What is child protection? Historical and methodological issues in comparative research on lastensuojelu/child protection

This article addresses comparative research on what has come to be called, in (British) English, 'child protection' or, rather differently, in Finnish ' lastensuojelu '. In developing a cross-national research project on lastensuojelu /child protection practices in England and Finland, we found it necessary to go back a few steps, to address what might usually be considered as 'background issues'. This article discusses the welfare state traditions in both countries, especially with respect to families and children, in order to contextualise the focus of ongoing qualitative research on micro comparisons. When comparing the mundane practices of child protection and the ways problems and clienthoods are constructed, as in this study, historical, social, cultural and linguistic issues matter. Indeed, very basic concepts such as 'child protection' and 'child protection case' become problematic in the comparison.     

Panel data and models of change: A comparison of first difference and conventional two-wave models

The method of first differences as an approach to modeling change is described and it is compared to more conventional two-wave panel models. Substantial advantages are found to the first-difference approach, especially if there are unmeasured, unchanging predictor variables in the model. It is also argued that there are substantial problems in the interpretation of results from the conventional two-wave models. Some of the analytic results are illustrated with a number of applications to the area of stressful life events.     

Cross sectional study of Australian midwives knowledge and use of sterile water injections for pain relief in labour

BackgroundThe effectiveness of sterile water injections (SWI) to relieve back pain in labour is supported by a number of randomised controlled trials. Although the procedure is available in a number of Australian maternity units, there is no information regarding the use of SWI by midwives, in terms of knowledge and availability, clinical application or technique used. Neither is there any data on midwives who do not use SWI nor the specific challengers and barriers encountered by midwives introducing SWI.MethodAn invitation to participate in an online survey was emailed to 4700 members of the Australian College of Midwives (ACM) and 484 members of CRANAplus (Remote Health Organisation). Nine hundred and seventy midwives completed the survey (19%).ResultsFour hundred and seven (42.5%) midwives currently used SWI in their practice and five hundred and fifty-one (57.5%) indicated they did not. Eighty-six percent (n = 478/548) indicated they would consider using SWI and 90% (n = 500/547) were interested in obtaining further information about SWI. The main reasons cited for not using SWI was the lack of a policy or guideline (n = 271, 57.5%) and being unable to access workshops or resource material (n = 68, 14.4%).ConclusionThis study indicates that SWI is not being used by the majority of midwives participating in the study, although there is a strong desire by midwives to learn about and explore its use. Greater access to information and workshops on SWI is highlighted. In response to the findings of this survey the authors are currently developing an online resource and training to support units to introduce SWI.     

Standardizing the care of detox patients to achieve quality outcomes

Providing appropriate treatment for detoxification patients is both challenging and difficult because alcohol abuse and dependence are largely underestimated in the acute hospital setting. Alcohol withdrawal syndrome is treated not only by addictionologists on chemical dependency units, but also by primary care physicians in acute inpatient settings. The need for consistent inpatient treatment through the use of identified protocols can help provide safe and effective care. The need for consistent, inpatient medical-surgical detoxification treatment in our organization became apparent with the staff's identification of patient care concerns. Using an organizational approach, a multidisciplinary team was created to standardize the care of detoxification patients, beginning with patient admission and ending with discharge and referral for outpatient management. Standardization would ensure consistent assessment and intervention, and improve communication among the clinical team members. A protocol was developed for both the emergency department and the inpatient units. The goals of the team were to decrease the adverse events related to detoxification, such as seizures and aggression, and provide a consistent method of treatment for staff to follow.     

Examining the Impact of Pre‐Implementation Expectations on Post‐Implementation Use of Enterprise Systems: A Longitudinal Study

This article builds upon the technology acceptance model and theories of technology sensemaking to explore pre‐enterprise system adoption expectations and post‐enterprise system adoption outcomes in a longitudinal setting. Building on the exploitation and exploration paradigm, we propose that task productivity and task innovation expectations are the key drivers of users’ pre‐adoption enterprise system usage intention. Further, we argue that the enterprise system facilitates generation of a common knowledge base that may encourage a more integrated organizational culture and promote shared understanding among employees. Considering the distinction between mandatory and voluntary contexts, we propose that user acceptance of the enterprise system at the pre‐ and post‐adoption stages will mediate these relationships in a mandatory context. The results show that the influence of pre‐adoption expectations regarding task productivity and task innovation on intention to use an enterprise system is mediated by user acceptance of the enterprise system. Intention to use an enterprise system is positively related to actual use. At the post‐adoption stage, the influence of actual use on shared understanding is mediated by user acceptance of an enterprise system and enterprise system use has a direct negative impact on task efficiency in the initial period after implementation. Overall, the results highlight that user acceptance at both pre‐ and post‐adoption stages are critical factors when usage is mandatory. These findings suggest a number of important implications for research and for managerial action.     

Developing a Core Competency Model and Educational Framework for Primary Maternity Services: a national consensus approach

BackgroundAn appropriately educated and competent workforce is crucial to an effective health care system. The National Health Workforce Taskforce (now Health Workforce Australia) and the Maternity Services Inter-Jurisdictional Committee funded a project to develop Core Competencies and Educational Framework for Primary Maternity Services in Australia. These competencies recognise the interdisciplinary nature of maternity care in Australia where care is provided by general practitioners, obstetricians and midwives as well as other professionals.ParticipantsKey stakeholders from professional organisations and providers of services related to maternity care and consumers of services.MethodsA national consensus approach was undertaken using consultation processes with a Steering Committee, a wider Reference Group and public consultation.FindingsA national Core Competencies and Educational Framework for Primary Maternity Services in Australia was developed through an iterative process with a range of key stakeholders. There are a number of strategies that may assist in the integration of these into primary maternity service provider professional groups’ education and practice.ConclusionsThe Core Competencies and Educational Framework are based on an interprofessional approach to learning and primary maternity service practice. They have sought to value professional expertise and stimulate awareness and respect for the roles of all primary maternity service providers. The competencies and framework described in this paper are now a critical component of Australian maternity services as they are included in actions in the newly released National Maternity Services Plan and thus have relevance for all providers of Australian maternity services.