The bereavement response : a cluster analysis

BACKGROUND: Literature and clinical experience suggest that some people experience atypical, complicated or pathological bereavement reactions in response to a major loss. METHOD: Three groups of community-based bereaved subjects--spouses (n = 44), adult children (n = 40), and parents (n = 36)--were followed up four times in the 13 months after a loss. A 17-item scale of core bereavement times was developed and used to investigate the intensity of the bereavement response over time. RESULTS: Cluster analysis revealed a pattern of bereavement-related symptoms approximating a syndrome of chronic grief in 11 (9.2%) of the 120 subjects. None of the respondents displayed a pattern consistent with delayed or absent grief. CONCLUSIONS: In a non-clinical community sample of bereaved people, delayed or absent grief is infrequently seen, unlike chronic grief, which is demonstrated in a minority.

Audit of the Care of the Dying in a Network of Hospitals and Institutions in Queensland

Background: Most Australians die in institutions and there is evidence to suggest that the care of these patients is not always optimal. Care pathways for the dying have been designed to transfer benchmarked hospice care to other settings (e.g. acute hospitals and residential age-care facilities) by defining goals of best care, providing guidelines to provide that care and documenting outcome. Method: A retrospective audit was undertaken across a network of health-care institutions in Queensland. The 18 goals considered essential for the care of the dying within the Liverpool Care Pathway were taken as a benchmark. Documentation of achievement of each of these goals was sought. Results: The notes of 160 patients who had died in eight institutions (four hospitals, three hospices, one nursing home) were reviewed. Several areas for improvement were identified, particularly in those goals relating to communication, resuscitation orders and care after death. Few units documented the provision of written information to families. Most patients were prescribed medications in anticipation of pain and agitation but less were prescribed drugs for other common symptoms in the dying. Most of the goals were achieved in a higher percentage of cases in hospice units. Marked differences in practice were noted between different institutions. Conclusion: The audit identified several aspects in the care of the terminally ill that could be improved. End-stage pathways may provide a model for improving the care of patients dying in hospitals and institutions in Australia.

'Homes for Life' : a critical ecological study of an independent living project

In this paper, an ‘ecological’ lens is applied to an independent living project aiming to provide ‘homes for life’ for adult children with disabilities. The qualities of the project as ecological praxis are highlighted along with the implications for an open-ended enquiry into ecologies for and of the interior. In terms of the ecological concern for intimate modes of being, interior design is shown to be well placed through its association with environments in which people spend most of their life and through powerful concepts such as ‘interiority’ and ‘home’ which link to fundamental existential notions of ‘self ’ and ‘identity’. However, despite the interior being a significant generative force, this has not happened to the exclusion of other disciplines. Ignoring territorial urges to claim areas and concepts as one’s own, the paper describes how the project has actively encouraged design disciplines to trespass in each other’s territories. Ecologies for and of the interior, while recognising the need for discipline emphasis, also demand an integrated and collective approach through what is in effect transdisciplinary practice.

Giving: The next generation – parental effects on donations

This paper provides a summary of what is known from social science research about the effects parents have on the donations of their children. It then goes on to summarize two on-going research projects. The first project provides estimates of the strength of the relationship between the charitable giving of parents and that of their adult children. The second provides estimates of the effect of inheritances on charitable donations. Both projects use data from the Center on Philanthropy Panel Study (COPPS); accordingly, the paper provides an introduction to these data. Finally, the paper draws implications for fundraisers from the two on-going projects, and suggests several other areas in which COPPS can generate knowledge to improve the practice of fundraising.

Towards a structured understanding of caregivers’ safety behaviour in the domestic and driveway setting

Slow speed run-overs represent a major cause of injury and death among Australian children, with higher rates of incidents being reported in Queensland than in the remaining Australian states. Yet, little attention has been given to how caregivers develop their safety behaviour in and around the driveway setting. To address this gap, the current study aimed to develop a conceptual model of driveway child safety behaviours among caregivers of children aged five years or younger. Semi-structured interviews were conducted with 26 caregivers (25 females/1 male, mean age, 33.24 year) from rural and metropolitan Queensland. To enable a comparison and validation of findings from the driveway, the study analysed both driveway and domestic safety behaviours. Domestic safety behaviours were categorised and validated against driveway safety behaviours, uncovering a process of risk appraisal and safety behaviour that was applicable in both settings (the Safety System Model). However, noteworthy differences between the domestic and driveway setting were uncovered. Unlike in the domestic setting, driveway risks were perceived as shifting according the presence of moving vehicles, which resulted in inconsistent safety behaviours. While the findings require further validation, they have implications for the design and implementation of driveway run-over interventions.

Using digital technologies at home

Internet-connected tablets and smart phones are being used increasingly by young children. Little is known, however, about their social interactions with family members when engaged with these technologies. This article examines video recorded interactions between a father and his two young children, one aged 18 months using an iPhone, and one aged three years accessing an iPad. Drawing on Ethnomethodology and Conversation Analysis, this analysis establishes ways the family members engage and disengage in talk to manage their individual activity with mobile devices and accomplish interaction with each other. Findings are relevant for understanding children’s everyday practices with mobile technologies.

Normal human mammary epithelial cells spontaneously escape senescence and acquire genomic changes

Senescence and genomic integrity are thought to be important barriers in the development of malignant lesions. Human fibroblasts undergo a limited number of cell divisions before entering an irreversible arrest, called senescence. Here we show that human mammary epithelial cells (HMECs) do not conform to this paradigm of senescence. In contrast to fibroblasts, HMECs exhibit an initial growth phase that is followed by a transient growth plateau (termed selection or M0; refs 3-5), from which proliferative cells emerge to undergo further population doublings (approximately 20-70), before entering a second growth plateau (previously termed senescence or M1; refs 4-6). We find that the first growth plateau exhibits characteristics of senescence but is not an insurmountable barrier to further growth. HMECs emerge from senescence, exhibit eroding telomeric sequences and ultimately enter telomere-based crisis to generate the types of chromosomal abnormalities seen in the earliest lesions of breast cancer. Growth past senescent barriers may be a pivotal event in the earliest steps of carcinogenesis, providing many genetic changes that predicate oncogenic evolution. The differences between epithelial cells and fibroblasts provide new insights into the mechanistic basis of neoplastic transformation.

Name-calling by a child diagnosed with asperger’s syndrome

Rendle-Short, Wilkinson, and Danby show how social interaction is directly relevant to maintaining friendships, mental health and well-being, and supportive peer relations. Using conversation analysis, the chapter focuses on conversational participants’ pursuit of affiliation and intimacy from a language as action perspective. It focuses on the use of derogatory naming practices by a 10-year-old girl diagnosed with Asperger’s Syndrome. The analysis shows how derogatory address terms, part of a wider pattern of behaviour evident in this child’s interaction, result in behaviour that might be thought of as impolite or lacking in restraint. It also illustrates how a single case study can draw attention to the context-specific nature of interaction when working with children with Asperger’s Syndrome. The chapter contributes to our understanding of the difficulty in pinpointing, with precision and with clear evidence, what counts as a ‘social interaction difficulty’ due to the context specific nature of interaction.

Compensation or consideration for a statutory right of user?

Section 180 of the Property Law Act 1974 (Qld) makes provision for an applicant to seek a statutory right of user over a neighbour’s property where such right of use is reasonably necessary in the interests of effective use in any reasonable manner of the dominant land. A key issue in an application under s 180 is compensation. Unfortunately, while s 180 expressly contemplates that an order for compensation will include provision for payment of compensation to the owner of servient land there are certain issues that are less clear. One of these is the basis for determination of the amount of compensation. In this regard, s 180(4)(a) provides that, in making an order for a statutory right of user, the court: (a) shall, except in special circumstances, include provision for payment by the applicant to such person or persons as may be specified in the order of such amount by way of compensation or consideration as in the circumstances appears to the court to be just The operation of this statutory provision was considered by de Jersey CJ (as he then was) in Peulen v Agius [2015] QSC 137.

A qualitative exploration of parental experiences of stigma while living with HIV in Bangladesh

With much of the focus on the “risk” groups, families have often been less studied in HIV research. Further, because of a focus on the aetiology and epidemiology of HIV, the social impacts associated with HIV on families and neighbours are sometimes overlooked. This study examined parental experiences of stigma and discrimination while living with HIV within a family context in Bangladesh. A qualitative research design using a grounded theory approach was used for this research. Data was collected through in-depth interviews with 19 HIV-positive parents, recruited with the support of two self-help groups of HIV-positive people, in two settings namely Khulna and Dhaka in Bangladesh. The findings indicate that HIV-positive parents held the view that they continue to experience significant stigma and their narratives clearly show how this affected them and their children. A range of informal practices were enacted in everyday contexts by extended family and community members to identify, demarcate and limit the social interaction of HIV-positive parents. Parents highlighted a number of factors including negative thoughts and behaviours, rejection, isolation and derogatory remarks as manifestations of stigma and discrimination, impacting upon them and their children because of their association with HIV.

Youth master plans as potential roadmaps to creating child- and youth-friendly cities

Communities across the globe are focusing on the needs of young people and their families in an effort to create child- and youth-friendly cities. In an attempt to become more child and youth friendly, over 40 communities in the United States have developed youth master plans (YMPs), as of 2009; however, our understanding of these plans is limited. To broaden this understanding, this research employed a multiple-methods approach, including an online questionnaire, plan analysis and semi-structured interviews with key community informants. Findings show that YMPs often focus on collaboration among community entities and youth participation, yet include only general normative statements regarding the physical environment. Furthermore, urban planners do not typically take the lead in development of YMPs, and, in some cases, are not involved at all. To inform and improve future YMPs, this paper recommends greater focus on the physical environment, particularly in relation to safety, access to nature and sustainable transportation.

Cancer incidence, mortality, and pregnancy outcome among women treated for cervical intraepithelial neoplasia

Cervical cancer develops through precursor lesions, i.e. cervical intraepithelialneoplasms (CIN). These can be detected and treated before progression to invasive cancer. The major risk factor for developing cervical cancer or CIN is persistent or recurrent infection with high-risk human papilloma virus (hrHPV). Other associated risk factors include low socioeconomic status, smoking, sexually transmitted infections, and high number of sexual partners, and these risk factors can predispose to some other cancers, excess mortality, and reproductive health complications as well. The aim was to study long-term cancer incidence, mortality, and reproductive health outcomes among women treated for CIN. Based on the results, we could evaluate the efficacy and safety of CIN treatment practices and estimate the role of the risk factors of CIN patients for cancer incidence, mortality, and reproductive health. We collected a cohort of 7 599 women treated for CIN at Helsinki University Central Hospital from 1974 to 2001. Information about their cancer incidence, cause of death, birth of children and other reproductive endpoints, and socio-economic status were gathered through registerlinkages to the Finnish Cancer Registry, Finnish Population Registry, and Statistics Finland. Depending on the endpoints in question, the women treated were compared to the general population, to themselves, or to an age- and municipality-matched reference cohort. Cervical cancer incidence was increased after treatment of CIN for at least 20 years, regardless of the grade of histology at treatment. Compared to all of the colposcopically guided methods, cold knife conization (CKC) was the least effective method of treatment in terms of later CIN 3 or cervical cancer incidence. In addition to cervical cancer, incidence of other HPV-related anogenital cancers was increased among those treated, as was the incidence of lung cancer and other smoking-related cancers. Mortality from cervical cancer among the women treated was not statistically significantly elevated, and after adjustment for socio-economic status, the hazard ratio (HR) was 1.0. In fact, the excess mortality among those treated was mainly due to increased mortality from other cancers, especially from lung cancer. In terms of post-treatment fertility, the CIN treatments seem to be safe: The women had more deliveries, and their incidence of pregnancy was similar before and after treatment. Incidence of extra-uterine pregnancies and induced abortions was elevated among the treated both before and after treatment. Thus this elevation did not occur because they were treated rather to a great extent was due to the other known risk factors these women had in excess, i.e. sexually transmitted infections. The purpose of any cancer preventive activity is to reduce cancer incidence and mortality. In Finland, cervical cancer is a rare disease and death from it even rarer, mostly due to the effective screening program. Despite this, the women treated are at increased risk for cancer; not just for cervical cancer. They must be followed up carefully and for a long period of time; general health education, especially cessation of smoking, is crucial in the management process, as well as interventions towards proper use of birth control such as condoms.

The Messaging Kettle: It’s IoTea time

We demonstrate a working prototype of a Messaging Kettle designed to facilitate asynchronous communication and enable a sense of presence between adult children and their older parents living abroad. Our goal is to offer a human centred critique of the Internet of Things, which has largely been conceived without consideration of the people who will use the things, and rather has traditionally moved from a technology oriented perspective. In the case of smart homes this approach has produced a wide array of projects focused on monitoring the habits of the elderly, recognizing anomalies and alerting the caregivers. In contrast we propose to focus on engagement and reciprocity, building on the rituals associated to habitually used and cherished objects. We conclude revisiting the technology oriented framework for the Internet of Things to include our observations on people’s perspective on smart communicating objects.

教养方式、亲子关系对青少年给予母亲情感支持的影响

Emotional support, as an important form of social supports, has great impact on the life of both caregivers and receivers. Many studies on adult children and old parents indicate that emotional support is closely related to parents’ well-being, and the relation quality between old parents and adult children is one of the factors influencing adult children’s support offering. However, the study on adolescents’ emotional support to their parents is quite rare. What’s more, it has been found that emotional support skills children have learnt at home have life-time influence on children’s response to other’s emotional needs. It is assumed that to some extent the emotional support styles between parents and adolescents are relatively stable, and they are related to the care children give to their parents after they advance to old age. Hence, it is necessary to study the emotional support of adolescent in order to at last improve the well-being of old parents. Totally speaking, the aim of this study is to explore the relation between parenting styles and adolescents’ emotional support offering, as well as the effects of mother-child relationships. In addition, culture is a factor having impact on parenting styles, parent-child relationships and emotional support. So we have designed this cross-cultural study to explore cultural differences. The results are as follows: (1) As to Chinese and Indonesian mothers, their Acceptance of adolescents’ behaviors has significant positive predictive effect on children’s emotional support. Besides, the Intimacy and Approval dimensions of mother-child relationships partially mediate the path from parenting styles to emotional support offering, and those effects have no significant difference in China and Indonesia. (2) Chinese and Indonesian mother’s Rejection to adolescents has significant positive predictive effect on Conflict between mothers and adolescents, but has no direct effect on adolescents’ emotional support offering. (3) Adolescents’ support offering has no significant predictive effect on their willingness to help their parents. (4) Adolescents’ support offering has significant predictive effect on their motivation to provide emotional support to their parents. However, the relation between adolescents’ support offering and the willingness to help their parents is not clear. (5) Adolescents have scored high in Acceptance parenting style dimension and relatively low in Rejection dimension, which indicate that mothers in China and Indonesia adopt positive parenting styles. Both Chinese and Indonesian mother-child relationships are good. However, Indonesian adolescents have perceived more Intimacy and Approval from mothers, and there is no significant difference between Chinese and Indonesian adolescents and mothers in the dimension of Conflict.

Reducing Child Protection Error in Social Work: Towards an Holistic-Rational Perspective

Social work in the United Kingdom remains embroiled in concerns about child protection error. The serious injury or death of vulnerable children continues to evince much consternation in the public and private spheres. Governmental responses to these concerns invariably draw on technocratic solutions involving more procedures, case management systems, information technology and bureaucratic regulation. Such solutions flow from an implicit use of instrumental rationality based on a ‘means-end’ logic. While bringing an important perspective to the problem of child protection error, instrumental rationality has been overused limiting discretion and other modes of rational inquiry. This paper argues that the social work profession should apply an enlarged form of rationality comprising not only the instrumental-rational mode but also the critical-rational, affective-rational and communicative-rational forms. It is suggested that this combined, conceptual arsenal of rational inquiry leads to a gestalt which has been termed the holistic-rational perspective. It is also argued that embracing a more rounded perspective such as this might offer greater opportunities for reducing child protection error.