Fatal child abuse-maltreatment syndrome. A retrospective study in Ontario,Canada, 1990-1995

Child death due to repeated episodes of physical assault or neglect has been termed the child abuse-maltreatment syndrome (CAMS). We characterized the injuries in a series of fatally abused or maltreated child to delineate objective diagnostic criteria for the CAMS for use by clinicians and pathologists. All deaths (age <17 years) investigated by the Office of the Chief Coroner for Ontario, Canada during the time period 1990-1995 were reviewed. Cases of CAMS were defined as death due to lethal recent injury or malnutrition in the presence of significant old (healing or healed) injuries indicative of repeated episode of inflicted trauma. The nature and frequency of the various injuries was determined. The frequency of the shaken baby syndrome, and the types and frequency of ano-genital injuries were also studied. Twenty-one cases of fatal CAMS were found in the study period. Most cases had significant recent head injury with intra-cranial hemorrhage (71%). Other significant recent injuries commonly observed included blunt injuries of the skin and soft tissues (67%), blunt abdominal trauma with visceral injuries (14%), and fractures (18%). Eight cases (38%) fulfilled accepted criteria for the shaken baby syndrome. Many children with fatal head injuries had evidence of older head trauma (38% of all cases). A significant minority of cases had evidence of malnutrition due to neglect (10%) or ongoing ano-genital injuries (10%). Most cases of child homicides due to repeated episodes of abuse or maltreatment involve head trauma including shaken baby syndrome. Fractures of long bone and ribs, the classical markers of child abuse, were relatively infrequent compared with head injury. A proportion of cases had ano-genital injuries due to repeated sexual abuse or punitive maltreatment. All clinicians and pathologists must recognize the wide spectrum of injuries in child abuse to ultimate protect the victim or other children in an at-risk situation.     

Need Public Policy Ignore the Third Sector? Government Policy in Australia and the United Kingdom

The policy of Australian governments, both Commonwealth, state and territory, toward those organisations that comprise a third sector of the organised economy is patchy and piecemeal. Absent is any recognition that they constitute a distinct sector; absent too is any recognition of their contribution to economy, society and politics. Such a situation is not inevitable. After identifying some of the gaps and contradictions in Australian policy toward the third sector, this article outlines the many policy initiatives to encourage the third sector or social economy (in European Union terms) taken by the Blair government in the United Kingdom. Given that there is a good deal of policy borrowing between Australia and the United Kingdom, the stark contrast between the two countries in this policy field is puzzling. This article concludes by identifying four developments that led to this policy explosion in the United Kingdom and finds them largely missing in Australia. This leads to a conclusion that a similar range of policies are unlikely to develop here.     

Costing Constitutional Change: Estimating the Cost of Five Variations on Australia's Federal System

Australia's system of government is by far the most centralised of the four 'classic' federations, hosting extremely centralised states, exceptionally weak local governments, and little of the substantive decentralisation and subsidiarity often presumed to derive from a federal structure. Five variations on the present structure are examined to estimate the costs of improved decentralisation, including New States models as traditionally advocated, Regional States models based on the ACT combined state–local prototype, and a National–Local model comprising a strengthened national government and local governments in essentially their present form. 1 Results indicate that the Regional States or National–Local models could deliver greater decentralisation while saving over $20 billion per annum compared to the present system. Generally, the analysis suggests that coherent modelling of alternative government structures may be more feasible than previously thought.     

Factors Contributing to Gender Differences in Depressive Symptoms: A Test of Three Developmental Models

In a longitudinal study on 115 early adolescents, the impact of major events, relationship stressors, and coping style in interaction with biological changes on depressive outcome in late adolescence were explored. Three developmental models proposed by Nolen-Hoeksema and Girgus (1994, Psychol. Bull. 115: 424–433), which attempt to explain the emergence of gender differences in adolescent depressive symptoms, were tested. Multiple regression analyses conducted to test Model 1 identified two etiological factors associated with gender differences of depression, namely, stress in the adolescent–mother relationship and a more negative body image. Tests of Model 2 revealed etiological factors which correlated with depression in adolescent girls but not adolescent boys. The correlational patterns of avoidant coping and body image emerged as relevant factors for Model 2. Finally, tests of Model 3 searched for factors which were more likely to be observed in adolescent girls than boys and which would put girls at risk should they interact with a third etiological factor. Early maturational timing emerged as a factor for Model 3.