A comparison of the stressors experienced by parents of intubated and non-intubated children

When children are ill enough to require admission to paediatric intensive care, parents may become distressed about their child's medical condition and this distress may be compounded by the unfamiliar nature of the highly technological environment Parents of children who are sick enough to warrant intubation are particularly likely to be exposed to a frightening array of technological equipment Seventy-one parents of intubated and non-intubated children completed the Parental Stressor Scale Paediatnc Intensive Care Unit (PSS PICU) Overall the findings suggest that parents were most distressed (a) by the painful procedures to which their children were subjected, (b) by the sights and sounds of the intensive care unit and (c) by their children's reactions to intensive care The behaviour of staff towards parents and the way that staff communicated with them caused the least distress When the levels of stress reported by parents of intubated children were compared with those reported by parents of non-intubated children, different patterns of stress were found Painful procedures were a source of greater stress to parents of intubated children whereas the behaviour of staff and the children's reactions to the intensive care experience caused greater stress to the parents of the non-intubated children In general the findings suggest that the needs of parents of non-intubated children are being overlooked, with staff focusing more of their attention on the parents of intubated children     

Addressing alcohol and other drug use among young people from migrant and ethnic minority backgrounds: Perspectives of service providers in Melbourne,Australia

Young people from migrant and ethnic minority backgrounds are recognised as emerging priority populations for reducing alcohol and other drug (AOD)-related harms in Australia. Limited research has investigated how service providers address AOD challenges in migrant communities. In this qualitative study, we interviewed 15 service providers from AOD, migrant support, community and other health services in a diverse region of Melbourne. Interviews explored the challenges that service providers faced and the strategies they implemented to engage with young migrants in relation to AOD use. Thematic analysis was used to generate four themes: stigma as a barrier to service delivery, intergenerational differences between young people and parents, the need for outreach and establishing trust and understanding over time. Service providers believed that stigma prevented many young people from migrant backgrounds having open conversations about their AOD use with family members and professionals. Participants perceived that some parents had less AOD-related knowledge and lower English language proficiency than their children creating challenges for effective communication. Service providers recognised the importance of engaging with young people in settings where they felt comfortable rather than expecting them to approach their service. Participants also acknowledged the need to invest time in establishing trust and understanding with young migrants so they could facilitate conversations about AOD use as relationships evolved. Although service providers had a strong understanding of young people's needs, they found it challenging to build relationships in the context of funding and time constraints. Our results indicate the need for long-term funding and timelines that enable service providers to build strong relationships with young migrants, their families and their broader cultural communities to facilitate access to AOD support.     

Perceptual Embodiment of Prosthetic Limbs by Transcutaneous Electrical Nerve Stimulation

Objectives: In able‐bodied participants, it is possible to induce a sense of perceptual embodiment in an artificial hand using a visual‐tactile illusion. In amputee patients, electrical stimulation of sensory afferents using transcutaneous electrical nerve stimulation (TENS) has been shown to generate somatic sensations in an amputee's phantom limb(s). However, the effects of TENS on the perceptual embodiment of an artificial limb are not known. Our objective was to investigate the effects of TENS on the perceptual embodiment of an artificial limb in fully intact able‐bodied participants. Materials and Methods: We used a modified version of the rubber hand illusion presented to 30 able‐bodied participants (16 women, 14 men) to convey TENS paresthesia to an artificial hand. TENS electrodes were located over superficial radial nerve on the lateral aspect of the right forearm (1 cm proximal to the wrist), which was hidden from view. TENS intensity was increased to a strong non‐painful TENS sensation (electrical paresthesia) was felt beneath the electrodes and projecting into the fingers of the hand. The electrical characteristics of TENS were asymmetric biphasic electrical pulsed waves, continuous pulse pattern, 120 Hz pulse frequency (rate), and 80 µs pulse duration (width). Results: Participants reported significantly higher intensities of the rubber hand illusion during the two TENS conditions (mean = 5.8, standard deviation = 1.9) compared with the two non‐TENS conditions (mean = 4.9, standard deviation = 1.7), p < 0.0005. Conclusions: Our findings provide initial evidence that TENS paresthesia can be projected into an artificial limb, and this can enhance the sense of perceptual embodiment of an artificial hand. Further exploratory studies involving an amputee population are warranted.