Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines

BackgroundMood disorders arising in the perinatal period (conception to the first postnatal year), occur in up to 13% of women. The adverse impact of mood disorders on mother, infant and family with potential long-term consequences are well documented. There is a need for clear, evidence-based, guidelines for midwives and other maternity care providers.AimTo describe the process undertaken to develop the Australian Clinical Practice Guidelines for Depression and Related Disorders in the Perinatal Period and to highlight the key recommendations and their implications for the maternity sector.MethodUsing NHMRC criteria, a rigorous systematic literature review was undertaken synthesising the evidence used to formulate graded guideline recommendations. Where there was insufficient evidence for recommendations, Good Practice Points were formulated. These are based on lower quality evidence and/or expert consensus.FindingsThe quality of the evidence was good in regards to the use of the Edinburgh Postnatal Depression Scale and psychological interventions, but limited as regards medication use and safety perinatally. Recommendations were made for staff training in psychosocial assessment; universal screening for depression across the perinatal period; and the use of evidence based psychological interventions for mild to moderate depression postnatally. Good Practice Points addressed the use of comprehensive psychosocial assessment – including risk to mother and infant, and consideration of the mother–infant interaction – and gave advice around the use and safety of psychotropic medications in pregnancy and breastfeeding. In contrast to their international counterparts, the Australian guidelines emphasize a more holistic, woman and family centred approach to the management of mental health and mood disorders in the perinatal setting.ConclusionThe development of these Guidelines is a first step in translating evidence into practice and providing Australian midwives and other maternity care providers with clear guidance on the psychosocial management of women and families.     

原住民治理的宪政构架

在如何理解澳大利亚政府的宪政构架上,需要一个观念转变。这个转变的基础,是理解原住民治理的存在及其在澳大利亚政治组织各个层面的实践,以及澳大利亚州的正式制度已暗中接纳各种形式的原住民治理。澳大利亚的联邦主义经验意味着理解这种转变很容易做到。当联邦和州的原住民政策最终和支持它们的治理构架一样强大时,这一转变必定出现。     

'A Pair of Stout Shoes and an Umbrella': The Role of the Mental Welfare Officer in Delivering Community Care in East Anglia: 1946-1970

via e-mail: sherolph{at}hotmail.com Summary In this paper we describe an oral history research project whichexplored a little-known aspect of the history of social work:the history of mental welfare officers and their role in communitycare. We interviewed former MWOs and analysed both private andpublic documents to explore this history in East Anglia between1946 and 1970. In the paper we address three themes. In thefirst place, we argue that MWOs, as well as carrying out theirstatutory function in overseeing hospital admissions, had asignificant role in community care for people with learningdifficulties and psychiatric problems. They began to advocateon behalf of clients, often making a case for home support andthey supported parents' groups. Increasingly, they carried outcase-work and painstaking social work with families. In thesecond place, we explore the surprising finding that, amongMWOs, genericism was not as new a concept in 1970 as many writershave assumed. Finally, we analyse some gender issues that emergedfrom the research and the way they influenced attitudes to communitycare held by some MWOs. The paper looks at the gradual developmentof a profession from one with little consistent training, toone in which specialist education began to be seen as an importantaspect of the role of the MWO.     

A randomized test of a small-group interactive social norms intervention

Social norms interventions are a common approach to addressing the problem of college student drinking. An increasingly popular but not yet well-validated social-norms-based intervention consists of providing normative feedback to students in small groups. OBJECTIVE, PARTICIPANTS, AND METHODS: In this study, the authors used a randomized design to test an interactive form of small-group social norms correction with 502 first-year students during September and October 2001. Because the unit of random assignment was at the level of the classroom, the authors used hierarchical linear modeling to estimate variability. They investigated whether small-group interactive social norms correction could influence alcohol perceptions and behaviors above and beyond a noninteractive social norms education approach. RESULTS: Results indicate that the approach has a fairly substantial influence on student perceptions; however, the findings do not support an influence of interactive small-group social norms correction on measures of alcohol use behaviors. CONCLUSIONS: Given these findings, the use of interactive small-group social norms approach to influence student misperceptions may be considered as a primer for population-level preventive interventions.     

Digital Accessibility as a Core Competency for E-Resources Librarians

Abstract

This article will outline the electronic resources life cycle and identify key elements involved in e-resource management that exhibit potential for growth in terms of accessibility remediation. The aim of the article is to convey an understanding of the importance of digital accessibility to electronic resources librarians and the role they may play in making digital collections more available to users with impairments.