The Politics of Adoption: International Perspectives on Law, Policy and Practice, Third edition

Adoption is a complex social phenomenon, intimately knitted into its family law framework and shaped by the pressures affecting the family in its local social context. It is a mirror reflecting the changes in our family life and the efforts of family law to address those changes. This has caused it to be variously defined in different societies in the same society, at different times and across a range of contemporary societies.

Roles, responsibilities and scope of practice: describing the ‘state of play’ for infection control professionals in Australia and New Zealand

Background In the past decade the policy and practice context for infection control in Australia and New Zealand has changed, with infection control professionals (ICPs) now involved in the implementation of a large number of national strategies. Little is known about the current ICP workforce and what they do in their day-to-day positions. The aim of this study was to describe the ICP workforce in Australia and New Zealand with a focus on roles, responsibilities, and scope of practice. Methods A cross-sectional design using snowball recruitment was employed. ICPs completed an anonymous web-based survey with questions on demographics; qualifications held; level of experience; workplace characteristics; and roles and responsibilities. Chi-squared tests were used to determine if any factors were associated with how often activities were undertaken. Results A total of 300 ICPs from all Australian states and territories and New Zealand participated. Most ICPs were female (94%); 53% were aged over 50, and 93% were employed in registered nursing roles. Scope of practice was diverse: all ICPs indicated they undertook a large number and variety of activities as part of their roles. Some activities were undertaken on a less frequent basis by sole practitioners and ICPs in small teams. Conclusion This survey provides useful information on the current education, experience levels and scope of practice of ICPs in Australia and New Zealand. Work is now required to establish the best mechanisms to support and potentially streamline scope of practice, so that infection-control practice is optimised.

“We don’t tell people what to do”: Ethical practice and Indigenous health promotion

Health promotion aspires to work in empowering, participatory ways, with the goal of supporting people to increase control over their health. However, buried in this goal is an ethical tension: while increasing people’s autonomy, health promotion also imposes a particular, health promotion-sanctioned version of what is good. This tension positions practitioners precariously, where the ethos of empowerment risks increasing health promotion’s paternalistic control over people, rather than people’s control over their own health. Here in we argue that this ethical tension is amplified in Indigenous Australia, where colonial processes of control over Indigenous lands, lives and cultures are indistinguishable from contemporary health promotion ‘interventions’. Moreover, the potential stigmatisation produced in any paternalistic acts ‘done for their own good’ cannot be assumed to have evaporated within the self-proclaimed ‘empowering’ narratives of health promotion. This issue’s guest editor’s call for health promotion to engage ‘with politics and with philosophical ideas about the state and the citizen’ is particularly relevant in an Indigenous Australian context. Indigenous Australians continue to experience health promotion as a moral project of control through intervention, which contradicts health promotion’s central goal of empowerment. Therefore, Indigenous health promotion is an invaluable site for discussion and analysis of health promotion’s broader ethical tensions. Given the persistent and alarming Indigenous health inequalities, this paper calls for systematic ethical reflection in order to redress health promotion’s general failure to reduce health inequalities experienced by Indigenous Australians.

Path+Ways. Towards best practice bridging and Indigenous participation through regional dual-sector universities

Regional and remote Indigenous students are underrepresented in both higher education and vocational education and training. Enabling education courses are important in lifting participation rates and potentially in encouraging mobility between the sectors, yet there is a clear lack of evidence underpinning their development. This report provides an overview of the data collection and analysis activities undertaken via a research project funded by the National Centre for Student Equity in Higher Education. The project purpose was to explore current practices dealing with Indigenous enabling courses, particularly in the context of regional, dual-sector universities. In particular, the project examined how these programs vary by institution (and region) in terms of structure, mode and ethos of offering; and direct and indirect impacts of these initiatives on Indigenous student participation and attainment; with a view to designing a best practice framework and implementation statement. Through its focus on students accessing Indigenous and mainstream enabling education, the project focussed on range of equity groups including those of low socio-economic status (both school leaver and mature-age categories), regional and/or remote students, Indigenous students and students with disability.

Book Review: "Safe Design and Construction of Machinery – Regulation, Practice and Performance [First edition]"

With Safe Design and Construction of Machinery, the author presents the results of empirical studies into this significant aspect of safety science in a very readable, well-structured format. The book contains 436 references, 17 tables, one figure and a comprehensive index. Liz Bluff addresses a complex and important, but often neglected domain in OHS – the safety of machinery – in a holistic and profound, yet evidence based analysis; with many applied cases from her studies, which make the book accessible and a pleasant lecture. Although research that led to this remarkable publication might have been primarily focused on the regulators, this book can be highly recommended to all OHS academics and practitioners. It provides an important contribution to the body of knowledge in OHS, and establishes one of the few Australian in-depth insights into the significance of machinery producers, rather than machinery users in the wider framework of risk management. The author bases this fresh perspective on the well-established European Machinery Safety guidelines, and grounds her mixed-methods research predominantly in qualitative analysis of motivation and knowledge, which eventually leads to specific safety outcomes. It should be noted that both European and Australian legal aspects are investigated and considered, as both equally apply to many machinery exporters. A detailed description of the research design and methods can be found in an appendix. Overall, the unique combination of quantitative safety performance data and qualitative analysis of safety behaviours form a valuable addition to the understanding of machinery safety. The author must be congratulated on making these complex relationships transparent to the reader through her meticulous inquiry.

Barriers to and facilitators of cervical screening practice among African immigrant women from refugee and non-refugee backgrounds living in Brisbane

This thesis investigated and compared barriers and facilitators of cervical screening among African-born refugee and non-refugee women living in Brisbane. Refugee women were more likely to have limited or no knowledge about cervical cancer and the screening test and also less likely to use Pap smear services than non-refugee women. The analysis identified belief systems, lack of knowledge about cervical cancer and screening practices, and lack of culturally appropriate screening programs as major barriers. In the context of health promotion interventions, these findings will contribute to addressing major differential screening needs among African immigrant refugee and non-refugee women.

Spirituality in Indian University students and its associations with socioeconomic status, religious background, social support, and mental health

The present study aimed to understand spirituality and its relationships with socioeconomic status (SES), religious background, social support, and mental health among Indian university students. It was hypothesized that: - (1) female university students will be more spiritual than male university students, - (2) four domains of spirituality will differ significantly across socioeconomic and religious background of the university students in addition to social support, and; - (3) there will be a positive relationship between spirituality and mental health of university students, irrespective of gender. A group of 475 postgraduate students aged 20–27 years, 241 males and 234 females, from various disciplines of Pondicherry University, India, participated in the study. Students’ background was collected using a structured questionnaire. Overall spirituality and its four dimensions were measured using the Spirituality Attitude Inventory, while mental health status was estimated based on scores of the psychological subscale of the WHO Quality of Life Questionnaire. Female students were significantly more spiritual than male students, particularly in spiritual practice and sense of purpose/connection. Hindu religion and lower family income were associated with lower spirituality. Higher spirituality was associated with congenial family environment and more support from teachers and classmates. There was a strong association between overall spirituality and two spirituality domains (spiritual belief and sense of purpose/connection) with better mental health. Findings suggest an opportunity for open dialogue on spirituality for university students as part of their mental health and support services that fosters a positive mind set and enhancement of resilience.

Social determinants of health and diabetic foot disease

Background Diabetic foot disease (DFD) is the leading cause of hospitalisation and lower extremity amputation (LEA) in people with diabetes. Many studies have established the relationship between DFD and clinical risk factors, such as peripheral neuropathy and peripheral arterial disease. Other studies have identified the relationship between diabetes and non-clinical risk factors termed social determinants of health (SDoH), such as socioeconomic status. However, it appears very few studies have investigated the relationship between DFD and SDoH. This paper aims to review the existing literature investigating the relationship between DFD and the SDoH factors socioeconomic status (SES), race and geographical remoteness (remoteness). Process Electronic databases (MEDLINE, CINAHL, and PubMed) were searched for studies reporting SES, race (including Aboriginal and Torres Strait Islander in Australia) and remoteness and their relationship to DFD and LEA. Exclusion criteria were studies conducted in developing countries and studies published prior to 2000. Findings Forty-eight studies met the inclusion criteria and were reviewed; 10 in Australia. Overall, 28 (58%) studies investigated LEA, 10 (21%) DFD, and 10 (21%) DFD and LEA as the DFD-related outcome. Thirty-six (75%) studies investigated the SDoH risk factor of race, 22 (46%) SES, and 20 (42%) remoteness. SES, race and remoteness were found to be individually associated with LEA and DFD in the majority of studies. Only four studies investigated interactions between SES, race and remoteness and DFD with contrasting findings. All four studies used only LEA as their investigated outcome. No Australian studies investigate the interaction of all three SDoH risk factors on DFD outcomes. Conclusions The SDoH risk factors of SES, race and GR appear to be individually associated with DFD. However, only few studies investigated the interaction of these three major SDoH risk factors and DFD outcomes with contrasting results. There is a clear gap in this area of DFD research and particularly in Australia. Until urgent future research is performed, current practice and policy does not adequately take into consideration the implication of SDoH on DFD.

Evidence-based practice

This chapter traces the history of evidence-based practice (EBP) from its roots in evidence-based medicine to contemporary thinking about its usefulness to public health practice. It defines EBP and differentiates it from ‘evidence-based medicine’, ‘evidence-based policy’ and ‘evidence-based healthcare’. As it is important to understand the subjective nature of knowledge and the research process, this chapter describes the nature and production of knowledge. This chapter considers the necessary skills for EBP, and the processes of attaining the necessary evidence. We examine the barriers and facilitators to identifying and implementing ‘best practice’, and when EBP is appropriate to use. There is a discussion about the limitations of EBP and the use of other information sources to guide practice, and concluding information about the application of evidence to guide policy and practice.

Futility and the law: Knowledge, practice and attitudes of doctors in end of life care

Despite the potential harm to patients (and others) and the financial cost of providing futile treatment at the end of life, this practice occurs. This article reports on empirical research undertaken in Queensland that explores doctors’ perceptions about the law that governs futile treatment at the end of life, and the role it plays in medical practice. The findings reveal that doctors have poor knowledge of their legal obligations and powers when making decisions about withholding or withdrawing futile treatment at the end of life; their attitudes towards the law were largely negative; and the law affected their clinical practice and had or would cause them to provide futile treatment.

Preparing health science students for interdisciplinary professional practice

In 2002, a number of lecturers from different clinical schools within the Faculty of Health Sciences at La Trobe University embarked on the development of a new interdisciplinary professional practice subject to be undertaken by all final-year undergraduate health science students. The subject was designed to better prepare students for their first professional appointment by introducing them to the concepts of interdisciplinary teamwork, the health care context, and the challenges and constraints that organizational contexts present. This report details the background of the project, the consultation and development that took place in the design of the subject, and implementation of the subject. The uniqueness of the project is explained by the number of disciplines involved, the online delivery, and the focus on a set of generic graduate attributes for health science students. It is hoped that students who have undertaken this subject will have a better understanding of the roles of other health professionals and the context in which they will be working by grappling with many real-life professional issues that they will face when they graduate and enter the workforce.

Serviço social e saúde da família: perspectivas de inserção e prática profissional

O presente trabalho tem como objetivo reconhecer as experiências de inserção do assistente social na Saúde da Família e as tendências da prática profissional nessa área. Diante das repercussões da contrarreforma na política e nas práticas de saúde, questionamos como o Serviço Social tem pautado suas experiências de inserção frente às contradições da Saúde da Família. Para isso, a pesquisa é baseada no referencial crítico dialético, em que utilizamos a metodologia da pesquisa documental com levantamento quanti-qualitativo. A análise foi realizada a partir das comunicações com referência à Saúde da Família do Congresso Brasileiro de Assistentes Sociais (CBAS) e Congresso Nacional de Serviço Social em Saúde (CONASSS) entre os anos de 2000 a 2009. Nos trabalhos foram identificados três eixos temáticos: Análise da Estratégia, Relato de experiência e Reflexão das possibilidades de inserção. A partir desses eixos buscamos reconhecer a dimensão teórico-metodológica, ético-política e técnico-operativa. Os resultados apontam que os assistentes sociais têm ocupado predominantemente funções de suporte em equipes de referência e que esta tem se apresentado como a possibilidade de inserção oficial através do NASF. Nas abordagens reconhecemos que as experiências pautadas na perspectiva crítica contam com histórico de articulação com os movimentos sociais, com referência à Reforma Sanitária e as discussões da categoria, e na prática, esses conceitos direcionam o processo de trabalho. Verificamos que há uma tendência majoritária de incorporação do discurso do Ministério da Saúde quanto à estrutura e processo de trabalho em Saúde da Família, o que tem contribuído para a incorporação de instrumentais construídos pela Estratégia na prática profissional. Essa tendência aponta que a inserção dos assistentes sociais na Saúde da Família tem recebido influências de vertentes neoconservadoras e sofrido os impactos da contrarreforma na política de saúde.

Serviço social e assistência social: conservadorismo ou direção histórico crítica?

O presente estudo tem como objeto de análise a direção social da ação dos assistentes sociais inseridos no projeto Agência de Famílias, que é desenvolvido pelo Banco da Providência. Por meio de nosso estudo pretendemos verificar se as ações realizadas pelos assistentes sociais em tal projeto contribuem para a reprodução da dominação capitalista meramente, uma vez que auxiliam no processo de reprodução da força de trabalho, evidenciando a promoção/legitimação da conformidade, ou se buscam a garantia dos direitos dos usuários, captando a contradição e promovendo formas e estratégias profissionais que viabilizem a resistência a tal dominação. Além disso, pretendemos perceber se pela forma inconsistente da captação das contradições inerentes à realidade social e institucional, os profissionais têm ações caracterizadas pela ambiguidade. Para tanto, foi necessário perceber a direção social da ação desse profissional, ou seja, o significado dessa ação, sua direção ético-política; se ocorre e em que medida é possível ocorrer a materialização dos atuais princípios ético-políticos do Serviço Social brasileiro no cotidiano do trabalho profissional. Isto por que, considerando o conservadorismo que nos parece caracterizar a instituição, entendemos que pode haver distinção entre os objetivos institucionais e profissionais e, que também há uma significativa tensão entre o atual Projeto Ético-Político do Serviço Social brasileiro e o fazer profissional, devido às novas configurações da sociedade capitalista, mediadas pela ideologia neoliberal, que se reportam cada vez mais ao (neo)conservadorismo profissional. A pesquisa foi realizada por meio de entrevistas com os profissionais e, como dito, objetivou enfatizar a compreensão da direção social, do significado e das implicações do fazer profissional dos assistentes sociais inseridos no projeto Agência de Famílias. Os dados analisados também são fruto das observações de campo realizadas no espaço ocupacional dos assistentes sociais entrevistados e, também, dos documentos, fichas e relatórios institucionais. A análise é baseada nos objetivos propostos pelo estudo, tomando como referencial o materialismo histórico e dialético, elaborado por Marx.

Serviço social: cotidiano profissional nas unidades de pronto atendimento geridas por organizações sociais no município do Rio de Janeiro

O presente trabalho objetiva analisar o exercício profissional dos assistentes sociais inseridos nas unidades de pronto atendimento (UPA) municipais da cidade do Rio de Janeiro geridas por Organizações Sociais (OS), no sentido de identificar os reais limites e possibilidades colocados para a efetivação do projeto ético-político do Serviço Social brasileiro como horizonte da prática nesses espaços. Na busca por restaurar suas taxas de lucro, o capital avança sobre o fundo público e tem as políticas sociais como seu lócus privilegiado. A satanização de tudo que é público e a suposta busca por qualidade e eficiência justifica a gestão privada dos serviços públicos. Assim, impõe-se a lógica do lucro, da produtividade, do foco no quantitativo ao setor público. No município do Rio de Janeiro, a expansão da rede de saúde vem se dando por meio da gestão dessas instituições qualificadas como Organizações Sociais (OS). É o caso das UPA que, focadas nos atendimentos de urgência e emergência dentro de uma rede de saúde precarizada que não prioriza ações de prevenção e promoção, são pouco resolutivas e quando geridas por OS estão focadas em números de altas e de transferências. Nesse contexto, o assistente social, um dos profissionais que responde por essa produtividade, uma vez que com prioridade operacionaliza burocraticamente o processo de transferência e alta, fragilizado teoricamente e pelo vínculo precário, não tem sido capaz de criar estratégias e alternativas para uma prática embasada pelo projeto ético-político, ou seja, que caminhe na direção das necessidades e interesses da classe trabalhadora.

O processo de trabalho do (a) assistente social na universidade pública: análise da política de assistência estudantil da Universidade do Estado do Rio de Janeiro

Esta dissertação busca analisar as particularidades do trabalho do(a) assistente social na universidade pública brasileira. A universidade vem sofrendo os rebatimentos das mudanças impostas pelos processos de reestruturação capitalista e de internacionalização da economia em ampla expansão desde o final do século XX e a Política de Educação Superior vêm apresentando submissão às regras e ditames do mercado. Nesse sentido, o presente trabalho procurou identificar as transformações da universidade pública brasileira na contemporaneidade; a análise da dinâmica da política de educação na área da educação superior; as particularidades do trabalho profissional no âmbito da política de assistência estudantil, já que essa é uma das principais requisições apresentadas aos assistentes sociais inseridos nesta área de atuação. Para tanto, tomou-se por referência de estudo a experiência da Universidade do Estado do Rio de Janeiro que já possui uma marca histórica de desenvolvimento de ações na área de assistência ao estudante. Por essa razão, este trabalho buscou examinar, através de uma pesquisa documental e entrevistas semi-estruturadas realizadas com as profissionais da UERJ que atuam com ações de assistência estudantil, as novas configurações e particularidades para o processo de trabalho do(a) assistente social neste contexto. Os dois grandes eixos de análise que evolveram essa pesquisa foram: as condições e particularidades do trabalho do(a) assistente social no âmbito da política de educação superior na UERJ; Programa ou Política de Assistência Estudantil na UERJ? Os principais resultados dessa pesquisa apontaram que existem diferentes processos de trabalho nos quais se inscreve a atividade do (a) assistente social e esses processos são organizados a partir da função política, ideológica e econômica do Estado no formato da prestação de serviços sociais. Diante do contexto de redução dos direitos sociais conforme preconizado pela agenda neoliberal, a Política de Assistência Estudantil afirma-se no espaço universitário público, fazendo interface tanto com a Política de Educação quanto com a Política de Assistência Social, e, portanto, compartilha das mesmas características das referidas políticas, a saber: ações pontuais, seletivas e focalizadas. Apesar da existência de uma Política Nacional de Assistência Estudantil PNAES, a prática da Assistência Estudantil no âmbito estadual encontra limites para a sua operacionalização e apresenta necessidade de articulação com outras Políticas, que devem ser apreendidas a partir de uma noção ampliada de Assistência Estudantil. Desta forma, verificamos que o processo de trabalho do(a) assistente social na universidade pública não prescinde das determinações que incidem sobre o mundo do trabalho e das condições objetivas que particulariza a educação superior.