Childhood maltreatment is extremely common in patients diagnosed with psychotic disorders. Moreover, it has been linked with impaired functioning of the Hypothalamic-Pituitary-Adrenal axis. Furthermore, abnormality of the HPA has been found in psychotic patients. Presence of childhood maltreatment could then explain why the HPA axis is dysfunctional in these subjects. Our objective was to clarify the role of childhood trauma in the cortisol profiles of psychotic patients. Thirty-one patients underwent assessments of childhood maltreatment. Diurnal cortisol and cortisol after a controlled psychosocial stress were also collected. Our results show that childhood trauma is associated with lower cortisol levels during the morning and during 24 hours. In men diagnosed with psychosis, childhood trauma is also associated with a higher cortisol response during psychosocial stress. This suggests an alteration of the HPA axis in psychotic patients, resulting from early trauma. Moreover, our results suggest that looking at specific types of childhood abuse may also be important.

Clients involved with child protection systems due to issues of neglect are known to have multiple needs. The issues that they confront are personal, situational, and social in nature. The emphasis on risk reduction in many jurisdictions within North America has meant that needs have been given less priority. The aim of the exploratory study was to gain a better understanding of both the nature of needs and risks in cases of child neglect in Ontario, as well as the similarities and differences in the views of clients and child protection workers. It is posited that through the acquisition of knowledge in those areas, that improvements can be made in assessing and planning, in creating agreed upon expectations about the objectives of intervention, and in developing a better balance between the addressing of needs and risks. / For the study, an instrument was designed to measure client perceptions of their problems and needs. It was compared with workers' perceptions of risk as contained in the risk assessment instrument completed by all child protection workers in Ontario. The Client Perception of Problems and Needs Scale was administered to 77 parents receiving services from Family and Children's Services of Renfrew County due to concerns about child neglect. / The finding that participants felt their needs were greatest in dealing with issues of stress, child behaviour and mental health issues, and in coping with socio-economic disadvantage was congruent with the few studies that have been conducted on the perceptions of child protection clients about their needs and problems. The analysis of the risk assessment data provided evidence that reliance on risk reduction at the expense of needs-based approaches, is not warranted. Few similarities were found in the perceptions of clients and workers about the issues of greatest concern. However, it was surprising that few concerns emerged about the clients' living conditions, or the affective interaction between clients and their children. Finally, the study demonstrated that the participants were able to recognize their problems, used various coping strategies for dealing with them, and were able to articulate strengths and resources on which they relied.

Sverige har en lagstadgad anmälningsplikt som är obligatorisk för alla som i sitt arbete kommer i kontakt med barn. Lagen är tydlig med att alla misstänka missförhållanden skall anmälas. Forskning visar att anmälningsplikten inte alltid fungerar och att det bara är en liten del av de barn som riskerar att fara illa som kommer till socialtjänstens kännedom. Vidare forskning visar att få anmälningar kommer från hälso- och sjukvården. Syftet var att beskriva sjuksköterskans erfarenheter i mötet med barn som far illa eller riskerar att fara illa. Litteraturstudien genomfördes med kvalitativ design och sökningar har gjorts i CINAHL, MEDLINE och PsycINFO. Åtta artiklar ansågs relevanta. Under analysen framkom tre teman: en emotionell utmaning, att känna sig begränsad och att våga agera. Resultatet visar att sjuksköterskan blir berörd i mötet med barn som far illa. Vidare beskriver sjuksköterskan osäkerhet, bristande kunskap och brister i organisationen. Sjuksköterskans professionella trygghet beskrivs utifrån kunskap och förvärvad erfarenhet. Det är angeläget att sjuksköterskans yrkeskompetens upprätthålls samt att det finns stöd att tillgå för att utveckla omvårdnaden kring barn som far illa. / In Sweden, everyone who comes in contact with children through their work has a statutory obligation to report child abuse. The law clearly states that any suspected child abuse must be reported. Research shows that the reporting does not always work. Only a small proportion of the children who might be victims of abuse come to the knowledge of Social Services. Further research shows that few notifications come from individuals within the health care system. The aim of this literature review was to describe nurses’ experiences of encounters with chil-dren who are victims of abuse or who are at risk of being abused. A qualitative design was used. CINAHL, MEDLINE and PsycINFO were used to select the articles, eight of which met the selection criteria. During the analysis, three themes emerged: An Emotional Challenge, Feeling Limited, and Daring to Act. The results show that the nurses are emotionally affected by their contact with abused children. The nurses also describe feelings of insecurity, a lack of knowledge, and organizational deficiencies. The nurses’ professional security is described as stemming from knowledge and experience. It is very important that the nurses’ professional competence is maintained and that there is support available in order to develop the care of abused children.

No description available.

This thesis is a case study of coordination policies and practices in child protection services. The study is an exploratory, descriptive account of the processes and outputs of interagency coordination rather than a hypothesis-testing study or an evaluation of the outcomes of coordination. It is based on empirical research undertaken in two research sites in the north of England. The principal data sources used in the research were: an analysis of the social services departmental case records relating to a sample of 48 children on child protection registers for physical or sexual abuse; interviews with 90 professionals (social workers, teachers, community nurses, police officers, doctors and others), drawn from a sub-sample of the 48 cases; a questionnaire issued to those interviewed and selected others, completed by 81 respondents; and analysis of central government guidance, local interagency procedures and other documents. In Chapter One of the thesis, selected topics in the literature on interagency coordination and the policy background to the study are reviewed. The research methods used and the characteristics of the case sample and the interview and questionnaire respondents are presented in Chapter Two. The principal research findings are presented in Chapters Three to Eleven covering three main topics: i) interagency coordination in the key phases of a case career (namely referral, initial investigation, medical assessment, case conferences, child protection plans and intervention, monitoring and review) ii) an examination of local interagency procedures and the role of Area Child Protection Committees and iii) the perceptions and experiences of respondents concerning interagency work. The thesis concludes that there is a high degree of routinised coordination with a relatively clear division of labour in child protection services; that coordination involves principally the exchange of information, arranging for the sequential and separate performance of key tasks and some limited shared decision-making but that there is little joint hands-on collaboration; that interagency activity peaks in the early phases of the construction of a case and diminishes thereafter; that the implementation of policy guidance may be seen as relatively successful and that there is some support for the idea that interagency coordination strategies tend towards conservatism.

Decisions made in Youth Protection cases are influenced by many different factors that have been outlined in previous research. Assessment tools, definitions of risk and the overarching cultural milieu intermingle to inform the decision-making process and, ultimately the final decision. This research seeks to explore the factors that affect the decision-making process and is intended to build on previous research. By qualitatively analyzing the transcripts from actual decision-making meetings, and talking to the participants about their experiences within the research it was shown that the decision-making process is a complicated one. The roles of the participants within the organization along with the pervasive culture of blame within society seem to primarily affect the dynamics of the people responsible for making the decisions. The effect that these factors have on the actual decision was not studied but would be beneficial to examine. Workers within the organization, especially caseworkers, struggled with wanting more autonomy while simultaneously reported not wanting the responsibility that coincides with it. It is felt that more responsibility would ultimately mean more possibility of blame.

Thesis (MSocSc)--University of South Australia, 1996

Thesis (M.A.)--University of Toronto, 2004. / Adviser: Katreena Scott.

Thesis(M.S.)--Auburn University, 2006. / Abstract. Vita. Includes bibliographic references.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 5 uppsatser.