Setting the standard? New Zealand's approach to ensuring health and disability services of an appropriate standard

This article critiques how health and disability providers' competence is monitored in New Zealand. The New Zealand Health and Disability Commissioner has the responsibility to uphold health and disability consumers' rights, including the right to an appropriate standard of care. Analysis of opinions examines how services of an appropriate standard are measured. Changes have been made to the Commissioner's investigative process since the current Commissioner took office in 2000, and comparison between opinions from 1999-2000 and 2004 assesses the impact of changes for providers and consumers. Currently, service providers interpret standards; a new approach is required to ensure consistent standard application so that consumers' rights are promoted according to the legislation.     

Wrongful birth in New Zealand

Wrongful birth cases have been a feature of the common law. In this article the author examines wrongful birth cases against the background of the New Zealand accident compensation scheme. Initially cases were accepted under the scheme, but after major changes to the legislation in 1992, wrongful birth cases were declined cover. The author argues that this should continue to be the case, and that, as a result, New Zealand courts will have to make the same policy decisions in this area as those made by other Commonwealth courts.     

Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

A Nation of Immigrants or a Nation of Immigrant Cities? The Urban Context of Australian Multiculturalism, 1947–2011

The article documents the urban dimension of Australia's immigration experience that, since the 1940s, has seen the country become one of the world's most multicultural societies. The article argues that the greatest impact of immigration has been in the major cities, especially Sydney and Melbourne, which in recent decades have emerged as internationally‐significant immigrant hubs that, like similar immigrant‐receiving destinations across the globe, are increasingly demographically and culturally distinct from their host nation. Drawing on census materials, oral history interviews, local newspapers and other sources, we chart the demographic transformation of urban Australia from the 1940s to the present day and suggest that these changes have implications for how urban Australians — especially those resident in the two biggest cities — will understand and represent themselves and the nation into the future.     

Identifying risk factors in stalking: a review of current research

Stalking is a behaviour which can cause substantial damage to its victims, whether the perpetrator is violent or not. Victims face a range of risks including not only assault, but persistent or recurrent stalking and varying degrees of psychological and social damage. The responsibility for assessing and managing these risks often falls to the mental health professional, yet the emerging stalking risk assessment literature is at too early a stage to provide clinicians with empirically derived evidence upon which to base their clinical practice. This paper reviews existing research to identify those factors currently believed to be associated with increased risk of physical and sexual assault; with persistent and/or recurrent stalking; and, with psychological and social damage.     

Chinese—Indian relations and the process of building confidence: Implications for the Asia‐Pacific

China's traditional approach to security questions appears to be antithetical to the cooperative security approach that has been adopted by ASEAN and by embryonic multilateral organizations such as the ASEAN Regional Forum. Yet, in the course of normalizing relations with India, China has shown itself willing to explore the kind of confidence‐ and security‐building measures associated with this approach. Although it was a change in interests that prompted China to explore the worth of such measures, nevertheless cooperative security ideas have proved helpful in defusing tensions between New Delhi and Beijing. Possibly as a result of its experience with India, there are indications that China has become more receptive to the use of a cooperative security framework elsewhere in the Asia‐Pacific, most notably in dealing with the ASEAN Regional Forum. Its involvement in this process has increased the diplomatic and economic costs that would be incurred should it decide to use force to make good its irredentist claims in the South China Sea.     

The development of a sexual abuse severity score: characteristics of childhood sexual abuse associated with trauma symptomatology, somatization, and alcohol abuse

Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e., attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of CSA.