Early Pregnancy Assessment Services in Australia: What psychosocial support is available? A qualitative study

ProblemWomen commonly experience emotional distress following miscarriage but do not receive the support they need from healthcare providers.BackgroundMiscarriage can result in psychological morbidity; however, appropriate support at the time of a miscarriage can lead to better psychological outcomes. Early Pregnancy Assessment Services (EPASs) are dedicated outpatient services considered the “gold standard” for miscarriage care. Little is known about the psychosocial support EPASs provide in Australia.AimsThe aim of this study was to explore the provision of psychosocial support in Australian EPASs.MethodsSemi-structured interviews were conducted with 29 purposively sampled key-informants from 13 EPASs. Interviews were audio-recorded, transcribed, and thematically analysed.FindingsConsiderable variation was found in how EPASs functioned and their provision of psychosocial support. Many services were co-located with antenatal services, run by doctors with limited experience and most did not offer any psychosocial training to staff specific to EPAS. Referrals for additional support were generally not offered for first trimester miscarriages, and follow-up typically focused on physical management rather than emotional wellbeing. All EPAS staff demonstrated a strong commitment to providing best possible care to women within their own clinical setting and acknowledged the need for improved psychosocial support.ConclusionThis study provides the first exploration of Australian EPASs’ provision of psychosocial support. It has shown that while health care professionals working in EPASs are dedicated to providing the best possible care to women within their clinical setting, psychosocial support is very limited and could be improved.     

Assessing Risk‐Based Upper Limits of Melamine Migration from Food Containers

Melamine contamination of food has become a major food safety issue because of incidents of infant disease caused by exposure to this chemical. This study was aimed at establishing a safety limit in Taiwan for the degree of melamine migration from food containers. Health risk assessment was performed for three exposure groups (preschool children, individuals who dine out, and elderly residents of nursing homes). Selected values of tolerable daily intake (TDI) for melamine were used to calculate the reference migration concentration limit (RMCL) or reference specific migration limit (RSML) for melamine food containers. The only existing values of these limits for international standards today are 1.2 mg/L (0.2 mg/dm²) in China and 30 mg/L (5 mg/dm²) in the European Union. The factors used in the calculations included the specific surface area of food containers, daily food consumption rate, body weight, TDI, and the percentile of the population protected at a given migration concentration limit (MCL). The results indicate that children are indeed at higher risk of melamine exposure at toxic levels than are other groups and that the 95th percentile of MCL (specific surface area = 5) for children aged 1–6 years should be the RMCL (0.07 mg/dm²) for protecting the sensitive and general population.     

Spatial Data Usage,Spatial Thinking and Spatial Knowledge Generation: The Case of Planning Practitioners in Arequipa,Peru

Spatial thinking and spatial knowledge generation in decision-making are still not mature fields of study in planning research, despite these being crucial elements in addressing the issues of the twenty-first-century city. This article contributes to their understanding by exploring their interrelationships with spatial data usage. Through storylines, it analyzes the arguments that planning practitioners offer in support of infrastructure-led decisions in Arequipa (Peru), before and after spatial data usage. The article concludes that spatial data usage improve spatial thinking to different extents, yet suggests aligning spatial data generation and the inclusion of GIS-based spatial analyses with the spatial knowledge needed by routine planning practice.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

A latent variable model for analyzing mixed longitudinal (k,l)-inflated count and ordinal responses

A random effects model for analyzing mixed longitudinal count and ordinal data is presented where the count response is inflated in two points (k and l) and an (k,l)-Inflated Power series distribution is used as its distribution. A full likelihood-based approach is used to obtain maximum likelihood estimates of parameters of the model. For data with non-ignorable missing values models with probit model for missing mechanism are used.The dependence between longitudinal sequences of responses and inflation parameters are investigated using a random effects approach. Also, to investigate the correlation between mixed ordinal and count responses of each individuals at each time, a shared random effect is used. In order to assess the performance of the model, a simulation study is performed for a case that the count response has (k,l)-Inflated Binomial distribution. Performance comparisons of count-ordinal random effect model, Zero-Inflated ordinal random effects model and (k,l)-Inflated ordinal random effects model are also given. The model is applied to a real social data set from the first two waves of the national longitudinal study of adolescent to adult health (Add Health study). In this data set, the joint responses are the number of days in a month that each individual smoked as the count response and the general health condition of each individual as the ordinal response. For the count response there is incidence of excess values of 0 and 30.     

Taking Stock of Neighbourhood Planning in England 2011–2016

Neighbourhood planning (NP) as enabled by the 2011 Localism Act in England has precipitated a considerable literature discussing its potential, limitations and likely shortcomings referenced against government rhetoric and the reporting of initial experiences of the process. This paper provides an overview of the current literature on neighbourhood planning and sets out how it has been received and practised across England drawing on empirical evidence. The extent of take-up and the experience of those involved in the first five years of neighbourhood planning is used to consider how community-led planning may be designed and used following operational principles of inclusivity, capacity-building and adding value.     

Do resources of network members help in help seeking? Social capital and health information search

Does social capital as resources of network members affect health information search? Analyzing data from the 2004 General Social Survey in the United States, this study measures two social capital indicators (average education of network members and proportion of network members with a high school degree or higher) using the name generator. Most results are consistent using those two indicators. Both indicators are positively associated with frequency of health information seeking and seekers’ frequency of use of two sources (friends or relatives and the Internet). Also average education of network members is positively associated with seekers’ diversity of used sources and frequency of consultation with medical professionals. But neither indicator is associated with seekers’ frequency of use of other four sources (health-related magazines or newsletters, general magazines, daily newspapers, and radio or television programs). The findings demonstrate the theoretical utility of social capital in the social dynamics of medical help-seeking.     

On the Post-90s＇ Modern Health Concept from the Perspective of Public Hygienic Events

伴随社会经济的迅猛发展和城市化步伐的加快，生态破坏、环境污染等问题日益加剧。生物界自然平衡状态的打破导致近年来我国各类公共卫生危机频发，处于公共卫生事件的高发期，“90后”作为一个特殊的青少年群体，由于其身心机能发育尚未成熟，不但是此类事件中最主要的易感人群，更容易产生各类心理障碍与行为问题。现代健康观念的树立和综合健康素养的提升在这一阶段尤为关键。研究发现，“90后”青少年的健康观念趋于科学理性，健康自我管理能力和习惯养成有待提升：对健康危机的忧患意识较强，危机状态下的心理承受能力较弱；具备一定的公民责任意识和行为自律意识，但面对一些较为复杂的社会现象，现代法制观念和人文关怀意识仍有所欠缺     

园林景观规划设计与地域文化

地域文化的缺失导致园林景观规划设计及其实施效果呈现雷同的趋势,通过提出规划设计中地域文化的范畴和意义,强调了体现地域文化在规划设计中的重要性。借助三个实际的规划设计案例从宏观角度提出规划概念应与地域自然特点、人文特点等要素有机结合,从而从微观角度提出设计可采用保留、抽取、融合、再现等手法来体现地域文化。此外,在规划设计中运用地域文化应该注意契合性、创新性、烂漫性及可实施性等的几个方面的问题。     

Public broadcast of health communication: Extending public relations through social capital in Taiwan

This paper shows how a public media can effectively utilize its social capital, and integrate with different resources from the related non-profit organizations and corporations in public relations perspective. A case study of a high-popularity Taiwanese public traffic radio: Police Broadcasting Service (PBS) is conducted. The finding shows that the public radio can cost-effectively deliver health communication with the principle of social marketing.