Ian C. Lewis

Changing patterns in community attitudes to child abuse

Abstract Tasmania is the island state of Australia with a population of 416,000 people. A statewide programme on child abuse was commenced with the passing of a Child Protection Act in 1974. The results of the introduction of education programmes for professional groups and of providing information for the community have been analysed. Since 1972 notifications of suspected cases of child abuse have risen sixfold, but even now there are fewer cases reported in areas away from the main professional centre in the state. In the types of abuse being reported, there has been a sharp rise in self referrals and children deemed to be at risk. Sexual abuse may have been dealt with by other agencies before, but is now being notified. There has been a change in the age groups of children coming under notice with an increase in those between 2 and 12 years and a fall in those 0–2 years. The proportions of notifications from the various agencies have changed with considerably more coming from self referrals, from community referrals and from the education services. These trends would seem to indicate that both the professionals and the community are more aware of child abuse than formerly.

Humanizing paediatric care

This paper deals with the development of a paediatric team approach to the care of children in the 70 bed paediatric unit in the Royal Hobart Hospital in Tasmania, Australia, and describes the measures used to help children and their parents adapt to life in hospital with a limited budget. The staff includes paediatricians and pediatric surgeon, resident staff, nurses, teachers, social worker, physiotherapist and pharmacist. There are no visiting hours but the wards are open to parents and relatives at any time. Parents are encouraged to stay in hospital and their accommodation is either in flats at the end of wards or in single or double bed wards using foldup beds. Each young child has a personal details form completed and placed on the end of the cot allowing a nurse to discover likes, dislikes, methods of feeding and sleeping, etc. Parents are asked to complete questionnaires at the time of the childs discharge, asking for their assessment of the standards of care their child received. Playleaders are rostered for evenings and weekends and they work with, and direct Red Cross volunteer ladies. Two full-time teachers cooperate with the childs school in maintaining the childs educational progress. Volunteer visitors entertain children whose relatives are unable to visit or stay in hospital. The methods used to raise the standards of paediatric nursing are also described. Community groups, particularly kindergarten and primary school children, are encouraged to visit the paediatric unit and each group is usually given a brief health education talk by a member of staff.

HAEMOPHILIA — ITS MEDICAL MANAGEMENT1

The name haemophilia was coined by a German, Schonlein, about 150 years ago but it is only really in the last decade that the patient with this disorder in one of its more severe forms has had any real hope of leading something approaching a normal life.