Exocrine pancreatic dysfunction in malnourished Australian Aboriginal children

Pancreatic exocrine dysfunction has been frequently recorded in protein-energy malnutrition in underdeveloped countries. In addition, the pancreas requires optimal nutrition for enzyme synthesis and potentially correctable pancreatic enzyme insufficiency may play a role in the continuation of protein-energy malnutrition. This problem has not been previously evaluated in Australian Aborigines. We have applied a screening test for pancreatic dysfunction (human immunoreactive trypsinogen [IRT] assay) to the study of 398 infants (6-36 months) admitted to the Alice Springs Hospital over a 20-month period. All infants were assessed by anthropometric measures and were assigned to to three nutritional groups (normal, moderate or severely malnourished) and two growth groups (stunted or not stunted). Of the 198 infants who had at least a single serum cationic trypsinogen measurement taken, normal values for serum IRT (with confidence limits) were obtained from 57 children, who were normally nourished. IRT levels were significantly correlated with the degree of underweight but there was no correlation with the degree of stunting or age. Mean IRT levels for the moderate and severely underweight groups were significantly greater than the mean for the normal group (P < 0.01). Seventeen children (8.6%) had trypsinogen levels in excess of the 95th percentile for the normally nourished group, reflecting acinar cell damage or ductal obstruction. We conclude that pancreatic dysfunction may be a common and important overlooked factor contributing to ongoing malnutrition and diseases in malnourished Australian Aboriginal children.

Liver transplantation in children: Experience with the development of an Australian pilot programme. The Queensland Liver Transplantation Programme

Children with end-stage liver disease now form a major sub-group of patients considered suitable for liver transplantation (ltp), and enjoy better survival statistics after transplantation than do adults. Since June 1984, a paediatric ltp programme has been developed in Brisbane with an initial working relationship and ongoing close links with two USA centres (Pittsburgh, and the UCLA Medical Center). Fourteen children with end-stage liver disease have been referred to the Queensland Liver Transplantation Programme for formal assessment. Following frank, informed discussion with their parents, 10 of these children were offered the option of ltp. During the transition stage, two infants with biliary atresia were referred to UCLA at their parents' request and, subsequently, eight children aged from 9 months to 6 years have been placed on a transplant candidacy list in Brisbane. A donor procurement team with access to a Queensland Government jet has been available to cover all mainland States except Western Australia. Six of the children have now had orthotopic ltp (two children at the UCLA Medical Center; four children at the Royal Children's Hospital, Brisbane). One UCLA patient died with a non-functioning graft, and one Brisbane patient died 5 weeks post-transplant with rejection, hepatic artery thrombosis and sepsis. The other four children are alive and well, three with normal liver function and one with unexplained intrahepatic cholestasis, during the 1-20 month follow-up to date. Three further children have died of their liver disease without a donor of an appropriate blood group and size being found, and one patient still awaits a suitable donor. The experience of these authors suggests that ltp is a major advance in the treatment of paediatric liver disease, and that the procedure can be carried out successfully in Australia with initial results comparable with leading overseas centres. The procedure requires the full array of services of a major paediatric tertiary care facility, an intensive team effort with awareness of the special needs of children, and a widespread procurement capability. A major problem for Australia is the procurement of sufficient numbers of optimal paediatric donor livers.

Contemporary issues in Australian family law: Do we need a more unified and interventionist judicial model

Recent decisions of the Family Court of Australian reflect concerns over the adversarial nature of the legal process. The processes and procedures of the judicial system militate against a detailed examination of the issues and rights of the parties in dispute. The limitations of the family law framework are particularly demonstrated in disputes over the custody of children where the Court has tended to neglect the rights and interests of the primary carer. An alternative "unified family court" framework will be examined in which the Court pursues a more active and interventionist approach in the determination of family law disputes.

In the mouth of the imagination : positioning children as co-researchers and co-artists to create a professional children's theatre production

In recent decades a number of Australian artists and teacher/artists have given serious attention to the creation of performance forms and performance engagement models that respect children’s intelligence, engage with themes of relevance, avoid the cliche´s of children’s theatre whilst connecting both sincerely and playfully with current understandings of the way in which young children develop and engage with the world. Historically a majority of performing arts companies touring Australian schools or companies seeking schools to view a performance in a dedicated performance venue engage with their audiences in what can be called a ‘drop-in drop-out’ model. A six-month practice-led research project (The Tashi Project) which challenged the tenets of the ‘drop-in drop-out’ model has been recently undertaken by Sandra Gattenhof and Mark Radvan in conjunction with early childhood students from three Brisbane primary school classrooms who were positioned as co-researchers and co-artists. The children, researchers and performers worked in a complimentary relationship in both the artistic process and the development of product.

Kids, counsellors and troubles-telling : morality-in-action in talk on an Australian children’s helpline

This chapter investigates one instance of ‘morality-in-action’, which transpires when children describe their troubles to the adult counsellors at Kids Help Line, an Australian national helpline that deals specifically with callers aged approximately 5-18 years. We focus, in particular, on how a young female caller who has forged a medical certificate in relation to a problem with school attendance, determines both what to report, and how this should be disclosed. Throughout the call, the moral implications of the troubles talk are delicately managed by both caller and counsellor. The call takes the form of an extended story (Labov & Waletzky, 1997) that includes a preface (‘I have some problems at school’), an orientation (“I was sick, went to the doctor, stayed home”), a complicating action (“I went back to school and photocopied my certificate from last time”), result (“I got caught”) and evaluation (“I don’t know why it happened”). As the account unfolds, we observe how both the student and counsellor seek to make sense of these actions. While this account is partly about deception, both the caller and counsellor delicately sidestep naming this action, precluding this implication. For example, the counsellor lets stand the caller’s main assessment of the trouble. He simply asks, “so what happened then,” when the caller reports that her forgery was discovered. The caller, from the very beginning of the call, seeks to find out why she could have done this, “you see I don’t know why it happened”. As the call unfolds, the counsellor follows the opening provided by the caller and they put forward motives for consideration. By agreeing that the motives are to be explored, the act takes on a character other than deception.

How is a fruit tree like you? Using artistic metaphors to explore and develop emotional competence in children

Counselling children often requires the use of supplementary strategies in order to interest and engage the child in the therapeutic process. One such strategy is the Metaphorical Fruit Tree (MFT); an art metaphor suited to exploring and developing self-concept. Quantitative and qualitative data was used to explore the relationships between children’s ability to use metaphor, age, gender, and level of emotional competence (N = 58). Quantitative and qualitative analyses revealed a significant negative relationship between self-reported emotional competence and ability to use the MFT. It is proposed that children rely on different processes to understand self and as children’s ability to cognitively report on their emotional capabilities via the Emotional Competence Questionnaire (ECQ) increases, their ability to report creatively on those capabilities via the MFT is undermined. It is suggested that the MFT may be used, via creative processes and as an alternative to cognitive processes, to increase understanding and awareness of intrapersonal and interpersonal concepts of self in the child during counselling.

Children's self-talk and academic self-concepts: The impact of teachers' statements

Data were collected from 269 Australian primary school children in grades 3 to 7. Self-report questionnaires measuring students' perceptions of the frequency of positive and negative statements directed to them by their teacher, their positive and negative self-talk; and their reading, mathematics and learning self-concepts were administered. Positive statements made by teachers were found to be directly related to positive self-talk and to maths and learning self-concepts. Teachers' positive statements were also indirectly related to reading self-concept through positive self-talk. Negative statements made by teachers were not predictive of self-talk or self-concepts for the total sample but were predictive of maths self-concept for girls and negative self-talk for boys. Implications for teachers and educational psychologists are discussed.

'We just make the pictures...?' How work is portrayed in children's feature length films

This article explores how adult paid work is portrayed in 'family' feature length films. The study extends previous critical media literature which has overwhelmingly focused on depictions of gender and violence, exploring the visual content of films that is relevant to adult employment. Forty-two G/PG films were analyzed for relevant themes. Consistent with the exploratory nature of the research, themes emerged inductively from the films' content. Results reveal six major themes: males are more visible in adult work roles than women; the division of labour remains gendered; work and home are not mutually exclusive domains; organizational authority and power is wielded in punitive ways; there are avenues to better employment prospects; and status/money is paramount. The findings of the study reflect a range of subject matters related to occupational characteristics and work-related communication and interactions which are typically viewed by children in contemporary society.

A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents

Objective: The study investigated previous research findings and clinical impressions which indicated that the intensity of grief for parents who had lost a child was likely to be higher than that for widows/widowers, who in turn were likely to have more intense reactions than adult children losing a parent. Method: In order to compare the intensities of the bereavement reactions among representative community samples of bereaved spouses (n = 44), adult children (n = 40) and parents (n = 36), and to follow the course of such phenomena, a detailed Bereavement Questionnaire was administered at four time points over a 13-month period following the loss. Results: Measures based on items central to the construct of bereavement showed significant time and group differences in accordance with the proposed hypothesis. More global items associated with the construct of resolution showed a significant time effect, but without significant group differences. Conclusions: Evidence from this study supports the hypothesis that in non-clinical, community-based populations the frequency with which core bereavement phenomena are experienced is in the order: bereaved parents bereaved spouses bereaved adult children.