Nursing, Midwifery & Health Systems Research Collection

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Now showing 1 - 5 of 150
  • Publication
    Integrated care for children living with complex care needs: an evolutionary concept analysis
    Children with complex care needs (CCNs) are in need of improved access to healthcare services, communication, and support from healthcare professionals to ensure high-quality care is delivered to meet their needs. Integrated care is viewed as a key component of care delivery for children with CCNs, as it promotes the integration of healthcare systems to provide family and child-centred care across the entire health spectrum. There are many definitions and frameworks that support integrated care, but there is a lack of conceptual clarity around the term. Furthermore, it is often unclear how integrated care can be delivered to children with CCNs, therefore reinforcing the need for further clarification on how to define integrated care. An evolutionary concept analysis was conducted to clarify how integrated care for children with CCNs is defined within current literature. We found that integrated care for children with CCNs refers to highly specialised individualised care within or across services, that is co-produced by interdisciplinary teams, families, and children, supported by digital health technologies. Conclusion: Given the variation in terms of study design, outcomes, and patient populations this paper highlights the need for further research into methods to measure integrated care.
      72Scopus© Citations 1
  • Publication
    Why Should the Welfare of Therapy Animals Involved in Animal Assisted Interventions Matter to Child Healthcare Researchers and Professionals?
    (Taylor and Francis, 2022-05-04) ;
    The rising interest of Human Animal Studies (HAS) within academia is linked to the animal protection movement, debate, and interest in animals as a subject worthy of philosophical and ethical inquiry (DeMello, 2012). The moral considerations of animal welfare were highlighted by two humanistic philosophers, Singer (1975) – Animal Liberation, and Regan (1983) – The Case for Animal Rights. They raised concerns around factory farming, especially in relation to excessive usage of crates to house animals, such as pigs, indoors. The intense confinement practices in agriculture, in the 1970s, raised public awareness on animal welfare in the 1980s and led to further exploration in this area through the study of human-animal relationships (Shapiro, 2020).
  • Publication
    Challenging the "old boys club" in academia: Gender and geographic representation in editorial boards of journals publishing in environmental sciences and public health
    (Public Library of Science (PLoS), 2022-06-21) ; ; ; ;
    In light of global environmental crises and the need for sustainable development, the fields of public health and environmental sciences have become increasingly interrelated. Both fields require interdisciplinary thinking and global solutions, which is largely directed by scientific progress documented in peer-reviewed journals. Journal editors play a critical role in coordinating and shaping what is accepted as scientific knowledge. Previous research has demonstrated a lack of diversity in the gender and geographic representation of editors across scientific disciplines. This study aimed to explore the diversity of journal editorial boards publishing in environmental science and public health. The Clarivate Journal Citation Reports database was used to identify journals classified as Public, Environmental, and Occupational (PEO) Health, Environmental Studies, or Environmental Sciences. Current EB members were identified from each journal’s publicly available website between 1 March and 31 May 2021. Individuals’ names, editorial board roles, institutional affiliations, geographic locations (city, country), and inferred gender were collected. Binomial 95% confidence intervals were calculated for the proportions of interest. Pearson correlations with false discovery rate adjustment were used to assess the correlation between journal-based indicators and editorial board characteristics. Linear regression and logistic regression models were fitted to further assess the relationship between gender presence, low- and middle-income country (LMIC) presence and several journal and editor-based indicators. After identifying 628 unique journals and excluding discontinued or unavailable journals, 615 journal editorial boards were included. In-depth analysis was conducted on 591 journals with complete gender and geographic data for their 27,772 editors. Overall, the majority of editors were men (65.9%), followed by women (32.9%) and non-binary/other gender minorities (0.05%). 75.5% journal editorial boards (n = 446) were composed of a majority of men (>55% men), whilst only 13.2% (n = 78) demonstrated gender parity (between 45–55% women/gender minorities). Journals categorized as PEO Health had the most gender diversity. Furthermore, 84% of editors (n = 23,280) were based in high-income countries and only 2.5% of journals (n = 15) demonstrated economic parity in their editorial boards (between 45–55% editors from LMICs). Geographically, the majority of editors’ institutions were based in the United Nations (UN) Western Europe and Other region (76.9%), with 35.2% of editors (n = 9,761) coming solely from the United States and 8.6% (n = 2,373) solely from the United Kingdom. None of the editors-in-chief and only 27 editors in total were women based in low-income countries. Through the examination of journal editorial boards, this study exposes the glaring lack of diversity in editorial boards in environmental science and public health, explores the power dynamics affecting the creation and dissemination of knowledge, and proposes concrete actions to remedy these structural inequities in order to inform more equitable, just and impactful knowledge creation.
  • Publication
    The impact of COVID-19 on attendance for reduced fetal movements during pregnancy
    Background: The World Health Organisation (WHO) declared a global pandemic on the 11th of March 2020. The Irish government subsequently imposed the first national lockdown and stringent measures to curb the spread of COVID-19 between March-May 2020. Concerns were raised about whether women were fearful of accessing maternity services during the lockdown. Maternal perception of reduced fetal movements (RFM) in pregnancy is a common reason for self-referral to maternity services. International guidelines recommend that women perceiving RFM attend their maternity unit for fetal assessment. Objectives: We sought to determine the impact of the first global pandemic lock-down on attendances for reduced fetal movements (RFM) during pregnancy in a large urban maternity unit. Methods: All women with a singleton pregnancy, presenting to the emergency department (ED) of the National Maternity Hospital, Dublin with a primary presentation of perceived reduced fetal movements after 24 weeks’ gestation between 1st January 2020 and 30th April 2020 were included. Findings: Between January 1 and February 29, 2020 there were 2135 total attendances to the ED; 264 of these were for RFM (12.4%). From March 1- April 30, we observed a significant decline in the number of attendances to ED, totalling 1458; 231 of these were for RFM (15.8%). During the first lock-down period (March-April 2020) overall attendances to the ED decreased by 31.7%, however referrals for RFM increased by 27.4%. Conclusions: There was a significant decrease in the number of attendances to the ED during the first lockdown of the COVID-19 pandemic, however referrals for RFM increased.
  • Publication
    The impact of the COVID-19 pandemic on child health and the provision of Care in Paediatric Emergency Departments: a qualitative study of frontline emergency care staff
    Background: The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the disease have wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments (EDs) have rapidly adapted provision of care in response to the pandemic. This qualitative study utilized insight from multidisciplinary frontline staff to understand 1) the changes in paediatric emergency healthcare utilization during COVID-19 2) the experiences of working within the restructured health system. Methods: Fifteen semi-structured interviews were conducted with frontline staff working in two paediatric EDs and two mixed adult and children EDs. Participants included emergency medicine clinicians (n = 5), nursing managerial staff (n = 6), social workers (n = 2) and nursing staff (n = 2). Thematic Analysis (TA) was applied to the data to identify key themes. Results: The pandemic and public health restrictions have had an adverse impact on children’s health and psychosocial wellbeing, compounded by difficulty in accessing primary and community services. The impact may have been more acute for children with disabilities and chronic health conditions and has raised child protection issues for vulnerable children. EDs have shown innovation and agility in the structural and operational changes they have implemented to continue to deliver care to children, however resource limitations and other challenges must be addressed to ensure high quality care delivery and protect the wellbeing of those tasked with delivering this care. Conclusions: The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications for children’s health and wellbeing. The interruption to health and social care services is manifesting in myriad ways in the ED, such as a rise in psychosocial presentations. As the pandemic continues to progress, policy makers and service providers must ensure the continued provision of essential health and social services, including targeted responses for those with existing conditions.
      77Scopus© Citations 15