Miracle-dz/UniFAR-FTUs huggingface dataset:
National comparison of child protection systems

Contact the Australian Institute of Family Studies for a copy of this publication. The report can also be downloaded in PDF (284K). You will need an Acrobat Reader which is free from the Adobe Systems Web site . ISBN 0 642 39525 X. ISSN 1446-9995 (Print); ISSN 1447-0004 (Online) ABSTRACT This paper is a national snapshot of Australian statutory child protection services. Data were collected in each state and territory via policy documents, procedure manuals and telephone interviews with relevant child protection personnel.Topics covered are: who is responsible for child protection; intake procedures; who notifies concerns to child protection services; and the process of providing child protection services in Australian states and territories (intake, risk assessment, investigation and case management). Similarities and differences across states and territories in each of these areas are highlighted. Despite different legislative frameworks and some operational differences, Australian state and territory statutory child protection services are providing very similar models of intervention. Implications are explored with regard to: competency standards, training and professional development; and cross-jurisdictional issues.
Registered and enrolled nurses' experiences of ethical issues in nursing practice

Research aims: To explore and describe registered and enrolled nurses' experiences of ethics and human rights issues in nursing practice in the Australian State of Victoria. Method: Descriptive survey of 398 Victorian nurses using the Ethical Issues Scale (EIS) survey questionnaire. Major findings: The most frequent and most disturbing ethical issues reported by the nurses surveyed included: protecting patients' rights and human dignity, providing care with possible risk to their own health, informed consent, staffing patterns that limited patient access to nursing care, the use of physical/chemical restraints, prolonging the dying process with inappropriate measures, working with unethical/impaired colleagues, caring for patients/families who are misinformed, not considering a patient's quality of life, poor working conditions. Conclusions: Nurses in Victoria frequently experience disturbing ethical issues in nursing practice that warrant focused attention by health service managers, educators and policy makers. (author abstract)
Removing baby at birth breached human rights

The funny thing is, as a volunteer you end up doing things that you would not dream of doing as a paid job, no matter how high the salary. You grab some sandwiches and a bottle of water at the station and just make the train, sitting for hours in front of a book you ought to be reading but can't even see. Then you take a taxi to the hospital to sit with a mother who has just had a caesarean, looking wan and devastated. There is no cot. Social workers came in and took her baby within hours of the birth, despite the consultant's warning about her high blood pressure. When the father arrives, he is equally distraught. Working with mothers after a stillbirth is not easy — especially when they believe the death was avoidable. But it was easier than my vigil that day. The absence of the baby was palpable, and filled every corner of the room.
Staff Development

Chapter 5 explores building classroom management techniques through the use of restorative practices, including how students, teachers, and staff members share the responsibility of managing issues and behavioral concerns within a classroom. The topic of finding a balance between focusing on academic content and integrating restorative practices into a classroom are also discussed. Finding a balance can sometimes mean that teachers and students must learn to be flexible within the classroom as the day's activities may need to shift in order to address an issue within the school. As the school community members learn to share the responsibility of managing the classroom, a change in roles can occur in which the teacher acts as a counselor, a counselor acts as a teacher, and a student acts as a teacher.
New risk or old risk, high risk or no risk? How scientists' standpoints shape their nanotechnology risk frames

Abstract This exploratory case study compares risk frames of scientists who are developing new nanotechnologies (upstream scientists) with those of scientists who might later study the health effects of these technologies (downstream scientists). It is based on a series of in-depth interviews with scientists at a major research university in the United States. Interviews reveal some substantial differences in risk frames among upstream and downstream scientists – many of which center on whether or not nanotechnologies and nanomaterials are perceived as ‘new’. Most upstream scientists said they do not think nanotechnologies pose new or substantial risks, while most downstream scientists said they are worried that they may pose new, unforeseen, and possibly substantial risks. Upstream scientists are less likely than downstream scientists to think that concerns about potential nanotechnology risks are based on valid science and tend to consider a narrower range of uncertainties. Interviews suggest that these risk and uncertainty frames are influenced by contrasting disciplinary backgrounds, information exposures, and interdisciplinary interactions. Findings suggest that more comprehensive nanotechnology risk policies might be developed if a wider variety of different kinds of scientists – including downstream scientists – are involved in upstream nanotechnology development and policymaking.
Nosocomial infections: surgical site infection in UCH Ibadan, Nigeria

Surgical wound infection is a good index of Hospital Acquired Infection (HAI). The programme of Surveillance of HAI in University College Hospital (UCH), Ibadan, Nigeria, started in January 1976. The last audit of the programme reported the situation between January 1989 and December 1991, whence the prevalence of HAI was found to be 4.9%. The programme of Surveillance of HAI from year 1995 to 2004 was audited. All wound swabs/biopsies sent for microscopy, culture and sensitivity were analysed. Previous incidence of nosocomial Infection in the environment was obtained from literature. The prevalence of HAI was 3.0%, Surgical Site Infection was the second most prevalent HAI. Surgical Site Infection was responsible for 27.9% of the nosocomial infections recorded. The ratio of Gram Positive to Gram Negative organisms was 1:2.3. Bacterial agents of Surgical Site Infection were Staphylococcus aureus 29.0%, Klebsiella spp 25.3%, Pseudomonas spp 21.7%, Proteus spp 11.7% E. coli 11.3%, Streptococcus pyogenes 0.6% and Enterococcus faecalis 0.3%. A decrease from 4.9% to 3.0% in prevalence rate of HAI was observed, compared with the earlier review as a result of refresher courses in Controls of Hospital Infections. To reduce the menace of Surgical Site Infections, prophylactic antibiotic with short courses of quinolone is advocated as well as adequate wound surveillance and Hospital Workers’ medical care.
Therapies for Chronic Hepatitis B: Review of Indications, Outcomes and New Tools for Tailoring Treatments to Patients

Chronic Hepatitis B is a major cause worldwide of liver cirrhosis, hepatocellular carcinoma and liver related mortality. The ultimate goals of treatment are to reduce the risk of these complications and the endpoints used in clinical practice are viral suppression, ALT normalisation and histological regression of fibrosis as well as HBeAg seroconversion in patients who are HBeAg positive. The indications for treatment differ slightly in different regions however may still be conceptualised in terms of the phase of chronic hepatitis B Treatment options include a finite course of Peg IFN which has immunomodulatory as well as antiviral effects although its use may be limited by troublesome side effects and low efficacy in some patients. Recent advances in the use of quantitative HBsAg and HBeAg levels during Peg IFN treatment has provided some predictors of response and therefore the ability to individualise treatment courses to a degree, avoiding unnecessary prolongation of treatment where it is likely to be futile. The oral nucleoside/nucleotide analogues now available have high potency and very low rates of resistance however must be continued indefinitely in HBeAg negative patients and most HBeAg positive patients. Lifelong treatment raises issues of side effects such as renal and bone disease, compliance, and management during pregnancy. Research aimed at novel targets in the HBV life cycle or host immune response is ongoing. The ultimate goal of therapies for CHB remains HBsAg clearance which at present still occurs only in a minority of cases.
Reflections on responsibility

The great William Osier once remarked that what distinguished man from the apes was a propensity to take medicines. A more pervasive distinction is man's need for explanations. It is this need which accounts for the almost universal existence of religions which attempt to explain our birth, our death and the pain of the journey in between.This need for explanations underpins the fallacy of association. Because things are associated it is tempting to convert the association into a causal relationship. For nineteen years I made my livelihood in whole — time general practice. Patients consulted me, I prescribed, and for the most part they got better. Both they and I believed that the medicines were largely responsible for their recovery, whereas this was only true in a minority of instances. The failure to discriminate between association and cause is part of the reason that learning from experience is nothing more than learning to make the same mistakes with increasing confidence.It is a commonplace to desc.
Practice as Research in Drama and Theatre: Introducing Narrative Supervision Methodology

For four decades, the Norwegian University of Science and Technology, NTNU Trondheim, has pioneered the field of drama and theatre in higher education in Norway. This article addresses educational, academic and artistic challenges that emerge when practice as research in the arts enters the academic field of humanities. In particular, the article examines narrative supervision methodology at the master’s level. The first part of the paper identifies the foundations of the contextual and methodological challenges. The main body of the article explores three discussion topics, each illustrated by case examples of practical-theoretical master’s projects. The first example investigates experiential and theoretical borderland tensions; the second addresses onto-epistemic questions; and the third explores the communication of complex narrative construction. Storytelling metaphors are used to advance our emphasis on narrative inquiry as practitioner-researchers and supervisors. The dilemmas outlined are relevant to the Nordic and international community currently navigating this relatively new research area.
Importance of New Technologies for Diabetes Monitoring

Diabetes and its ramifications and treatments are presented, followed by discussion of the importance of communication between patient and clinician. Improved communication approaches, including telephone consultations, blood glucose communications to a provider with feedback, and active electronic diaries on smartphones for both type 1 and type 2 diabetes mellitus, are reviewed. What Exactly Is Diabetes? Diabetes is a metabolic disease: a disorder of how the body uses food. Most of the food eaten is digested into glucose, which enters into the bloodstream, where cells use it for growth and energy. Insulin, a hormone produced by the pancreas, must be present for glucose to be absorbed into cells. Normally, when people eat, the pancreas produces the proper amount of insulin necessary for glucose to be moved from the blood stream into the cells. In individuals with diabetes the pancreas produces either insufficient or no insulin, or the body’s cells do not respond correctly to the insulin which is produced. The net result: the body loses its fuel source even though the bloodstream contains more than sufficient glucose. Three types of diabetes mellitus exist: (1) type 1 diabetes (formerly called juvenile diabetes); (2) type 2 diabetes (formerly called adult onset diabetes); and (3) gestational diabetes. Type 1 diabetes accounts for about 5-10% of diagnosed diabetes in the U.S. and occurs mostly in children and young adults but can appear at any age (“Types of Diabetes”, 2012). It occurs because the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. If not diagnosed and treated with
A single weekly bout of exercise may reduce cardiovascular mortality: how little pain for cardiac gain? ‘The HUNT study, Norway’

Background The observation that exercise training reduces cardiovascular mortality is robust and consistent, but the amount and intensity of exercise that is required for risk reduction is not yet resolved. Methods We studied the association between the amount and intensity of exercise and cardiovascular mortality in 27 143 men and 28 929 women who were free from known cardiovascular disease at the beginning of follow-up between 1984 and 1986. The relative risk of death was calculated as the rate of death among participants within a given physical activity category compared with the rate of death in the reference category (no physical activity). We used Cox regression analysis to adjust for age and other potentially confounding factors. Results After 16 years (SD 4 years) of follow-up, 2946 men (10.8%) and 2486 women (8.6%) had died from ischaemic heart disease or stroke. A single weekly bout of exercise of high intensity reduced the risk of cardiovascular death, both in men [relative risk (RR) 0.61, 95% confidence interval (CI) 0.49–0.75], and women (RR 0.49, 95% CI 0.27–0.89), compared with those who reported no activity. There was no additional benefit from increasing the duration or the number of exercise sessions per week. The risk reduction related to exercise increased with increasing age in men, but not in women. Conclusion These results challenge the current recommendation that expenditure of at least 1000 kcal per week is required to achieve exercise-induced protection against premature cardiovascular mortality.
Serum Levels of Soluble TNFα Receptors (sTNFR1 and sTNFR2) During Corticosteroid Treatment in Patients with Graves' Ophthalmopathy

TNFα was shown to play an important role in the autoimmune inflammatory process of Graves' ophthalmopathy (GO). In our previous study we found no significant changes in serum TNFα levels in GO patients. The aim of the present study was to estimate an influence of corticosteroids on serum levels of TNFα receptors (sTNFR1 and sTNFR2) in GO patients and to assess their potential as a guideline of immunosuppressive therapy. We detected serum sTNFR1 and sTNFR2 in three groups of subjects: 18 patients with clinical symptoms of ophthalmopathy [Clinical Activity Score (CAS) ≥ 4, anamnesis of GO ≥ 1 yr], 16 patients with Graves' disease without ophthalmopathy (Gd) and 14 healthy volunteers. Corticosteroid therapy consisted of intravenous infusions of methylprednisolone (MP) and subsequent treatment with oral prednisone (P). The serum samples were collected 24 hours before MP, 24 hours after MP, 14 days of treatment with prednisone and after the end of the corticosteroid therapy. The levels of serum sTNFR1 and sTNFR2 were determined by ELISA. Serum levels of sTNFR1 were significantly higher in GO individuals as compared to the control group (p < 0.01). We have found a significant decrease in sTNFR1 concentration in corticosteroid‐respondent patients (satisfactory clinical effect, decrease of CAS ≥ 1) as compared to the pretreatment values after MP treatment (p < 0.05) and after 14 days of prednisone (p < 0.01). There were significant differences in sTNFR2 level after MP treatment (p < 0.02) and after corticosteroid administration (p < 0.05) between responders and non‐responders. Baseline values of sTNFR1 in GO individuals were positively correlated with CAS (r = 0.6, p < 0.02). Conclusions: TNFα acting through its receptors plays an important role in the pathogenesis of Graves' ophthalmopathy. Moreover, the beneficial influence of corticosteroids on the course of GO may be explained, at least in part, by an inhibition of sTNFR1 and sTNFR2. Measurement of soluble TNFα receptors might potentially serve as an indicator in prognostic estimation of corticosteroids' efficacy.
Vascular Risk and Cognitive Impairment in an Older, British, African‐Caribbean Population

OBJECTIVES: In an older, British, African‐Caribbean population with high prevalence rates of hypertension and diabetes mellitus, we ascertained clinical vascular disease (stroke or ischemic heart disease) and vascula; risk (including hypertension, diabetes, and lipid profile) and investigated their associations with cognitive impairment.
Knowledge and child care practices regarding childhood diarrhoea- A cross sectional study

Background: Diarrhea still continues to be a leading cause of childhood morbidity and mortality and holds the second rank (after pneumonia) for mortality in children < 5 years of age. The majority of these deaths can be avoided by timely intervention. The knowledge of caretakers about the severity of diarrheal illness ultimately affects the choice for childcare practices and influences the type of therapies received. Objectives: To assess the various aspect of maternal knowledge about diarrhea in under-five age children. To determine the child care practices of mothers during diarrheal episodes.Materials and methods: A cross-sectional survey was carried out from February to May 2014. 5 villages were selected by systematic random sampling method in rural field training area of medical college. A self-designed and pre-tested structured questionnaire was used as study tool which covers different aspect of knowledge and childcare practices by mothers/caretakers regarding diarrhea. Overall responses of participants were scored as good, average and poor for assessment of knowledge and practice. Results: Total 972 mother/caretakers were interviewed. Most of the mothers/caretakers (62.1%) were in favor of giving of breast milk as preferred oral fluid during diarrheal episode. Nearly one fourth of mothers/caretakers (26.1%) identify symptoms and signs of "dehydration" and the need for consultation. During diarrheal episodes less amount of food and fluid was given by 49.9% and 20.4% mothers/caretaker respectively. The higher level educated and employed mothers had better practices (P < 0.001) Conclusion: The study showed that knowledge and childcare practices for diarrhea still remains a great challenge among the rural population. This could be only deals with improvement in female literacy and to develop and implement diarrhea related educational interventions for mothers/caretakers.
The extended Segmüller flap.

A modification of the homodigital lateral V-Y advancement flaps described by Segmuller in 1976 for the treatment of fingertip injuries is described. The extended flap used in this series makes this flap more versatile in the treatment of injuries with considerable soft-tissue loss from the volar aspect of the fingertip. The Segmuller flap technique, its applications, and the results of 100 flaps are reported and discussed.
Anthropometry in a children's hospital: a study of staff knowledge, use and quality of equipment

Aims: The aims of this study were to investigate the extent of documentation of anthropometric measurements in a children's hospital records, the response of ward staff to children with heights and weights below the 3rd centile, and the availability and accuracy of measuring equipment. Also to assess the nutritional knowledge of medical staff. Methods: A prospective study was carried out in which 305 medical case notes were reviewed for records of anthropometric measures and action taken. A survey was undertaken of the availability of anthropometric equipment and its accuracy assessed over a range of weights and heights. A sample of medical staff (n=25) were interviewed about clinical nutrition. Results: Eighty-three per cent of the nursing notes and 13% of the medical notes contained records of weights, and 12% of the nursing notes and 8% of the medical notes contained records of heights. Only 40% of case notes had growth charts present, of which 54% had weights recorded and 32% had heights recorded. Surgical ward notes more frequently had inadequate records of weights, heights and growth charts than those of medical wards (surgical wards had 17% growth charts present compared to 65% growth charts on the medical wards). Overall, most wards and clinics had working and accurate weighing equipment (82% were accurate within 1%) and height equipment (43% were 100% accurate). Over 80% of ward staff appeared to have adequate knowledge of the theory behind anthropometry and recognized the value of growth charts. Conclusions: The weights and heights of children continue to be recorded inadequately in hospital notes, suggesting a need for in-service training and education on the importance of the nutritional assessment of paediatric patients.
Cytomorphometric Analysis of Oral Mucosa in Diabetic Patients in Bhopal Region an In-Situ Study.

Background: Diabetes is a common endocrine metabolic disorder and prevalence is increasing worldwide. In condition like diabetes, premalignant lesions and iron deficiency anemia; oral exfoliative cytology may be more appropriate as the invasive techniques lose viability. Aim: The study was conducted to analyze the cytomorphometric changes in exfoliated cells of oral mucosa as an adjunct to diagnosis of diabetes. Method: Samples were collected from buccal mucosa and divided into 2 groups; 100 diabetic patients (study) and 100 healthy individuals (control). The smears were stained with rapid Papanicolaou stain (PAP). Nuclear area (NA), cytoplasmic area (CA) and cytoplasmic to nuclear ratio (CNR) were evaluated in 50 cells in each smear using Image analysis software (Magnus pro™) and research microscope (Lawrance & Mayo™). Results: Mean NA was significantly higher (p 0.001). The mean CNR was significantly lower in study group (p < 0.001). Conclusion: Clinical observations and results suggested morphologic and functional alterations in oral epithelial cells in diabetic patients; detectable by microscopic and cytomorphometric analysis using exfoliative cytology and can be used in diagnosis.
Inconsistencies in Section 136 assessments

Liz Tate[1][1] rightfully mentioned that there are junior trainees attending to the Section 136 assessments, despite clear guidance in the Mental Health Act Code of Practice that it should be done by Section 12(2)-approved doctors. Further to that, the Code states that a reason should be documented