Breathe easier online : evaluation of a randomized controlled pilot trial of an internet-based intervention to improve well-being in children and adolescents with a chronic respiratory condition

Background Chronic respiratory illnesses are the most common group of childhood chronic health conditions and are overrepresented in socially isolated groups. Objective To conduct a randomized controlled pilot trial to evaluate the efficacy of Breathe Easier Online (BEO), an Internet-based problem-solving program with minimal facilitator involvement to improve psychosocial well-being in children and adolescents with a chronic respiratory condition. Methods We randomly assigned 42 socially isolated children and adolescents (18 males), aged between 10 and 17 years to either a BEO (final n = 19) or a wait-list control (final n = 20) condition. In total, 3 participants (2 from BEO and 1 from control) did not complete the intervention. Psychosocial well-being was operationalized through self-reported scores on depression symptoms and social problem solving. Secondary outcome measures included self-reported attitudes toward their illness and spirometry results. Paper-and-pencil questionnaires were completed at the hospital when participants attended a briefing session at baseline (time 1) and in their homes after the intervention for the BEO group or a matched 9-week time period for the wait-list group (time 2). Results The two groups were comparable at baseline across all demographic measures (all F < 1). For the primary outcome measures, there were no significant group differences on depression (P = .17) or social problem solving (P = .61). However, following the online intervention, those in the BEO group reported significantly lower depression (P = .04), less impulsive/careless problem solving (P = .01), and an improvement in positive attitude toward their illness (P = .04) compared with baseline. The wait-list group did not show these differences. Children in the BEO group and their parents rated the online modules very favorably. Conclusions Although there were no significant group differences on primary outcome measures, our pilot data provide tentative support for the feasibility (acceptability and user satisfaction) and initial efficacy of an Internet-based intervention for improving well-being in children and adolescents with a chronic respiratory condition. Trial registration Australian New Zealand Clinical Trials Registry number: ACTRN12610000214033;

Mandatory Reporting Laws and Identification of Child Abuse and Neglect: Consideration of Differential Maltreatment Types, and a Cross-Jurisdictional Analysis of Child Sexual Abuse Reports

Mandatory reporting laws have been created in many jurisdictions as a way of identifying cases of severe child maltreatment on the basis that cases will otherwise remain hidden. These laws usually apply to all four maltreatment types. Other jurisdictions have narrower approaches supplemented by differential response systems, and others still have chosen not to enact mandatory reporting laws for any type of maltreatment. In scholarly research and normative debates about mandatory reporting laws and their effects, the four major forms of child maltreatment—physical abuse, sexual abuse, emotional abuse, and neglect—are often grouped together as if they are homogenous in nature, cause, and consequence. Yet, the heterogeneity of maltreatment types, and different reporting practices regarding them, must be acknowledged and explored when considering what legal and policy frameworks are best suited to identify and respond to cases. A related question which is often conjectured upon but seldom empirically explored, is whether reporting laws make a difference in case identification. This article first considers different types of child abuse and neglect, before exploring the nature and operation of mandatory reporting laws in different contexts. It then posits a differentiation thesis, arguing that different patterns of reporting between both reporter groups and maltreatment types must be acknowledged and analysed, and should inform discussions and assessments of optimal approaches in law, policy and practice. Finally, to contribute to the evidence base required to inform discussion, this article conducts an empirical cross-jurisdictional comparison of the reporting and identification of child sexual abuse in jurisdictions with and withoutmandatory reporting, and concludes that mandatory reporting laws appear to be associated with better case identification.

Assessment of damages in wrongful birth cases

More than ten years has passed since the High Court of Australia confirmed the recoverability of damages for the cost of raising a child in the well know decision of Cattanach v Melchior . A recent decision of the Supreme Court of New South Wales was widely anticipated as potentially providing a comprehensive discussion of the principles relevant to the assessment of damages in wrongful birth cases.

Co-occurring anger in young people with Asperger's syndrome

Objectives: The co-occurrence of anger in young people with Asperger's syndrome (AS) has received little attention despite aggression, agitation, and tantrums frequently being identified as issues of concern in this population. The present study investigated the occurrence of anger in young people with AS and explores its relationship with anxiety and depression. Method: Sixty-two young people (12-23 years old) diagnosed with AS were assessed using the Beck Anger Inventory for Youth, Spence Children's Anxiety Scale, and Reynolds Adolescent Depression Scale. Results: Among young people with AS who participated in this study, 41% of participants reported clinically significant levels of anger (17%), anxiety (25.8%) and/or depression (11.5%). Anger, anxiety, and depression were positively correlated with each other. Depression, however, was the only significant predictor of anger. Conclusion: Anger is commonly experienced by young people with AS and is correlated with anxiety and depression. These findings suggest that the emotional and behavioral presentation of anger could serve as a cue for further assessment, and facilitate earlier identification and intervention for anger, as well as other mental health problems.

The influence of families on early adolescent school connectedness : evidence that this association varies with adolescent involvement in peer drinking networks

School connectedness is central to the long term well-being of adolescents, and high quality parent-child relationships facilitate school connectedness. This study examined the extent to which family relationship quality is associated with the school connectedness of pre- and early teenagers, and how this association varies with adolescent involvement in peer drinking networks. The sample consisted of 7,372 10-14 year olds recruited from 231 schools in 30 Australian communities. Participants completed the Communities that Care youth survey. A multi-level model of school connectedness was used, with a random term for school-level variation. Key independent variables included family relationship quality, peer drinking networks, and school grade. Control variables included child gender, sensation seeking, depression, child alcohol use, parent education, and language spoken at home. For grade 6 students, the association of family relationship quality and school connectedness was lower when peer drinking networks were present, and this effect was nonsignificant for older (grade 8) students. Post hoc analyses indicated that the effect for family relationship quality on school connectedness was nonsignificant when adolescents in grade 6 reported that the majority of friends consumed alcohol. The results point to the importance of familyschool partnerships in early intervention and prevention.

The Journey of Becoming Involved in Urban Spaces by Children with Diverse Mobility

Participation is a word frequently espoused in the literature of childhood and urban studies. It has also been made sacrosanct through the Convention on the Rights of the Child and other rights-based policy and programming. Despite this importance, what it means and how it is experienced in the everyday lives of children with diverse abilities is not well understood. This chapter provides insight into the everyday experiences of participation by ten children 9-12 years of age, who have diverse personal mobility from various physical conditions that affect muscle and movement differently, including: Muscular Dystrophy, Cerebral Palsy, and Autoimmune Rheumatic Diseases. The children participants live in the outer suburbs and inner regions of south-east Queensland, Australia. The chapter discusses a new way of understanding and theorising participation as a journey of becoming involved. This knowledge emerged through the children’s body-space-time routines (body ballets) and their descriptions of inhabiting urban space. This chapter also establishes how body-space-context interplays shape the experiences of becoming and being involved in everyday life, as well as the preconceptions of body embed in space which divide and constrain children and families actualisation of full and genuine participation.

From fare evasion to illegal downloads : the cost of defiance

Australian households currently pay the second highest “honesty tax” in the world at $290 per household per year, levied by retailers to offset the $AU1.86 billion in losses they incur from customer theft. Theft is only one type of consumer deviance, which can include behaviours that are against the law, an organisation’s policy, or behaviours that violate normally accepted conduct. An individual’s “deviant behaviour” can vary from one person to the next. My research exploring consumer definitions of right and wrong has found a number of things can inform what an individual thinks is “deviant behaviour”, beyond what the law or organisational policy states as right or wrong. Consumers then use their own justifications to excuse their actions...

Portrayals of child abuse scandals in the media in Australia and England : impacts on practice, policy, and systems

This article describes how the media have played a key role in placing the issue of child maltreatment and the problems associated with child protection high on public and political agendas over the last 50 years. It also describes how the influence of the media is far from unambiguous. Although the media has been crucial in bringing the problems into the open, it often does so in particular ways. In being so concerned with scandals and tragedies in a variety of institutionalized and community settings, the media have portrayed the nature of child maltreatment in ways which deflect attention from many of its core characteristics and causes. A focus on the media is important because of the power the media have to help transform the private into the public, but at the same time, to undermine trust, reputation, and legitimacy of the professionals working in the field. This concern is key for those working in the child protection field and has been a source of tension in public policy in both Australia and England for many years...

Management of atopic dermatitis in children : evaluation of parents' self-efficacy, outcome expectations, and self-reported task performance using the Child Eczema Management Questionnaire

Child behaviour management is crucial to successful treatment of atopic dermatitis. This study tested relationships between parents’ self-efficacy, outcome expectations, and self-reported task performance when caring for a child with atopic dermatitis. Using a cross-sectional study design, a community-based convenience sample of 120 parents participated in pilot-testing of the Child Eczema Management Questionnaire - a self-administered questionnaire which appraises parents’ self-efficacy, outcome expectations, and self-reported task performance when managing atopic dermatitis. Overall, parents’ self-reported confidence and success with performing routine management tasks was greater than that for managing their child’s symptoms and behaviour. Therewas a positive relationship between time since diagnosis and self-reported performance of routine management tasks; however, success with managing the child’s symptoms and behaviour did not improve with illness duration. Longer time since diagnosis was also associated with more positive outcome expectations of performing tasks that involved others in the child’s care (i.e. healthcare professionals, or the child themselves). This study provides the foundation for further research examining relationships between child, parent, and family psychosocial variables, parent management of atopic dermatitis, and child health outcomes. Improved understanding of these relationships will assist healthcare providers to better support parents and families caring for children with atopic dermatitis. KEYWORDS