The limitations of using statutory child protection data for research into child maltreatment

Child protection legislation has undergone a number of changes since its inception, changes that have redefined the population of children in need of protection. However, child protection data on notifications and substantiations remain the most common source of data for statistics on the rate of maltreatment and the breakdown of specific maltreatment types. In the present study, three factors are identified that have compromised the accuracy of child protection data reporting the incidence of child abuse and neglect: (i) the legislative changes that mandate child protection services to protect children from harm rather than from identifiable adult actions; (ii) the shift from the Harm Standard to the Endangerment Standard; and (iii) the assignment of responsibility solely to parents.

Multiple mini-interview : how long is long enough?

Objectives The multiple mini-interview (MMI) overcomes the limitations of the traditional panel interview by multiple sampling to provide improved objectivity and reliability. Reliability of the MMI is affected by number of stations; however, there are few data reporting the influence of interview duration on MMI outcome and reliability. We aimed to determine whether MMI stations can be shortened without affecting applicant rankings or compromising test reliability.
Methods A total of 175 applicants were interviewed and assessed at 10 8-minute stations. Applicants were scored once after 8 minutes at five control stations and twice after 5 minutes and 8 minutes at five experimental stations. Scores at 5 and 8 minutes were compared using t-tests and correlation coefficients. Rankings of applicants based on 5- and 8-minute scores were compared using Spearman's rank order coefficient. The reliability of the MMI was examined for 5- and 8-minute scores using generalisability theory.
Results Mean scores at 5 minutes were lower than mean scores at 8 minutes. Cumulative scores at 5 minutes were also lower. There were highly significant correlations between 5- and 8-minute scores at all experimental stations (0.82–0.91; P < 0.01) and between the cumulative scores at 5 and 8 minutes (0.92; P < 0.01). There was a strong correlation between applicant rankings based on cumulative 5- and 8-minute scores (Spearman's rank order coefficient 0.92). Reliability was not affected.
Conclusions Reducing the duration of MMI stations from 8 to 5 minutes conserves resources with minimal effect on applicant ranking and test reliability.

Antioxidant treatments for schizophrenia

Background: There is accumulating evidence that progressive changes in brain structure and function take place as schizophrenia unfolds. Among many possible candidates, oxidative stress may be one of the mediators of neuroprogression, grey matter loss and subsequent cognitive and functional impairment. Antioxidants are exogenous or endogenous molecules that mitigate any form of oxidative stress or its consequences. They may act from directly scavenging free radicals to increasing anti-oxidative defences. There is evidence that current treatments impact oxidative pathways and may to some extent reverse pro-oxidative states in schizophrenia. The existing literature, however, indicates that these treatments do not fully restore the deficits in antioxidant levels or restore levels of oxidants in schizophrenia. As such, there has been interest in developing interventions aimed at restoring this oxidative balance beyond the benefits of antipsychotics in this direction. If antioxidants are to have a place in the treatment of this serious condition, the relevant and up-to-date information should be available to clinicians and investigators. Objectives: To evaluate the effect of antioxidants as add-on treatments to standard antipsychotic medication for improving acute psychotic episodes and core symptoms, and preventing relapse in people with schizophrenia. Search methods: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials which is based on regular searches of CINAHL, BIOSIS, AMED, Embase, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. There are no language, time, document type, or publication status limitations for inclusion of records in the register. We ran this search in November 2010, and again on 8 January 2015. We also inspected references of all identified studies for further trials and contacted authors of trials for additional information. Selection criteria: We included reports if they were randomised controlled trials (RCTs) involving people with schizophrenia who had been allocated to either a substance with antioxidant potential or to a placebo as an adjunct to standard antipsychotic treatment. Data collection and analysis: We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assessed risk of bias for included studies and created a 'Summary of findings' table using GRADE. Main results: The review includes 22 RCTs of varying quality and sample size studying Ginkgo biloba, N-acetyl cysteine (NAC), allopurinol, dehydroepiandrosterone (DHEA), vitamin C, vitamin E or selegiline. Median follow-up was eight weeks. Only three studies including a minority of the participants reported our a priori selected primary outcome of clinically important response. Short-term data for this outcome (measured as at least 20% improvement in scores on Positive and Negative Syndrome Scale (PANSS)) were similar (3 RCTs, n = 229, RR 0.77, 95% CI 0.53 to 1.12, low quality evidence). Studies usually reported only endpoint psychopathology rating scale scores. Psychotic symptoms were lower in those using an adjunctive antioxidant according to the PANSS ( 7 RCTS, n = 584, MD -6.00, 95% CI -10.35 to -1.65, very low quality evidence) and the Brief Psychiatric Rating Scale (BPRS) (8 RCTS, n = 843, MD -3.20, 95% CI -5.63 to -0.78, low quality evidence). There was no overall short-term difference in leaving the study early (16 RCTs, n = 1584, RR 0.73, 95% CI 0.48 to 1.11, moderate quality evidence), or in general functioning (2 RCTs, n = 52, MD -1.11, 95% CI -8.07 to 5.86, low quality evidence). Adverse events were generally poorly reported. Three studies reported useable data for 'any serious adverse effect', results were equivocal (3 RCTs, n = 234, RR 0.65, 95% CI 0.19 to 2.27, low quality evidence). No evidence was available for relapse, quality of life or service use. Authors' conclusions: Although 22 trials could be included in this review, the evidence provided is limited and mostly not relevant to clinicians or consumers. Overall, although there was low risk of attrition and selective data reporting bias within the trials, the trials themselves were not adequately powered and need more substantial follow-up periods. There is a need for larger trials with longer periods of follow-up to be conducted. Outcomes should be meaningful for those with schizophrenia, and include measures of improvement and relapse (not just rating scale scores), functioning and quality of life and acceptability and, importantly, safety data.

A profile of four patterns of vulnerability to functional decline in older general medicine patients in Victoria, Australia: a cross sectional survey

BACKGROUND: There are limited published data reporting Australian hospitalized elders' vulnerability to functional decline to guide best practice interventions. The objectives of this study were to describe the prevalence of vulnerability to functional decline and explore profiles of vulnerability related to the performance of physical activity in a representative group of elders in a single centre in Victoria, Australia.

METHODS: A cross-sectional survey of patients aged ≥ 70 years (Mean age 82.4, SD 7 years) admitted to a general medical ward of an Australian tertiary-referral metropolitan public hospital from March 2010 to March 2011 (n = 526). Patients were screened using the Vulnerable Elders Survey (VES-13). Distinct typologies of physical difficulties were identified using latent class analysis.

RESULTS: Most elders scored ≥3/10 on the VES-13 and were rated vulnerable to functional decline (n = 480, 89.5 %). Four distinct classes of physical difficulty were identified: 1) Elders with higher physical functioning (n = 114, 21.7 %); 2) Ambulant elders with diminished strength (n = 24, 4.6 %); 3) Elders with impaired mobility, strength and ability to stoop (n = 267, 50.8 %) and 4) Elders with extensive physical impairment (n = 121, 23 %) Vulnerable elders were distributed through all classes.

CONCLUSIONS: Older general medicine patients in Victoria, Australia, are highly vulnerable to functional decline. We identified four distinct patterns of physical difficulties associated with vulnerability to functional decline that can inform health service planning, delivery and education.

Easier analysis and better reporting : modelling ordinal data in mathematics education research

This article presents an examination of the use of Rasch modelling in a major research project, 'Improving Middle Years Mathematics and Science' (IMYMS). It is unarguable that it is important to take students' perceptions, or views, into account when planning learning and teaching for them. The IMYMS student perceptions survey is an attempt to make visible these student viewpoints, and report them in a way that is accessible to teachers and researchers involved in the project. The project involves four clusters of schools from urban and regions of Victoria to investigate the role of mathematics and science knowledge and subject cultures in mediating change processes in the middle years of schooling. There are five secondary and twenty-eight primary schools. The project has generated both qualitative and quantitative data, with much of the qualitative data being ordinal in nature. Reporting the results of analyses for a range of audiences necessitates careful, well-designed report formats. Some useful new report formats based on Rasch modeling -the Modified Variable Map, the Ordinal Map, the Threshold Map, and the Annotated Ordinal Map - are illustrated using data from the IMYMS project. The Rasch analysis and the derived reporting formats avoid the pitfalls that exist when working with ordinal data and provide insights into the respondents' views about their experiences in schools unavailable by other approaches.

Program assessment and reporting: linking people, processes and data

As part of a larger Simplification Project for program quality assurance processes conducted at RMIT University, this paper chronicles the refinement of one aspect: program assessment and reporting. This involved the realignment of criteria used in program quality assurance with those developed in higher-level strategic and business planning processes. In addition, the project attempted to address the lack of alignment between annual program processes and subsequent decisions made about the future of programs, particularly in profile planning processes.
A revised Program Annual Report process was developed that aimed to achieve simplicity and alignment while re-engaging program leaders and heads of schools with the quality agenda. A concerted effort was made to develop a process that improved on previously poor vertical communication inherent in program quality assurance. This paper explores the ways in which this was achieved by a) linking people to data through the use of agreed and contextualised performance indicators, and b) linking people to process through more meaningful input into planning and opportunity for dialogue.

Data warehouse design and legal visualization – the applicability of H2 for reporting

The steady increase of regulations and its acceleration due to the financial crisis heavily affect the management of regulatory compliance. Regulations, such as Basel III and Solvency II particularly impact data warehouses and lead to many organizational and technical changes. From an IS perspective modeling techniques for data warehouse requirement elicitation help to manage conceptual requirements. From a legal perspective attempts to visualize regulatory requirements – so called legal visualization approaches – have been developed. This paper investigates whether a conceptual modeling technique for regulatory-driven data warehouse requirements is applicable for representing data warehouse requirements in a legal environment. Applying the modeling technique H2 for Reporting in three extensive modeling projects provides three contributions. First, evidence for the applicability of a modeling technique for regulatory-driven data warehouse requirements is given. Second, lessons learned for further modeling projects are provided. Third, a discussion towards a combined perspective of information modeling and legal visualization is presented.

Feedback reporting of survey data to healthcare aides

Background

This project occurred during the course of the Translating Research in Elder Care (TREC) program of research. TREC is a multilevel and longitudinal research program being conducted in the three Canadian Prairie Provinces of Alberta, Saskatchewan, and Manitoba. The main purpose of TREC is to increase understanding about the role of organizational context in influencing knowledge use in residential long-term care settings. The purpose of this study was to evaluate healthcare aides’ (HCAs) perceptions of a one-page poster designed to feed back aggregated data (including demographic information and perceptions about influences on best practice) from the TREC survey they had recently completed.

Methods
A convenience sample of 7 of the 15 nursing homes participating in the TREC research program in Alberta were invited to participate. Specific facility-level summary data were provided to each facility in the form of a one-page poster report. Two weeks following delivery of the report, a convenience sample of HCAs was surveyed using one-to-one structured interviews.

Results
One hundred twenty-three HCAs responded to the evaluation survey. Overall, HCAs’ opinions about presentation of the feedback report and the understandability, usability, and usefulness of the content were positive. For each report, analysis of data and production and inspection of the report took up to one hour. Information sessions to introduce and explain the reports averaged 18 minutes. Two feedback reports (minimum) were supplied to each facility at a cost of CAN$2.39 per report, for printing and laminating.

Conclusions
This study highlights not only the feasibility of producing understandable, usable, and useful feedback reports of survey data but also the value and importance of providing feedback to survey respondents. More broadly, the findings suggest that modest strategies may have a positive and desirable effect in participating sites.

Terrestrial avifauna of the Gippsland Plain and Strzlecki Ranges, Victoria, Australia: insights from Atlas data.

The rate and spatial scale at which natural environments are being modified by human land-uses mean that a regional or national perspective is necessary to understand the status of the native biota. Here, we outline a landscape-based approach for using data from the ‘New Atlas of Australian Birds’ to examine the distribution and status of avifauna at a regional scale. We use data from two bioregions in south-east Australia – the Gippsland Plain and the Strzelecki Ranges (collectively termed the greater Gippsland Plains) – to demonstrate this approach. Records were compiled for 57 landscape units, each 10′ latitude by 10′ longitude (~270 km2) across the study region. A total of 165 terrestrial bird species was recorded from 1870 ‘area searches’, with a further 24 species added from incidental observations and other surveys. Of these, 108 species were considered ‘typical’ of the greater Gippsland Plain in that they currently or historically occur regularly in the study region. An index of species ‘occurrence’, combining reporting rate and breadth of distribution, was used to identify rare, common, widespread and restricted species. Ordination of the dataset highlighted assemblages of birds that had similar spatial distributions. A complementarity analysis identified a subset of 14 landscape units that together contained records from at least three different landscape units for each of the 108 ‘typical’ species. When compared with the 40 most common ‘typical’ species, the 40 least common species were more likely to be forest specialists, nest on the ground and, owing to the prevalence of raptors in the least common group, take prey on the wing. The future status of the terrestrial avifauna of the greater Gippsland Plains will depend on the extent to which effective restoration actions can be undertaken to ensure adequate representation of habitats for all species, especially for the large number of species of conservation concern.

Decades of research efforts to link economic and environmental performance: still data in search of a theory?

With the proliferation of social investment vehicles, stakeholders, particularly investors, are increasingly aware of the relationship between economic, social and environmental performance, and disclosure to external parties. This is particularly evident in The Securities and Exchange Commission's Environmental Disclosure Rules. The thesis of this paper is that, after three decades of academic and professional research efforts, there are still no firm proactive guidelines to firmly link the financial performance with environmental and social performance. The purpose of this paper is to revisit empirical research efforts spanning three decades in order to delineate potential links that may assist in systematic, comparable reporting

There are always two sides to a story: the use of social dramas as a mode of data analysis in information systems

With the continually evolving social nature of information systems research there is a need to identify different “modes of analysis” (Myers, 1997) to uncover our understanding of the complex, messy and often chaotic nature of human factors. One suggested mode of analysis is that of social dramas, a tool developed in the anthropological discipline by Victor Turner. The use of social dramas also utilises the work by Goffman (1959; 1997) and enables the researcher to investigate events from the front stage, reporting obvious issues in systems implementation, and from the back stage, identifying the hidden aspects of systems implementation and the underpinning discourses. A case study exploring the social dramas involved in systems selection and implementation has been provided to support the use of this methodological tool.

Generating best evidence from qualitative research: the role of data analysis

Objective: To outline the importance of the clarity of data analysis in the doing and reporting of interview-based qualitative research.

Approach: We explore the clear links between data analysis and evidence. We argue that transparency in the data analysis process is integral to determining the evidence that is generated. Data analysis must occur concurrently with data collection and comprises an ongoing process of 'testing the fit' between the data collected and analysis. We discuss four steps in the process of thematic data analysis: immersion, coding, categorising and generation of themes.

Conclusion: Rigorous and systematic analysis of qualitative data is integral to the production of high-quality research. Studies that give an explicit account of the data analysis process provide insights into how conclusions are reached while studies that explain themes anchored to data and theory produce the strongest evidence.

What have sampling and data collection got to do with good qualitative research?

Objective: To highlight the importance of sampling and data collection  processes in qualitative interview studies, and to discuss the contribution of  these processes to determining the strength of the evidence generated and  thereby to decisions for public health practice and policy.

Approach: This discussion is informed by a hierarchy-of-evidence-for-practice  model. The paper provides succinct guidelines for key sampling and data  collection considerations in qualitative research involving interview studies. The  importance of allowing time for immersion in a given community to become  familiar with the context and population is discussed, as well as the practical  constraints that sometimes operate against this stage. The role of theory in  guiding sample selection is discussed both in terms of identifying likely sources  of rich data and in understanding the issues emerging from the data. It is noted  that sampling further assists in confirming the developing evidence and also  illuminates data that does not seem to fit. The importance of reporting sampling  and data collection processes is highlighted clearly to enable others to assess  both the strength of the evidence and the broader applications of the findings.

Conclusion: Sampling and data collection processes are critical to determining  the quality of a study and the generalisability of the findings. We argue that  these processes should operate within the parameters of the research goal, be  guided by emerging theoretical considerations, cover a range of relevant   participant perspectives, and be clearly outlined in research reports with an  explanation of any research limitations.

Under-reporting of energy intake in the 1997 national nutrition survey

Aims To estimate the level of under-reporting of energy intake by gender, age, ethnicity and body size (normal, overweight, obese) in the 1997 National Nutrition Survey (NNS97) in New Zealand.
Methods Data were from 4,258 participants (1,808 men and 2,450 women aged 15 years and over) who completed the 24-hour diet recall; the primary methodology used in the NNS97. Under-reporting was assessed using the ratio of reported energy intake to estimated resting metabolic rate (EI: RMRest). Cut-off limits were used to identify percentages of under-reporters in the various subgroups.
Results Mean EI: RMRest was 1.40 for all participants (1.51 for men, 1.30 for women, p<0.001) with older age being associated with lower EI: RMRest (p<0.001). There were no significant differences in mean EI: RMRest between ethnic groups for men.
Mean EI: RMRest for women were: Maori 1.46, European 1.29, and Pacific 1.37 (p<0.01). A larger body size was associated with a significantly lower EI: RMRest especially for women.
Percentages of ‘definite’ under-reporters (individual EI: RMRest <0.9) were as follows: men 12%, women 21%; Europeans 16%, Maori 23% and Pacific 26%; normal weight (11%), overweight (19%) and obese (27%) participants; and from 10% in the youngest to 23% in the oldest age group (p<0.001 for all results).
Conclusion In this study, in agreement with the literature, women, older people and obese people under-reported more than men, younger people and non-obese people. Possible ethnic differences in under-reporting rates need further study. Care is needed in interpreting the energy intake data from the NNS97.