Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the Queensland Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Queensland. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., teachers, doctors, nurses, and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the South Australian Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in South Australia. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the Tasmanian Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Tasmania. Government administrative data over a nine year period (2004-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the Victorian Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Victoria. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the West Australian Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Western Australia. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (e.g., police, teachers, doctors, nurses, family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Mutations in known monogenic high bone mass loci only explain a small proportion of high bone mass cases

High bone mass (HBM) can be an incidental clinical finding; however, monogenic HBM disorders (eg, LRP5 or SOST mutations) are rare. We aimed to determine to what extent HBM is explained by mutations in known HBM genes. A total of 258 unrelated HBM cases were identified from a review of 335,115 DXA scans from 13 UK centers. Cases were assessed clinically and underwent sequencing of known anabolic HBM loci: LRP5 (exons 2, 3, 4), LRP4 (exons 25, 26), SOST (exons 1, 2, and the van Buchem's disease [VBD] 52-kb intronic deletion 3'). Family members were assessed for HBM segregation with identified variants. Three-dimensional protein models were constructed for identified variants. Two novel missense LRP5 HBM mutations ([c.518C>T; p.Thr173Met], [c.796C>T; p.Arg266Cys]) were identified, plus three previously reported missense LRP5 mutations ([c.593A>G; p.Asn198Ser], [c.724G>A; p.Ala242Thr], [c.266A>G; p.Gln89Arg]), associated with HBM in 11 adults from seven families. Individuals with LRP5 HBM ( approximately prevalence 5/100,000) displayed a variable phenotype of skeletal dysplasia with increased trabecular BMD and cortical thickness on HRpQCT, and gynoid fat mass accumulation on DXA, compared with both non-LRP5 HBM and controls. One mostly asymptomatic woman carried a novel heterozygous nonsense SOST mutation (c.530C>A; p.Ser177X) predicted to prematurely truncate sclerostin. Protein modeling suggests the severity of the LRP5-HBM phenotype corresponds to the degree of protein disruption and the consequent effect on SOST-LRP5 binding. We predict p.Asn198Ser and p.Ala242Thr directly disrupt SOST binding; both correspond to severe HBM phenotypes (BMD Z-scores +3.1 to +12.2, inability to float). Less disruptive structural alterations predicted from p.Arg266Cys, p.Thr173Met, and p.Gln89Arg were associated with less severe phenotypes (Z-scores +2.4 to +6.2, ability to float). In conclusion, although mutations in known HBM loci may be asymptomatic, they only account for a very small proportion ( approximately 3%) of HBM individuals, suggesting the great majority are explained by either unknown monogenic causes or polygenic inheritance.

Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Following Stroke practice guidelines, update 2015

Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals, and the evidence suggests one-third or more will experience vascular-cognitive impairment, and/or intractable fatigue, either alone or in combination. The 2015 update of the Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Module guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. The three consequences of stroke that are the focus of the this guideline (poststroke depression, vascular cognitive impairment, and fatigue) have high incidence rates and significant impact on the lives of people who have had a stroke, impede recovery, and result in worse long-term outcomes. Significant practice variations and gaps in the research evidence have been reported for initial screening and in-depth assessment of stroke patients for these conditions. Also of concern, an increased number of family members and informal caregivers may also experience depressive symptoms in the poststroke recovery phase which further impact patient recovery. These factors emphasize the need for a system of care that ensures screening occurs as a standard and consistent component of clinical practice across settings as stroke patients transition from acute care to active rehabilitation and reintegration into their community. Additionally, building system capacity to ensure access to appropriate specialists for treatment and ongoing management of stroke survivors with these conditions is another great challenge.

'Hero to healing' drink driving program for Indigenous communities in Far North Queensland

Issue addressed: Alcohol-related road crashes are a leading cause of the injury burden experienced by Indigenous Australians. Existing drink driving programs are primarily designed for the mainstream population. The ‘Hero to Healing’ program was specifically developed with Indigenous communities and is underpinned by the Community Reinforcement Approach (CRA). This paper reports on the formative evaluation of the program from delivery in two Far North Queensland communities. Methods: Focus groups and semistructured interviews were conducted with drink driver participants (n = 17) and other Elders and community members (n = 8) after each program. Qualitative content analysis was used to categorise the transcripts. Results: The CRA appealed to participants because of its flexible nature and encouragement of rearranging lifestyle factors, without specific focus on alcohol use. Participants readily identified with the social and peer-related risk and protective factors discussed. Cofacilitation of the program with Elders was identified as a key aspect of the program. More in-depth discussion about cannabis and driving, anger management skills and relationship issues are recommended. Conclusions: Participants’ recognition of content reinforced earlier project results, particularly the use of kinship pressure to motivate younger family members to drink drive. Study findings suggest that the principles of the CRA are useful; however, some amendments to the CRA components and program content were necessary. So what?: Treating drink driving in regional and remote Indigenous Australian communities as a community and social issue, rather than an individual phenomenon, is likely to lead to a reduction in the number of road-related injuries Indigenous people experience.