Do the Child Welfare and Protection Services Involve Children in Cases With Parental Mental Health Problems? A Norwegian Case-File Study

Background: Parental mental health problems is a common source of concern reported to child welfare and protection services (CWPS). In this study we explored to what extent the child was invited to participate in the investigation process. We aimed to study: (a) what was the current practice in the child protection service in Norway when the CWPS received a report of concern about children whose parents were affected by mental health problems or substance abuse, (b) to what extent were children involved and consulted, (c) which factors predicted the decision to involve the children, and (d) in cases in which conversations with children were conducted: what was the main content of the conversations.Method: The study was a cross-sectional case file study (N = 1,123). Data were collected retrospectively from case records in 16 different child protection agencies. The cases were randomly drawn from all referrals registered in the participating agencies. Differences in how investigations were conducted in cases with and without concerns about parental mental health were analyzed using t-tests and chi-square testes. Predictors of child involvement in cases with parental mental health problems (N = 324) were estimated by logistic regression analyses.Results: When the referral to the CWPS contained concerns about parental mental health, there were more consultations with parents, more frequent home visits and the investigation took longer to conclude. The children, however, were less likely to be involved. Children in such cases were consulted in 47.5% of cases. Predictors for involving the children in those cases were child age, concern about the child's emotional problems and if the child was known from previous referrals.Conclusion: In Norwegian child protection investigations, in which there were concerns about the parent's mental health, conversations with children were conducted to a significantly lower degree compared to cases where the child's problem was the main concern. In such cases, the CWPS workers have to overcome a threshold before they consult with the child. The threshold decreases with child age and when case worker already knows the child.

Off-Label Use of Medicines in Children Attending a Secondary Healthcare Facility in Federal Capital Territory

Before a new drug is approved for marketing in any country, it must have undergone three phases of clinical trials designed to assess its efficacy and safety when used according to an approved recommendation. After a drug has been tested and approved by the regulatory authorities, the drug is usually given a ‘label’ or ‘license’ which is a report describing the drug intended use and dosage. This study aimed at evaluating the use of medicines outside the terms stated in the label. The study was conducted using a data collection form to obtain information from patients’ case file. Data were analysed using Statistical Package for Social Sciences. The case notes of 449 patients were included in the study. The ages of the patients ranged from 4 days to 16 years. Females constituted 51.7% (232) and males 48.3% (217). A total of 1866 drugs were administered to patients, of which 469 (25.13%) were off-label prescriptions. The highest category of off-label drug was indication (45%). This study has revealed a considerable prevalence of off-label use of medicines, there is however need for proper pharmaceutical care to be emplaced in healthcare facilities so as to minimize off-label drug use and prevent adverse effect of drugs as a result of inappropriate use of medicines.

Prescription audit of antihypertensive drugs used in stroke patients in a tertiary care teaching hospital

Background: Stroke is considered as one of the important reasons of death and disability worldwide. A rational use of medications is needed to prevent the recurrence and the disease related complications.Methods: The current study is a prospective observational study. All stroke cases, with patients above the age of 25 and treated with antihypertensive agents were included in the study. A total of 189 patients were found suitable for inclusion in the study. Using a suitably designed data collection form, all pertinent data such as patient demographics, prescribed medicines, drug interactions and adverse drug reactions were collected from the patient’s case file, nurses’ charts, and medication charts. Prescription pattern of antihypertensive drugs were obtained. The causality of the ADR was assessed using the Naranjo causality assessment scale and reported in the institution where the study was conducted.Results: Majority of patients included in the study were in the age group of 61-70 years. The incidence of stroke in this study was more in males than in the females. Ischemic stroke (72%) was more prevalent when compared to Hemorrhagic stroke. Among the antihypertensive agents, calcium channel blockers (32%) were the most commonly prescribed class of drugs. In our audit, drug related problems were observed in 27% of the cases which included cases with improper dose (3 cases), contraindications (4 cases), major drug interactions (20 cases), and adverse drug reactions (17 cases). Most of the prescriptions were legible. Drug related problems had a great impact on the overall stroketherapy.Conclusions: The drug related problems are a relevant aspect to be considered when treating patients with stroke and it can arise irrespective of adherence to guidelines.

The Adoptive Parents

The chapter draws on case file data and papers presented to the court at the time of the adoption order. The 210 adoptees were placed in 138 adoptive homes. The adoptive parents were on average ten years older than birth parents and had more stable relationships. They were also better educated. Most lived in owner-occupied homes and the secondary carer was generally in full-time work. Attempts to match children with families of the same ethnicity and culture and to place siblings together were mostly successful: 77% of children with siblings were placed in intact groups; only 8% were placed alone. Almost half (44%) the parents adopted more than one child; 9% adopted three or more; many also had biological children still living with them. While adoptive parents had considerable resources, they also faced challenges including helping children overcome the sequelae of early adverse experiences and parenting several children with diverse needs.

“If not Mine, She Won't Belong to Another”: Mechanisms of Moral Disengagement in a Femicide Perpetrator from Brazil

Case files can show how aggressors use different explanations to reduce the seriousness of their crime. We aimed to identify and categorize a 2016 Brazilian case file from a perpetrator of femicide, based on moral disengagement theory. Content analysis yielded 47 verbalized excerpts, with 70 disengagement occurrences. The most frequently used mechanisms throughout the aggressor's speeches consisted of moral justification and blaming the victim herself. Results indicated that he reduced the seriousness of the femicide and sought reduction of the consequences. We discuss how speeches in criminal cases can serve as a secondary source for producing data on violence.

PRE-TRIAL CHAMBER. FINDING THE NULLITY OF THE INDICTMENT AND OF THE CRIMINAL PROSECUTION ACTS DUE TO THE BREACH OF THE DEFENDANT'S RIGHT OF DEFENCE

The purpose of this paper is to analyze the limits within which the judge of the pre-trial chamber may order the restitution of the case to the prosecutor, starting from a concrete deed that was the subject of case file no. 5609/245/2018 / a1 pending before the Iaşi District Court and the Iaşi County. In this case, the Pre-Trial Chamber judge considered that the suspect was not given the necessary time to prepare his defense as he was heard as defendant on the same day when he was also heard as a suspect, although when he was heard as a suspect he requested a break for the preparation of the defense, the report on the termination of the criminal prosecution was drawn up on the same day when he was heard, and his request for a forensic examination in question was rejected by the prosecutor, without the court waiting for the submission of the objectives of the expertise. For these reasons, the pre-trial chamber judge considered that it is necessary to find the nullity of all criminal proceedings subsequent to the date and time when the suspect was heard, as he was deprived of the possibility to enforce his defense during the criminal proceedings, a procedural stage that has been completed.

Access to electronic court records in Botswana

Governments all over the world are using information and communication technologies (ICTs) to enable the delivery of their programmes more effectively and efficiently and to increase the participation of the citizens in their governance through their e-government initiatives. The main purpose of this study was to explore issues of access to electronic case files at the Gaborone Magisterial District. Since 2005, the Department of Administration of Justice (AOJ) in Botswana has implemented an electronic Court Records Management System (CRMS) to manage case file records at the high courts and magistrates’ courts of Botswana as one of the government’s public sector reforms to improve service delivery at the courts. This study used both the quantitative and qualitative approaches with data collected through a questionnaire, document review, interviews with respondents and observation of respondents at the Gaborone Magisterial District as well as at justice stakeholders, which are Department of Public Prosecutions and the Department of Prisons and Rehabilitation. The questionnaire was supplemented with interviews. The study used the Records Continuum Model as lens to examine how electronic case files were used and accessed through the CRMS. The findings of the study revealed inadequate legislation on the management of electronic case files in Botswana. Challenges such as network disruptions, shortage of computers, resistance to change, training and a lack of commitment by staff affected access to court records on the CRMS. The study also established that access to electronic case files was limited to court personnel only. The study recommends the adoption of relevant policies and the provision of adequate infrastructure and remote access to electronic court records by the public and other stakeholders in the justice system in Botswana. Failure to provide online access to court records goes against the spirit of the Botswana National ICT policy and the National Vision 2036, which advocates for digital access to information and community access through the use of ICTs.

Access to electronic court records in Botswana

Governments all over the world are using information and communication technologies (ICTs) to enable the delivery of their programmes more effectively and efficiently and to increase the participation of the citizens in their governance through their e-government initiatives. The main purpose of this study was to explore issues of access to electronic case files at the Gaborone Magisterial District. Since 2005, the Department of Administration of Justice (AOJ) in Botswana has implemented an electronic Court Records Management System (CRMS) to manage case file records at the high courts and magistrates’ courts of Botswana as one of the government’s public sector reforms to improve service delivery at the courts. This study used both the quantitative and qualitative approaches with data collected through a questionnaire, document review, interviews with respondents and observation of respondents at the Gaborone Magisterial District as well as at justice stakeholders, which are Department of Public Prosecutions and the Department of Prisons and Rehabilitation. The questionnaire was supplemented with interviews. The study used the Records Continuum Model as lens to examine how electronic case files were used and accessed through the CRMS. The findings of the study revealed inadequate legislation on the management of electronic case files in Botswana. Challenges such as network disruptions, shortage of computers, resistance to change, training and a lack of commitment by staff affected access to court records on the CRMS. The study also established that access to electronic case files was limited to court personnel only. The study recommends the adoption of relevant policies and the provision of adequate infrastructure and remote access to electronic court records by the public and other stakeholders in the justice system in Botswana. Failure to provide online access to court records goes against the spirit of the Botswana National ICT policy and the National Vision 2036, which advocates for digital access to information and community access through the use of ICTs.

An illustration of delays in Mucormycosis: A case Study

Background: Mucormycosis is an opportunistic fungal infection with a high fatality rate and is the third most common fungal infection that is invasive in nature, next to candidiasis and aspergillosis. It is attributed to the poor socio-economic status and triggered by the local trauma due to unhygienic setup or poor health care. The pathway of pathogenesis is not clearly understood in immunocompetent patients and therefore becomes a matter of great concern.Aim& Objective: To explore the pathway of mucormycosis in a case of post SARS-CoV-2 infection Settings and Design: Tertiary Care hospital of Jabalpur DistrictMethods and Material: Interview with the case and care taker and case file review.Results: We could conclude this as a case of rhino- orbital mucormycosis attributed to uncontrolled blood sugar during treatment of SARS-CoV-2 infection, three delays that have occurred during the disease progression like ignorance from health service provider, late diagnosis, non compliance to the advice given by health facility, poor oral and nasal hygiene and no use of distilled water in humidifier. Conclusions: The early diagnosis, prompt Treatment , surgical intervention , proper blood sugar monitoring and rational use of steroids are important steps of successful outcome of the disease.