Facilitating post traumatic growth

Background: Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house.
Methods: In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity.
Results: Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living.
Conclusion: There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and
spiritual growth.

Family law in Australia: re Patrick and the matter of Child A

In Re Patrick, Guest J of the Family Court of Australia dealt with the issue of whether a gay sperm donor, known to the lesbian mother of the child, had a right under Australian law to regular contact with the child. Justice Guest held that the sperm donor was allowed contact with the child to the extent that this was in the child's best interests. His Honour did, however, find that due to the way in which particular provisions of Australia's Family Law Act 1975 (Cth) are drafted, a sperm donor cannot be regarded as the 'parent' of the child, and accordingly called for legislative reform to recognise the rights of known sperm donors wanting involvement with the child. In this article, we discuss the matter of Re Patrick, comparing it with the strikingly similar matter of Pursuer Against Defender in the Case of Child A, decided recently by Sheriff Laura Duncan in the Glasgow Sheriff Court. We will then outline a proposal to amend the Family Law Act 1975 so that sperm donors can apply for an order to be a 'parent' for the purposes of the law, and therefore have the same rights and responsibilities as any other parent. In response to the tragic ending to the matter of Re Patrick, we conclude by stressing the need for an educational programme to be established, so that lesbian women who are considering parenthood may do so in the knowledge that the sperm donor does have the status of 'father', and in some jurisdictions 'parent', rather than merely being a 'donor'.

Nurses' perceived training needs in child protection issues

Purpose – The purpose of this research is to explore nurses' perceptions of their current skills and knowledge and training needs to identify cases of child abuse and their understanding of their roles and responsibilities in relation to child abuse. Nurses, including health visitors and midwives, have been recognised as having a key role in the protection and care of children, especially in identifying and referring possible cases of child abuse and neglect.

Design/methodology/approach – A structured questionnaire concerning knowledge and training needs in child protection was sent to all nurses employed in a Scottish NHS Primary Care Trust (approximately 1,900), of whom one-third (667) responded. These survey results were complemented by semi-structured interviews with 99 members of the nursing workforce.

Findings – Almost all training in child protection had been confined to health visitors, resulting in the Trust giving an implicit message that child protection is not a role in which other nurses need have any involvement. In general, those nurses who both worked with children and had involvement in child protection issues, considered themselves to be most in need of knowledge around child protection work, to have the greatest level of knowledge and to consider further training a priority.

Research limitations/implications – Nurses who had an interest or involvement in child protection work were more likely to participate in the research, which may have biased the results.

Practical implications – Training strategies need to address the diversity of nurses' involvements in child protection work through the development of training programmes which are appropriate for different workplaces and different occupational groupings. Nurses in some settings will need to be first convinced they have the potential to play an important role in protecting children from abuse and neglect.

Originality/value – Many NHS Trusts have in recent years introduced mandatory training in child protection for all staff in contact with children. However, previously published studies have considered training issues only in respect of nurses identified as working directly with children, whereas this study explores child protection issues for all nurses employed in a primary care NHS Trust.

Who`s complaining? Using MOSAIC to identify the profile of complainants

Purpose – The purpose of this article is to bring together established research in the field of consumer complaint responses: to contextualise this research into the area of complaints about advertising in Australia; and to empirically test the proposition that it is possible to construct a profile
of complainants about advertising in Australia.

Design/methodology/approach – Postcodes obtained from the Advertising Standards Board complaints database were entered into Pacific micro marketing MOSAIC software, which uses data at the postcode level to cluster individuals into homogeneous groups.

Findings – Characteristics shared among consumers who engage in “amplified voicing” include above average income levels, above average disposable income levels, higher than average education levels, professional and associate professional occupations, middle- to late-middle-aged household heads and above average representation of working women. Their interests tend towards culture, technology, entertaining, sport, food and fashion.

Research limitations/implications – Complainants seem to be unrepresentative of those most likely to be disadvantaged by “unacceptable” advertising. It is suggested that it now falls to advertising professionals and marketing academics to encourage greater involvement of all members of Australian society in the current complaints process and build wider understanding of practices that contravene the regulatory system.

Originality/value – This study investigates the effects of advertising on consumers and hence on society in general, and examines the changing nature and structure of the advertising self-regulatory system in Australia. Though based on fieldwork in Australia, it provides an international perspective, and is potentially transferable to other societies.

Child protection and public health: nurses' responsibilities

Background. Health care workers have been recognized as having a key role in the protection and care of Scotland's children, particularly in respect of identification and detection of child abuse. Nurses, especially health visitors, are often the first professionals to suspect that child abuse has taken place. While previous research has found that health visitors have primarily perceived their role as that of providing support and advice to vulnerable families, there are pressures on them to fulfil a more narrow surveillance role. Concurrent with a lack of clarity about the role of health visitors in child protection, there has been increasing recognition that other nurses can also make an important contribution, including those who do not work directly with children.

Aims. The aim of the study was to explore nurses' understanding of their professional responsibilities in relation to child protection, and the potential for nurses to be involved in the protection of children from abuse.

Methods. A qualitative interview-based design was used, and 99 nurses working in an National Health Service trust in a Scottish city were interviewed, either individually or in groups, about their professional involvements in child protection issues. Interview data were subjected to thematic analysis.

Findings. There was lack of consensus among interviewees about the nursing remit in child protection issues, particularly with respect to the extent to which nurses should actively seek to detect cases of child abuse. An emphasis on identification and detection was not easily accepted by many nurses, and was perceived by some to be a change from their more traditional role of supporting families, as well as being potentially in conflict with some public health responsibilities.

Conclusion. In spite of the perception of some nurses that there is a sharp divide between child protection work and public health interventions, many of the child protection roles identified by nurses, such as supporting families, parenting education and service development, are clearly within the ambit of contemporary notions of public health. Furthermore, it is clear that there is a role in child protection for a much wider group of nurses than health visitors.

Can written nursing practice standards improve documentation of initial assessment of ED patients?

Introduction: There is wide variation in emergency nursing practice in terms of initial patient assessment and the interventions implemented in response to these patient assessment findings. It is hypothesised that written ED nursing practice standards will reduce variability in documentation standards related to initial patient assessment.

Aim: This study aimed to examine the effect of written ED nursing practice standards augmented by an in-service education programme on the documentation of the initial nursing assessment.

Method: A pre-test/post-test design was used. Initial patient assessment was assessed using the Emergency Department Observation Chart. All adult patients (>18 years) who presented with chest pain and who were triaged to the general adult cubicles were eligible for inclusion in the study. Random sampling was used to select the patients for the pre-test (n = 78) and post-test groups (n = 74).

Results: There was significant improvement in documentation of all aspects of symptom assessment except quality and historical variables: pre-hospital care, cardiac risk factors, and past medical history. Improvements in documentation of elements of primary survey assessment were variable. There were significant increases in documentation of respiratory effort, chest auscultation findings, capillary refill and conscious state. There was a significant 18.3% decrease in the frequency of documentation of respiratory rate and no significant changes in documentation of oxygen saturation, heart rate or blood pressure.

Conclusion: Written ED nursing practice standards were effective in improving the documentation of some elements of initial nursing assessment for patients with chest pain. Active implementation strategies are important to ensure effective uptake of written practice standards and the relationship between nursing documentation and actual clinical practice warrants further consideration using a naturalistic approach in real practice settings.

The Australian advertising self-regulatory framework - Who`s complaining?

Complaints about advertising in Australia have been on the increase in recent years under the stewardship of the new industry self-regulatory body, the Advertising Standards Board. This study utilises clustering analyses based on geodemographic and psychographic data to present a concrete profile of complainants about advertising in Australia. The findings indicate that the advertising publics must shoulder responsibility and ensure that greater care is taken to include all members of Australian society in the current complaints
process and that this inclusivity will ensure that the highest possible standards are the norms of the industry.

Dietary composition of pregnant women is related to size of the baby at birth

The fetal origins theory of adult disease suggests that term infants who are small for their gestational age have an increased susceptibility to chronic disease in adulthood as a consequence of physiologic adaptations to undernutrition during fetal life. Consistent evidence for an influence of women's dietary composition during pregnancy on growth of their babies is lacking, despite robust effects in animal experiments. We undertook a prospective observational study of 557 women aged 18-41 y, living in Adelaide, South Australia. Diet was assessed in early and late pregnancy using an FFQ. In early pregnancy, medians for energy intake, the proportion of energy derived from protein and from carbohydrate were 9.0 MJ, 17 and 48%, respectively. In late pregnancy the corresponding medians were 9.2 MJ, 16 and 49%. In early pregnancy, the percentage of energy derived from protein was positively associated with birth weight (P = 0.02) and placental weight (P = 0.07), independently of energy intake and weight gain during pregnancy, and after adjustment for potential confounders, including maternal age, parity, and smoking. Effects were stronger among women (n = 429) who had reliable data, based on prespecified criteria including the plausibility of dietary data when referenced against estimated energy expenditure. In addition, for this subgroup, the percentage of energy from carbohydrate in early and late pregnancy was negatively associated with ponderal index of the baby, and a specific effect of protein from dairy sources was identified. These data support the proposition that maternal dietary composition has an effect on fetal growth. Maternal diet in Western societies may therefore be important for the long-term health of the child.

"Who says yes? Collective and individual framing of Pacific children`s consent to, and participation in, research in New Zealand"

The complex debate surrounding child consent has been addressed from a predominantly western perspective that often fails to address the important issue of collective rights. Indigenous groups argue that legal and ethical considerations of child consent and research participation are framed within concepts of individual rights and ownership. Such individualistic frameworks are problematic for Pacific communities where the rights of children in extended families are collectively framed, knowledge is collectively owned, and ‘life stage’1 is privileged over age. We discuss the need to frame Pacific children’s rights to consent to, and participate in, research within a collective Pacific worldview.

Child labour in developing countries: review of theoretical and empirical issues

Contents:Child labour and economic development : emerging issues in developing Asia /​ Gamini Herath and Kishor Sharma
Child labour in developing countries : review of theoretical and : empirical issues /​ Gamini Herath
Cumulative causation as explanation and policy base for child labour /​ G. Bamberry
Child labour : an integrated approach /​ Manohar Pawar
Trade, growth and child labour practices in South Asia /​ Kishor Sharma
An overview of child labour laws, prevention strategies and assessment of their effectiveness in Bangladesh /​ Jesmul Hasan
An overview of child labour in India /​ Subhashini Subbaraman and Harald von Witzke
Child labour in India : a critical evaluation of four issues /​ Anna Pinto
Prevention of child labour in Nepal : an overview of strategy and effectiveness
Chiranjibi nepal
Prevention of child labour in Pakistan : analysis of strategy and effectiveness /​ Shafqat Munir and Hassan Mangi
Issues relating to prevention of child labour in Sri Lanka /​ Nisha Arunatilake and Roshani de Silva.

Female-perpetrated child sex abuse: definitional and categorisational analysis

A recent series of court cases in Australia in which teachers have been convicted of sexual crimes against children and adolescents has brought to attention the fact that females are capable of, and do commit, such crimes. However, the nature of the crimes does not reflect the range of sexually abusive behaviours females may perpetrate, nor the kinds of women who may engage in such behaviour. We consider definitional problems in identifying female-perpetrated sexual abuse, and note that apart from one attempt to describe the range of sexual abuse perpetrated by mothers, there is little to guide researchers or clinicians in relation to female perpetrated offences more generally. We then consider approaches to categorising female sex offenders, and conclude that, although there a several such approaches that overlap in some ways, a multidimensional approach that combines aspects of each taxonomy may be more useful.

Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index

Background
While much cross-sectional data is available, there have been few longitudinal investigations of patterns of electronic media use in children. Further, the possibility of a bi-directional relationship between electronic media use and body mass index in children has not been considered. This study aimed to describe longitudinal patterns of television viewing and electronic game/computer use, and investigate relationships with body mass index (BMI).
Methods
This prospective cohort study was conducted in elementary schools in Victoria, Australia. 1278 children aged 5–10 years at baseline and 8–13 years at follow-up had their BMI calculated, from measured height and weight, and transformed to z-scores based on US 2000 growth data. Weight status (non-overweight, overweight and obese) was based on international BMI cut-off points. Weekly television viewing and electronic game/computer use were reported by parents, these were summed to generate total weekly screen time. Children were classified as meeting electronic media use guidelines if their total screen time was ≤14 hrs/wk.
Results
Electronic media use increased over the course of the study; 40% met guidelines at baseline but only 18% three years later. Television viewing and electronic game/computer use tracked moderately and total screen time was positively associated with adiposity cross-sectionally. While weaker relationships with adiposity were observed longitudinally, baseline z-BMI and weight status were positively associated with follow-up screen time and baseline screen time was positively associated with z-BMI and weight status at follow-up. Children who did not meet guidelines at baseline had significantly higher z-BMI and were more likely to be classified as overweight/obese at follow-up.

Conclusion
Electronic media use in Australian elementary school children is high, increases with age and tracks over time. There appears to be a bi-directional association suggesting that interventions targeting reductions in either screen time or adiposity may have a positive effect on both screen time and adiposity.

Export-led growth hypothesis: evidence from Papua New Guinea and Fiji

Purpose - This paper aims to examine the export-led growth hypothesis for Fiji and Papua New Guinea (PNG).

Design/methodology/approach – The paper investigates the export-led growth hypothesis for Fiji and PNG who have been facing dismal economic growth performances over the last couple of decades.

Findings – Findings of the study suggest that for Fiji there is evidence of export-led growth in the long-run, while for PNG there is evidence of export-led growth in the short-run.

Originality/value – The findings of this paper have important messages for policy makers given that export sectors in both countries investigated are underdeveloped due mainly to a sustained period of political instability.

Who is responsible for the protection of children? Implicit and explicit interpretations of marketing messages

In this paper, we examine ethical issues related to advertising to children in light of evidence that people can hold ‘implicit’ as well as ‘explicit’ consumer attitudes. From a review of the important features of implicit versus explicit attitudes, we hypothesise three important features of implicit consumer attitudes in children. First, we suggest they are likely to be acquired automatically from, in part, exposure to marketing messages. Second, we predict that these attitudes will be resistant to change through reflection or reason by the child or other person. Third, we hypothesise that children’s implicit consumer attitudes will be powerful predictors of their consumer choices in many situations. We discuss the implications for the ethics of marketing to children, and propose a research framework to begin investigating this important issue.

Emotional growth: helping children and families 'bounce back'

Background: Depression is becoming increasingly prevalent in young people and is occurring earlier. General practitioners are prescribing antidepressants more frequently for this group, yet they are usually not the answer to the problem. Objective: This article examines the increase in prevalence rates of childhood and adolescent depression. We draw on recent research into resilience and positive psychology to suggest guidelines for the GP in helping young people and their parents develop better coping skills in the short term, and greater resilience in the long term. Discussion: Resilience is the ability to bounce back after encountering difficulties, negative events, hard times or adversity and to be able to return to the original level of emotional wellbeing. It is the capacity to maintain a healthy and fulfilling life despite adversity. Young people who have the skills to be resilient have a lower likelihood of becoming depressed or suicidal and a higher likelihood of maintaining emotional wellbeing. Self efficacy, optimistic and helpful thinking, and maintaining a success orientation are all important skills in being resilient.