Patrina Caldwell - Academia.edu (original) (raw)

Papers by Patrina Caldwell

Archives of disease in childhood, Jan 2, 2018

Chronic conditions are the leading cause of mortality, morbidity and disability in children. Howe... more Chronic conditions are the leading cause of mortality, morbidity and disability in children. However, children and caregivers are rarely involved in identifying research priorities, which may limit the value of research in supporting patient-centred practice and policy. To identify priorities of patients, caregivers and health professionals for research in childhood chronic conditions and describe the reason for their choices. An Australian paediatric hospital and health consumer organisations. Recruited participants (n=73) included patients aged 8 to 14 years with a chronic condition (n=3), parents/caregivers of children aged 0 to 18 years with a chronic condition (n=19), representatives from consumer organisations (n=13) and health professionals including clinicians, researches (n=38) identified and discussed research priorities. Transcripts were thematically analysed. Seventy-eight research questions were identified. Five themes underpinned participants' priorities: maintaini...

Internal Medicine Journal, 2014

Despite a drive to increase research in healthcare settings, clinician participation in research ... more Despite a drive to increase research in healthcare settings, clinician participation in research remains infrequent. This paper describes an online survey comparing attitudes with research participation among clinicians (doctors, nurses and allied health professionals) at an Australian tertiary children's hospital. Differences between professional groups support the existence of different professional cultures surrounding research, suggesting that multiple strategies are required to improve participation in research.

Evidence-Based Child Health: A Cochrane Review Journal, 2006

Pediatric Nephrology

Background Children with chronic kidney disease (CKD) require multidisciplinary care to meet thei... more Background Children with chronic kidney disease (CKD) require multidisciplinary care to meet their complex healthcare needs. Patient navigators are trained non-medical personnel who assist patients and caregivers to overcome barriers to accessing health services through care coordination. This trial aims to determine the effectiveness of a patient navigator program in children with CKD. Methods The NAVKIDS 2 trial is a multi-center, waitlisted, randomized controlled trial of patient navigators in children with CKD conducted at five sites across Australia. Children (0-16 years) with CKD from low socioeconomic status rural or remote areas were randomized to an intervention group or a waitlisted control group (to receive intervention after 6 months). The study primary and secondary endpoints include the self-rated health (SRH) (primary), and utility-based quality of life, progression of kidney dysfunction of the child, SRH, and satisfaction with healthcare of the caregiver at 6 months post-randomization. Results The trial completed recruitment in October 2021 with expected completion of follow-up by October 2022. There were 162 patients enrolled with 80 and 82 patients randomized to the immediate intervention and waitlisted groups, respectively. Fifty-eight (36%) participants were from regional/remote areas, with a median (IQR) age of 9.5 (5.0, 13.0) years, 46% were of European Australian ethnicity, and 65% were male. A total of 109 children (67%) had CKD stages 1-5, 42 (26%) were transplant recipients, and 11 (7%) were receiving dialysis. Conclusion The NAVKIDS 2 trial is designed to evaluate the effectiveness of patient navigation in children with CKD from families experiencing socioeconomic disadvantage.

BMC Public Health

Background The internet and social media are increasingly popular sources of health information f... more Background The internet and social media are increasingly popular sources of health information for adolescents. Using online health information requires digital health literacy, consisting of literacy, analytical skills and personal capabilities such as self-efficacy. Appraising trustworthiness and relevance of online health information requires critical health literacy to discriminate between sources, critically analyse meaning and relevance, and use information for personal health. Adolescents with poor digital health literacy risk using misinformation, with potential negative health outcomes. We aimed to understand adolescents’ contemporary digital health literacy and compared self-efficacy with capability. Methods Adolescents (12–17 years) completed an eHEALS self-report digital health literacy measure, a practical search task using a think-aloud protocol and an interview to capture perceived and actual digital health literacy. eHEALS scores were generated using descriptive sta...

Italian Journal of Computational Linguistics, 2021

Embodied Conversational Agents (ECAs) are virtual agents that exhibit humanlike verbal and non-ve... more Embodied Conversational Agents (ECAs) are virtual agents that exhibit humanlike verbal and non-verbal behaviours. When it comes to eHealth, ECAs can provide vital support to patients by being more reachable. In order to make ECAs more effective, humanlike empathy expressed during conversation through relational cues is essential. Empathy revolves around a wide range of verbal and non-verbal behaviours that include, for example, the choice of words in social dialogues. Owing to the COVID-19 situation, there was an opportunity to record online consultations in the Incontinence Clinic and Sleep Clinic at the Children's Hospital at Westmead in Sydney, Australia. The present study analysed these human dialogues using qualitative research methods to understand the role of empathic dialogue used by the medical team. The qualitative analysis of the live calls used psychology-based relational cues derived from conversational characteristics of humans to build a coding framework around the most relevant themes. Statistical analysis was used to compare relational cue usage between healthcare roles. Finally, using the framework dialogues of the medical team and two ECAs known as Dr Evie (eVirtual Agent for Incontinence and Enuresis) and SAM (Sleep Adherence Mentor) were compared to provide recommendations for health practitioners and future ECA dialogue development.

Journal of Paediatrics and Child Health, 2021

AimGiggle incontinence is a distinct entity of childhood daytime urinary incontinence (DUI), wher... more AimGiggle incontinence is a distinct entity of childhood daytime urinary incontinence (DUI), where children wet themselves only when they laugh. The prevalence of true giggle incontinence is unknown, with confusion about the diagnosis of urinary incontinence occurring during laughter and true giggle incontinence. The aim of the study is to improve our understanding of urinary incontinence during laughter by comparing those children with children who have DUI at other times, but not with laughter.MethodsWe conducted a retrospective medical record review of children with DUI who presented to a tertiary continence service from 2017 to 2018, collecting data on age, gender, associated comorbidities, lower urinary tract symptoms, investigations, provisional diagnosis at first visit and initial treatment responses. Differences between those with DUI occurring during laughter and those with DUI at other times, but not with laughter were compared using standard statistical methods.ResultsOf ...

Journal of Paediatrics and Child Health, 2020

AimToilet training children with special needs can be challenging and can result in long‐term con... more AimToilet training children with special needs can be challenging and can result in long‐term consequences if inadequately addressed. This study evaluates the use of a ‘Potty Monkey’ toy for toilet training children with special needs.MethodsA pilot study using a ‘Potty Monkey’ to model timed voiding in children with special needs. We collected parental feedback and examined the experience of families using a ‘Potty Monkey’ to toilet train their child. Using logistic regression we explored patient factors for association with outcomes.ResultsOf 21 children in our study, 15 were male. Age ranged 4–10 years (median 6.3 years). Days that ‘Potty Monkey’ was used ranged 0–156 (median 22 days). At 6 months, nine children had improved, five were unchanged and four were worse (three were unknown). We found no evidence of association between patient factors (age, gender, days using ‘Potty Monkey’, baseline toileting ability, Paediatric Incontinence Questionnaire score) and toileting outcome....

Medical Teacher, 2020

Background: The learner has a central role in feedback. We developed a feedback workshop for medi... more Background: The learner has a central role in feedback. We developed a feedback workshop for medical students grounded in two concepts: (1) Student agency in feedback and its interplay in the context of brief clinical attachments; (2) The educational alliance. Aims: To determine whether a brief feedback training workshop prior to a series of two-week clinical attachments improves agentic student feedback behaviour (e.g. seeking, recognising, evaluating and utilising feedback) and student satisfaction with feedback. Methods: We conducted surveys among three consecutive student cohorts undertaking three fortnightly paediatric clinical attachments. We pilot tested a workshop with Cohort 1 and implemented it for the entire Cohorts 2 (n ¼ 58) and 3 (n ¼ 68). Participants completed the same survey at the start and end of term, with different free-text items. Quantitative and qualitative responses were compared between groups. Results: Student-reported agentic feedback behaviour increased across all outcomes except for feedback utilisation. Overall student satisfaction with feedback increased during the term in Cohorts 2 (23-65%, p ¼ 0.002) and 3 (40-70%, p ¼ 0.003) but not in Cohort 1 non-participating students (27-42%, p ¼ 0.42). Conclusions: A brief one-off student-directed feedback workshop may improve agentic student feedback behaviours (e.g. feedback-seeking) and student satisfaction with feedback.

BMC Nephrology, 2019

Background Chronic kidney disease (CKD) is a devastating illness associated with increased mortal... more Background Chronic kidney disease (CKD) is a devastating illness associated with increased mortality, reduced quality of life, impaired growth, neurocognitive impairment and psychosocial maladjustment in children. There is growing evidence of socioeconomic disparities in health outcomes among children with CKD. Patient navigators are trained non-medical personnel who assist patients with chronic conditions journey through the continuum of care and transit across different care settings. They help vulnerable and underserved populations to better understand their diagnosis, treatment options, and available resources, guide them through complex medical systems, and help them to overcome barriers to health care access. Given the complexity and chronicity of the disease process and concerns that current models of care may not adequately support the provision of high-level care in children with CKD from socioeconomically disadvantaged backgrounds, a patient navigator program may improve t...

The Journal of Pediatrics, 2020

OBJECTIVE To assess the role of trust when adolescents search for and appraise online health info... more OBJECTIVE To assess the role of trust when adolescents search for and appraise online health information. STUDY DESIGN A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, and ERIC) was performed. Google Scholar and reference lists for included studies were manually searched for additional articles. Studies were included if they examined the role of trust when adolescents (in the 13- to 18-year-old age range) searched for and/or appraised online health information. Findings were synthesized using thematic analysis. RESULTS There were 22 studies that met the inclusion criteria. Four key themes were identified: adolescents generally distrust the Internet but use it anyway (subthemes were why adolescents distrust online health information; why adolescents still use online health information), adolescents use heuristics to appraise the trustworthiness of online health information (subthemes were different heuristics used by different adolescents, range of heuristics used by adolescents), adolescents trust websites more than social media or social networking sites, and adolescents' level of trust in online health information guides their actions and responses. CONCLUSIONS Adolescents often distrust health information from the Internet, but continue to use it. Adolescents are aware of the need to evaluate the trustworthiness of online health information; however, their approaches vary in sophistication. As the reach and content of the Internet expands, it is important to equip adolescents with effective eHealth literacy to assess the trustworthiness of online health information.

Australian and New Zealand Continence Journal, 2020

Australian Journal of General Practice, 2019

Background and objectives General practitioners (GPs) often see children with enuresis and daytim... more Background and objectives General practitioners (GPs) often see children with enuresis and daytime urinary incontinence, and adults with persistent enuresis. The aim of this study was to assess Australian community health practitioners' knowledge and experiences with managing these conditions. Methods Health practitioners were surveyed about their knowledge and experience managing urinary incontinence that begins in childhood. Associations between participant characteristics and knowledge/experience were examined using chi-square tests. Results The 1495 participants were mostly female, experienced, GPs who worked in a metropolitan area and/or saw patients with incontinence infrequently, but felt knowledgeable and confident about management of incontinence. Correct survey answers were given by 93% of participants for managing enuresis, 81% for daytime urinary incontinence (with 18% choosing inappropriate and potentially dangerous responses), and 61% for managing enuresis that has persisted into adulthood.

Journal of Paediatrics and Child Health, 2018

Enuresis (bedwetting) is common in school‐aged children and can impact health, psychosocial well‐... more Enuresis (bedwetting) is common in school‐aged children and can impact health, psychosocial well‐being and quality of life. Although effective treatment is available, treatment resistance is encountered in about 50%. This paper discusses the management of treatment‐resistant enuresis from a multidisciplinary perspective. Causes of treatment resistance include lower urinary tract problems, constipation, incorrect alarm training techniques, sleep disorders including sleep apnoea and psychological comorbidities. Practical suggestions to address treatment resistance are offered utilising expertise from clinicians from different disciplines.

BMJ Paediatrics Open, 2019

ObjectivesFor 300 paediatric trials, we evaluated the reporting of: a data monitoring committee (... more ObjectivesFor 300 paediatric trials, we evaluated the reporting of: a data monitoring committee (DMC); interim analyses, stopping rules and early stopping; and adverse events and harm-related endpoints.MethodsFor this cross-sectional evaluation, we randomly selected 300 paediatric trials published in 2012 from the Cochrane Central Register of Controlled Trials. We collected data on the reporting of a DMC; interim analyses, stopping rules and early stopping; and adverse events and harm-related endpoints. We reported the findings descriptively and stratified by trial characteristics.ResultsEighty-five (28%) of the trials investigated drugs, and 18% (n=55/300) reported a DMC. The reporting of a DMC was more common among multicentre than single centre trials (n=41/132, 31% vs n=14/139, 10%, p<0.001) and industry-sponsored trials compared with those sponsored by other sources (n=16/50, 32% vs n=39/250, 16%, p=0.009). Trials that reported a DMC enrolled more participants than those tha...

BMJ Paediatrics Open, 2018

ObjectivesWe evaluated 300 paediatric trials to determine: the consent and recruitment strategies... more ObjectivesWe evaluated 300 paediatric trials to determine: the consent and recruitment strategies used, who trial information was targeted to, how incentives were used and if they achieved their recruitment targets.MethodsFor this cross-sectional evaluation, we searched the Cochrane Central Register of Controlled Trials for paediatric trials published in 2012 and randomly selected 300 that reported on outcomes for participants aged ≤21 years. We collected data on consent and recruitment procedures for each trial and undertook descriptive analyses in SPSS statistics V.23.ResultsAll but one trial (99.7%) used a standard recruitment strategy. Most (92%) trials reported that consent was obtained but only 13% reported who obtained consent. Two-thirds (65%) of trials included school-aged participants, and of these 68% reported obtaining assent. Half (50%) of the trials reported who the trial information was targeted to. Most trials (75%) of school-aged participants targeted information to...

BMC complementary and alternative medicine, Jan 28, 2018

Neonatal jaundice affects at least 481,000 newborns every year. Phototherapy is recommended but i... more Neonatal jaundice affects at least 481,000 newborns every year. Phototherapy is recommended but it's effects are limited and adverse reactions can occur. In China, phototherapy combined with Yinzhihuang oral liquid is also used for this condition. This systematic review evaluated the effectiveness and safety of combination therapy with Yinzhihuang oral liquid and phototherapy compared to phototherapy alone for treating neonatal jaundice. A comprehensive literature search was performed in four Chinese databases, two English language databases and two trial registries from inception to June 2017. Two authors independently screened the citations and retrieved full publications for randomized trials on Yinzhihuang oral liquid combined with phototherapy for neonatal jaundice. The methodological quality of the trials was assessed according to the Cochrane Collaboration's tool for assessing risk of bias. Data were analyzed using RevMan 5.3. Totally 17 trials (involving 2561 neonate...

Archives of disease in childhood, Jan 11, 2018

To evaluate research priority setting approaches in childhood chronic diseases and to describe th... more To evaluate research priority setting approaches in childhood chronic diseases and to describe the priorities of stakeholders including patients, caregivers/families and health professionals. We conducted a systematic review of MEDLINE, Embase, PsycINFO and CINAHL from inception to 16 October 2016. Studies that elicited stakeholder priorities for paediatric chronic disease research were eligible for inclusion. Data on the prioritisation process were extracted using an appraisal checklist. Generated priorities were collated into common topic areas. We identified 83 studies (n=15 722). Twenty (24%) studies involved parents/caregivers and four (5%) children. The top three health areas were cancer (11%), neurology (8%) and endocrine/metabolism (8%). Priority topic areas were treatment (78%), disease trajectory (48%), quality of life/psychosocial impact (48%), disease onset/prevention (43%), knowledge/self-management (33%), prevalence (30%), diagnostic methods (28%), access to healthcare...

Journal of paediatrics and child health, 2018

of multiple DA is difficult pre-operatively, 3 and usually, it is made intra-operatively. 1,2 It ... more of multiple DA is difficult pre-operatively, 3 and usually, it is made intra-operatively. 1,2 It may be associated with Trisomy 21, coronary heart disease, malrotation, polysplenia or further small bowel atresia. 2 Rarely, perforation may occur before intervention. 1 Most of the current reports detail successful outcome. We feel that our patient being premature with limited resources did not respond successfully. Multiple DA is a neonatal challenge. Having knowledge of this uncommon entity prepares the surgeon to handle the challenges posed by it.