Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences.

INTRODUCTION: Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience. METHODS: Inclusion criteria included PICU stay >48 h, physician approval, smartphone access, and English-speaking caregiver. Eligible parents received a text-based baseline survey and surveys every other day while hospitalized regarding their mood/experiences and optional open-ended questions regarding stressors. They received post-discharge follow-up surveys at 1 week and 1, 3, and 6 months. Follow-up surveys assessed mood and symptoms of depression, anxiety, and post-traumatic stress. Interviews and surveys about the interface were conducted 1 week and 3 months following discharge. Feasibility was assessed by descriptive statistics (eg, response rates), and acceptability was assessed by descriptive statistics (survey results) and thematic analyses of interviews. RESULTS: Of 20 enrolled participants, the first 5 were excluded due to technical issues. Of the 15 included, results demonstrated feasibility and acceptability. Most participants (86%) completed all surveys during the PICU stay and continued to complete surveys at a high rate: 79%-94% 3 months post-discharge. All participants agreed that the system was easy to use and were satisfied with the system at discharge, and 91% remained satisfied 3 months post-discharge. Additionally, 76% reported comfort, and 69% reported benefit. From the interviews, participants lauded the system's convenience and applicability of content. Some proposed changes to improve ergonomics. Many suggested this interface could help teams better support families. CONCLUSIONS: A text-based interface for measuring experience in the PICU is feasible and acceptable to parents. Further research can explore how this could identify parents most at risk of adverse psychological sequelae and lead to earlier supportive interventions.

Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives.

BACKGROUND: Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. METHODS: Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. RESULTS: Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. CONCLUSIONS: This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.

Localization and morphological variation of three bacteriome-inhabiting symbionts within a planthopper of the genus Oliarus (Hemiptera: Cixiidae).

Many planthoppers of the family Cixiidae (Hemiptera: Fulgoroidea) host three bacteriome-inhabiting bacteria: a gammaproteobacterium: 'Ca.Purcelliella pentastirinorum', a betaproteobacterium: 'Ca. Vidania fulgoroidea', and a member of the bacteroidetes: 'Ca.Sulcia muelleri'. Through light microscopy observations, DGGE PCR and FISH analysis, we examined the morphology and localization of these three endosymbionts within the abdomens of females of the planthopper Oliarus filicicola. Our results indicate a complex distribution and variation in bacterial morphologies. 'Ca. Sulcia muelleri' singularly colonize one pair of bacteriomes and have cells of irregular shape with an average diameter of approximately 4-5 µm. 'Ca.Purcelliella pentastirinorum' bacteria are roughly globular and have an average diameter of approximately 1.5-2 µm in a pair of bacteriomes located near the posterior end of the abdomen, which are surrounded by giant and highly degenerated cells of 'Ca.Vidania fulgoroidea'. In addition, 'Ca.Vidania fulgoroidea' colonizes the 'rectal organ' (sensu Buchner) and the bacterial cells appear as a small, roughly globular with an average diameter of 3 µm; whereas, 'Ca.Purcelliella pentastirinorum' infects an additional two bacteriomes and the bacterial cells appear tightly packed and highly degenerated. All three endosymbionts colocalize in the forming eggs inside the host's ovaries. Based on the abdominal distribution of bacteriomes and bacterial morphologies, we suggest that 'Ca.Vidania fulgoroidea' and 'Ca.Purcelliella pentastirinorum' correspond to the symbionts described by Buchner as the 'x-' and the 'c + d symbiont' respectively.