Suchergebnisse

AbstractA household's wealth provides an important form of economic security for a family, as well as enabling parents to invest in children to help them realize their aspirations. Yet in the United States, wealth inequality between white families and families of color who are earning the same incomes has reached startling levels. The racial wealth gap, which reduces the opportunities available to African American families, has proved to be a pernicious and enduring phenomenon since it was first identified in 1990. This article identifies and explores the role of neighborhoods in creating and perpetuating the ongoing racial wealth gap. Wealth available to a family influences the neighborhood a family is able to afford to live in: through wealth available to purchase a home or wealth available to put down a deposit on an apartment. This article makes the case that the neighborhood a family lives in not only influences social outcomes, but also influences how much wealth a family can build over the years, either as a homeowner or a renter. It also discusses the key wealth mechanisms that influence neighborhood access as well as how a household's neighborhood location influences wealth accumulation. Historical government policies created an inequitable landscape of neighborhoods across the United States. Government policies must seek to address this historical injustice.

Background  Although grandparents are recognized as an important source of support for families of children with intellectual and other disabilities, there has been very little research in this area. The aim of the present paper is to present a brief overview of the literature, and to present data from a preliminary study of relationships between parental stress and grandparent support and conflict.Methods  Sixty‐one parents of children with Down's syndrome (34 mothers and 27 fathers) completed questionnaires on grandparent support and conflict. Parents also completed the Friedrich Short Form of the Questionnaire on Resources and Stress (QRS) with scoring amended to include a depression sub‐scale.Results  The main findings were: (1) grandparent support and conflict were associated with mothers' but not fathers' ratings of stress on the QRS, and (2) both grandparent support and conflict made independent contributions to the prediction of mothers' stress on at least one dimension of the QRS.Conclusions  Practical implications of the results for interventions designed to encourage grandparent support for families are discussed. Issues for further research and methodological problems with the study are also identified.

BACKGROUND: Medical equipment donation to low-resource settings is a frequently used strategy to address existing disparities, but there is a paucity of reported experience and evaluation. Challenges such as infrastructure gaps, lack of technological and maintenance capabilities, and non-prioritisation of essential supplies have previously been highlighted. This pragmatic review summarises existing guidelines and literature relevant to surgical and anaesthesia equipment, with recommendations for future initiatives and research. METHODS: Retrospective literature review including both academic and grey literature from 1980 to 2018. We conducted a narrative synthesis to identify key factors that were condensed thematically. RESULTS: Thirty-three biomedical equipment donation guidelines were identified from governments, WHO, World Bank, academic colleges and non-governmental organisations, and 36 relevant studies in peer-reviewed literature. These highlighted the need to consider all stages of the donation process, including planning, sourcing, transporting, training, maintaining and evaluating equipment donation. Donors were advised to consult national guidelines to ensure equipment was appropriate, desirable and non-costly to both parties. User training and access to biomechanical engineers were suggested as necessary for long-term sustainability. Finally, equitable partnerships between donors and recipients were integral to reducing inappropriate donations and to improve follow-up and evaluation. CONCLUSION: There is a paucity of evidence on the causes of success or failure in medical equipment donation, despite its domination of equipment sourcing across many low-resource settings. Equitable partnerships, consultation of policies and guidelines, and careful planning may improve equipment usability and life span. A concerted effort is required to increase awareness of guidelines among health professionals worldwide.

BACKGROUND: Delays in accessing skilled delivery services are a major contributor to high maternal mortality in resource-limited settings. In 2015, the government of The Gambia initiated a results-based financing intervention that sought to increase uptake of skilled delivery. We performed a midline evaluation to determine the impact of the intervention and explore causes of delays. METHODS: A mixed methods design was used to measure changes in uptake of skilled delivery and explore underlying reasons, with communities randomly assigned to four arms: (1) community-based intervention, (2) facility-based intervention, (3) community- and facility-based intervention, and (4) control. We obtained quantitative data from household surveys conducted at baseline (n = 1423) and midline (n = 1573). Qualitative data came from semi-structured interviews (baseline n = 20; midline n = 20) and focus group discussions (baseline n = 27; midline n = 39) with a range of stakeholders. Multivariable linear regression models were estimated using pooled data from baseline and midline. Qualitative data were recorded, transcribed, translated and thematically analyzed. RESULTS: No increase was found in uptake of skilled delivery services between baseline and midline. However, relative to the control group, significant increases in referral to health facilities for delivery were found in areas receiving the community-based intervention (beta = 0.078, p < 0.10) and areas receiving both the community-based and facility-based interventions (beta = 0.198, p < 0.05). There was also an increase in accompaniment to health facilities for delivery in areas receiving only community-based interventions (beta = 0.095, p < 0.05). Transportation to health facilities for delivery increased in areas with both interventions (beta = 0.102, p < 0.05). Qualitative data indicate that delays in the decision to seek institutional delivery usually occurred when women had limited knowledge of delivery indications. Delays in reaching a health facility ...

Abstract
Objectives
Depression and anxiety often emerge in adolescence and persist into early adulthood. Developing a greater understanding of the factors that influence their persistence may inform psychological interventions. Their association with an insecure attachment style is well established although the mediating role of attachment anxiety in the persistence of depression and anxiety over time has not been examined. This study aimed to examine if anxious attachment mediated depression and anxiety from adolescence to early adulthood.

Methods
Data from 3,436 participants in a longitudinal birth cohort study were examined. At 14-years and 21-years, participants completed the Achenbach Youth Self Report (YSR) and the Achenbach Young Adult Self-Report (YASR) respectively. At 21-years, participants completed the Attachment Style Questionnaire (ASQ). Attachment anxiety as a mediator for the persistence of anxiety/depressive symptoms from 14- to 21-years was examined.

Results
Attachment anxiety accounted for approximately 60% of the persistence of anxiety and depressive symptoms at 14- and 21- years after adjusting for covariates. Results were similar when stratifying by males and females.

Conclusions
Attachment anxiety significantly contributes to the persistence of anxiety and depressive symptoms from adolescence into early adulthood for both males and females. Incorporating interventions that address attachment anxiety in adolescents may improve the response to therapy for anxiety and depression.

Abstract
Background
Satisfying close relationships are associated with higher levels of life satisfaction throughout the life course. Despite the fundamental role of attachment style in close relationships, few studies have longitudinally examined the association between attachment style in young adults with later life satisfaction.

Method
Data from 2,088 participants in a longitudinal birth cohort study were examined. At 21-years, participants completed the Attachment Style Questionnaire which comprises five domains reflective of internal working models of interpersonal relationships and attachment style: confidence (security), discomfort with closeness and relationships as secondary (avoidance), need for approval and preoccupation with relationships (anxiety). At 30-years, participants self-reported their overall life satisfaction. Linear regression was used to longitudinally examine the association between attachment domains at 21-years and life satisfaction at age 30.

Results
After adjustments, confidence was positively associated with life satisfaction (β = 0.41, 95% CI 0.25–0.56, p < 0.001), while need for approval was negatively associated with life satisfaction (β = -0.17, 95% CI -0.30 – -0.04, p < 0.001). Low income at 21, caring for a child by age 21, and leaving the parental home at 16-years or under were negatively associated with life satisfaction at 30-years.

Conclusion
Young adult attachment style is associated with later life satisfaction, particularly through confidence in self and others. Promoting positive internal working models of interpersonal relationships and fostering greater confidence in self and others in adolescence may be an effective strategy for improving life satisfaction later in life.

Despite increased awareness of the adverse impact of bullying on mental health, the prevalence of bullying in Australia is uncertain. The aim of the current study was to conduct a systematic review and meta-analysis to estimate the prevalence of bullying (traditional and cyber) among Australian children and adolescents. This study synthesised bullying prevalence studies on victimisation experiences (being bullied) and perpetration experiences (bullying others). A systematic review of electronic databases (A+ Education, EMBASE, ERIC, PubMed, PsycINFO and Scopus up to 27 May 2017) was conducted. In addition, reference lists of included studies, theses recorded at the National Library of Australia, and government websites were surveyed to identify local area data as well as state and nationally representative data. Overall, 898 studies were screened and out of the 126 studies assessed for eligibility, 46 satisfied the pre-determined inclusion criteria. Meta-analyses based on quality-effects models generated pooled prevalence estimates for each of the two types of bullying involvement (victimisation and perpetration), as well as distinct models for traditional bullying and cyberbullying experiences by the type of involvement. Overall, the 12-month prevalence of bullying victimisation was 15.17% (95% confidence interval = [9.17, 22.30]) and perpetration was 5.27% (95% confidence interval = [3.13, 7.92]). The lifetime prevalence for traditional bullying victimisation was 25.13% (95% confidence interval = [18.73, 32.11]) and perpetration was 11.61% (95% confidence interval = [7.41, 16.57]). Cyberbullying victimisation and perpetration were less common with lifetime prevalence of 7.02% (95% confidence interval = [2.41, 13.54]) and 3.45% (95% confidence interval = [1.13, 6.84]), respectively. Bullying is common among children and adolescents in Australia. There is a need to improve the measurement of bullying using a standardised instrument and for prevalence estimates to be collected on a regular basis to assess change over time. Wide implementation of anti-bullying programmes in Australian schools is a viable public health approach for the prevention of mental health problems.

Abstract Context Understanding what constitutes high-quality habitat for threatened species is critical for conservation management planning. The endangered northern quoll (Dasyurus hallucatus) has experienced an uneven range contraction among habitat types. Once common across multiple habitats of northern mainland Australia, declining populations have now contracted to rocky escarpments. Aim The island refuge of Groote Eylandt, Northern Territory, Australia, has not experienced the declines as seen on mainland Australia. Here, northern quolls persist in both rocky escarpment and savanna woodland, which provides a rare opportunity to investigate the habitat quality of rocky escarpments and savanna woodland for the northern quoll. Methods Northern quolls (n = 111) were trapped in both rocky escarpment (n = 61) and savanna woodland (n = 50) habitats before the breeding season (May). We conducted body condition assessment, scat analysis, and measured trophic niche breadth of individuals occupying each habitat type. Key results Female quolls occupying rocky escarpments exhibited a lower body condition than did quolls occupying savanna woodland. Quolls from rocky escarpments consumed a significantly higher proportion of mammals and fed within a narrower dietary niche than did those occupying savanna woodland. Conclusions Quolls had adapted to the dietary resources available within each habitat type, suggesting that the lack of quolls in savanna woodland on the mainland is due to factors other than availability of dietary resources. Implications Groote Eylandt is of critical conservation significance, where high numbers of northern quolls exist in both rocky escarpment and savanna woodland habitats. For population viability on the mainland, managing threats such as feral predators and inappropriate fire regimes in savanna woodland, particularly those surrounding rocky escarpment, should be prioritised.

BACKGROUND: Bullying victimisation is a global public health problem that has been predominantly studied in high income countries. This study aimed to estimate the population level prevalence of bullying victimisation and its association with peer and parental supports amongst adolescents across low and middle income to high income countries (LMIC—HICs). METHODS: Data were drawn from the Global School-based Student Health Survey of school children aged 12–17 years, between 2003 and 2015, in 83 LMIC—HICs in the six World Health Organization (WHO) regions. We estimated the weighted prevalence of bullying victimisation at country, region and global level. We used multiple binary logistic regression models to estimate the adjusted association of age, gender, socioeconomic status, and parental support and peer support, and country level variables (GDP and government expenditure on education) with adolescent bullying victimisation. FINDINGS: Of the 317,869 adolescents studied, 151,036 (48%) were males, and 166,833 (52%) females. The pooled prevalence of bullying victimisation on one or more days in the past 30 days amongst adolescents aged 12–17 years was 30·5% (95% CI: 30·2–31·0%). The highest prevalence was observed in the Eastern Mediterranean Region (45·1%, 44·3–46·0%) and African region (43·5%, 43·0–44·3%), and the lowest in Europe (8·4%, 8·0–9·0%). Bullying victimisation was associated with male gender (OR: 1·21; 1·11–1·32), below average socio-economic status (OR: 1·47, 1·35–1·61), and younger age (OR: 1·11, 1·0–1·24). Higher levels of peer support (0·51, 0·46–0·57), higher levels of parental support (e.g., understanding children's problems (OR: 0·85, 0·77–0·95), and knowing the importance of free time spent with children (OR: 0·77, 0·70–0·85)), were significantly associated with a reduced risk of bullying victimisation. INTERPRETATIONS: Bullying victimisation is prevalent amongst adolescents globally, particularly in the Eastern Mediterranean and African regions. Parental and peer supports are protective ...