Healthcare users’ experiences of communicating with healthcare professionals about children who have life-limiting conditions: A qualitative systematic review protocol

REVIEW QUESTION / OBJECTIVE The objective of this review is to identify and synthesize the best international qualitative evidence on healthcare users’ experiences of communication with healthcare professionals about children who have life-limiting conditions. For the purposes of this review, “healthcare users” will be taken to include children who have life-limiting conditions and their families. The question to be addressed is: - What are healthcare users’ experiences of communicating with healthcare professionals about children who have life-limiting conditions? INCLUSION CRITERIA - Types of participants: This review will consider all qualitative studies that focus on users of healthcare services for children who have life-limiting conditions. These users are anticipated to include children who have a life-limiting condition and their family members. In instances where children are not under the legal care of one or both parents, service users may also include other types of legal guardians. - Phenomena of interest: This review will consider experiences of communicating with healthcare professionals about children who have life-limiting conditions. - Context: This review will consider studies relating to communication with healthcare professionals about children who have a life-limiting condition, irrespective of whether the healthcare service is based in a hospital, hospice, or community setting. There is no restriction on the country in which a study was conducted.

Feasibility of an in-patient exercise intervention for children undergoing haematopoietic stem cell transplant

With improving survival rates following HSCT in children, QOL and management of short- and long-term effects need to be considered. Exercise may help mitigate fatigue and declines in fitness and strength. The aims of this study were to assess the feasibility of an inpatient exercise intervention for children undergoing HSCT and observe the changes in physical and psychological health. Fourteen patients were recruited, mean age 10 yr. A 6MWT, isometric upper and lower body strength, balance, fatigue, and QOL were assessed prior to Tx and six wk post-Tx. A supervised exercise program was offered five days per week during the inpatient period and feasibility assessed through uptake rate. The study had 100% program completion and 60% uptake rate of exercise sessions. The mean (±s.d.) weekly activity was 117.5 (±79.3) minutes. Younger children performed significantly more minutes of exercise than adolescents. At reassessment, strength and fatigue were stabilized while aerobic fitness and balance decreased. QOL revealed a non-statistical trend towards improvement. No exercise-related adverse events were reported. A supervised inpatient exercise program is safe and feasible, with potential physiological and psychosocial benefits.

Vineland Adaptive Behavior Scales - II profile of young children with Autism Spectrum Disorder

Adaptive behaviour is a crucial area of assessment for individuals with Autism Spectrum Disorder (ASD). This study examined the adaptive behaviour profile of 77 young children with ASD using the Vineland-II, and analysed factors associated with adaptive functioning. Consistent with previous research with the original Vineland a distinct autism profile of Vineland-II age equivalent scores, but not standard scores, was found. Highest scores were in motor skills and lowest scores were in socialisation. The addition of the Autism Diagnostic Observation Schedule (ADOS) calibrated severity score did not contribute significant variance to Vineland-II scores beyond that accounted for by age and nonverbal ability. Limitations, future directions, and implications are discussed.

Language in Acquisition : Early Lexical Development and Associations between Lexicon and Grammar Findings from Full-Term and Very-Low-Birth-Weight Finnish Children

The aim was to analyse the growth and compositional development of the receptive and expressive lexicons between the ages 0,9 and 2;0 in the full-term (FT) and the very-low-birth-weight (VLBW) children who are acquiring Finnish. The associations between the expressive lexicon and grammar at 1;6 and 2;0 in the FT children were also studied. In addition, the language skills of the VLBW children at 2;0 were analysed, as well as the predictive value of early lexicon to the later language performance. Four groups took part in the studies: the longitudinal (N = 35) and cross-sectional (N = 146) samples of the FT children, and the longitudinal (N = 32) and cross-sectional (N = 66) samples of VLBW children. The data was gathered by applying of the structured parental rating method (the Finnish version of the Communicative Development Inventory), through analysis of the children´s spontaneous speech and by administering a a formal test (Reynell Developmental Language Scales). The FT children acquired their receptive lexicons earlier, at a faster rate and with larger individual variation than their expressive lexicons. The acquisition rate of the expressive lexicon increased from slow to faster in most children (91%). Highly parallel developmental paths for lexical semantic categories were detected in the receptive and expressive lexicons of the Finnish children when they were analysed in relation to the growth of the lexicon size, as described in the literature for children acquiring other languages. The emergence of grammar was closely associated with expressive lexical growth. The VLBW children acquired their receptive lexicons at a slower rate and had weaker language skills at 2;0 than the full-term children. The compositional development of both lexicons happened at a slower rate in the VLBW children when compared to the FT controls. However, when the compositional development was analysed in relation to the growth of lexicon size, this development occurred qualitatively in a nearly parallel manner in the VLBW children as in the FT children. Early receptive and expressive lexicon sizes were significantly associated with later language skills in both groups. The effect of the background variables (gender, length of the mother s basic education, birth weight) on the language development in the FT and the VLBW children differed. The results provide new information of early language acquisition by the Finnish FT and VLBW children. The results support the view that the early acquisition of the semantic lexical categories is related to lexicon growth. The current findings also propose that the early grammatical acquisition is closely related to the growth of expressive vocabulary size. The language development of the VLBW children should be followed in clinical work.

Pellon pientareelta akateemisiin sfääreihin : Opettajuuden rakentuminen ja muuttuminen sotienjälkeisessä Suomessa opettajien omaelämäkertojen valossa

From the field to the academic sphere how teachers professional identities and roles have changed in post-war Finland This study explores teacher autobiographies. The span of the writings extends mainly from the Second World War to the new millennium. The autobiographers are mostly elementary and secondary school teachers in Finland, although there are a few who have worked in vocational schools, polytechnic institutes or one of the various adult education centres. The researcher is aware of the diversity among those educational institutions and their teachers, but wanted to concentrate on similarities rather than differences. The autobiographers have been explored with four different research questions in view. The first was to identify professional and personal elements and themes mentioned by teachers in writing about themselves. The second was to identify the factors that have affected those elements and themes. The third was to examine the kinds of literary forms teachers used in their autobiographies. The fourth was the most crucial and an endeavour to connect the previous questions: how teachers professional identities and roles have changed during the period studied. In the first five chapters the teachers voices come through clearly. Two of these chapters are organized in chronological order. The first is about childhood, youth and the time spent in school, the second deals with the years studying in university or teachers college and finally being recruited to the teachers. In these chapters the rural background of many teachers stands out, an issue that also emerged symbolically or de facto in the autobiographies. The chronological scheme changes to a thematic order, in which social matters (students, parents, colleagues) and teachers working circumstances are dealt with. Four selected autobiographies are examined closely. In these autobiographies five different types of teacher narratives can be identified. To begin with, teachers stressed their vocation, which is quite a normal work orientation for those working in the educational field. Others emphasised how they were looking for professional development; a few wrote about personal advancement as well. There are also narratives by teachers who simply drifted into the profession of teaching, while a few teachers felt unwelcome in their own schools. As for the changes that teachers have witnessed, there are also some themes that are widely shared. Most pointed out how the teacher has become more foster parent than educator, as real parents have withdrawn from their responsibilities of raising children. This theme was frequently broached, although attitude towards it and ways of handling the phenomenon differed substantially. Teachers also stressed how their profession has lost the aura and prestige it once had. At the same time teachers are being expected to collaborate more with their colleagues, which is not in line with the centuries-old tradition of working alone. Teachers seem to be in a state of flux, buffeted by elements of stability and change interacting simultaneously. Many teachers are demanding a re-examination of their working reality. Teachers long and intimate relationship with society and the state may be at a crossroads. Key words: teachers professional identity and role, autobiographical study, post-war Finland

Tipping points: Teachers' reported reasons for referring primary school children for excessive anxiety

The current study explored the reasons that primary school teachers reported were tipping points for them in deciding whether or not and when to refer a child to the school student support team for excessive anxiety. Twenty teachers in two Queensland primary schools were interviewed. Content analysis of interview transcripts revealed six themes reflecting teachers' perceived reasons for deciding to refer anxious children: 1)impact on learning; 2)atypical child behavior; 3)repeated difficulties that do not improve over time; 4)poor response to strategies; 5)teachers' need for support; and 6)information from parents/carers. Teachers considered different combinations of reasons, and had many different tipping points for making a referral. Both teacher-and system-level influences impacted referral decisions. Implications and future research are discussed.

Family-based programmes for preventing smoking by children and adolescents: Evidence and implications for public health

- P -General population, nonsmoking children (aged 5 to 12) and adolescents (aged 13 to 18) with their parents - I -Interventions with children and family members intended to deter tobacco use. Any components to change parenting behaviour, parental or sibling smoking behaviour, or family communication and interaction. - C -Usual practice, or a program of no family intervention - O -Smoking status of children who reported no use of tobacco at baseline.

Outdoor portrait of Hans Frankenbach (right) with unidentified boy Portraits Children

Digital Image

Portrait of Albert (obscured) and Erwin Loewenson Portraits; Children

Verso: Handsigned Erwin Loewenson

Godshaw (Gottschalk) children Hal, Elisabeth, Kurt, Walter, Ursula, and Freddy.

Front row from left to right: Walter, Ursula, Freddy; top row from left to right: Hal, Elisabeth, Kurt