
status of young people in care, many of whom do not complete secondary
or post-secondary education; innovative interventions to improve
their educational outcomes; and the effectiveness of tutoring,
which is the most common educational intervention for young people
in care.

Infection control and meticillin-resistant Staphylococcus aureus decolonization:the perspective of nursing home staff

Infection control and meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes have started to assume greater importance in practice and policy.

Dynamic Buffer Management for Multimedia Services in Beyond 3G Wireless Networks

This paper investigates a dynamic buffer man-agement scheme for QoS control of multimedia services in be-yond 3G wireless systems. The scheme is studied in the context of the state-of-the-art 3.5G system i.e. the High Speed Downlink Packet Access (HSDPA) which enhances 3G UMTS to support high-speed packet switched services. Unlike earlier systems, UMTS-evolved systems from HSDPA and beyond incorporate mechanisms such as packet scheduling and HARQ in the base station necessitating data buffering at the air interface. This introduces a potential bottleneck to end-to-end communication. Hence, buffer management at the air interface is crucial for end-to-end QoS support of multimedia services with multi-plexed parallel diverse flows such as video and data in the same end-user session. The dynamic buffer management scheme for HSDPA multimedia sessions with aggregated real-time and non real-time flows is investigated via extensive HSDPA simulations. The impact of the scheme on end-to-end traffic performance is evaluated with an example multimedia session comprising a real-time streaming flow concurrent with TCP-based non real-time flow. Results demonstrate that the scheme can guar-antee the end-to-end QoS of the real-time streaming flow, whilst simultaneously protecting the non real-time flow from starva-tion resulting in improved end-to-end throughput performance

Dynamic Buffer Management for Multimedia Services in 3.5G Wireless Networks

This paper presents and investigates a dynamic
buffer management scheme for QoS control of multimedia
services in a 3.5G wireless system i.e. the High Speed Downlink
Packet Access (HSDPA). HSDPA was introduced to enhance
UMTS for high-speed packet switched services. With HSDPA,
packet scheduling and HARQ mechanisms in the base station
require data buffering at the air interface thus introducing a
potential bottleneck to end-to-end communication. Hence, for
multimedia services with multiplexed parallel diverse flows
such as video and data in the same end-user session, buffer
management schemes in the base station are essential to support
end-to-end QoS provision. We propose a dynamic buffer management
scheme for HSDPA multimedia sessions with aggregated real-time and non real-time flows in the paper. The end-to-end performance impact of the scheme is evaluated with an example multimedia session comprising a real-time streaming
flow concurrent with TCP-based non real-time flow via extensive HSDPA simulations. Results demonstrate that the scheme can guarantee the end-to-end QoS of the real-time streaming flow, whilst simultaneously protecting non real-time flow from starvation resulting in improved end-to-end throughput performance

Buffer Management for Multimedia QoS control over HSDPA Downlink

HSDPA specifications include support for a flexible framework for QoS management. In this paper, it is shown how buffer management could be incorporated into HSDPA QoS framework for 'multimedia' traffic QoS control in the MAC-hs of the Node-B. A time-space-priority (TSP) scheme is proposed as viable buffer management scheme to this effect. Comparative simulation study with other schemes is presented, demonstrating the effectiveness of the TSP buffer management scheme for 'multimedia' service QoS control in HSDPA Node-B data buffers