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Parenting in the age of social media: The buffering effect of parental self-efficacy on the relationship between parental social media use and parent child-relationship quality
Get PDFThe widespread use of technology in daily life has raised concerns about its potential to disrupt social relationships, particularly within one of the most important human relationships: the parent-child relationship. This study assesses whether parental social media use (measured by a novel parental social media intensity scale) affects the parent-child relationship (measured by the child-parent relationship scale – short form), and whether parental self-efficacy (PSE, measured by the parenting sense of competence scale) moderates this effect. A cross-sectional, online survey study using correlational methods was utilised, with a final sample of 89 parents and caregivers (71.9 % women), averaging 42.6 years old (SD = 3.9). Contrary to expectations, parental social media use did not significantly influence the parent-child relationship, however, when parental social media use and PSE were included in the moderated multiple regression model, 53 % of the variance parent-child relationship quality was explained. Further, the moderation hypothesis proposing that higher levels of PSE weaken the negative impact of parental social media use on the parent-child relationship, was supported. These results highlight the critical role of PSE in mitigating the negative effects of high parental social media use on the parent-child relationship for parents with average or higher levels of PSE. Crucially, these findings have important implications for parents with low PSE and high social media use, who reported the lowest parent-child relationship within the sample
Reducing methamphetamine use in Aboriginal and Torres Strait Islander communities with the “We Can Do This” web app: Qualitative evaluation of acceptability and feasibility
Get PDFBackground: Preventing and treating methamphetamine-related harm in Aboriginal and Torres Strait Islander populations is a significant challenge for health care services. Digital health care may offer opportunities to support individuals and families in ways that complement existing methamphetamine treatment options. This study responds to a community-identified priority as Aboriginal Community Controlled Health Services identified methamphetamine use as a key concern and sought support to respond to the needs of people who use methamphetamine and their families. Objective: This paper reports on a process evaluation of the web application’s acceptability and feasibility when used by clients and clinicians in residential rehabilitation services and primary care. This study is part of a larger project entitled “Novel Interventions to address Methamphetamine use in Aboriginal and Torres Strait Islander Communities” (NIMAC), which seeks to develop culturally appropriate and strengths-based prevention and treatment interventions to reduce methamphetamine related harm. “We Can Do This” was a web application developed for Aboriginal and Torres Strait Islander people who are seeking to reduce or stop methamphetamine use. Methods: Clinicians and clients who had used the web application were recruited through Aboriginal Community Controlled Health Services and Aboriginal residential rehabilitation services in urban and regional Victoria and South Australia. Unidentified usage data was collected from all participants. After using the web application, those who indicated a willingness to be interviewed were contacted and interviewed by phone or in person and asked about the feasibility and acceptability of the web application. The framework method of analysis was used to structure and summarise the resulting qualitative data. Results: Interviews with 24 clients and 11 clinicians explored the acceptability and feasibility of the web application. Acceptability incorporated the following domains: affective attitude, burden, ethicality, cultural appropriateness, coherence, opportunity cost, perceived effectiveness, and self-efficacy. The evaluation of feasibility assessed barriers and facilitators to the implementation of the program, with a focus on demand, practicality, fidelity, and integration. Results indicated that both clients and clinicians found the web application content coherent, relatable, empowering, and culturally safe. Barriers to using the web application for clients included a lack of internet connectivity and personal issues such as scheduling. Conclusions: Process evaluation is often under-valued. However, as “We Can Do This” was new, innovative and targeted a hard-to-reach population, understanding its feasibility and acceptability as a clinical tool was essential to understanding its potential. “We Can Do This” is unique as the only evidence-based, culturally appropriate internet-based therapeutic program specifically designed for Aboriginal and Torres Strait Islander people who use methamphetamine. Findings suggest it was both acceptable and feasible as a low-cost adjunct to usual care in residential rehabilitation and primary care settings
Sediment burial negatively impacts the growth of seagrass Posidonia sinuosa
Get PDFBurial disturbances affect foundation plant species in marine ecosystems. Deposition of dredge spoil can bury seagrass meadows yet we have limited threshold information to predict the trajectory of impact from burial or possible recovery. To investigate the response to burial by dredge spoil, established seagrass ramets of Posidonia sinuosa were collected from a population in Western Australia and exposed to cutter suction dredge spoil sediment. Plant responses were measured during a burial phase after 2, 4 and 8 weeks to assess the influence of duration to burial depths (0, 1, 4, 8 and 16 cm). Sediments were then removed, and recovery was monitored after 5 and 8 weeks. P. sinuosa was unaffected by burial of 1 and 4 cm whereas greater depths of burial led to negative impacts on ramet photophysiology and growth. In the 8 and 16 cm treatments, declines in seagrass growth were significant and sediment redox damaged seagrass health, reflecting conditions consistent with impaired plant physiology and anoxic sediment in the root zone. After burial was removed, seagrass growth rates in 8 and 16 cm treatments showed no recovery after 8 weeks. Although shoots were not lost, reduced growth and no shoot recovery in the short-term, 8 cm or more of dredge-deposition sediment could be used as a threshold for dredging management. Plant response under 16 cm of sediment suggests that the greater the seagrass burial depth the greater the adverse effect on the seagrass community including an impeded ability to recover and reduced population resilience
Woman-centred ethical grid for midwifery education: A content analysis
Get PDFBackground: Midwives across the world are required to practice in accordance with an internationally agreed set of ethical principles. Midwifery education for many students includes ethics theory content, but this does not necessarily provide them with the skills toward ethical competence in practice. Aim: To understand students\u27 perception of ethical issues and to use these findings as foundational information with which to create an ethical deliberation tool for practice. Methods: Qualitative Content Analysis was used for this study. Purposive sampling provided twenty-one ethics-focused reflective assignments from one Western Australian university. Ethical considerations: Institutional review board approval was obtained. Findings: Three themes were created which captured midwifery students experience of ethics on clinical placement: ‘Bearing witness and feeling moral distress’; ‘Relationship with the woman fostered ethical awareness’ and ‘Learning to advocate’. These findings were then integrated with ethical theory to create a new Woman-Centred Ethical Grid to help students deliberate ethical issues. Discussion: Midwifery students identified ethical issues during practical placement related to consent, interventions, insensitive practice, and overuse of technology, but felt powerless to act, which caused subsequent moral distress. Conclusion: Midwifery students require practical and supported education to better navigate the complex ethical issues that exist in maternity care. The Grid provides a comprehensive framework for ethical deliberation in midwifery practice to enhance midwifery advocacy
Hitting the jackpot: What drives casino hotel stock returns’ predictability?
Get PDFForecasting casino hotel stock prices are strategically important to key stakeholders making investment decisions. However, there is a paucity of studies that have examined the impact of macro-economic variables, sector-specific variables and firm-specific variables on casino stock returns. This research fills a research gap by examining the predictability of Australian casino hotel stock returns. The forecasting of casino hotel stock prices was modelled using econometric panel predictive regression analysis through the efficacy of 26 predictors comprising macroeconomic variables, sector-specific variables, and firm-specific variables as predictors. All eight casinos listed on the Australia Stock Exchange (ASX) were included in our sample. Our econometric panel predictive regression model found macro-economic variables with the strongest return predictability relative to the sector-specific and firm-specific variables. Our study contributes to the theoretical advancement of forecasting methodology through panel predictive regression modelling by addressing the endogeneity, persistency and heteroskedasticity of stock predictors by considering a large set of macro-economic variables, sector-specific and firm-specific variables as predictors to develop an econometric framework that suits the features of hotel financial data
Early, standardised, and precise treatment of COPD exacerbations and COVID-19
No full textBackground: Background Chronic Obstructive Pulmonary Disease (COPD) is a common chronic condition causing significant morbidity and mortality. Patients with COPD report sudden episodes of deteriorating respiratory symptoms called exacerbations, often presumed to be precipitated by infections. COPD is in the top 5 causes of death globally. COPD exacerbations drive a large proportion of these deaths. Despite this, there is no standardised model of care for the sickest patients who need hospitalisations for exacerbations. Meanwhile, treatment for COPD exacerbations continues to be guided by symptoms, instead of underlying biology. Most patients are treated with unnecessary and harmful systemic corticosteroids. During the COVID-19 pandemic, patients with COPD were found to be underrepresented in patients requiring hospitalisation for severe COVID-19. Among other explanations, the use of inhaled corticosteroids in this population has been hypothesised for this apparent reduction in risk.
Purpose: The objectives of this research were to: obtain a detailed European expert consensus on the assessment, investigation, management and follow up of patients hospitalised with an exacerbation of COPD; investigate the use of a point of care blood eosinophil count to determine the patients that need systemic corticosteroids in primary care treated COPD exacerbations; and investigate the use of inhaled budesonide to reduce the risk of clinical deterioration and subsequent hospitalisation in patients with early COVID-19.
Methods: Three studies were conducted: one Delphi survey of European COPD experts, a multi-centre double blind randomised controlled trial of patients presenting to primary care with COPD exacerbations, and an open label community trial of patients with early COVID-19.
For the Delphi study, 25 experts from 18 countries participated in a three round online Delphi survey. Experts were asked their opinion on over 700 individual components of clinical assessment, management and follow up of patients hospitalised for acute hospitalised exacerbation of COPD. Importance and feasibility of every item were assessed. Consensus and stability thresholds for opinions were pre-determined prior to survey commencement.
In the STARR2 clinical trial, 14 primary care practices in the UK randomised 144 exacerbations from 93 patients to blood eosinophil biomarker guided directed care or standard care. Patients who were allocated to the biomarker guided arm received 14 days of systemic corticosteroids if their blood eosinophil count was ≥2% of total white cell count on a point of care test. If they had a blood eosinophil count which was less than 2%, they received matching placebo. All patients in the standard care arm received 14 days of systemic corticosteroids regardless of blood eosinophil count. All allocation and treatments were delivered in a double-blind manner. The primary outcome was the need for any additional treatment to treat a COPD exacerbation at 30 days. STARR2 also assessed symptoms, lung function and quality of life recovery between groups.
In the STOIC clinical trial, 146 patients with symptoms suggestive of COVID-19 within 7 days of symptom onset were recruited. Patients were randomly allocated to receive inhaled budesonide 800 micrograms twice a day until symptoms resolved, or usual care. The primary endpoint was COVID-19-related urgent care visit, including emergency department assessment or hospitalisation. The secondary outcomes were self-reported clinical recovery, viral symptoms questionnaires, body temperature, blood oxygen saturation and SARS-CoV-2 viral load.
Results: In the Delphi study, experts agreed that a detailed history and examination were needed. Experts also agreed on which treatments are needed and how soon these should be delivered. Experts recommended that a full blood count, renal function, C-reactive protein, and cardiac blood biomarkers should be measured within 4 hours of admission and that the modified Medical Research Council dyspnoea scale and COPD Assessment Test should be performed at time of exacerbation and follow up. Experts encouraged COPD clinicians to strongly consider discussing palliative care, if indicated, at time of hospitalisation.
In the STARR2 trial, 144 exacerbations were included in the modified intention to treat analysis. There were 14 (19%) treatment failures in the biomarker guided treatment and 23 (32%) in the usual care arm. The analysis comparing biomarker guided care against standard care showed a large non-significant estimated effect (RR 0.60, 95% CI 0.33 to 1.04, p=0.070) in reducing treatment failures after a COPD exacerbation. The non-inferiority analysis confirmed that BET was non-inferior to ST. Frequency of adverse events were similar between the study arms.
In the STOIC trial, 146 participants were randomly assigned to usual care or inhaled budesonide. In the intention to treat population, the primary outcome occurred in 11 (15%) participants in the usual care group and two (3%) participants in the budesonide group (difference in proportions 0·123, 95% CI 0·033 to 0·213; p=0·009). The number needed to treat with inhaled budesonide to reduce COVID-19 deterioration was eight. Clinical recovery was 1 day shorter in the budesonide group compared with the usual care group (median 7 days [95% CI 6 to 9] in the budesonide group vs 8 days [7 to 11] in the usual care group; log-rank test p=0·007).
Conclusions: COPD exacerbation care has not changed in over 30 years. All exacerbations are treated equally with little focus on the biological cause of the exacerbation. The Delphi study shows that there is a great deal of agreement among respiratory physicians on how patients should be assessed, cared for and followed up when they are hospitalised for a COPD exacerbation. The STARR2 study showed that blood eosinophil count assessment was safe and effective for identifying patients who needed systemic steroids for the treatment of COPD exacerbations treated in primary care. The time for change in COPD care has arrived. Early COVID-19 shares many similarities with COPD exacerbations. The use of inhaled budesonide in patients with early COVID-19 reduced the risk of clinical progression and improved symptom recovery. Early, accurate and standardised care is needed for patients with COPD exacerbations and COVID-19
She Speaks: Amplifying women\u27s voices for wellbeing
No full textThe SheSpeaks project successfully transformed how 223 Western Australian women understand and practice self-care, demonstrating that targeted wellbeing literacy interventions can create lasting change in women’s relationship with their own wellbeing. Funded by the Women’s Grants for a Stronger Future program, this innovative initiative combined evidence-based workshops with authentic podcasting to challenge the pervasive cultural narrative that positions women’s self-care as selfish or impossible
Evaluating the impact of the ‘blow, breathe, cough’ health promotion intervention in resolving otitis media with effusion in children: An adaptive randomized-controlled trial protocol
No full textIntroduction: Otitis media with effusion (OME) affects hearing, speech development, and quality of life (QoL) in children. The ‘Blow, Breathe, Cough’ (BBC) intervention promotes nasal, respiratory, and middle ear clearance through nose blowing, deep breathing, coughing, and hand hygiene. It shows promise in resolving OME but lacks randomized-controlled trial (RCT) evaluation. This paper presents a RCT protocol evaluating BBC\u27s effect on OME resolution, hearing, speech, and QoL in children aged two to seven years. Methods: This parallel-group, 1:1, outcome assessor-blinded, individual adaptive RCT investigates whether completing the BBC intervention plus hand hygiene twice-daily at home increases OME resolution after 4-to-6 weeks in children with OME, compared to hand hygiene alone. Families (n = 250) perform their individually randomized program (BBC plus hand hygiene, or hand hygiene only) at home. The primary outcome is the difference in OME resolution rates between trial arms, assessed using tympanometry (type B to A or C1 transition) and otoscopy. Secondary outcomes include natural OME resolution, discharges from tertiary care, family satisfaction, hearing thresholds, QoL, bacterial load in the nasopharynx and on hands, cost comparison within the RCT versus standard care, and adverse events. All outcomes are measured by blinded researchers. An intention-to-treat analysis will be performed on all randomized participants. Guided by an Aboriginal Community Advisory Group, the RCT ensures culturally appropriate research whilst addressing community priorities in managing childhood ear disease. Discussion: If efficacious, BBC could reform OME treatment, reduce costs, and improve long-term hearing, speech, and QoL outcomes in some children. Its accessibility offers a globally scalable solution
Exercise perceptions in people with metabolic dysfunction-associated steatotic liver disease: Insights from a qualitative study
No full textBackground: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic liver condition associated with lifestyle and metabolic risk factors. While exercise is a beneficial treatment strategy, many patients struggle to implement and perform exercise regularly. It is important for practitioners to know about patient awareness, attitudes, and preferences regarding exercise in the con-text of MASLD. In this study, we examined exercise knowledge, attitudes, and exercise preferences among patients with MASLD to improve their exercise behavior changes. Methods: We conducted a questionnaire and semi-structured inter-view study in adults with MASLD to assess their disease awareness, perspectives on exercise and exercise preferences. MASLD severity was assessed using controlled attenuation parameter (CAP) and tran-sient elastography (TE) to determine the severity of hepatic steatosis and fibrosis, respectively. Transcripts were coded using NVivo soft-ware, and thematic analysis was employed to extract key themes. Results: A total of 18 interviews were completed with 18 MASLD patients (37-76 years), who attended an outpatient hepatology clinic. The majority of participants demonstrated awareness of MASLD’s severity but lacked knowledge about exercise as a treatment option. Participants expressed preferences for exercises that were time-effi-cient, easy to perform, non-strenuous, and portable. Walking emerged as the most favored exercise, followed by resistance exercises with free weights and eccentric-biased bodyweight exercises. Conclusions: This study provides insights into individuals’ perspectives on exercise in MASLD, highlighting the need for targeted edu-cation and personalized exercise interventions. Understanding these perspectives can inform the development of effective strategies to promote long-term exercise adherence and improve clinical outcomes in MASLD management
Impact of perceived discrimination and social exclusion on wellbeing of black African immigrants in Australia
No full textAcross the globe, a significant number of immigrants frequently encounter discrimination and social exclusion in their host nations, prompting discussions regarding policies and societal attitudes toward these groups. This study is guided by the structural social work framework which provides a very important structure to understand the experiences of Black African immigrants in Australia. Drawing on the case of Black African immigrants in Australia, this study investigates the effects of discrimination and social exclusion on their wellbeing. This research builds upon existing literature concerning the discrimination and social exclusion of immigrants, incorporating the perspectives of 27 social workers and immigrants who have resided in Australia for at least of 2 years. We conducted semi-structured interviews with eight social workers and 19 Black African immigrants purposefully selected from Brisbane, Townsville, Melbourne, and Sydney. These interviews were conducted both face-to-face and online via Zoom, Teams, and WhatsApp calls. We audio-recorded and transcribed the interviews, employing a thematic analysis approach with the assistance of NVivo software to analyze the data. Our findings reveal that Black African immigrants often experience discrimination, primarily manifested through their perceptions of exclusion and discrimination in job recruitment, social environments, and social contexts. Participants emphasized that discrimination in its various forms affects their wellbeing. Our findings contribute to the scholarship on wellbeing. We argue that interventions aimed at enhancing the wellbeing of Black African immigrants should address discriminatory and exclusionary systems, advocate for policy reform, and re-emphasize the role of practitioners as agents of social activism and change