1,721,013 research outputs found
COVID-19 Testing and Diagnosis in Children Under Six Years of Age: A Systematic Review
No full textIntroduction: Severe acute respiratory syndrome was first detected in 2003 and escalated in 2019 with COVID-19 causing a worldwide pandemic. This new virus presented challenges in diagnosis, especially in those under 6 years of age. While often classified as a mild disease in children, COVID-19 still presents significant health risks in the young, especially for children under 1 year of age and those with pre-existing comorbidities. Because of this, clinical guidelines and protocols addressing COVID-19 testing in preschool- aged children became necessary to direct evidence-based practice.
Aim: The aim of this systematic review was to explore COVID-19 testing and diagnosis in children under 6 years of age from international peer-reviewed published manuscripts to facilitate a wider and more thorough understanding of this practice from a diverse sample of parents, children, and health care providers to inform and direct practice within Aotearoa/New Zealand.
Methods: A systematic review was undertaken based on guidelines by Siddaway et al. (2019). Extant empirical research published in peer-reviewed journals from 2020–2024 on COVID-19 testing in children under 6 years of age was identified from Scopus, CINAHL, MEDLINE via PubMed, and PsycInfo via Ovid databases. Data were analysed using deductive thematic analysis.
Findings: Fourteen studies involving over 5,000 participants were included. Deductive content analysis identified seven key areas: 1. Symptomology, 2. Diagnostic tests, 4. Efficacy and acceptability of testing, 4. Viral loads, 5. Vulnerability/Risk factors, 6. Health outcomes, and 7. Recommendations.
Conclusion: While common symptoms such as fever and cough are prevalent in children under 6 years of age infected with COVID-19, symptomology alone is not a foolproof diagnostic tool. Additional diagnostic testing, such as nasopharyngeal swabs and polymerase chain reaction testing, is complementary to diagnosis. However, an understanding of the risk factors for contracting COVID-19, as well as the vulnerability and health outcomes of children with COVID-19, is important to consider.
Implications for practice: Common symptomology for children under 6 years of age includes fever and cough; however, these symptoms are also common for other viruses. A history of exposure to COVID-19 is the most frequent positive predictive factor for infection. An assessment of the child before any decisions on diagnostic testing is useful
The Effectiveness, Acceptability and Practicality of a CBT-Sensory Modulation Intervention for Children 4-7 Years Old Presenting with Anxiety
No full textBackground
Childhood anxiety is associated with long-term consequences, including the development of mood disorders and functional challenges, if not treated early. However, literature shows that young children do not receive timely interventions due to long waiting lists, a shortage of psychologists, and an inability to complete interventions that are between 9 and 20 sessions, due to their parents’ competing commitments. Cognitive Behavioural Therapy (CBT) is the main non-pharmacological intervention used for the treatment of anxiety. CBT is a talking-based therapy which helps people explore and manage unhelpful thoughts to reduce distressing emotions or problematic behaviours. While often recommended, CBT alone may not be effective in treating childhood anxiety and is not always developmentally appropriate for younger children. Sensory modulation is a clinical intervention that uses sensory-based strategies to help with emotion regulation and can be adapted for young children. To address a gap in early intervention for younger children with anxiety, a modified CBT plus sensory modulation intervention was developed, which could potentially be delivered by a wide range of clinicians.
Study Design
The current study tested the effectiveness, acceptability, and practicality of a 6-session modified CBT plus sensory modulation anxiety intervention developed for children aged 4 to 7 years old presenting with anxiety. The study used a multiple baseline single case experimental design. Six children with clinically significant anxiety were admitted to the study. Four therapists delivered the intervention with the children and their mothers (n=6) at a Child, Adolescent, and Family Service and a Child and Family Care Trust. The six children received the intervention during the study phase, where the intervention was delivered in a staggered fashion. Data, including the levels of each child’s anxiety and functioning, were collected at multiple baseline points, then during and post-intervention and 1-month follow-up. Visual and statistical analyses of data were completed to determine the effectiveness of the intervention. Subjective feedback from the mothers and therapists were also collected. Content analysis was used to analyse the subjective feedback to determine the acceptability and practicality of the intervention.
Results
Quantitative findings and visual analysis of data provided evidence supporting the effectiveness of the intervention in treating childhood anxiety. Subjective feedback data showed that the intervention was received as an acceptable and practicable intervention for younger children with anxiety. One month post-intervention data showed that gains were maintained, with four children not meeting the threshold for a primary diagnosis of anxiety with which they were diagnosed upon entering the study.
Implications
This study was the first to combine CBT and sensory modulation for younger children presenting with anxiety. The study findings provide preliminary evidence that the intervention was effective, acceptable, and practicable. However, larger randomised clinical trials are required to confirm the effectiveness of the intervention. The results contribute to the further understanding of how to develop age-appropriate interventions for the management of childhood anxiety, including the use of sensory-based strategies for younger children. The manualised intervention has the potential to help address childhood anxiety by providing non-psychology professionals, with a framework for supporting younger children early
Adjusting to a Different Way of Parenting: The Experiences and Perspectives of Mothers Raising a Child with Cerebral Palsy in New Zealand. An Interpretative Descriptive Study
No full textCerebral palsy (CP) is a neurodevelopmental condition that has widely variable physical and non-physical challenges. Children with CP have long-term care requirements that exceed that of a typical child and, therefore, are more dependent on parents and caregivers for daily assistance. CP is the most common disability worldwide; yet, there is limited qualitative research exploring the experiences of parents and caregivers both internationally and in New Zealand. This research used interpretative descriptive methodology to explore the experiences and perspectives of parents and caregivers in New Zealand raising a school age child with CP. The intention of the research is to provide insight into this topic so that key stakeholders, such as the government, policy makers, and health professionals, can understand the experience and use it to provide services, supports, and practice changes that are evidenced based.
Purposive sampling was used to recruit the 15 participants, all of whom were mothers as they were the only caregiver to respond to the call for volunteers. Semi structured one on one interviews were conducted in person or via Zoom and transcribed through a transcription application (transcribe.com). Analysis of the data revealed an overarching concept of adjusting to a different way of parenting which is made up of three themes: a difficult start, rowing upstream, and winning but not as expected.
These themes represent the parenting journey that the mothers had taken. A difficult start covers a very influential time in the mother’s life which often started with a complicated labour and led to many experiencing a rollercoaster of emotions. For many, this time in mothers’ lives had a profound effect both on their physical health and their mental health and well-being. Overwhelmingly, this difficult start required them to adjust to a different way of parenting than they had envisaged. Rowing upstream represents the work and worries mothers experienced and reflects how much harder mothers felt it was parenting their child with CP. It includes the challenges and battles they faced with schools and government supports. These variables required mothers to adjust to a different way of parenting than expected. The final theme, winning but not as expected, represents the place where mothers arrived at in their parenting journey and consists of growth through gratitude and the discovery of a warm blanket of community support. All these experiences led to mothers feeling positive about their parenting journey and that they were winning in life, just in a different way to what they had imagined and expected.
This study highlights a significant gap in qualitative disability research in New Zealand while also revealing the resilience and strength of mothers and their children as they navigate the challenges of disability. It has highlighted the inequities in the NZ health and education systems responsible for providing disability related support and care and uncovered the trauma mothers have experienced. These are important findings that both health and education professionals, policy makers, and disability support organisations should be made aware of. These research findings are intended to be shared widely to highlight the important issues that they have uncovered with a view to influence change
You Are Not Alone. Supporting Health Professionals Following a Clinical Error. Understanding the Psychological Impact That Clinical Error Has on Health Professionals and if Organisational Culture Influences the Experience of the Health Professional
No full textBackground: Despite significant advancements in patient safety over the past two decades, everyday patients continue to be harmed. In the context of the escalating pressures of increasing workloads, staff shortages, burnout, low morale and high staff turnover faced by healthcare organisations, the negative impact these pressures have on patient care is evident. Well-trained staff with years of experience can make errors. These individuals who make an error are recognised as the ‘second victims’ (Wu, 2000). Becoming a second victim can have severe negative effects that are often long-lasting on a health professional’s psychological and physical well-being, and in turn can negatively impact patient care. Organisational support and a positive safety culture play a critical role in lessening the effects of the second victim phenomenon. This research offers a unique insight into the current situation within New Zealand and contributes to the international literature relating to clinical error and the second victim phenomenon.
The aims of this research were, to answer the following questions:
I. What psychological impact does involvement with clinical error have on New Zealand health professionals?
II. What impact does organisational culture have on the recovery of health professionals following a clinical error?
III. What support do health professionals want following a clinical error?
Method: This research adopted a mixed-method embedded convergent parallel design; the study was largely quantitative and included qualitative data to enhance the quantitative results. The quantitative data was collected using a self-reporting survey tool with a Likert scale. The tool was developed by combining selected questions taken from three existing tools, The Second Victim Experience and Support Tool, The Safety Attitudes Questionnaire and The Safety Climate Survey, with the inclusion of two open ended questions. The study included a final sample of 41 participants, all registered New-Zealand-based health professionals, including doctors, nurses, medical imaging technologists and clinical pharmacists.
Findings: There were several significant findings, many of which were consistent with other published studies. Overall, participants experienced greater psychological distress than physical distress. The most reported psychological symptom was the ‘fear of embarrassment.’ Female participants experienced more severe psychological and physical effects (p=0.045) than males, whilst medical imaging technologists reported more severe psychological effects than nurses or doctors. The most desired support following involvement with a clinical error was colleague support. The difference between gender was statistically significant (p=0.002), and females reported a stronger desire for support than males (p=0.037).
Conclusion: This research has identified that the second victim phenomenon is real and is not well managed. There are several nuances that this study has observed across the different professional groups. These major findings provide a unique insight into the experience of New Zealand health professionals and has contributed to the existing second victim and safety culture research, including a new understanding of the impact clinical errors have on medical imaging technologists. Furthermore, this research has several implications for future research and practice in New Zealand and internationally and provides an opportunity for expanding this research to a wider population
Healthcare Professionals’ Perceptions and Knowledge of the Management and Removal of Underwater Seal Chest Drains in Children and Young People: New Zealand
No full textPaediatric patients with underwater seal chest drains are cared for in certain areas within a paediatric hospital setting. Presently within a paediatric hospital in New Zealand there is a clinical underwater seal chest drain guideline to guide chest drain insertion, management, and removal yet there is inconsistency in what the guideline states and current practice. This quality improvement project undertook a integrative review of the international literature on underwater seal chest drain management and explored healthcare workers perceptions and knowledge on the management and removal of underwater seal chest drains in children and young people at a large children’s hospital in New Zealand.
Method: An integrative review was undertaken to summarise previous international empirical peer-reviewed literature published from 2011 - 2022 to provide a comprehensive understanding on the management and removal of underwater seal chest drains in children and young people. A qualitative design using face-to-face interviews with healthcare professionals from one large children’s hospital in New Zealand who had a key role in underwater seal chest drain management and removal was undertaken in 2022.
Analysis: The integrative review and face to face interview data were analysed separately using the six phases of Braun and Clarks’ (2006) thematic analysis. This included familiarising oneself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes and generating a report. The findings of both research designs were brought together in the discussion.
Results: A total of nine studies were included in the review. An inductive analysis of nine manuscripts generated one theme (disparity in healthcare professionals’ knowledge and practice with underwater seal chest drain management), three sub-themes (healthcare professionals, practice considerations, adverse events) and nine categories (discipline and context, knowledge, education, indications, underwater seal chest drain tubing and characteristics, management, assessment, complications, interventions). Face to face interviews were undertaken with seven healthcare professionals. An inductive analysis of the interviews generated one theme (a gap between theory, guidelines and practice of underwater seal chest drain management), four subthemes (management, practice considerations, scope of practice, current practice), eleven categories (collaboration, care delivery, indications, insertion-removal, adverse events, guidelines, knowledge, demographics, reality, ability, context). The results highlighted that there was a disparity in healthcare professionals’ knowledge and practice with underwater seal chest drain management as well as a gap between theory, guidelines and reality of practice for underwater seal chest drain management.
Conclusion: There is a lack of research for underwater seal chest drain management and removal, particularly in paediatrics. There is a discrepancy between healthcare professionals’ perceptions and knowledge of underwater seal chest drain management and removal, to what is required to manage and remove underwater seal chest drains safely and effectively. There is an urgent need to provide healthcare professionals with the relevant education and knowledge to be able to adequately care for children with underwater seal chest drains and ultimately prevent any adverse events. It is also recommended that healthcare professionals utilise contemporary evidence-based research to create and update clinical practice guidelines for underwater seal chest drain management and removal
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Children in Hospital Over Christmas [Editorial]
No full textNursing children in hospital over Christmas requires a thoughtful and compassionate Child and Family Centred Care (CFCC) approach that honours the rights of every child (Al-Motlaq et al., 2021; Foster & Blamires, 2023; United Nations Human Rights Office of the High Commissioner, 1989). It is important to approach every child and family with empathy, sensitivity, and cultural competence, recognizing that the holiday season can be a challenging time
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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