ListenSeptember 2008
With comprehensive instruction that includes emphasis on diverse cultures, English learners and reading in the Digital Age, Pearson's revolutionary new school reading programs moved one step closer to the classroom today as the California Curriculum Commission voted to recommend all six submissions to the State Board of Education for final approval in November. Pearson today also announced plans to showcase its programs at the California Reading Association's (CRA) annual meeting in Sacramento next month, where the conference theme is 'Comprehension . . . A Key to Many Doors.'
"Our reading programs are indeed aimed at boosting comprehension," said Vicky Bush, Pearson's Vice President for California. "In fact, Pearson's curriculum has been designed specifically to ensure that the state's teachers possess all the keys they need to open those doors that will build the next generation of readers."
Bush noted that Pearson, the world's premier educational company, is the only publisher whose materials are being recommended in all curriculum categories and that "our deep bench of authors is second to none."
The six comprehensive K-12 programs address a wide range of critical reading issues confronting the state's schools, she said. Pearson's customized programs represent a continuum of curriculum aligned to California standards from kindergarten through high school. The recommended submissions include an integrated array of instructional materials with embedded intervention and assessment, and digital media, all aligned to Reading First requirements and revised State standards. The offerings are published in identical formats in Spanish and include professional development for teachers.
"We are the only publisher with such a unified and seamless approach to the learning and instruction of reading in California," said Bush. "All the programs easily and naturally connect with one another."
The publisher's research-based customizations for California meet new state requirements while addressing the realities of 21st century learning in the nation's most diverse state. Bush noted that Pearson's programs have been infused with new material and concepts specifically relevant for California, contributed by nationally renowned experts who are co-authors for the programs.
Press Release: PRWeb
26 September 2008
http://www.prweb.com/releases/2008/9/prweb1391864.htm
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CANADA
Hosted by the University of Winnipeg, Canada, an important meeting has brought together representatives from Canada and around the world over the last two days to discuss the role the private sector plays through socially responsible initiatives to curb sexual exploitation of children.
The Global Expert Thematic Consultation on Corporate Social Responsibility for the Protection of Children from Sexual Exploitation is one of the five thematic focuses of the 3rd World Congress against the Sexual Exploitation of Children and Adolescents to be held in Rio de Janeiro, Brazil, on 25-28 November 2008.
The number of children in both affluent and impoverished parts of the globe who are trafficked for sexual purposes, exploited by tourists, and abused through pornography and Internet-related crimes, continues to increase year by year. This growing phenomenon of the sexual exploitation of children and adolescents can take many forms: child pornography, trafficking of children, child sex tourism, abuse and exploitation in the family and in schools, child marriage, sexual exploitation in labour and supply chains, abuse of child domestic workers, or sexual violence in conflict and post-conflict settings.
"It is our shared commitment to curbing the sexual exploitation of children that unites us and has drawn us here this week" says Nigel Fisher, President and CEO of UNICEF Canada and co-rapporteur of the meeting. "No longer hidden behind the doors of homes and hotel rooms, it is only a keystroke away from each of us. Curbing the violation of our children is a challenge all of us must take up together. We have a new opportunity to commit to act on it."
Lessons learned
In the last two days, the participants in the Winnipeg Global
Consultation have worked together to examine what's working and what
more is required. They are now expected to shape the recommendations and
dialogue for the corporate social responsibility theme at the World
Congress, as well as to inspire the private sector to expand the
exemplary work of industry leaders. The group has learned more about
codes of internal and industry-wide corporate conduct, and about their
effective implementation and monitoring; about innovative legislation to
protect children from sexual exploitation; and about the latest research
on what works to guide its efforts. The delegates have heard directly
from young people about what they need to do.
The Winnipeg Global Consultation is organized by UNICEF Canada and the Child Welfare League of Canada, with the contribution of the Canadian Red Cross, Beyond Borders, the Canadian Centre for Child Protection in collaboration with the Central Organizing Committee for the World Congress, and with the financial support of the City of Winnipeg, the Winnipeg Foundation, Healthy Child Manitoba and the Canadian International Development Agency (CIDA).
On the road to Rio
The private sector plays an important and growing role in the
prevention of violence, exploitation and abuse. The evolving face of
child sexual exploitation in travel and tourism, in virtual space, and
in the media renders it impossible to counter without the private
sector's involvement and support. The travel and tourism industry and
new technologies have been at the centre of private sector initiatives
to eliminate sexual exploitation of children. Other sectors and their
roles to prevent the sexual exploitation of children have only been
marginally considered.
The aim of the working meeting in Winnipeg leading up to World Congress has been to broaden the range of socially responsible partnerships among a variety of industries, and with companies large and small. On the road to Rio, global expert thematic consultations are gathering the perspectives of researchers, industry leaders, government, civil society and young people to discuss and resolve to act on measures to address the sexual exploitation of children.
Referring to what has been accomplished so far, Nigel Fisher concludes by saying: "It's no longer good enough for governments and civil society organizations to labour alone against this blight on humanity. Private sector entities also have an obligation to act. There are more children exploited today than when we first officially joined efforts at the first World Congress just over 10 years ago," says Fisher.
The 3rd World Congress against the Sexual Exploitation of Children and Adolescents will gather over 3,000 participants to decide and commit to actions to be undertaken across all sectors to build a stronger protective environment for children. For more information, visit: www.sedh.gov.br or www.ecpat.net/worldCongressIII.
Press Release: PR_Canada
28 September 2008
http://pr-canada.net/index.php?option=com_content&task=view&id=49169&Itemid=61
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NEW ZEALAND
Mortality rates for children and youth improving
Mortality rates for children and young people have declined considerably over the last 20 years, an independent advisory committee said in a report tabled in Parliament today. The Child and Youth Mortality Review Committee’s Fourth Report to the Minister of Health covered deaths of children and young people from January 2002 to December 2005. “This report intends to give a fuller picture of child and youth mortality in New Zealand and help us understand the complex issues relating to these deaths,” said Professor Barry Taylor, former Chair of the Committee.
Established in 2002, the Committee collects information on all mortality occurring between four weeks and 25 years of age, to determine trends and patterns and to review the circumstances of mortality to seek preventable factors. It then makes recommendations to the Minister of Health on ways to reduce mortality. The committee is supported by a large number of advisors and a network of local groups.
The overall trends for child and youth mortality rates are improving. However, international comparison suggests that New Zealand is behind many other OECD (Organisation for Co-operation and Economic Development) countries, and ethnic disparities remain a concern.
“Many deaths are preventable. The prevention of deaths requires work across the whole community, far beyond the health sector,” says Nick Baker, current Chair of the Committee. Improvements in mortality review systems and processes over the last few years will contribute to reducing preventable deaths. As more information is collected it will provide direction for action and enable monitoring of that action over time.
Some of the issues the Report highlights include the:-
improving child and youth mortality rates
need for every baby to have a safe place to sleep
importance of developing youth health services and interagency collaboration to create supportive environments for young people
value of bringing information together at a local and a national level to understand the factors that contribute to child and youth mortality.
The Committee has worked with the Ministry of Health to ensure that professionals have access to up to date and relevant information and messages to help parents and the community understand the need for safe sleeping places, safe sleeping positions and protecting infants to keep them safe while sleeping.
The importance of creating supportive environments for our young people as a way of reducing risk taking behaviour and preventable deaths is highlighted in the report. Youth Health: A guide to action is acknowledged, and it is recommended that DHBs should be encouraged to implement it. This will support young people to build healthy connections across whânau, schools, peers, work and training, culture and environment. The Mortality Review process brings together “the pieces of the puzzle” at both the local and national level. Local Child and Youth Mortality Review Groups (LCYMRGs) are currently operating in ten DHBs. It is planned that local mortality review will be operational in all DHBs within the next year.
“Every death is a tragedy. While we cannot undo the circumstances of deaths we must learn from them and act to prevent similar deaths. Developing the system of collecting information has been important; we must now continue to develop ways to make best use of this information to benefit our children and young people. Much work is still to be done.” said Dr Nick Baker, the Review Committee’s current Chair.
Press Release: Ministry of Health
23 September 2008
http://www.scoop.co.nz/stories/GE0809/S00144.htm
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Millions of American children are exposed to violence in their homes each year, putting them at risk for a variety of emotional and behavioral problems. According to a new study in the September/October 2008 issue of the journal Child Development, children who are maltreated tend to have a lot of re-exposure to family violence, and this re-exposure often leads to increased psychological problems.
Researchers at the University of Pennsylvania, University of California, Irvine, and West Chester University found that the types of violence that abused children were subsequently re-exposed to led to specific types of psychological problems. Specifically, previously abused children who witnessed family violence had more symptoms of depression and anxiety, while previously abused children who were subjected to harsh physical discipline were more aggressive and broke rules more frequently.
"Our study has implications for mental health treatment and policy: Clinicians and service providers should be especially concerned about the substantial number of maltreatment victims who are re-exposed to family violence, because these children are highly vulnerable to ongoing emotional and behavioral problems," according to Andrea Kohn Maikovich, a Ph.D. candidate at the University of Pennsylvania and the study's lead author. "Understanding more about how violence affects youth can help us develop more cost-effective and targeted interventions for our nation's young victims of violence," she added. "Because victims of abuse and neglect are at increased risk of witnessing and experiencing other forms of family violence, intervention efforts must focus not only on protecting children from re-victimization as it is defined legally, but work to decrease even non-abusive forms of physical discipline such as corporal punishment and the amount of adult domestic violence children witness in their homes."
In the study, family violence was defined as partner-on-partner abuse, including yelling, throwing an object, hitting, beating up, pointing or using a knife or gun, and dealing drugs, as well as adult-on-child abuse, including the above examples and spanking. Harsh physical discipline was defined as anything from an adult spanking a child to an adult choking a child.
The researchers studied a racially diverse group of 2,925 children ages 5 to 16 years. All of the children had been reported to Child Protective Services as suspected victims of abuse (for neglect as well as physical, sexual, and emotional abuse). Three times over a three-year period, the children's caregivers reported how much physical discipline they used with the children, and the children reported how much violence they saw in their homes. Caregivers also reported on the children's emotional and behavioral problems.
It can be difficult to determine whether a child's emotional and behavioral problems are the result of experiencing violence in the home or are caused by the other stressful events that many victims of family violence experience. The researchers used a type of statistical testing that allowed them to examine whether witnessing home violence and experiencing harsh physical discipline were associated with children's emotional and behavioral problems above and beyond the effects of other factors that predict childhood mental illness and are strongly tied to violence, including poverty and caregivers' mental health problems. They also took into consideration each child's age and gender, as well as normal expected changes in childhood mental health over time.
Summarized from Child Development, Vol. 79,
Issue 5, Article adapted by Medical News Today from original
press release.
18 September 2008
http://www.medicalnewstoday.com/articles/121827.php
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The European Commission unveiled Thursday a new action plan for tackling drug abuse, with cocaine consumption in Europe on the rise.
The plan, for the 2009-2012 period, aims to reduce demand for and supply of illegal drugs, raise public awareness and improve education about the dangers and boost international cooperation on fighting the phenomena. It offers ways to improve medical treatment, forge better police and customs cooperation to counter organised crime within the 27 EU nations, but also on drug trafficking routes from Afghanistan and Latin America. "With up to two million problem drug users in the EU, it's high time to raise awareness of vulnerable groups, especially youth, on the risks of drug taking," said EU Justice Commissioner Jacques Barrot.
EU data shows that cocaine consumption is rising in a number of countries -- notably Britain, Spain and France -- with at least 12 million people estimated to have used the drug. Cannabis remains the most popular drug -- around 70 million people have used or use it -- while 9.5 million people have taken ecstacy and 11 million used amphetamines. Around 7,500 people die of drug overdoses each year.
The commission expects the plan to be adopted by EU nations by the end of 2008.
EU Business
18 September 2008
http://www.eubusiness.com/news-eu/1221743822.29
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US
Today the House of Representatives passed historic child welfare reform legislation allowing for the first time federal foster care assistance to be made available to kinship and relative caregivers. Also for the first time eligibility for federal adoption assistance will no longer be tied to the non-existent Aid to Families with Dependent Children program.
The Fostering Connections to Success and Increasing Adoptions Act was passed by a wide margin with broad bi-partisan support. The Senate is expected to take up the bill in the next few days. "This is an historic moment for foster children and families. We congratulate the House and urge the Senate to pass this bill as soon as possible. The kinship benefits and breaking the link to the old AFDC program are major steps forward and necessary as we strive to improve the child welfare system," said Christine James-Brown, President and CEO of the Child Welfare League of America. The legislation was introduced by Representatives Jim McDermott (D-WA) and Jerry Weller (R-IL) in the House. Senate Finance Committee chair Max Baucus (D-MT), Ranking member Charles Grassley (R-IA), and John Rockefeller (D-WV) are leading the effort in the Senate.
Kinship care is recognized as an effective way to increase stability and permanency for children who cannot stay with their parents. Living with relatives such as grandparents or aunts and uncles provides safety and a loving environment.
Language in the bill de-links eligibility for adoption assistance to the old AFDC program. This will make all special needs adoptions eligible for federal assistance and will encourage many more adoptions. Other significant reforms in the legislation include providing Native American child welfare organizations with direct access to federal foster care and adoption assistance, and providing states the option of extending foster care eligibility for youth up to age 21 from 18 and opening federal training resources to private non-profit child welfare agencies. Also included in the legislation are improvements regarding education and health services for children in the foster and child welfare system.
"The legislation marks a significant turn around in support for our most vulnerable children, youth, and families. We call on the Senate to act quickly and for the President to sign this bill as soon as it arrives at his desk," said Ms. James-Brown.
Founded in 1920, the Child Welfare League of America (CWLA) is the pre-eminent organization dedicated to ensuring that disadvantaged and vulnerable children are protected from harm and have the tools and resources available to help them grow into happy and healthy adults.
SOURCE Child Welfare League of America
PRNewswire-USNewswire
17 September 2008
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The University of Washington School of Social Work (UWSSW) and its new innovative center, Partners for Our Children (POC) has been selected by the American Public Human Services Association (APHSA) as the recipient of the 2008 Academic Excellence Award.
"The partnership is a unique public-private collaboration between the Washington State Department of Social and Health Services (DSHS), the University of Washington School of Social Work, and private sector committed to making positive changes in the child welfare system," said Robin Arnold-Williams, Secretary of the Washington Department of Social and Health Services who nominated the School.
"We are honored to receive this top national
honor for excellence on behalf of children and families," said Edwina
Uehara, Dean of the School of Social Work. "We believe by bringing not
only the resources of the UWSSW, but
all the disciplines of the university together, we will reach our goal
of improving services provided by the child welfare system."
In addition to serving as the home for POC, the UW School of Social Work also houses the Child Welfare Training and Advancement Program, which focuses on training new social workers and those already in the field in state-of-the-art child welfare practice. "We are grateful for and honored by the recognition provided by this human services award," said Mark Courtney, executive director, POC. "It is through partnerships such as ours -- grounded in rigorous evidence about what families truly need -- that real child welfare reform will take place."
POC's work involves research directed towards
improving understanding of the needs of children and families,
development and evaluation of promising approaches to improving outcomes
for foster children, workforce development activities intended to
improve the child welfare workforce, and public education and
communication. A variety of institutions have taken on one or more of
these objectives, but none has integrated them all into one
independent organization. Since July 2007, POC and DSHS have been
working together to better understand how best to increase resources for
foster family recruitment and retention, examining family reunification
standards across the state, analyzing the state's placement stability
rates compared to other states, and working to improve birth parent
engagement. "Partners for Our Children already has proven to be a
valuable partner in bringing together the state's experience, the
university's mind power and the resources of the private sector to
better understand the factors that impact the well-being of children,"
said Arnold-Williams. "State agencies can't do it alone. This type of
public-private partnership is one way that can better solve
complex human problems."
The Academic Excellence Award was established to recognize academic programs or institutions for outstanding contributions to the field of human services. "Colleges and universities can be important partners in efforts to serve clients and improve outcomes for vulnerable children, adults and families in the communities we serve," said Jerry Friedman, executive director of the APHSA. "The School has demonstrated its commitment to excellence in human services."
In 2007, over 32,000 of the most vulnerable children in Washington state received services while living in foster care or group care or after leaving care. On a given day, about 10,000 children and youth are part of the "system" because they can't safely stay at home with their parents. Because this population of children and families faces a complex set of challenges, it will take a multi-disciplinary approach to sustained improvement in outcomes for children.
About Partners for Our Children
POC was launched in 2007 with more than $12 million in direct
and in-kind investments, including a $10 million donation from Connie
and Steve Ballmer, $1 from State of Washington's 2007 Supplemental
Budget, and $1 million per year in salaries and in-kind operational
contributions from the University of Washington. The goal of POC is to
improve the well-being of children and youth in out-of home care.
Press release: PRNewswire
SOURCE Partners for Our Children
15 September 2008
http://www.earthtimes.org/articles/show/university-of-washington-school-of,540972.shtml
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Disabilities among refugees and conflict-affected populations
The World Health Organization (WHO) estimates that between 7 and 10 percent of the world's population live with disabilities. As such, it can be assumed that between 2.5 and 3.5 million of the world's 35 million displaced persons also live with disabilities. Among displaced persons who have fled civil conflict, war or natural disasters, the number with disabilities may be even higher.
Yet persons with disabilities remain among the most hidden, neglected and socially excluded of all displaced people today. People with disabilities are often literally and programmatically "invisible" in refugee and internally displaced persons (IDP) assistance programs. They are not identified or counted in refugee registration and data collection exercises; they are excluded from or unable to access mainstream assistance programs as a result of attitudinal, physical and social barriers; they are forgotten in the establishment of specialized and targeted services; and they are ignored in the appointment of camp leadership and community management structures. Disabled persons' potential to contribute and participate is seldom recognized: they are more often seen as a problem than a resource. Moreover, traditional community coping mechanisms, including extended families, neighbors and other caregivers, often break down during displacement. The loss of caregivers can leave persons with disabilities extremely vulnerable and exposed to protection risks.
This report is the culmination of a six-month project commissioned by the Women's Commission for Refugee Women and Children and co-funded by the United Nations High Commissioner for Refugees (UNHCR) to address the rights and needs of displaced persons with disabilities, with a particular focus on women (including older women), children and youth. Based on field research in five refugee situations, as well as global desk research, the Women's Commission sought to map existing services for displaced persons with disabilities, identify gaps and good practices and make recommendations on how to improve services, protection and participation for displaced persons with disabilities. The objective of the project was to gather initial empirical data and produce a Resource Kit that would be of practical use to UN and nongovernmental organization (NGO) field staff working with displaced persons with disabilities.
While refugees and IDPs with disabilities face enormous challenges, the research was not wholly negative. The Women's Commission found examples of innovative and successful programs for refugees with disabilities, particularly in the areas of inclusive and special needs education, vocational and skills training, community health care and outreach programs and prosthetics and physical rehabilitation (especially for land mine survivors). We found situations where refugees with disabilities and their families were highly organized and had formed their own self-help support groups. The Women's Commission also found examples of positive disability awareness programs. Given an accessible physical environment, heightened disability awareness, both within their community and the local host community, and an inclusive approach by agencies assisting them, displaced persons with disabilities can live independent lives, participate fully in public affairs and make positive contributions to their communities.
The research found that, in general, services and opportunities for refugees with disabilities were better in refugee camps than in urban settings. Due to the more geographically and socially cohesive nature of refugee camps, it is easier to identify refugees with disabilities, adapt programs to be more inclusive and set up specialized services. It is also easier to effect attitudinal and programmatic change in refugee camps. Urban refugee communities are more dispersed and less physically cohesive. Many urban refugees are undocumented and lack any legal status. They are often afraid of the authorities and prefer to remain "hidden." This makes it much harder to identify persons with disabilities or to integrate them into mainstream or specialized services.
The study showed that less information and fewer services were available for people with mental disabilities than those with physical and sensory disabilities. Refugees with mental disabilities tended to be more "invisible" and "hidden" from public view than those with physical disabilities. They were less likely to be identified in registration and data collection exercises and tended to be more excluded from both mainstream and targeted assistance programs. They were less likely to be included in decision-making processes or in leadership and program management structures.
Full Report (pdf format – 1.9 Mbytes)
ReliefWeb, Switzerland
10 September 2008
http://www.reliefweb.int/rw/rwb.nsf/db900SID/MYAI-7JD5DK?OpenDocument
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Public backs tougher tobacco control to protect the young
More than 8,000 people have written to the Department of Health calling for tougher tobacco control to protect young people and put tobacco out of sight and out of mind. This comes as new Cancer Research UK findings from the University of Stirling reveal that the more cigarette brands young people can name, the more likely they are to smoke. In fact, for every cigarette brand a young person can recall having seen at the point of sale their chance of smoking increases by 35 per cent.
The calls for stronger legislation are being submitted alongside Cancer Research UK's response to the Government consultation on the future of tobacco control. The charity believes that three measures – removing tobacco products from sight at the point of sale, removing cigarette vending machines and making plain packaging compulsory for tobacco products – should be adopted as part of a broader national tobacco control strategy.
More than 80 per cent of smokers start before the age of 19 and half of all long-term smokers will die of cancer or other smoking-related diseases. Around 22 per cent of the population currently smoke so new measures are needed to help reduce this figure and build on the success of last year's smokefree legislation.
The prime location of point of sale displays still offer tobacco companies a key opportunity to promote the packs and the product. Beginning in 2003 most forms of tobacco advertising and promotion have been prohibited across the UK but this has not included restrictions on point of sale displays or on pack design. In response the tobacco industry has continued to develop displays in shops by using lighting, brand specific colours on surrounding areas and attention-grabbing designs as well as making the packs themselves even more enticing. These loopholes are having a dramatic impact on young people.
The tobacco industry claims that smokers need these displays to help choose their brand of cigarettes and that they are not designed to attract new smokers. However, Cancer Research UK evidence shows that only 6 per cent of smokers decide on which product to buy based on these displays. The overwhelming majority of smokers always buy the same brand.
The report also shows that tobacco related products – roll your own papers, lighters and matches – make use of a variety of marketing techniques that are prohibited for the marketing of tobacco. The techniques are increasingly targeted, directly or indirectly, at young people.
Many young people, particularly underage smokers, buy cigarettes from vending machines. Removing these machines altogether is the only effective means of preventing underage smokers obtaining cigarettes from these sources.
Professor Gerard Hastings, director of social marketing at the University of Stirling, said: "We know that the younger you are when you start smoking the harder it is to quit. Our research shows that the point of sale displays allow tobacco companies to package and market cigarettes with powerful brand imagery to entice new smokers. This turns the pack, or 'silent salesman', into a small advertisement and the wall of cigarettes into a big one. Children are still being exploited and ultimately, they will only be truly protected when tobacco promotion and marketing in all its forms ceases to exist."
Scotland currently leads the UK with plans to introduce legislation in the coming year to remove the display of tobacco products at point of sale. This current consultation is for England but these measures to protect young people could also be introduced in Wales and Northern Ireland.
Jean King, Cancer Research UK's director of
tobacco control, said: "We've come a long way – introducing smokefree
laws and making it illegal to sell cigarettes to under 18's – but the
job isn't done. The evidence is clear and strong support from the public
is there – we need to put tobacco out of sight and out of mind to
protect all young people. The Government has the opportunity to act with
conviction and further reduce the devastating impact that tobacco has on
so many lives."
Child Health News
7 September 2008
http://www.news-medical.net/?id=41226
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MUHC researchers develop a questionnaire for children to determine if their hospitalization made them fearful, anxious, worried
Children who spend time in the intensive care unit of a hospital can be traumatized by the experience even months after returning home. Dr. Janet Rennick from the Research Institute of The Montreal Children's Hospital of the McGill University Health Centre and her colleagues have developed the Children's Critical Illness Impact Scale to measure psychological distress in children following hospital discharge. This is the first self-report scale ever created to measure the psychological impact of intensive care unit hospitalization on children. The Journal of Pediatric Critical Care Medicine recently published the study.
This 23-item questionnaire provides a tool that will allow health care professionals to pick up on and recognize those children who need psychological support as a result of their hospital stay. It is based on the results of 64 interviews conducted with children who had been hospitalized in an intensive care unit, their parents, and health care professionals. The study was conducted across three Canadian pediatric hospitals.
"We know some children suffer post traumatic stress symptoms after having spent time in the intensive care unit," explains Dr. Rennick, "Parents and children have described delusional memories of their hospital experience which continue to bother the child after they go home. In addition, parents have described behavioural changes and ongoing fears in their children, and children have told us they don't feel the same as they did before they were critically ill. This tells us something negative is going on with these children, but there was no way to capture the whole story since questionnaires had not been developed specifically for use with this population of children. As a result, we found that some kids were falling through the cracks and not getting the help needed to cope with the stress of hospitalization."
Dr. Rennick and her colleagues decided to develop a questionnaire specifically for children aged six to 12 years. It was a challenging exercise because they had to find a way of interviewing children that would encourage and allow them to share their feelings and fears.
The interviews were done in two ways, focus groups and individual interviews. For younger children, researchers used a storyboard with felt pieces and hospital play sets. The children were encouraged to use the felt pieces to tell a four part story about: being in the hospital, going home, going back to school, and returning to the hospital for a check up.
"This interviewing method worked well for younger children who created detailed stories of their experiences But we discovered that the storyboard method was less effective for children 10 years and older. While it helped them focus on their hospital experiences, they didn't interact with the storyboard in the same way the younger children did. They would handle the felt pieces, and simply tell their story as we changed the storyboards," says Dr. Rennick.
Dr. Rennick believes this child friendly, self-report questionnaire will allow health care workers to more effectively determine if children are bouncing back after an intensive care unit stay. "With this new scale we will be better able to pick-up and help the child whose life simply hasn't returned to normal."
Press release: EurekAlert
Source: McGill University Health Centre
3 September 2008
http://www.eurekalert.org/pub_releases/2008-09/muhc-sti090308.php
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Call for more children's panel volunteers in Scotland
Adults across
Scotland are being urged to help improve the outlook for children who
have been neglected or abused by getting involved in children's panels.
Children's Minister Adam Ingram today kickstarted this year's call for
more children's panel volunteers – with top Scots actress Daniela
Nardini backing the drive as the voice of a hard-hitting national radio
campaign.
Mr Ingram, who met young people who have had experiences of children's
panels as he launched the campaign, said:
"We owe every child the chance to fulfil their potential and children's
panels make a huge difference to young people's lives, helping them
through turbulent times and trying situations.
"By listening to children who have been neglected, abused or have fallen
foul of the law and ensuring support is in place early we can improve
the future outlook for them, and for Scotland as a whole.
"Helping vulnerable young people and guiding them through difficult
periods has to be one of the most worthwhile and rewarding contributions
any of us can make as adults.
"Local panels rely on volunteers, there are no special qualifications
needed and we want people from all backgrounds to consider joining up
this year to improve the life chances for young people in their area.
"If you are over 18, can spare some time and want to help – we want to
hear from you. Just call 0845 601 2770 or text Panel3 to 61611 or go to
www.infoscotland.com/childrenspanel."
Daniela Nardini – who shot to fame in hit BBC drama This Life – said:
"As a mum, helping shape and change the direction of children's lives
for the better is something I feel passionately about. That's why this
campaign is so important. I commend and congratulate all those involved
with children's panels but we need more volunteers to help improve the
lives of children in Scotland."
The four week recruitment campaign for the children's panel will include
radio, print and digital advertisements. Around 550 volunteers are
needed across Scotland.
The children's panel is unique to Scotland and was established in 1971
to address the needs and behaviour of children and young people who face
serious problems in their lives. These problems can include, for
example, a child being abused, a child failing to attend school, the
child's parents having difficulty looking after them or a child
committing an offence.
Children are referred to a children's hearing where compulsory measures
of supervision are thought to be needed. A children's hearing is a lay
tribunal of three panel members. The child, parents/carers and relevant
professionals all normally attend the hearing and take part in the
discussion. The children's hearing considers and makes decisions on the
measures required to best meet the needs of the child or young person
before them. The "needs" of the child include addressing any "deeds".
During 2006-07, over 56,000 children were referred to the Children's
Reporter. Only a small percentage of these cases go on to a Children's
Hearing.
A public consultation on proposals to reform and streamline Scotland's
Children's Hearings system, to improve the support given to vulnerable
young people and create a more integrated system were announced by the
Scottish Government recently.
Source: Scottish Government
2 September 2008
http://www.egovmonitor.com/node/20720
___
Suicide Prevention And
Antidepressants
Antidepressants are the cornerstone of treatment of depressive disorders
in health care. Their efficacy in treating depression is undisputable,
although it leaves room for improvement. However, recent reports also
suggest that antidepressants might, in some rare cases, actually worsen
suicidal tendencies instead of alleviating them. As a consequence,
research has intensified to clarify this issue, and regulatory
authorities in many countries have reconsidered their cost-benefit
ratio. While there is no doubt that such potential side-effects of
antidepressant therapy are a very serious issue, it is important to
obtain a balanced view of all the clinical and epidemiological facts
pertaining the effect of antidepressant therapy in relation to suicidal
behaviour.
Depression and risk of suicidal behaviour
Suicide is a significant public health issue. The World Health
Organization (WHO) estimates that annually about one million people
worldwide complete suicide. Thus, worldwide significantly more people
die by suicide than e.g. in armed conflicts or as victims of terror, or
tragic natural disasters such as earthquakes. Furthermore, completed
suicides represent only a tip of the iceberg of suicidal behaviour, as
for every completed suicide, there is more than ten-fold number of
non-fatal suicide attempts, and as many as almost one tenth of
individuals worldwide, also in the EU, report having had suicidal
ideation over their lifetime (Bernal et al., 2007; Nock et al., 2008).
In numerous psychological autopsy studies conducted worldwide, more than
90% of subjects completing suicide were shown to have suffered from
mental disorders. Suicides have multiple causes and should therefore not
be seen as merely consequences of mental disorders. Nevertheless, for
health care, the strong relationship between mental disorders and
suicides involves an obligation for prevention. Mood disorders,
principally major depression and bipolar disorder, are associated with
about 60% of completed suicides (Mann et al., 2005). More than half of
the subjects completing suicide during major depression communicate
their intent during the final 3 months, and almost all patients
attempting suicide report suicidal ideation (Isometsä et al., 1994;
Sokero et al., 2003). This communication of intent allows prevention by
appropriate treatment and other measures. However, the problem faced by
psychiatrists is a high number of suicidal patients and the difficulty
of identifying those at highest risk of completion among them.
Among psychiatric patients with major depression, non-fatal suicidal
behaviour is remarkably common. Almost half (about 40%) have attempted
suicide, and one half to two thirds of them (47%-69%) have suicidal
ideation (Sokero et al., 2003; Malone et al., 1995) when depressed. The
risk for suicide attempts is closely intertwined with the commonly
recurrent course of depression; the risk is about eightfold during a
major depressive episode compared to periods of full remission (Sokero
et al., 2005). The more time a patient spends in a depressed state, the
higher is the risk of suicidal acts over time. Among depressed patients
having suicidal ideation, decline in suicidal ideation is predicted by
declines in the levels of both depressive symptoms as well as
hopelessness (Sokero et al., 2006).
Thus, reducing the severity and the duration of a depressed state by
antidepressant treatment is likely to be an effective preventive measure
for suicidal acts, and alleviation of depression and hopelessness can be
reasonably expected to result in disappearance of suicidal thoughts.
Suicide prevention strategies
Depression is present in more than half of suicides, but in the majority
of these suicides it has remained untreated at time of death (Isometsä
et al, 1994; Henriksson et al., 2001). Even after a suicide attempt,
depression often remains unrecognized, untreated or undertreated
(Oquendo et al., 2002).
The role of targeting depression for suicide prevention has been
highlighted in a worldwide review and consensus of leading authorities
in suicide research, in which the effectiveness of specific
suicide-preventive interventions was examined: Only physician education
in recognition and treatment of depression as well as restricting access
to lethal means were clearly identified to prevent suicide, other
interventions still need more testing (Mann et al., 2005). Thus,
treating mood disorders and other psychiatric disorders is a central
component of suicide prevention.
Improved recognition and treatment of depressed patients in primary care
alongside improved access to psychiatric services is a key prevention
strategy for suicide.
Antidepressants and suicide risk: what is the evidence?
In numerous short-term randomized clinical trials (RCTs) of
antidepressants for depression in children and adolescents (<19 years),
antidepressants are found to be associated with a slightly higher
proportion (0.7%) of patients reporting suicidal ideation or a suicide
attempt than control patients receiving placebo (Bridge et al., 2007).
It is important to note that there are no completed suicides in these
studies. Adults treated with SSRI antidepressants in randomized clinical
trials have a similar risk of either non-fatal self harm or suicidal
thoughts than those on placebo (Gunnell et al., 2005 & 2006). It is
undisputable that at least among children and adolescents,
antidepressants have some potential of causing harm to a small subgroup
of vulnerable patients, at least in the beginning of treatment. However,
there are several reasons why such trials are likely to create a
distorted view of the total balance of benefits and harms of
antidepressants:
First, short-term clinical trials are designed to produce statistical evidence of efficacy for regulatory purposes, and their duration is only as long as necessary to produce this evidence. Thus, the trial ends when the drug response has evolved. During the trial patients spend most of their weeks with possible side effects, but not yet full antidepressant response. With regard to suicidal behaviour, the benefits come with the response, gradually over time.
Second, for ethical reasons, subjects who are severely suicidal at the time of evaluation for the trial must be excluded, since they might receive placebo. This changes the balance between observed negative and positive effects with regard to suicidal behaviour in these trials. Worsening of mild pre-existing or newly emerging suicidal behaviour can be usually detected. However, as most severely suicidal patients must be excluded before a trial starts, it remains unknown whether they would benefit from the active treatment. As naturalistic studies do suggest such improvement, this bias is not merely hypothetical. Antidepressant trials have not been designed to investigate suicidal behaviour, and they cannot provide unbiased information on their overall effects related to it.
Third, factors resulting in short-term suicidal ideation, or even less severe suicide attempts do not necessarily result in significantly increased risk for completed suicide, as mental disorders and their symptoms related to completed suicides are usually more severe. There is no evidence of increased rates completed suicides in antidepressant trials (Khan et al, 2003).
Fourth, clinical trials do not reflect usual treatment. In usual care, the attending doctor can promptly discontinue antidepressants that involve intolerable side-effects, adjust dosage, and switch and combine agents. Antidepressants are only part of treatment, which should always include a trustful relationship between the doctor and the patient, with necessary support and psychosocial treatments.
The most important test for the role of
antidepressants in suicide prevention is real life: In contrast to these
randomized clinical trials, observational studies of antidepressant
treatment, which typically include abundantly highly suicidal patients,
demonstrate a marked alleviation of suicidal behaviour in the vast
majority of patients. In clinical practice, the benefits of treatment
are seen over time as the drug response consolidates. Patient population
studies of adolescents report lower rates of suicide attempts and of
adults both attempts and completions over time as treatment continues
(Valuck et al., 2004; Jick et al., 2004; Simon et al., 2007; Sokero et
al., 2006; Simon et al., 2006).
In many western countries (e.g. Korkeila et al., 2007), increasing use
of antidepressants on the national and regional level expectedly
correlates with declining suicide mortality. Of course, such ecological
studies do not prove that antidepressants have caused the observed
decline in suicides, but nevertheless, they are consistent with a
positive or at worst, neutral net effect on suicides. Most importantly,
there is no evidence for increased national suicide rates due to
increased use of antidepressants.
Antidepressants reduce the severity, and the time a patient spends in a
depressive state, which are credible factors in reducing the risk for
suicidal acts.
Clinical implications
Depression is the most important single factor predisposing to suicide, and more than half of all subjects completing suicide are known to have suffered from depression. Thus, any treatment that is widely available, safe and efficacious in alleviating depression is plausible for purposes of suicide prevention.
Register-based and observational studies have provided individual-level information on depressed subjects on and off antidepressants in real life conditions: Compared to randomized clinical trials these studies give a more realistic account of risk of suicidal behaviour, and suggest antidepressants to be beneficial for suicide prevention.
While antidepressants likely have a potential for provoking suicidal behaviour in some vulnerable individuals in the early phases of treatment, from a public health perspective, the epidemiologically much more important effect of antidepressants is to alleviate depression and thus reduce the risk of suicide.
Adapted by Medical News Today from original
press release.
1 September 200-8
http://www.medicalnewstoday.com/articles/119783.php
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