Separate spheres and public policy : the role of women in the development of children\u27s services in Victorian local government, 1840-1992

The thesis is an explanation of the development of pre-school children\u27s services (infant welfare, kindergartens and child care) at local government level in Victoria. The critical framework of analysis focuses on three dimensions of public policy: 1) the socio-historical environment; 2) the political processes involved in the development of the specific children\u27s service; and 3) the major individuals and groups that exerted pressure for children\u27s service, The argument is threefold. Firstly it is argued that the political environment of children\u27s services has been dominated by the practice of separate spheres of public and private, in which the care of children is primarily the role of women. Secondly, it is argued that the political processes surrounding the development of local children\u27s services have involved all levels of government in what is termed a local state. Thirdly, it is argued that the development of these children\u27s services in local government has resulted mainly from the work of women both individually and collectively. Since the three services of infant welfare, kindergartens and child care all became a normal function of children\u27s services at different times, the circumstances that surrounded each development exhibited different aspects of the three major arguments. The periodisation is broken into four phases: 1) the establishment of local government with no children\u27s services in the nineteenth century; 2) the establishment of infant welfare services in local government in the early part of the twentieth century; 3) the incorporation of kindergartens into local government after the second world war; and 4) the incorporation of child care into local government in the 1970s and 1980s. The thesis concludes by arguing that the existence of children\u27s services in local government in Victoria is testimony to the remarkable work of those women who have pursued the issue both individually and collectively. It has been the identification of children\u27s services as a women\u27s issue in Australian politics that has enabled women\u27s groups at different times to influence the policy makers in diverse ways. However, while the establishment of children\u27s services as a legitimate political concern brings the matter onto the public agenda, the separate spheres still remains a contested issue in the public policies of children\u27s services

Hyperbaric oxygen therapy for large composite grafts: An alternative in pediatric facial reconstruction

BACKGROUND: Management of pediatric facial defects can be challenging, as reattachment of large composite grafts is usually unsuccessful. Hyperbaric oxygen therapy (HBO) has been researched to augment composite graft survival, but clinical use for this application remains anecdotal. The authors present their successful experience managing select cases with large composite grafts and HBO as an adjunct. METHODS: A retrospective chart review identified children presenting with facial defects and managed operatively with large composite grafts (≥1.5 × 1.5 cm) and HBO therapy. Records were reviewed for defect characteristics, management details, and outcomes at last follow-up. RESULTS: Nine children (avg. 8.4 years, range 1.6-15.1) presented with ear or nose defects secondary to dog bites (n=7), falls (n=1), or congenital causes (n=1). Three experienced ear amputations, and six suffered nasal avulsions of varying degrees. All avulsed ears were reattached. Three cases of nose avulsions were reattached; the other three underwent secondary reconstruction with composite ear grafts. HBO was initiated immediately and continued for 8-10 days. All grafts survived at least 80% with no postoperative complications. At last follow-up (avg. 30.1 months; 0.8-63.9), all patients demonstrated good cosmetic results with minimal residual deformity. CONCLUSION: When reconstruction of pediatric facial defects warrants a large chondrocutaneous graft, immediate postoperative HBO therapy can increase survival. Particularly when reattaching amputated segments, if successful, this approach offers an anatomically ideal result without donor site morbidity. If unsuccessful, it does not burn bridges and decreases the extent of secondary reconstruction. The authors present their HBO protocol along with a review of available literature