Developing pathways to assist parents to exit the child protection system in Australia

The prevalence of child abuse and neglect is an international concern that justifies the existence of child protection systems. An important first principle for all such statutory child protection systems is to ensure that the system itself does no further harm. It can be argued that there are specific circumstances within which well‐meaning services have the potential to do harm: specifically, processes and actions that disempower parents by reducing their autonomy and capacity for positive action. Exploring the circumstances in which reduced parental autonomy impacts negatively on families is an important first step in developing procedures for working with families that not only avoid harm but are orientated to produce meaningful change. Two evidence‐based programs are described that together have the potential to assist child protection practitioners to develop a collaborative helping partnership with families, clarify goals for change and support parents to achieve meaningful improvement in their family functioning. The programs described are both manualised and have empirical support for their effectiveness. The potential benefits for both families and practitioners working within child protection agencies in the two programs are described.     

A negative trial of sodium valproate in cluster headache: methodological issues

We report the result of a double-blind placebo controlled study of sodium valproate (SV) (1000-2000 mg/day) in the prophylaxis of cluster headache CH. Episodic and chronic CH were defined according to the International Headache Society classification. Ninety-six patients were included, 50 in the SV group and 46 in the placebo group. After a 7-day run-in period, patients were treated for 2 weeks. The primary efficacy criterion was the percentage of patients successfully improved, i.e having an at least 50% reduction in the average number of attacks per week between the run-in period and the last week of treatment. Whatever the type of CH, there was no difference between the two groups: 50% of subjects in the SV group and 62% in the placebo group were successfully improved (P = 0.23). This high success rate observed in the placebo group, which is likely to be due to the spontaneous remission of the episode, does not allow us to draw any valid conclusion with regard to the true efficacy of SV in the prophylaxis of CH.     

Globalization and the cultural safety of an immigrant Muslim community

AIM: This paper reports a study the aim of which was to further understanding of cultural safety by focusing on the social health of a small immigrant community of Muslims in a relatively homogeneous region of Canada following the terror attacks on 11 September 2001 (9/11). BACKGROUND: The aftermath of 9/11 negatively affected Muslims living in many centers of Western Europe and North America. Little is known about the social health of Muslims in smaller areas with little cultural diversity. Developed by Maori nurses, the cultural safety concept captures the negative health effects of inequities experienced by the indigenous people of New Zealand. Nurses in Canada have used the concept to understand the health of Aboriginal peoples. It has also been used to investigate the nursing care of immigrants in a Canadian metropolitan centre. Findings indicated, however, that the dichotomy between culturally safe and unsafe groups was blurred. METHOD: The methodology was qualitative, based on the constructivist paradigm. A purposive sample of 26 Muslims of Middle Eastern, Indian or Pakistani origin and residing in the province of New Brunswick, Canada were interviewed in 2002-2003. Findings. Participants experienced a sudden transition from cultural safety to cultural risk following 9/11. Their experience of cultural safety included a sense of social integration in the community and invisibility as a minority. Cultural risk stemmed from being in the spotlight of an international media and becoming a visible minority. CONCLUSION: Cultural risk is not necessarily rooted in historical events and may be generated by outside forces rather than by longstanding inequities in relationships between groups within the community. Nurses need to think about the cultural safety of their practices when caring for members of socially disadvantaged cultural minority groups as this may affect the health services delivered to them.     

Shifting sands: the complexities and uncertainties of the evolving US regulatory,policy, and scientific landscape for biospecimen research

Human tissue biorepositories and the biospecimens they provide play a critical role in advancing research and medical care, especially in supporting research to develop precision medicine. However, advancements in genomics, informatics, and other sophisticated technologies and extensive biospecimen and data sharing have raised questions about how best to protect research participants. Complex ethical issues remain unresolved, such as the identifiability of biospecimens and associated data, the best consent models for future research, ownership and commercial use of biospecimens, and return of individual research results.This review summarizes the relevant US regulations and recent changes to them, as well as current and future ethical and policy issues related to biospecimen research. Because many issues remain unresolved, additional policy development will be needed. We discuss approaches for how researchers and other stakeholders can provide input to ensure that these policies will protect research participants while facilitating research important for scientific and medical advancements.     

Translation of scales in cross-cultural research: issues and techniques

AIMS: This paper is a report of a study designed to: (i) describe issues and techniques of translation of standard measures for use in international research; (ii) identify a user-friendly and valid translation method when researchers have limited resources during translation procedure; and (iii) discuss translation issues using data from a pilot study as an example. BACKGROUND: The process of translation is an important part of cross-cultural studies. Cross-cultural researchers are often confronted by the need to translate scales from one language to another and to do this with limited resources. METHOD: The lessons learned from our experience in a pilot study are presented to underline the importance of using appropriate translation procedures. The issues of the back-translation method are discussed to identify strategies to ensure success when translating measures. FINDINGS: A combined technique is an appropriate method to maintain the content equivalences between the original and translated instruments in international research. There are several possible combinations of translation techniques. However, there is no gold standard of translation techniques because the research environment (e.g. accessibility and availability of bilingual people) and the research questions are different. CONCLUSIONS: It is important to use appropriate translation procedures and to employ a combined translation technique based on the research environment and questions.     

精神科护理中潜在性法律问题及对策

精神科护理行为涉及护理文件书写及护理操作时的相关法律问题。稍不留意医患纠纷时医院可能会处于被动地位。而且有可能触犯法律。护理部需要能预见护理工作中存在的法律问题，针对存在问题不断完善相关规章制度和执行措施。因此，护理人员必须学法、懂法，在护理行为中遵守法律法规和护理技术操作规程，以避免和减少医患纠纷的发生。