Community consultation is increasingly favoured as a means of ensuring that health services adequately meet population needs, yet research, has highlighted the frequency of inadequate and tokenistic ...consultation. Our aim was to address the gap in understanding of the mechanisms of successful community consultation by being the first study to examine consultation events for older adults in one of the most deprived local authority areas in the UK. A naturalistic world café was co‐designed with a community engagement service. Adults aged 68–91 years (n = 103) participated in one of two world café discussions. Qualitative findings demonstrated the mechanisms behind and the added value of consultation with disadvantaged older adults. Forums were found to not only offer space within which opinions could be voiced, they also supported information gathering, the adoption of civic responsibilities and social activities. Understanding of the added value of consultation forums may incentivise service providers to facilitate more meaningful consultation and encourage scholars to examine think more critically about social mechanisms that promote active ageing.
This article provides an overview and critical analysis of inquiries into historical institutional child abuse and examines their multiple functions and complex effects. The article takes a broadly ...international view but focuses primarily on Australia, the UK and Ireland, jurisdictions in which there have been major national inquiries. Drawing on sociological and other social science literature, it begins by considering the forms, functions, and purposes of inquiries. An overview of emergent concerns with institutional abuse in the 1980s and 1990s is then provided, followed by an examination of the response of many governments since that time in establishing inquiries. Key findings and recommendations are considered. The final sections of the article explore the evaluation of inquiries, both during their operation and in their aftermath. Policy change and legislative reform are discussed but the focus is on aspects often underplayed or overlooked, including an inquiry’s credibility, its role in processes of knowledge production, and the part it plays in producing social and cultural shifts. In the context of growing numbers of inquiries across Western democracies, including the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, it is argued that grasping the complexity of the inquiry mechanism, with its inherent tensions and its multiple effects, is crucial to evaluating inquiry outcomes.
Abstract
Chronic exposure to manganese (Mn) is associated with neuroinflammation and extrapyramidal motor deficits resembling features of Parkinson’s disease. Activation of astrocytes and microglia ...is implicated in neuronal injury from Mn but it is not known whether early life exposure to Mn may predispose glia to more severe inflammatory responses during aging. We therefore examined astrocyte nuclear factor kappa B (NF-κB) signaling in mediating innate immune inflammatory responses during multiple neurotoxic exposures spanning juvenile development into adulthood. MnCl2 was given in drinking water for 30-day postweaning to both wildtype mice and astrocyte-specific knockout (KO) mice lacking I kappa B kinase 2, the central upstream activator of NF-κB. Following juvenile exposure to Mn, mice were subsequently administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) at 4 months of age. Animals were evaluated for behavioral alterations and brain tissue was analyzed for catecholamine neurotransmitters. Stereological analysis of neuronal and glial cell counts from multiple brain regions indicated that juvenile exposure to Mn amplified glial activation and neuronal loss from MPTP exposure in the caudate-putamen and globus pallidus, as well as increased the severity of neurobehavioral deficits in open field activity assays. These alterations were prevented in astrocyte-specific I kappa B kinase 2 KO mice. Juvenile exposure to Mn increased the number of neurotoxic A1 astrocytes expressing C3 as well as the number of activated microglia in adult mice following MPTP challenge, both of which were inhibited in KO mice. These results demonstrate that exposure to Mn during juvenile development heightens the innate immune inflammatory response in glia during a subsequent neurotoxic challenge through NF-κB signaling in astrocytes.
This article considers current concerns with promoting student mental health and wellbeing against the backdrop of critiques of the 'therapeutic turn' in education. It begins by situating accounts of ...'therapeutic education' within broader theorisation of therapeutic culture. In doing so, the importance of this work is acknowledged, but key assumptions are questioned. The emergence of concerns about self-esteem and wellbeing are then examined through an analysis of changing educational aims in Australia. This enables consideration of the broader context for policy reforms and emergent ideas about the importance of fostering wellbeing and attending to the social and emotional aspects of learning. Finally, the article argues for the salience of historicising both educational policy and scholarly critiques of therapeutic education in order to: (1) situate the contemporary emphasis on student wellbeing within a longer history of educational reforms aimed at supporting young people; (2) unsettle taken-for-granted ways in which mental health and wellbeing are currently foregrounded in contemporary schooling; and (3) develop new perspectives on the therapeutic turn in education. Author abstract
"Help for wayward children" Wright, Katie
History of education review,
01/2012, Volume:
41, Issue:
1
Journal Article
Peer reviewed
Purpose - Historical studies of the expert management of childhood in Australia often make passing reference to the establishment of child guidance clinics. Yet beyond acknowledgement of their ...founding during the interwar years, there has been little explication of the dynamics of their institutional development. The purpose of this article is to examine the introduction of child guidance in Australia against the backdrop of the international influences that shaped local developments.Design methodology approach - The article investigates the establishment of child guidance clinics in Melbourne and Sydney in the 1930s. In doing so, it explores the influence of American philanthropy, the promise of prevention that inspired the mental hygiene movement, and some of the difficulties faced in putting its child guidance ideals into practice in Australia.Findings - American philanthropy played an important role in the transnational carriage of ideas about mental hygiene and child guidance into Australia. However, it was state support of child guidance activities that proved critical to its establishment. In addition to institutional developments, what also emerges as important in the 1930s is the traction gained in the broader realm of ideas about "adjustment" and mental health, particularly in relation to the efficacy of early intervention and multidisciplinary approaches to treating problems of childhood.Originality value - In tracing its early development, the article argues for the importance of understanding child guidance not only in terms of its administrative successes and failures, but also more broadly in terms of how early intervention as an influential mode of thought and practice took root internationally.
Aims‘To Err is Human: Building Safer Healthcare System’, published in 1999, highlighted that errors in medicine are directly related to human factors. Non-technical skills (NTS) constitute a ...significant proportion of human factors and implementing this into medical education can lead to better patient safety outcomes. Simulation is well evidenced as an effective way of improving NTS.The aim of this unique project is to improve confidence in trainee NTS in a children’s emergency department (CED) through in-situ simulation and shared learning.MethodsThree PDSA cycles were run with focus on improving NTS in CED through in-situ simulation over a period of 4 months from March to July 2021. The first PDSA cycle involved reinstating weekly in-situ simulation conducted by designated consultants and registrars. The second and third cycles built on this through feedback from trainees. These cycles focused on sharing learnt NTS from the weekly simulation sessions with all trainees in the department via a dedicated education WhatsApp group, and by displaying key learning points on a departmental education board on a weekly basis.Feedback was collected from departmental surveys (using SurveyMonkey®) after each PDSA cycle, which required trainees to rate their confidence in NTS from 0 (no confidence) to 4 (high confidence). The following 5 areas of NTS comprised the focus of this work: leadership, teamwork & communication, situation awareness, task management and decision making.Results17 out of 21 trainees in CED responded to the surveys. Figure 1 presents trainees’ NTS confidence ratings following each PDSA cycle.Most trainees responded as being confident (rating 3) in all 5 NTS in the all three surveys. Notably, there was a 24% and 23% improvement in the confidence ratings between the 1st and 2nd PDSA cycles for task management and decision making respectively. Whilst task management and decision making continued to improve following the third PDSA cycle, there was no further improvement in trainee confidence in other NTS. There was an overall sustained improvement in most NTS areas in comparison to the start of the project, apart from in leadership and situation awareness which showed 5% and 3% a decline in confidence ratings.Abstract 1259 Figure 1Confidence rating of trainee non-technical skill (0= no confidence to 4= high confidence) following 1st PDSA cycle involving re-instating simulation in CED (children’s emergency department)Abstract 1259 Figure 2Confidence rating of trainee non-technical skill (0= no confidence to 4= high confidence) following 2nd PDSA cycle involving display of an editable weekly shared learning poster on CED education boardConclusionThe non-technical skills of task management and decision-making showed a sustained improvement with in-situ simulation and sharing learning. This project highlighted areas of focus (leadership and situation awareness) for future in-situ simulation based NTS learning. Further PDSA cycles targeted to these specific NTS are recommended.
The damaging effects of abuse in childhood were repeatedly emphasised in public hearings and in media coverage of the Royal Commission into Institutional Responses to Child Sexual Abuse. Testimony ...from earlier Australian inquiries, which documented widespread experiences of child maltreatment, particularly in institutions, also underscored the ongoing and often intergenerational impact of abuse. Taking institutional child abuse inquiries as a case study, this article examines how psychological and therapeutic concepts have been mobilised politically. It argues that therapeutically oriented and psychologically informed cultural narratives of childhood trauma and its ongoing effects have provided a framework for making sense of long-term experiences of adversity and suffering and have enriched attention to "the question of justice" for survivors of historical institutional child abuse.
Wellbeing has become a keyword in youth and social policy, a construct deployed as a measure of a good life. Often associated with physical and mental health, wellbeing encompasses numerous ...indicators, from subjective experiences of happiness and satisfaction to markers of economic prosperity and basic human needs of security. This article examines wellbeing as an organizing concept in discourses on young people and argues for defamiliarizing its truth claims and cultural authority by investigating what wellbeing does. We begin by examining the rise of wellbeing, drawing attention to its conceptual muddiness and ambiguity. Framed by the Foucauldian notion of problematization, the analysis proceeds along two routes: first, through an historical consideration of wellbeing as a relational concept with antecedents, focusing on 'self-esteem'; and second, through a reading of wellbeing in contemporary educational policy. Informed by Somers' historical sociology of concept formation and Bacchi's critical policy analysis, we illuminate the mixed dimensions of wellbeing's reach, placing it within longer traditions of youth studies and psy-knowledges and showing its transformative promise as well as its individualizing effects. In doing so, we elaborate a methodological approach that can be adapted to examine other keywords in youth studies and social policy discourse.
Psychedelic compounds are on the cusp of being approved by medical regulators for treatment‐resistant mental health disorders. Following promising clinical trials, and as rates of mental ill health ...rise globally, psychedelic medicine presents a new paradigm for treating depression, anxiety, addiction and post‐traumatic stress disorder. The novelty of psychedelic therapies, the cultural stigma they elicit, and the challenges of regulation and implementation urgently call for a sociological lens onto this emerging field of psychiatry. This article identifies key sociological issues related to the medicalisation of psychedelic‐assisted therapies. It begins with a brief overview of the field's history and current treatment approaches. We then identify and critically examine three areas of sociological interest: the of role advocacy in the advancement of scientific research and the destigmatisation of psychedelics; issues related to the medicalisation and pharmaceuticalisation; and integration into healthcare systems. The challenges and affordances of psychedelics to existing therapeutic models, regulation and monetisation are highlighted, and the socio‐political context of the pharmaceutical industry, research, investment and implementation is examined. Drawing on health science literature in this field, the article offers a sociological lens on clinical psychedelic medicine as an emerging and potentially paradigm shifting field of psychiatry and psychotherapy.
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