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161.
The Mental Health Act 1986 (Victoria) established the Mental Health Review Board to periodically review the detention of involuntary patients in State mental institutions. The purported rationale for the inclusion of two non-medical personnel on the Board is that compulsory detention decisions should not be made by doctors alone and should include social and legal considerations. It is argued that the effectiveness of non-medical members is restricted by the dominance of medical discourse within Board hearings, the lack of availability of community-based care and treatment facilities and a failure to identify the relevance of non-medical issues to the decision-making process.  相似文献   
162.
Despite the increase in public knowledge about the existence of child sexual abuse, caused by public inquiries, media attention and the significant number of publications on the subject, the problem of child sexual abuse has failed to be systematically addressed as a policy problem. It appears that neither the public nor the government has been convinced that child sexual abuse is a serious problem which is common, persistent and widespread across the dimensions of race, ability and social class. This paper examines the factors which enable child sexual abuse to be obfuscated, that is, obscured and hidden. © 1997 by John Wiley & Sons, Ltd.  相似文献   
163.
Although extensively collected, data on people's reasons for their behaviour provided retrospectively have been met with some scepticism on the grounds that they may be subject to biases and errors that jeopardize their usefulness. This study investigates, for a sample of 1,327 births, the reliability with which women in Peninsular Malaysia recalled, at intervals 12 years apart, reasons for not initiating or for stopping breastfeeding less than 3 months after a birth. Overall, we find low to moderate reliability of recall. Levels of reliability are relatively high for some reasons (the child died and no or insufficient milk) but low for some others (child ill, breastfeeding inconvenient). Results from selection models show that reliability does not vary with the length of time since the child's birth but is inversely related to socio-economic status (proxied by education and employment). Social status, social norms, and health-related factors appear to be significant influences on women's consistency of reporting.  相似文献   
164.
165.

Background

Midwives have a primary role in facilitating the first stage of perinatal mental health risk reduction through inquiring about perinatal mental health, identifying risk factors and current perinatal mental health problems, providing support or crisis intervention, referring for treatment and decreasing stigmatisation.

Aims

The aims of this study were to determine midwives’ (a) knowledge of and confidence to identify and manage perinatal mental health problems, (b) attitudes towards women who experience severe mental illness and (c) perceived learning needs.

Design

A cross-sectional survey design.

Methods

The study was conducted between September 2016 and April 2017 in seven Maternity services in the Republic of Ireland with a purposeful non-random convenience sample of midwives (n = 157). Data was anonymously collected utilising the Perinatal Mental Health Questionnaire, the Mental Illness: Clinician’s Attitudes scale and the Perinatal Mental Health Learning Needs questionnaire.

Findings

Midwives indicated high levels of knowledge (71.1%) and confidence (72%) in identifying women who experience depression and anxiety however, they reported less confidence in caring (43.9%) for women. Only 17.8% (n = 28) of midwives felt equipped to support women whilst 15.3% (n = 24) reported having access to sufficient information. Midwives desire education on the spectrum of perinatal mental health problems. The mean score for the Mental Illness: Clinician’s Attitudes scale was 36.31 (SD = 7.60), indicating positive attitudes towards women with severe mental illness.

Conclusion

Midwives require further education on perinatal mental health across cultures with a skill focus and which explores attitudes delivered in a study day format.  相似文献   
166.
The Investigating Choice Experiments Capability Measure (ICECAP) is a new preference-based measure of the extent to which a person is able to achieve attributes or capabilities related to the quality of life. Conceptually, it differs from health-related quality of life (HRQoL) as the focus is upon the ability or capacity to achieve as distinct from the current experience of the attributes. The objective of this study was to explore the empirical relationships between capability as assessed by the ICECAP for Adults (ICECAP-A) and HRQoL as assessed by the Assessment of Quality of Life (AQoL)-8D and the five-level EuroQol Five Dimensions questionnaire (EQ-5D). To compare these measures, the study employed self-reported survey data from the healthy public and from seven disease areas in five countries. Results indicate that, despite their conceptual origins, the ICECAP-A is strongly associated with the AQoL-8D and that the clear distinction between capabilities and HRQoL found in other studies is attributable to the use of the EQ-5D in the comparison and the weaker association between the EQ-5D and ICECAP-A. The suggestion that ICECAP-A should be included in evaluation studies along with a HRQoL instrument is more persuasive when the instrument is the EQ-5D. The case for its inclusion with other HRQoL instruments requires further research and evaluation.  相似文献   
167.
It’s more than just luck: A qualitative exploration of breastfeeding in rural Australia

Problem

Despite significant public health benefits, breastfeeding for six months continues to be challenging for women.

Background

In the Mid North of South Australia, healthcare professionals were concerned that breastfeeding rates were lower than the national average and that a collaborative approach was needed to promote breastfeeding.

Aim

To explore the experiences of women and health professional in the Mid North, to inform interventions to improve breastfeeding longevity.

Method

Two focus groups were conducted to examine breastfeeding experience in the region. Focus group one included nine mothers who had breastfed more than six months and focus group two consisted of ten health professionals from the Mid North. Thematic analysis was used to analyse the data.

Findings

Two overarching themes were identified; ‘breastfeeding: It’s more than just luck’ represented the voices of the mothers and ‘breastfeeding: It’s everybody’s business’ captured the discussion between the health professionals. Women described themselves as lucky while acknowledging that their own persistence, as well as positive support was vital. Health professionals identified education and support as key foci, and a need for a holistic approach to improve breastfeeding rates.

Discussion

Breastfeeding should be understood as a relationship, in which broadly applied solutions do not necessarily influence longevity, particularly in rural communities. Strategies should also reflect a realistic picture of breastfeeding and safeguard against idealistic expectation of the experience.

Conclusion

A holistic approach to improve breastfeeding rates is imperative. One of the most promising antidotes to the breastfeeding dilemma is the provision of midwifery continuity of care.  相似文献   
168.
169.
In this article, the development of a digital ‘toolkit’ for adoptive parents in the children’s social care service of a single local authority is described. A work in progress, the toolkit is to be accessed by parents online and involves a series of videos around parenting topics and the post-adoption therapeutic work undertaken in the service, as well as links to other parenting information and resources. The article combines accounts of the toolkit’s development in the authority and a piece of ‘practice research’ being carried out that makes use of a DVD version.  相似文献   
170.
In 2015, the Administration for Community Living (ACL) established the first federal “home” for Adult Protective Services (APS). This leadership has included working collaboratively with state Adult Protective Service systems to ensure that older adults and adults with disabilities are afforded the same protections against abuse, neglect, and financial exploitation regardless of where in the country they live. As part of that leadership, ACL created draft Voluntary Consensus Guidelines for State APS Systems. ACL undertook a process of public and stakeholder engagement and analyzed the resulting comments to improve upon the initial draft of the draft to arrive at the final version. This article examines the comments, including the concerns raised by the commenters about specific areas of the Guidelines, areas identified for future research, and reflections and opinions on the role of the federal government in guiding the development of the field of adult protection.  相似文献   
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