Acting ethically,responding culturally: framing the new reproductive and genetic technologies in Sri Lanka

The spread of new reproductive and genetic technologies to the developing world stimulates reflection on the ethical issues they generate. The ‘built-in-ness’ of assumptions about personhood and relationality within these technologies means that local professionals must, perforce, engage with attempts to make sense of new technology with reference to local meanings and traditions or take positions which reject them. This paper explores such attempts to indigenise bioethics in contemporary Sri Lanka with reference to ethical/ cultural conflicts surrounding two practices: donor insemination and consanguinity counselling. The former is discussed in relation to the now defunct practice of polyandry and the latter in relation to matrilateral cross-cousin marriage. The final discussion takes up the consequences of this detailed parsing of local relationality for the larger project of rendering bioethics in some sense comparative.     

The challenges of a hidden disability: Social work practice in the field of traumatic brain injury

Abstract

Traumatic brain injury (TBI) has become an important area for social work practice. Children and adults sustaining TBI often undergo hospitalisation, rehabilitation and face the prospect of lifelong cognitive and psychosocial impairments. Families are profoundly affected by the consequences of the injury. TBI is a ‘hidden disability’ because there are typically no physical markers indicating a person has brain damage. This paper aims to provide some guidelines for social work practice in the area, in particular, outlining options for social work interventions at individual, family, community, service system and policy levels. Social workers need to acquire specialised knowledge about brain injury, reformulate traditional models of grief counselling to address the adjustment challenges and utilise community education and service innovation to address the social stigma and reduced level of community participation associated with brain damage. Finally, social workers aim to nurture a sense of hope in the face of the tragedy.     

Cognitive function in toddlers with congenital heart disease: The impact of a stimulating home environment

Infants born with congenital heart disease (CHD) are at increased risk of neurodevelopmental difficulties in childhood. The extent to which perioperative factors, cardiac physiology, brain injury severity, socioeconomic status, and home environment influence early neurodevelopment is not clear. Sixty-nine newborns with CHD were recruited from St Thomas’ Hospital. Infants underwent presurgical magnetic resonance imaging on a 3-Tesla scanner situated on the neonatal unit. At 22 months, children completed the Bayley Scales of Infant and Toddler Development-3rd edition and parents completed the cognitively stimulating parenting scale to assess cognitive stimulation at home. Level of maternal education and total annual household income were also collected. Hospital records were reviewed to calculate days on the intensive care unit post-surgery, time on bypass during surgery, and days to corrective or definitive palliative surgical intervention. In the final analysis of 56 infants, higher scores on the cognitively stimulating parenting scale were associated with higher cognitive scores at age 22 months, correcting for gestational age at birth, sex, and maternal education. There were no relationships between outcome scores and clinical factors; socioeconomic status; or brain injury severity. Supporting parents to provide a stimulating home environment for children may promote cognitive development in this high-risk population.     

Men in Non‐Traditional Occupations: Career Entry,Career Orientation and Experience of Role Strain

This article explores the experiences of men in non‐traditional occupations. In particular it focuses on the dynamics of career entry, career orientation (namely, a preference for intrinsic or extrinsic rewards) and the possible existence, nature and consequences of role strain. Four occupational groups are examined: nurses, cabin crew, librarians and primary school teachers. The results suggest that men fall into three main categories: seekers (who actively chose the ‘female’ occupation), ‘finders’ (who did not actively seek a non‐traditional career but who found the occupation in the process of making general career decisions) and settlers (who actively chose the occupation, often as a result of dissatisfaction with a more ‘masculine’ job, and who then settled in their non‐traditional career). Settlers, in particular, are associated with a more intrinsic career orientation and express a desire to remain close to occupational and professional practice. Role strain is prevalent in men's experiences in their non‐traditional career. The potential sources of such role strain and the implications for career aspirations and career choices are explored.