Effects of persisting emotional impact from child abuse and norepinephrine transporter genetic variation on antidepressant efficacy in major depression: a pilot study

OBJECTIVE: Previous studies suggest child abuse and serotonergic polymorphism influence depression susceptibility and antidepressant efficacy. Polymorphisms of the norepinephrine transporter (NET) may also be involved. Research in the area is possibly clouded by under reporting of abuse in researcher trials. METHODS: Adults (n=51) with major depressive disorder has 8 weeks treatment with escitalopram or venlafaxine. Abuse history was obtained, the ongoing emotional impact of which was measured with the 15-item impact of event scale (IES-15). The 17-item Hamilton Depression Rating Scale (HDRS) was applied serially. Two NET polymorphisms (rs2242446 and rs5569) were assayed, blinded to HDRS ratings and abuse history. RESULTS: No subjects reporting abuse with high impact in adulthood (IES-15 ≥26, n=12) remitted; whereas 77% reporting low impact (IES-15 <26; n=26) remitted (p<0.001). Subjects reporting high impact abuse (n=12) had a 50-fold (95% confidence interval=4.85-514.6) greater odds of carrying rs2242446-TT genotype, but the small sample size leaves this finding vulnerable to type I error. CONCLUSIONS: The level of persisting impact of child abuse appears relevant to antidepressant efficacy, with susceptibility to such possibly being influence by NET rs2242446 polymorphism. Larger studies may be merited to expand on this pilot level finding given potential for biomarker utility.

Space, place and race: Ethics in practice for educational research in ethnically diverse rural Australia

Research in Australia’s ethnically diverse rural and regional communities requires an approach that is informed by notions of space, place and culture, and which recognises race as a relational social construct mediated by social and political discourse and context, and prone to change overtime. This critical review examines how teacher education researchers connect culturally competent research and rural ethics with the view to improving education systems, addressing rural teacher workforce issues, informing the preparation of pre-service teachers, and, most importantly, ensuring that rural students have access to educational opportunities that are engaging and meet their needs. It focuses specifically on researcher positionality on the insider-outsider continuum and how this informs ethical research in diverse rural communities, particularly those in which visible new migrants reside. Peer-reviewed journal articles that discuss how education researchers negotiate working in rural space are examined and considered in relation to discourse about ethics in practice and the insider/outsider continuum. Scholarship reflected in the literature spanned the fields of rural/research ethics, inclusive education, education research methodology and research with new migrants, minority and marginalised groups.

Parent, child and state in Chinese children’s books

The representation of the relationship between parent and child, the moral cornerstone of Chinese society, is uniquely influential in Chinese children’s literature. After an extended period of almost two thousand years during which depictions of this relationship were static and unchanging, the beginning of the twentieth century ushered in a dynamic series of changes which responded to political needs. In this study we focus on these changes, examining four distinctive periods: the pre-modern dynastic period until 1911; the Republican and Nationalist phase from 1911 to 1949; the phase of Mao’s socialism from 1949 to 1976; and the post-Mao phase from 1976 to 2000.

The decision-making processes adopted by rurally located mandated professionals when child abuse or neglect is suspected

The reporting of suspected child abuse and neglect is a mandated role of medical doctors, nurses, police and teachers in Victoria, Australia. This paper reports on a research study that sought to explicate how mandated professionals working in rural Victorian contexts identify a child/ren at risk and the decisions they make subsequently.

Understanding the dynamics between social entrepreneurship and inclusive growth in subsistence marketplaces

This article explores how social entrepreneurs utilize their unique circumstances and resources at a micro level to facilitate the creation of shared value at the meso level, leading to inclusive growth at a macro level in the context of subsistence marketplaces. Drawing from explanatory case studies of two social enterprises—Waste Concern (Bangladesh) and Seven Women (Nepal)—the findings suggest that social entrepreneurs act as bricoleurs to integrate their operant and operand resources in subsistence marketplaces to facilitate inclusive growth. The authors further connect with and extend three discourses of research—social entrepreneurship, social bricolage, and service-dominant logic—to develop a framework providing insights into the “bottom-up” approach, the underlying dynamics of shared value creation, and inclusive growth in subsistence marketplaces by social entrepreneurs. The findings also strengthen Dees's (2001) definition of social entrepreneurship, confirming its applicability and relevance in subsistence marketplaces and further extending the theory of social bricolage. The authors discuss the implications of these findings, including tactical interventions aimed at providing better understanding of how social entrepreneurs create value in resource-constrained marketplaces, from a bottom-up perspective.

Communication keys: understanding the importance of the early childhood teacher's role in children's language and literacy development within a holistic, integrative approach to child development

Early childhood is a critical period in children’s lives during which experiences and the quality of the interactions lay the foundation for their subsequent learning and behavior, impacting upon the their lives. In response to Early Years research that identifies the positive impact of quality early years education upon children’s future learning, governments worldwide are implementing changes in policy, processes, professional learning and practice and are pouring funds into early childhood education. A range of approaches and multiple strategies are being adopted in an effort to improve children’s health, education and overall well-being, including the holistic and integrative approach such as that undertaken in Indonesia. This paper argues that high quality Early Childhood teachers play an important role within these approaches and this is discussed in light of the research - policy - praxis nexus, with language and literacy development as a focus area.

Community factors influencing child and adolescent depression: A systematic review and meta-analysis

OBJECTIVE: Depression has been identified as a priority disorder among children and adolescents. While numerous reviews have examined the individual and family factors that contribute to child and adolescent depressive symptoms, less is known about community-level risk and protective factors. The aim of this study was to complete a systematic review to identify community risk and protective factors for depression in school-aged children (4-18 years). METHOD: The review adopted the procedures recommended by the Cochrane Non-Randomised Studies Methods Working Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify both observational and intervention study designs in both peer-reviewed and non-peer reviewed publications. RESULTS: A total of 21 studies met the inclusion criteria. Seventeen of the 18 community association studies and 2 of the 3 intervention studies reported one or more significant effects. Results indicated that community safety and community minority ethnicity and discrimination act as risk factors for depressive symptoms in school-aged children. Community disadvantage failed to achieve significance in meta-analytic results but findings suggest that the role of disadvantage may be influenced by other factors. Community connectedness was also not directly associated with depressive symptoms. CONCLUSION: There is evidence that a number of potentially modifiable community-level risk and protective factors influence child and adolescent depressive symptoms suggesting the importance of continuing research and intervention efforts at the community-level.

‘It should be a big responsibility’: Separated low-income mothers’ evaluation of child support arrangements and the conduct of fathers

The Australian Child Support Scheme was established as a means of ensuring adequate financial support for children of separated parents. However, within the financial transfer of child support exist notions of ‘trust’ and ‘fairness’ based on parents navigating their changed relationship post-separation. Previous research has explored the assessment and outcomes of child support for both payee and payer parents, however little attention has been given to how women evaluate the assessment and outcomes of child support. As such, this research aimed to explore payee mothers’ evaluation of their child support experiences based on the value of their child support assessment and the extent to which these payments were received. Following the methods of constructivist grounded theory, in-depth interviews were conducted with 20 low-income single mothers. Analysis revealed that payee mothers evaluated child support based on the moral assumptions and the rationalities they perceived were underlying payer fathers’ child support compliance. While payee mothers desired arrangements that reflected joint parental financial responsibility, in reality many experienced problematic child support payments, which may ultimately undermine payee parents’ confidence in the Child Support Scheme.

Child obesity prevention in primary health care: the role of practice nurses

Aim

Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting.

Methods

PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10).

Results

Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training.

Conclusions

Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity.

Research to practice: application of an evidence building framework to a childhood obesity prevention initiative in New South Wales, Australia

Issue addressed: Building evidence-based health promotion programs involves a number of steps. This paper aims to develop a set of criteria for assessing the evidence available according to a five-stage evidence-building framework, and apply these criteria to current child obesity prevention programs in NSW to determine the usefulness of the framework in identifying gaps in evidence and opportunities for future research and evaluation. Methods: A set of scoring criteria were developed for application within the five stages of an 'evidence-building' framework: problem definition, solution generation, intervention testing (efficacy), intervention replication, and dissemination research. The research evidence surrounding the 10 childhood obesity prevention programs planned for state-wide implementation in the New South Wales Healthy Children Initiative (HCI) was identified and examined using these criteria within the framework. Results: The evidence for the component programs of the HCI is at different stages of development. While problem definition and, to a lesser extent, solution generation was thoroughly addressed across all programs, there were a number of evidence gaps, indicating research opportunities for efficacy testing and intervention replication across a variety of settings and populations. Conclusions: The five-stage evidence-building framework helped identify important research and evaluation opportunities that could improve health promotion practice in NSW. More work is needed to determine the validity and reliability of the criteria for rating the extent and quality of the evidence for each stage.