Looking again at troubled families: parents' perspectives on multiple adversities

The 'Troubled Families' policy and intervention agenda is based on a deficit approach that tends to ignore the role of structural disadvantage in the lives of the families it targets. In an effort to support this rhetoric, both quantitative and qualitative data have been used, and misused, to create a representation of these families, which emphasizes risk and individual blame and minimizes societal factors. This current paper presents findings from an in-depth qualitative study using a biographical narrative approach to explore parents' experiences of multiple adversities at different times over the life-course. Key themes relating to the pattern and nature of adversities experienced by participants provide a more nuanced understanding of the lives of families experiencing multiple and complex problems, highlighting how multiple interpretations are often possible within the context of professional intervention. The findings support the increasing call to move away from procedurally driven, risk averse child protection practice towards more relationally based practice, which addresses not only the needs of all family members but recognizes parents as individuals in their own right.

Charles C. Chapman's birthday celebration, Fullerton, California,1932

Family portrait taken at Charles C. Chapman's birthday celebration, Fullerton, California,July 2, 1932. The group poses outside his residence on the lawn. Top row [left to right]: Arthur Irvin, Charles Wickett, Irvin Chapman, Sam Collins, Paul Williams, Grant Chapman,, Sidney Chapman, Clay McCarn, Earl Chapman's son David McDougal, Earl Chapman's son William McDougal, Earl Chapman, Harry Chapman, William Wickett Sr. Second row [left to right]: Mr. VanMeter, Mrs. Sinclair, C. C. Sinclair, John Franklin, Way Bagley, Marjorie Collins, Emma Williams, Ruth Chapman, Vesta Chapman, Inez Bagley, Grace Chapman, Bertha Chapman, Clough Chapman, Frank and Bertha Chapman's daughter Agnes McDougal [Streech], Georgiana Chapman, Thela Clough, Mrs. Earl [Ann] Chapman, Bessie Reynolds, Fred Chapman, E. B. [Bert] Reynolds. Seated [left to right]: Mrs. VanMeter, Hattie Clark, Louie Messlar, Charlie Thamer, Louella Thamer, Dolla Harris, Stanley Chapman Sr. holding Mary Anne, Ethel Wickett, Charles C. Chapman, Clara Chapman, Colum C. Chapman, Aunt Annie Colum, Deryth Chapman, Anna Marie Chapman, Floy Chapman, Edith Chapman. Front row [left to right]: Sam E. Collins, Bill Wickett Jr., Joyce Chapman, Marilyn Chapman, Elizabeth Chapman, Mary McCarn, Nina Chapman Lescher, Jodeane Collins, Bob Gibb, Jean Chapman. In front is a floral arrangement with drawing of a Western Union telegram "To Chas. C. Chapman, July 2, 1932, N. Fullerton, Cal., 'Wishing you a happy birthday, Nina."

Le rôle de consultation selon l'expérience d'un groupe d'infirmières cliniciennes spécialisées

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Desarrollo de habilidades sociales necesarias para la gestión pacifica de conflictos en el área escolar

La propuesta que se presenta tiene como fin desarrollar habilidades sociales en niños del Colegio Cofraternidad de San Fernando, de la Localidad de Ciudad Bolívar, que les permita solucionar problemas interpersonales por medio de estrategias no agresivas, para mejorar su convivencia tanto en la Institución Educativa, como en otros contextos

COSMOS: COmparing standard maternity care with one-to-one midwifery support: a randomised controlled trial

Background: In Australia and internationally, there is concern about the growing proportion of women giving birth by caesarean section. There is evidence of increased risk of placenta accreta and percreta in subsequent pregnancies as well as decreased fertility; and significant resource implications. Randomised controlled trials (RCTs) of continuity of midwifery care have reported reduced caesareans and other interventions in labour, as well as increased maternal satisfaction, with no statistically significant differences in perinatal morbidity or mortality. RCTs conducted in the UK and in Australia have largely measured the effect of teams of care providers (commonly 6–12 midwives) with very few testing caseload (one-to-one) midwifery care. This study aims to determine whether caseload (one-to-one) midwifery care for women at low risk of medical complications decreases the proportion of women delivering by caesarean section compared with women receiving 'standard' care. This paper presents the trial protocol in detail.

Methods/design: A two-arm RCT design will be used. Women who are identified at low medical risk will be recruited from the antenatal booking clinics of a tertiary women's hospital in Melbourne, Australia. Baseline data will be collected, then women randomised to caseload midwifery or standard low risk care. Women allocated to the caseload intervention will receive antenatal, intrapartum and postpartum care from a designated primary midwife with one or two antenatal visits conducted by a 'back-up' midwife. The midwives will collaborate with obstetricians and other health professionals as necessary. If the woman has an extended labour, or if the primary midwife is unavailable, care will be provided by the back-up midwife. For women allocated to standard care, options include midwifery-led care with varying levels of continuity, junior obstetric care and community based general medical practitioner care. Data will be collected at recruitment (self administered survey) and at 2 and 6 months postpartum by postal survey. Medical/obstetric outcomes will be abstracted from the medical record. The sample size of 2008 was calculated to identify a decrease in caesarean birth from 19 to 14% and detect a range of other significant clinical differences. Comprehensive process and economic evaluations will be conducted.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN012607000073404.

CD1d-restricted NKT cells contribute to malarial splenomegaly and enhance parasite-specific antibody responses

CD1d-restricted NKT cells are a novel T cell lineage with unusual features. They co-express some NK cell receptors and recognize glycolipid antigens through an invariant T cell receptor (TCR) in the context of CD1d molecules. Upon activation through the TCR, NKT cells produce large amounts of IFN- and IL-4. It has been proposed that rapid cytokine output by activated NKT cells may induce bystander activation of other lymphoid lineages. The impact of CD1d-restricted NKT cell activation in the induction of B cell-mediated immune responses to infection is still unclear. We show here that CD1-restricted NKT cells contribute to malarial splenomegaly associated with expansion of the splenic B cell pool and enhance parasite-specific antibody formation in response to Plasmodium berghei infection. The increased B cell-mediated response correlates with the ability of NKT cells to promote Th2 immune responses. Additionally, antibody responses against the glycosylphosphatidylinositol (GPI)-anchored protein merozoite surface protein 1 (MSP-1) were found to be significantly lower in CD1-/- mice compared to wild-type animals. P. berghei-infected MHC class II (MHCII)-/- mice also generated antibodies against MSP-1, suggesting that antibody production against GPI-anchored antigens in response to malaria infection can arisefrom both MHCII-dependent and independent pathways.

Genetics and public health - evolution, or revolution?

During the 19th and early 20th century, public health and genetics shared common ground through similar approaches to health promotion in the population. By the mid-20th century there was a division between public health and genetics, with eugenicists estranged and clinical genetics focused on single gene disorders, usually only relevant to small numbers of people. Now through a common interest in the aetiology of complex diseases such as heart disease and cancer, there is a need for people working in public health and genetics to collaborate. This is not a comfortable convergence for many, particularly those in public health. Nine main concerns are reviewed: fear of eugenics; genetic reductionism; predictive power of genes; non-modifiable risk factors; rights of individuals compared with populations; resource allocation; commercial imperative; discrimination; and understanding and education. This paper aims to contribute to the thinking and discussion about an evolutionary, multidisciplinary approach to understanding, preventing, and treating complex diseases.

Cost-effectiveness of reducing salt intake in the Pacific Islands: protocol for a before and after intervention study

Background
There is broad consensus that diets high in salt are bad for health and that reducing salt intake is a cost-effective strategy for preventing chronic diseases. The World Health Organization has been supporting the development of salt reduction strategies in the Pacific Islands where salt intakes are thought to be high. However, there are no accurate measures of salt intake in these countries. The aims of this project are to establish baseline levels of salt intake in two Pacific Island countries, implement multi-pronged, cross-sectoral salt reduction programs in both, and determine the effects and cost-effectiveness of the intervention strategies.

Methods/Design
Intervention effectiveness will be assessed from cross-sectional surveys before and after population-based salt reduction interventions in Fiji and Samoa. Baseline surveys began in July 2012 and follow-up surveys will be completed by July 2015 after a 2-year intervention period.

A three-stage stratified cluster random sampling strategy will be used for the population surveys, building on existing government surveys in each country. Data on salt intake, salt levels in foods and sources of dietary salt measured at baseline will be combined with an in-depth qualitative analysis of stakeholder views to develop and implement targeted interventions to reduce salt intake.

Discussion
Salt reduction is a global priority and all Member States of the World Health Organization have agreed on a target to reduce salt intake by 30% by 2025, as part of the global action plan to reduce the burden of non-communicable diseases. The study described by this protocol will be the first to provide a robust assessment of salt intake and the impact of salt reduction interventions in the Pacific Islands. As such, it will inform the development of strategies for other Pacific Island countries and comparable low and middle-income settings around the world.

Bollywood’s Australian yarn

 It’s 101 years since the birth of Bollywood, the world’s largest and most vibrant movie industry and, of course, that’s more than enough time to mature and alter, to grow arms and legs. For some time, but since the 1990s particularly, the connections between Australia and Bollywood have really taken hold. So sit back and enjoy a cinematic journey that’s sure to entertain. As a genre Bollywood has grown and developed over a period of 100 years, coloured by India’s history, politics, socio-economic conditions, culture, sensibilities, dreams, fantasies, hopes and expectations. The ever-increasing presence of the Indian diaspora in different parts of the world has helped to realise what we might think of as Bollywood’s cultural diplomacy project. Various Australian state tourism bodies have since supported Indian productions and used Bollywood stars as ambassadors to promote Australia as a welcoming nation. The 1996 film Indian has been credited for featuring the first appearance of kangaroos in Indian cinema. But I have noticed that as early as 1974, a Hindi film Majboor made first reference to Australia and its iconic boxing kangaroo. It featured Bollywood superstar Amitabh Bachchan with a poster captioned: ‘Just hop, skip and jump every Thursday to Perth Sydney’. Australia is now a hot destination for Bollywood as well as regional language film-makers, with a successful foray of films from Soldier (1998) to Bhaag Milkha Bhaag (2013). Over the past two decades, Australian films such as Holy Smoke! (1999), The Waiting City (2009), Save Your Legs! (2012), feature India, not just as a background location but as an integral part of the plot. Bollywood’s influence on Australia can be gauged by the direction of Australian film careers. Be it the Indian-Australian actress Pallavi Sharda (Besharam) or Australia’s bowling sensation Brett Lee (Asha and Friends), Mary Ann Evans – AKA Fearless Nadia, Louise Lightfoot, Tom Cowan, Bob Christo, Tania Zaetta (Salaam Namaste), Nicholas Brown (Kites), Tabrett Bethell (Dhoom 3), Rebecca Breeds (Bhaag Milkha Bhaag), Kristina Akheeva (Yamla Pagla Deewana 2), Emma Brown Garett (Yamala Pagla Deewana), Vimala Raman (Mumbai Mirror), Anusha Dandekar (Delhi Belly), and Maheep Sandhu (Shivam). In this paper I would focus on the journeys and stories of actors, chiefly Fearless Nadia, Bob Christo, and Pallavi Sharda; and also compare a few Bollywood films, particularly Kya Kehna (2000) and Salaam Namaste (2005) made on same theme but set in India and Australia respectively, to show how Australia as has been presented as sexually liberating, visually romantic, and fantastical land of beaches and beauties.

Salt intake assessed by 24 h urinary sodium excretion in a random and opportunistic sample in Australia

The gold standard method for measuring population sodium intake is based on a 24 h urine collection carried out in a random population sample. However, because participant burden is high, response rates are typically low with less than one in four agreeing to provide specimens. At this low level of response it is possible that simply asking for volunteers would produce the same results.

The association of knowledge, attitudes and behaviours related to salt with 24-hour urinary sodium excretion

Salt reduction efforts usually have a strong focus on consumer education. Understanding the association between salt consumption levels and knowledge, attitudes and behaviours towards salt should provide insight into the likely effectiveness of education-based programs.

Protocol for the implementation and evaluation of a community-based intervention seeking to reduce dietary salt intake in Lithgow, Australia

Excess dietary salt is a leading risk for health. Multiple health, government, industry and community organisations have identified the need to reduce consumption of dietary salt. This project seeks to implement and evaluate a community-based salt reduction intervention.