Beyond Chapter 4.7

Chapter 4.7 of the National Statement on Ethical Conduct in Human Research refers specifically to Aboriginal and Torres Strait Islander Peoples. It lays out the points at which researchers working with Aboriginal and Torres Strait Islanders must consider their approach, and the engagement with individuals, communities or groups who are involved in or affected by their research. History, of Australia and of research involving Aboriginal and Torres Strait Islander Australians, has informed this approach. The response to that history has been a rational, institutionalised, systematic demand for a different perception of what should direct research and research processes to ensure engagement with and service to the community with whom the researchers wish to do the work. This paper considers whether these principles could inform the approach to other research work.not applicabl

New England Regional Health Equity Profile & Call to Action

Good health is a foundation that allows people to participate in the most important aspects of life. The purpose of the New England Regional Health Equity Profile and Call to Action is to identify where differences in good health exist among racial, ethnic, and disability populations in New England as well as foster policy, programmatic, and individual action to combat health disparities and achieve health equity for racial, ethnic, disability and underserved populations in New England. The report was written by the members of the New England Regional Health Equity Council (RHEC), one of ten regional health equity councils formed by the Office of Minority Health at the federal Department of Health and Human Services. The mission of the New England RHEC is to achieve health equity for all through collective action in the New England region. The New England RHEC’s vision is to achieve health equity through cross-sector interaction and collaboration of activities and resources to optimize health for all where they live, learn, work, and play. The New England Regional Health Equity Profile and Call to Action uses a “social determinants of health” approach. A social determinants of health approach focuses on understanding how the intersection of the social and physical environments; individual behaviors; and access to education, income, healthy foods and health care, impacts a wide range of health and quality-of-life outcomes. The report examines the following topics: Socio-Economic Status, Healthy Eating and Physical Activity, Risky Behaviors, Cultural Competency in Health Care, Health Care Access, Health Outcomes, and the Intersection of Race/Ethnicity & Disability. It also includes a description of State Health Equity Activities and a Regional Call to Action

Social work training or social work education? An approach to curriculum design

Population ageing, economic circumstances, and human behaviour are placing social welfare systems under great strain. In England extensive reform of the social work profession is taking place. Training curricula are being redesigned in the context of new standards of competence for social workers – the Professional Capabilities Framework (PCF). Students must be equipped on qualifying to address an extensive range of human problems, presenting major challenges to educators. Critical theory suggests an approach to tackle one such challenge – selecting the essential content required for areas of particular practice. Teaching on social work with older people is used to illustrate this. Habermas’ theory of cognitive interests highlights the different professional roles served by the social work knowledge base - instrumental, interpretive, and emancipatory. Howe’s application of sociological theory distinguished four social work roles corresponding to these. It is suggested that curriculum design decisions must enable practitioners to operate in each. When preparing students to work with older people, educators therefore need to include interpretive and emancipatory perspectives, and not construct social work purely as an instrumental response to problems older people present. This approach provides one useful rationale for curriculum design decisions, which is applicable to other areas of practice, and to contexts outside England

Breast-milk iodine concentration declines over the first 6 mo postpartum in iodine-deficient women.

BACKGROUND: Little is known about the iodine status of lactating mothers and their infants during the first 6 mo postpartum or, if deficient, the amount of supplemental iodine required to improve status. OBJECTIVE: The objective was to determine maternal and infant iodine status and the breast-milk iodine concentration (BMIC) over the first 6 mo of breastfeeding. DESIGN: A randomized, double-blind, placebo-controlled supplementation trial was conducted in lactating women who received placebo (n = 56), 75 μg I/d (n = 27), or 150 μg I/d (n = 26) after their infants' birth until 24 wk postpartum. Maternal and infant urine samples and breast-milk samples were collected at 1, 2, 4, 8, 12, 16, 20, and 24 wk. Maternal serum thyrotropin and free thyroxine concentrations were measured at 24 wk. RESULTS: Over 24 wk, the median urinary iodine concentration (UIC) of unsupplemented women and their infants ranged from 20 to 41 μg/L and 34 to 49 μg/L, respectively, which indicated iodine deficiency (ie, UIC < 100 μg/L). Mean maternal UIC was 2.1-2.4 times higher in supplemented than in unsupplemented women (P < 0.001) but did not differ significantly between the 2 supplemented groups. BMIC in the placebo group decreased by 40% over 24 wk (P < 0.001) and was 1.3 times and 1.7 times higher in women supplemented with 75 μg I/d (P = 0.030) and 150 μg I/d (P < 0.001), respectively, than in unsupplemented women. Thyrotropin and free thyroxine did not differ significantly between groups. CONCLUSION: BMIC decreased in the first 6 mo in these iodine-deficient lactating women; supplementation with 75 or 150 μg I/d increased the BMIC but was insufficient to ensure adequate iodine status in women or their infants. The study was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12605000345684

Regulatory Futures in Retrospect

In our 1998 volume ‘The Politics of Chemical Risk: Scenarios for a regulatory Future’ we envisioned four ideal typical scenarios for the future of European chemicals policies. The scenarios focused on the nature of expertise (seen either as a universal or a localised phenomenon) and the organisation of the boundary between science and policy (as either diverging or converging). The four scenarios were titled International Experts, European Risk Consultation, European Coordination of Assessment, and Europe as a Translator. For all four scenarios, we hypothesized internal dynamics and articulated dilemmas related to the development of the sciences contributing to chemical assessment, the relation between the EU and member states and the role of the public. In this contribution, we look back on our four scenarios fifteen years later, to see which ones have materialized and to explore whether the dilemmas we saw have indeed surfaced. We conclude that the International Experts scenario by and large has materialized and explore some of the underlying tensions and dynamics in this development

Do adults in contact with Australia's public sector mental health services get better?

This paper describes the outcomes of episodes of care for adults in public sector mental health services across Australia, with a view to informing the debate on service quality. Health of the Nation Outcome Scales (HoNOS) change scores and effect sizes were calculated for 14,659 acute inpatient episodes and 23,692 community episodes. The results showed that people in contact with public sector mental health services generally do get better, although the magnitude of improvement depends on the setting and episode type. This confirmatory finding is particularly positive, given current community concerns about the quality and effectiveness of mental health services