Making available information from studies sponsored by the pharmaceutical industry: some current practices

Since the web-based registry ClinicalTrials.gov was launched on 29 February 2000, the pharmaceutical industry has made available an increasing amount of information about the clinical trials that it sponsors. The process has been spurred on by a number of factors including a wish by the industry to provide greater transparency regarding clinical trial data; and has been both aided and complicated by the number of institutions that have a legitimate interest in guiding and defining what should be made available. This article reviews the history of this process of making information about clinical trials publicly available. It provides a reader's guide to the study registries and the databases of results; and looks at some indicators of consistency in the posting of study information.     

An account of significant events influencing Australian breastfeeding practice over the last 40 years

Background

Low breastfeeding duration rates reflect the pain and distress experienced by many women who discontinue breastfeeding in the early weeks and months of life. This paper explores modern key historical events that have significantly influenced Australian breastfeeding education and practice.

Method

Relevant literature reviewed from 1970 to 2010 identified key events that appear to have contributed to the decrease in Australian breastfeeding rates and the increase in women experiencing breastfeeding complications, particularly nipple pain and trauma.

Findings and discussion

The rise in institutionalisation and medical intervention in labour and birth has also medicalised midwifery practice. Technocratic intrusion and institutionalised care is contributing to the separation of the mother and newborn at birth. Delayed mother–baby initiation of breastfeeding and interruption of the duration of the first, and subsequent breastfeeds, negatively affects the innate ability of the mother and newborn to establish and sustain breastfeeding. The ‘pathologising’ of breastfeeding that involve midwives teaching women complicated and unnatural breastfeeding techniques interfere with instinctive sensory and mammalian behaviours and further contributes to the high complication rates.

Conclusion

Midwives are encouraged to reflect on their role as ‘experts’ in the breastfeeding process and give confidence to women so that they utilise their instinctive ability to breastfeed by self-determined techniques that encourage mammalian skills for newborn sustenance and survival.     

The role of networks of practice and webs of influencers on farmers' engagement with and learning about agricultural innovations

Drawing on the UK research project, ‘Farmers’ understandings of GM crops within local communities’, this paper considers the application of the concepts of communities of practice and networks of practice in the agricultural context. A brief review of theories about communities of practice and networks of practice is given and some of our findings are discussed in the context of those theories.Farmers were found to be a particular type of network of practice, characterised by a weak organisational framework but with a relatively stable network of other communities of practice (or networks of practice) they interact with, which we have called a ‘web of influencers on practice’. Together, farmers’ network of practice and their web of influencers on practice represent the whole environment in which learning may occur, and so provide insights into their social learning system. Most farmers have to work at the boundary of their network of practice and their web of influencers, which creates a significant load on their knowledge management. This is in contrast to other networks of practice where only some members take on this boundary brokering role. The paper concludes that these theories (on networks and communities of practice) provide a useful lens through which to view farmers and their practice, highlighting important points for policy. However, in such contexts these theories need to be extended to include the role of a broader ‘web of influencers on practice’.     

Associations between ongoing COVID-19 lockdown and the financial and mental health experiences of Australian families

In 2020, Australia's successful COVID-19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss; material deprivation (inability to pay for essential items); income poverty; mental health (Kessler-6); perceived impact on caregiver/child mental health; and caregiver/child coping. Data from caregivers (N = 1207/902) in June/September were analysed using difference-in-difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%); Kessler-6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school-aged children (vs. pre-/high-school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence-informed financial and mental health supports.     

Evaluating the psychometrics of the SSIS SEL in a socio-economically diverse sample

The increasing interest in implementing social-emotional learning (SEL) interventions within schools calls for more reliable and valid assessment tools to measure the effectiveness of SEL programs. We investigated the factor structure and psychometric properties of the Social Skills Improvement System – Social-Emotional Learning Edition (SSIS SEL) with a group of ethnically and socio-economically diverse grade 3 students in Ontario, Canada (n = 427). The SSIS SEL is an age-normed measure used for the evaluation of interventions and prevention initiatives. Data collected included both teacher-report and student self-report measures. The factor structure proposed by the scale developers was not replicated using this smaller single grade sample. However, the study demonstrates evidence of good construct and convergent validity supporting the novel factor structure. Results from this study suggest that more research on the SSIS SEL's application in real-world intervention research programs is needed.