Quality of child abuse information in emergency department injury surveillance data : linking hospital and child welfare data

Emergency departments (EDs) are often the first point of contact with an abused child. Despite legal mandate, the reporting of definite or suspected abusive injury to child safety authorities by ED clinicians varies due to a number of factors including training, access to child safety professionals, departmental culture and a fear of ‘getting it wrong’. This study examined the quality of documentation and coding of child abuse captured by ED based injury surveillance data and ED medical records in the state of Queensland and the concordance of these data with child welfare records. A retrospective medical record review was used to examine the clinical documentation of almost 1000 injured children included in the Queensland Injury Surveillance Unit database (QISU) from 10 hospitals in urban and rural centres. Independent experts re-coded the records based on their review of the notes. A data linkage methodology was then used to link these records with records in the state government’s child welfare database. Cases were sampled from three sub-groups according to the surveillance intent codes: Maltreatment by parent, Undetermined and Unintentional injury. Only 0.1% of cases coded as unintentional injury were recoded to maltreatment by parent, while 1.2% of cases coded as maltreatment by parent were reclassified as unintentional and 5% of cases where the intent was undetermined by the triage nurse were recoded as maltreatment by parent. Quality of documentation varied across type of hospital (tertiary referral centre, children’s, urban, regional and remote). Concordance of health data with child welfare data varied across patient subgroups. Outcomes from this research will guide initiatives to improve the quality of intentional child injury surveillance systems.

Pondering policy and parental perspectives : how parents view their role in shaping early childhood public policy

The focus of this paper is the role of Australian parents in early childhood education and care (ECEC), in particular, their role in shaping ECEC public policy. The paper reports the findings of a study investigating the different ways in which a group of parents viewed and experienced this role. Set against a policy backdrop where parents are positioned as 'consumers' and 'participants' in ECEC, the study employed a phenomenographic research approach to describe this role as viewed and experienced by parents. The study identified four logically related, qualitatively different ways of constituting this role among this group of parents, ranging from 'no role in shaping public policy' (the no role conception) to 'participating in policy decision-making, particularly where policy was likely to affect their child and family (the participating in policy decision-making conception). The study provides an insider-perspective on the role of parents in shaping policy and highlights variation in how this role is constituted by parents. The study also identifies factors perceived by parents as influencing their participation and discusses their implications for both policy and practice.

Effectiveness of nurse-led preoperative assessment services for elective surgery : a systematic review

Background--The admission and assessment of patients for elective procedures is a task faced by all healthcare organisations that provide elective surgical services. Several different strategies have been used to facilitate the management of these tasks. Nurse-led preadmission clinics or services have been implemented in many health services as one of these management strategies; however their effectiveness has not been established. Objectives--The objective of this review was to examine the available research on the effectiveness of nurse-led elective surgery preoperative assessment clinics or services on patient outcomes.--Results--Of the 19 included articles, there were 10 audits of patient and hospital data, 3 surveys or questionnaires, 3 descriptive studies, 1 action research design, 1 prospective observational study and 1 RCT. Five of ten studies reporting data on cancellations rates found that nurse-led preadmission services reduced the number of day-of-surgery cancellations. Non-attendance for surgery was also reduced, with nine studies reporting decreases in the number of patients failing to attend. Eight studies reporting data on patient or parent satisfaction found high levels of satisfaction with nurse-led preadmission services. Three of four studies investigating the effect of the nurse-led preadmission service on patient anxiety found a reduction in reported anxiety levels. Three studies found that preoperative preparation was enhanced by the use of a nurse-led preadmission service.--Conclusions--While all included studies reported evidence of effectiveness for nurse-led preadmission services on a wide range of outcomes for elective surgery patients, the lack of experimental trials means that the level of evidence is low, and further research is needed.--Implications for practice--Nurse-led preadmission services may be an effective strategy for reducing procedural cancellations, failure to attend for procedures, and patient anxiety, however currently the evidence level is low.

Script proposals: a device for empowering clients in counselling

Much of the research on the delivery of advice by professionals such as physicians, health workers and counsellors, both on the telephone and in face to face interaction more generally, has focused on the theme of client resistance and the consequent need for professionals to adopt particular formats to assist in the uptake of the advice. In this paper we consider one setting, Kid’s Helpline, the national Australian counselling service for children and young people, where there is an institutional mandate not to give explicit advice in accordance with the values of self-direction and empowerment. The paper examines one practice, the use of script proposals by counsellors, which appears to offer a way of providing support which is consistent with these values. Script proposals entail the counsellors packaging their advice as something that the caller might say – at some future time – to a third party such as a friend, teacher, parent, or partner, and involve the counsellor adopting the speaking position of the caller in what appears as a rehearsal of a forthcoming strip of interaction. Although the core feature of a script proposal is the counsellor’s use of direct reported speech they appear to be delivered, not so much as exact words to be followed, but as the type of conversation that the client needs to have with the 3rd party. Script proposals, in short, provide models of what to say as well as alluding to how these could be emulated by the client. In their design script proposals invariably incorporate one or more of the most common rhetorical formats for maximising the persuasive force of an utterance such as a three part list or a contrastive pair. Script proposals, moreover, stand in a complex relation to the prior talk and one of their functions appears to be to summarise, respecify or expand upon the client’s own ideas or suggestions for problem solving that have emerged in these preceding sequences.

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

Background The relationship between positive parent-child interactions and optimal child development is well established. Families with a child with a disability may face additional challenges to establishing positive parent-child relationships. There are limited studies addressing the effectiveness of interventions which seek to address these issues with parents and young children with a disability. In particular, prior studies of music therapy with this group have been limited by small sample sizes and the use of measures of limited reliability and validity. Objective This study investigates the effectiveness of a short-term group music therapy intervention for parents who have a child with a disability and explores the factors associated with higher outcomes for participating families. Methods The participants were 201 mother-child dyads, where the child had a disability. Pre and post intervention parental questionnaires and clinician observation measures were taken on a range of parental wellbeing, parenting behaviours and child developmental factors. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. Results Significant improvements pre to post were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence that parents were very satisfied with the program and that it brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. Conclusions This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas. Whilst several limitations are discussed, the study does address some of the gaps in the music therapy evidence base in this area.

Early Intervention Program Final Evaluation Report

The Early Intervention Program aims to facilitate contact between children and their non-residential parent as soon as practicable after breakdown and separation of the immediate family unit. The Program is auspiced by the Sunshine Coast Family Contact Centre Association. The Program has been offered since late 2007 following receipt of a grant from the National Community Crime Prevention Program [NCCP] for Domestic Violence Prevention. This external evaluator report summarised main achievements with respect to meeting program objectives and also makes recommentations in view the of the continuation of this innovative program.

Parents’ risky choices around the IB Diploma

In recent years there has been a rapid growth in the International Baccalaureate Diploma(IBD), a secondary curriculum administered by the International Baccalaureate Organisation(IBO), as an alternative to the local curriculum in Australian schools in some schools. This growth is indicative of an increasing demand from Australian families for new educational structures, practices and processes. With more curriculum options and pathways such as the IBD available in the secondary education system, parents are faced with a more complex high stakes decision when it comes to choosing the optimal education path for their offspring, one which requires a careful assessment of potential outcomes and risks. This paper reports on the responses of 184 parents to an online survey conducted in 26 Australian schools that offer the IBD as a curricular alternative. It examines which parents either chose, or chose not to, enrol their children in the program, why, and what risks they perceived to be associated with that choice. The paper will compare the choice behaviour of the two groups of parents from a sociological perspective, framing the enquiry with reference to globalisation and neo-liberal education policy and its effect on parental choice of schooling. This paper will make evident how parental choice of educational alternatives has become a more complicated process for Australian families.

A study of parents’ conceptions of their roles as home educators of their children

Home education is a growing phenomenon in Australia. It is the practice whereby parents engage in the full time education of their children at home. This study used a phenomenographic approach to identify and analyse how home educating parents conceive of their roles as home educators. Data analysis presented an outcome space of the parents‘ qualitatively different conceptions of their roles as home educators. This outcome space exemplifies the phenomenon of the roles of parent home educators. This thesis reports on the qualitatively different ways in which a group of 27 home educating parents viewed their roles in the education of their children. Four categories of description of parent home educator roles emerged from the analysis. These parents saw themselves in the role of a (1) learner, as they needed to gain knowledge and skills in order to both commence and to continue home education. Further, they perceived of themselves as (2) partners, usually with their spouse, in an educational partnership, which provided the family‘s educational infrastructure. They also saw themselves in the role of (3) teachers of their children, facilitating their education and development. Finally, they conceived of themselves as (4) educational pioneers in their communities. These four categories were linked and differentiated from each other by three key themes or dimensions of variation. These were the themes of (1) educational influence; (2) educational example; and (3) spirituality, which impacted both their families and the wider community. The findings of the study indicate that home educators experience their roles in four critically different ways, each of which contributes to their family educational enterprise. The findings suggest that home educators, are bona fide educators and that they access parental qualities that provide a form of education which differs from the educational practices characteristic of the majority of Australians. The study has the potential to generate further understandings of home education for home educators and for the wider community. It may also inform policy makers in the fields of education, social welfare, and the law, where there is a vested interest in the education and welfare of children and families.

Parents resourcing children’s early development and learning

Parents deal with a complex web of choices when seeking and using knowledge and resources related to their young children’s literacy development. Information about children’s learning and development comes in many forms and is produced by an increasingly diverse range of players including governments, nongovernment organisations and commercial businesses. This study used a survey, interview and artefact collection to investigate mothers’ and fathers’ reported activities in seeking, accessing, producing and circulating information and resources related to children’s learning and development. Differences were found relating to parent gender and level of education. Parents’ resourcing activities are also shaped by their particular goals for their children.

Teachers’ and parents’ perspectives of digital technology in the lives of young children

The pervasiveness of technology in the 21st Century has meant that adults and children live in a society where digital devices are integral to their everyday lives and participation in society. How we communicate, learn, work, entertain ourselves, and even shop is influenced by technology. Therefore, before children begin school they are potentially exposed to a range of learning opportunities mediated by digital devices. These devices include microwaves, mobile phones, computers, and console games such as Playstations® and iPods®. In Queensland preparatory classrooms and in the homes of these children, teachers and parents support and scaffold young children’s experiences, providing them with access to a range of tools that promote learning and provide entertainment. This paper examines teachers’ and parents’ perspectives and considers whether they are techno-optimists who advocate for and promote the inclusion of digital technology, or whether they are they techno-pessimists, who prefer to exclude digital devices from young children’s everyday experiences. An exploratory, single case study design was utilised to gather data from three teachers and ten parents of children in the preparatory year. Teacher data was collected through interviews and email correspondence. Parent data was collected from questionnaires and focus groups. All parents who responded to the research invitation were mothers. The results of data analysis identified a misalignment among adults’ perspectives. Teachers were identified as techno-optimists and parents were identified as techno-pessimists with further emergent themes particular to each category being established. This is concerning because both teachers and mothers influence young children’s experiences and numeracy knowledge, thus, a shared understanding and a common commitment to supporting young children’s use of technology would be beneficial. Further research must investigate fathers’ perspectives of digital devices and the beneficial and detrimental roles that a range of digital devices, tools, and entertainment gadgets play in 21st Century children’s lives.

Integrated literacies : every online player wins a prize

QUT Library’s model of learning support brings together academic literacy (study skills) and information literacy (research skills). The blended portfolio enables holistic planning and development, seamless services, connected learning resources and more authentic curriculum-embedded education. The model reinforces the Library’s strategic focus on learning service innovation and active engagement in teaching and learning. ----- ----- ----- The online learning strategy is a critical component of the broader literacies framework. This strategy unifies new and existing online resources (e.g.: Pilot, QUT cite|write and IFN001|AIRS Online) to augment learner capability. Across the suite, prudent application of emerging technologies with visual communications and learning design delivers a wide range of adaptive study tools. Separately and together, these resources meet the learning needs and styles of a diverse cohort providing positive and individual learning opportunities. Deliberate articulation with strategic directions regarding First Year Experience, assessment, retention and curriculum alignment assures that the Library’s initiatives move in step with institutional objectives relating to enhancing the student experience and flexible blended learning. ----- ----- ----- The release of Studywell in 2010 emphasises the continuing commitment to blended literacy education. Targeting undergraduate learners (particularly 1st year/transition), this online environment provides 24/7 access to practical study and research tools. Studywell’s design and application of technology creates a “discovery infrastructure” [1] which facilitates greater self-directed learning and interaction with content. ----- ----- ----- This paper presents QUT Library’s online learning strategy within the context of the parent “integrated literacies” framework. Highlighting the key online learning resources, the paper describes the inter-relationships between those resources to develop complementary literacies. The paper details broad aspects of the overarching learning and study support framework as well as the online strategy, including strategic positioning, quality and evaluation processes, maintenance, development, implementation, and client engagement and satisfaction with the learning resources.

Observational assessment and maternal reports of motivation in children and adolescents with Down Syndrome

Despite a lack of consistent empirical evidence, there has been an ongoing assumption that intellectual disability is associated with reduced levels of motivation. The participants in this study were 33 children with Down syndrome ages 10–15 years and 33 typically developing 3–8-year-old children. Motivation was measured through observational assessments of curiosity, preference for challenge, and persistence, as well as maternal reports. There were no significant group differences on motivation tasks, but mothers of children with Down syndrome rated their children significantly lower on motivation than did parents of typically developing children. There were some intriguing group differences in the pattern of correlations among observations and parent reports. The findings challenge long-held views that individuals with intellectual disability are invariably deficient in motivation.

Children’s food and activity patterns following a six-month child weight management program

Objective To describe the impact of a parent-led, family focused child weight management program on the food intake and activity patterns of pre-pubertal children. Methods n assessor-blinded, randomized controlled trial involving 111 (64% female) overweight, pre-pubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Study outcomes were assessed at baseline, 6 months, and 12 months. This paper presents data on food intake assessed via a validated 54-item parent completed dietary questionnaire and activity behaviours assessed via a parent-report 20-item activity questionnaire. Results Intake of energy-dense nutrient poor foods was lower in both intervention groups at 6 months (mean difference, P+DA -1.5 serves [CI -2.0;-1.0]; P -1.0 serves [-2.0;-0.5]) and 12 months (mean difference P+DA -1.0 serves [CI -2.0;-0.5]; P -1.0 serves [-1.5; 0.0]) compared to baseline. Intake of vegetables, fruit, breads and cereals, meat and alternatives and dairy foods remained unchanged. Regardless of study group there were significant reductions over time in the reported time spent engaged in small screen activities and an increase in the time reported spent in active play. Conclusion Child weight management intervention that promotes food intake in line with national dietary guidelines achieves a reduction in children’s intake of energy dense, nutrient poor foods. This was achieved without compromising intake of nutrient-rich food and changes in were maintained even once the intervention ceased.

Psychometric properties of the parents' fever management scale in a Turkish population

Aim: This paper reports a study designed to assess the psychometric properties (validity and reliability) of a Turkish version of the Australian Parents’ Fever Management Scale (PFMS). Background: Little is known about childhood fever management among Turkish parents. No scales to measure parents’ fever management practices in Turkey are available. Design: This is a methodological study. Methods: Eighty parents, of febrile children aged six months to five years, were randomly selected from the paedaitric hospital and two community family health centers in Sakarya, Turkey. The PFMS was back translated; language equivalence and content validity were validated. PFMS and socio-demographic data were collected in 2009. Means and standard deviations were calculated for interval level data and p values greater than 0.05 were considered statistically significant. Unrotated principal component analysis was used to determine construct validity and Cronbach’s coefficient alpha determined the internal consistency reliability. Results: The PFMS was psychometrically sound in this population. Construct validity, confirmed by confirmatory factor analysis [KMO 0.812, Bartlett’s Specificity (χ² = 182.799, df=28, P < 0·001)] revealed the Turkish version to be comprised of the eight original PFMS items. Internal consistency reliability coefficient was 0.80 and the scale’s total-item correlation coefficients ranged from 0.15 to 0.66 and were significant (p<0.001). Interestingly parents reported high scores on the PFMS 34.52±4.60 (range 8-40 with 40 indicating a high burden of care for febrile children). Conclusion: The PFMS was as psychometrically robust in a Turkish population as in an Australian population and is, therefore, a useful tool for health professionals to identify parents’ practices, provide targeted education thereby in reducing the unnecessary burden of care they place on themselves when caring for a febrile child. Relevance to clinical practice. Testing in different populations, cultures and healthcare systems will further assist in reporting the PFMS usefulness in clinical practice and research.