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.

International students in transnational mobility: intercultural connectedness with domestic and international peers, institutions and the wider community

International students’ connectedness with their peers, institutions and the broader community significantly affects their learning and wellbeing. It is important to understand their multiple desires for intercultural connectedness in order to nurture it. This paper analyses the motives and nature of international students’ intercultural connectedness. It is based on a study that includes more than 150 interviews and fieldwork with international students and staff from 25 vocational education colleges in Australia. Drawing on Blumer’s symbolic interactionism theory as a conceptual framework, the study found international students’ motivation to engage in intercultural connectedness is linked to not only their desire for respect and recognition for intellectual, cultural and linguistic capacities and diversities but also for employment aspirations. The research shows various dimensions in which intercultural engagement is seen to encompass not only empathy, sociability and equity but also employability. The findings suggest meaningful interaction is essentially bound to reciprocal learning.

Disciplinary proceedings against doctors who abuse controlled substances

Study examined 27 reports from disciplinary tribunals against medical practitioners who abused narcotic analgesics (often combined with other drugs of addiction) between 2010 and 2015. The study covered all States and Territories except Tasmania (no reports were accessible for this jurisdiction. The reports revealed that 12 medical practitioners were in their 40s; five in their 30s; and one person still in the 20s. Although majority were General Practitioners (15 out of 27), other medical specialties were also represented. Self-administered Pethidine was the most prevalent opioid (11 out of 27), and was the only drug used alone. Morphine was self-administered by six doctors; the same number used high doses of Panadeine Forte, Codeine and Codeine Phosphate, and Fentanyl was abused by five doctors. Surprisingly, fewer medical practitioners appear to use such opiates such as Propofol, Tramadol and Tramol, Oxycodone and Endone. The examination of cases suggests lack of consistency in the imposition of professional sanctions and penalties by the relevant tribunals. The study concludes that disciplinary tribunals should apply the test of proportionality in the form of ‘reasonable necessity’ when deciding whether to remove or suspend the addicted medical practitioner from the Register.

Child sexual abuse research: challenges of case tracking through administrative databases

Child sexual abuse has a serious impact on victims, their families and the broader community. As such, there is a critical need for sound research evidence to inform specialist responses. Increasingly, researchers are utilising administrative databases to track outcomes of individual cases across health, justice and other government agencies. There are unique advantages to this approach, including the ability to access a rich source of information at a population-wide level. However, the potential limitations of utilising administrative databases have not been fully explored. Because these databases were created originally for administrative rather than research purposes, there are significant problems with using this data at face value for research projects. We draw on our collective research experience in child sexual abuse to highlight common problems that have emerged when applying administrative databases to research questions. Some of the problems discussed include identification of relevant cases, ensuring reliability and dealing with missing data. Our article concludes with recommendations for researchers and policy-makers to enhance data quality.

Measuring community and service provider attitudes to child sexual abuse in remote indigenous communities in Western Australia

This study aimed to evaluate a scale to measure attitudes to child sexual abuse (CSA) in remote Australian Indigenous communities. The scale was developed to gauge attitudes that may be inhibiting the reporting of cases of CSA to police, as well as to evaluate whether interventions that focused on collaborative relationships between community members and police resulted in changes in attitudes. Participants included service providers living outside the community (58%), community members (living within the community; 9%), and service providers who were also community members (33%); 18% of participants identified as Indigenous. Principal components analysis revealed a nonintuitive six-factor solution that did not support the original four concepts. Four intuitive factors emerged from an abridged version of the scale: entrenched issues, personal understanding and knowledge, communication between community and government, and community action. The scale detected significant differences between community status and between Indigenous status groups on some factors.

Prosecutors’ perceptions of how to improve the quality of evidence in domestic violence cases

Limited evidence in domestic violence prosecutions is a persistent problem. Focus groups with 13 prosecutors from across Australia and New Zealand were used to explore how to improve the quality of evidence collected and presented in these cases. A thematic analysis identified three main strategies: improving the quality of investigations by initial police responders, supporting the complainant and tailoring the trial process to the domestic violence context. The most discussed strategy within these categories has previously received little attention– police video recording the complainant's initial account and using that video as the basis for the complainant's courtroom testimony.

The effect of victim age on police authorisation of charges in cases of child sexual abuse

In the study, a cohort of 440 child sexual abuse cases were used to model the effect of victim age on police authorisation of charges. Linear and quadratic effects of age were modelled in a logistic regression that controlled for case characteristics and evidence. The quadratic effect of victim age was strengthened when control variables were included in the model and the linear effect of age was not significant in the final model. The results indicated that cases involving victims in middle childhood had a higher proportion of suspects charged than cases involving victims in early childhood and adolescence. Possible mediators of the relationship between victim age and charges were explored and it was found that cases with older victims had a higher prevalence of extra-familial abuse and suspect confessions, and these factors had a positive effect on the proportion of suspects charged. Possible explanations for the quadratic effect of victim age and mediation are discussed.

Indonesian approach to ASEAN Plus Three financial cooperation: power relations, domestic politics, and regulatory regionalism

 This study examines Indonesia’s responses to financial regionalism within ASEAN Plus Three cooperation. It derives largely from the discussions, debates and empirical findings on how the Indonesian financial agencies exercise their authority and mandates, formulate policy coordination with international counterparts, and internalize and execute policy options into domestic financial regimes.

The use and abuse of 'community' and 'neighbourhood' within disability research: an exposé, clarification, and recommendation

Almost invariably in the disability literature, the terms 'neighbourhood' and 'community' are used as though they have some commonly understood meaning. They do not, and authors rarely offer a definition. This problem adds opacity to the literature describing people's living environment and the nature of their interaction with others living in the same area. This ambiguity becomes crucial to understanding when these terms are linked to other vague, but emotionally-charged words, such as 'inclusion' or 'integration'. This review presents some of the ways 'neighbourhood' and 'community' may be correctly employed. It also explores the theoretical basis for understanding how and why their use may be misleading. Finally, it is demonstrated that the assumed relevance of neighbourhood participation for life quality has been greatly exaggerated. We recommend that authors carefully define their use of these terms in order to facilitate understanding free from emotional bias.

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.

Applying a we al-li educaring framework to address histories of violence with Aboriginal women

An Aboriginal woman living in a remote area is 45 times more likely to experience domestic violence than their white peers. (Gordon et al, 2002) The nature of that violence is multi-layered, complex and incorporates a history of intergenerational loss, grief, trauma and the impact of colonisation, as discussed by Atkinson, C (2008). It involves women, children, families, communities. It is a story about people, many of whom find themselves in trouble with the legal system. Of the 25 male parents who killed their children in a domestic violence context five identified as Aboriginal (20%) (NSW Domestic Violence Death Review Team Annual Report, 2015, p.17). The percentage of women in Victorian prisons who have been victims of sexual, physical or emotional abuse has been reported to be 87% (Johnson, 2004). This figure is supported by the latest Ombudsman’s report on Victorian Prisons (2015).None of the 17 females who killed their children identified as Aboriginal or Torres Strait Islander (NSW Domestic Violence Death Review Team Annual Report 2015, p.18). The most common charge/offence for both Aboriginal men and women is an act intended to cause injury (see Figure 2).The stories of women in this program and anecdotal evidence from people working in the field reveals that most of this violence is lateral, ie within families and communities which is not an uncommon occurrence where there is a history of colonisation.

Evaluation of a collaborative operation to improve child sexual abuse reporting in Western Australian indigenous communities

This study presents an evaluation of Operation RESET, a community engagement intervention designed to help remote Indigenous communities and human service agencies to uncover, respond to, and prevent child sexual abuse. The primary aim of this evaluation was to determine whether the intervention was associated with increased reporting. Data were obtained for six Western Australian regions between 2007 and 2012. Number of reports and arrests significantly increased in the intervention areas during the intervention compared with the pre-intervention time period but not in the control areas. Arrest rates significantly increased during the intervention and increased further following the intervention. There were no changes in arrest rates in regions that did not participate in the operation. This evidence suggests that the reforms led to a marked improvement in some key outcomes for Indigenous victims of child sexual abuse and supports the adoption of this collaborative approach by other jurisdictions.

Children impacted by parental substance abuse: an evaluation of the supporting kids and their environment program

The deleterious impact of parental substance abuse on child development and family functioning is well established. However, evaluations of interventions designed to ameliorate such impacts are very limited. This paper presents the results of a service evaluation using a pre-post design of the Supporting Kids And Their Environment (SKATE) program; a child-focused group program run by Glastonbury Community Services from 2006 to 2010 in the Geelong region of Victoria, Australia. The intervention was an 8-week psycho-educative model that used family-based techniques. Outcomes are reported for child behavior problems, assessed on the Child Behavior Checklist, and family functioning, assessed on the Family Support Scale. A total of 89 children and families within 13 intervention groups were recruited via adult Drug and Alcohol Services (Mean age = 10.4 years; SD = 2.4). Results suggest reductions in emotional and behavioral problems in children as well as improving family functioning with small to moderate effect sizes after children’s participation in the SKATE program compared to pre-test. These preliminary findings suggest that children whose parents are substance abusing are a high-risk group but they may benefit from targeted intervention programs that are well integrated with the adult drug treatment system. Such interventions warrant further development and evaluation.