Birth control practices and levels of development in India.

PubMed

Karan, P P; Bladen, W A; Singh, G

1978-11-01

The paper examines the acceptance of birth control practices in India, and examines the relationhsip of these patterns to levels of economic development. A study of selected couples with markedly low incomes revealed that fertility tended to increase until a certain level of per capita income was reached. From this level onward, fertility and desired family size goals declined with increasing economic status. The study reveals an association in India between those less developed states and poor acceptance of family planning. The level of medical and administrative personnel for family planning services is superior in the more developed states and, logically, adoption of family planning practices is also higher. In higher-income states, characterized by relatively higher spatial mobility and literacy rates, the spread of family planning practices is relatively rapid. In less developed states, characterized by poorly developed centralized systems of communication and distribution, a lower spatial mobility of people, and a lower diffusion of knowledge through personal contact, family planning methods tend to spread very slowly or become less and less popular. A classification of Indian states as related to their acceptance of formal family planning policy and governmental efforts has been helpful in developing regionally-oriented program strategies for the future. Such strategies would take into account varying socioeconomic, cultural and administrative infrastructure differences in order to better assure delivery of services. As India also faces a shortage of trained physicians and personnel for the National Family Planning program, a regionally-based spatial allocation policy must be formulated that will divert some family planning personnel from states with high-acceptance patterns to the more densely populated, less developed regions of the country.

Controlling food, controlling relationships: exploring the meanings and dynamics of family food practices through the diary-interview approach.

PubMed

MacDonald, Sarah; Murphy, Simon; Elliott, Eva

2018-04-06

Potential merits of a social practice perspective for examining the meanings and dynamics of family food include moving beyond individual behaviour, and exploring how practices emerge, develop and change. However, researchers have struggled to encourage reflection on mundane practices, and how to understand associated meanings. Drawing on a study of families in South Wales, this article reflects on the value of the diary-interview approach in addressing these methodological challenges, and aims to explore and understand the dynamics of control across family contexts. Contemporary practice theories distinguish between practices as 'performances' and practices as 'entities' and the diary-interview method facilitated an examination of these dimensions. Detailed accounts of daily 'performances' (through diaries), alongside reflection on underlying contexts and 'entities' (through interviews), illustrated the entanglement of control, practices and context. The article adds further complexity to the concept of practice 'bundles' which facilitated an understanding of how food was interrelated with other practices - across family contexts and across generations. Sociological approaches with a practices perspective at the core, offer potential for developing public health interventions by acknowledging: the relational meaning of food; the embeddedness of food within everyday practices; and the need to consider interventions across a range of policy areas. © 2018 Foundation for the Sociology of Health & Illness.

Transforming family practice in British Columbia: the General Practice Services Committee.

PubMed

Cavers, William J R; Tregillus, Valerie H F; Micco, Angela; Hollander, Marcus J

2010-12-01

To describe a new approach to primary care reform developed in British Columbia (BC) under the leadership of the General Practice Services Committee (GPSC). COMPOSITION OF THE COMMITTEE: The GPSC is a joint committee of the BC Ministry of Health Services, the BC Medical Association, and the Society of General Practitioners of BC. Representatives of BC's health authorities also attend as guests. This paper is based on the 2008-2009 annual report of the GPSC. It summarizes the history and main activities of the GPSC. The GPSC is currently supporting a number of key activities to transform primary care in BC. These activities include the Full Service Family Practice Incentive Program, which provides incentive payments to promote enhanced primary care; the Practice Support Program, which provides family physicians and their medical office assistants with various practical evidence-based strategies and tools for managing practice enhancement; the Family Physicians for BC Program to develop family practices in areas of identified need; the Shared Care Committee, which supports and enables the determination of appropriate scopes of practice among GPs, specialists, and other health care professionals; the Divisions of Family Practice, which are designed to facilitate interactions among family doctors and between doctors and their respective health authorities; and the Community Healthcare and Resource Directory, a Web-based resource to help health care providers find appropriate mental health resources. Early results indicate that the GPSC's initiatives are enhancing the delivery of primary care services in BC.

The Development of Core Competencies for the Practice of Marriage and Family Therapy

ERIC Educational Resources Information Center

Nelson, Thorana S.; Chenail, Ronald J.; Alexander, James F.; Crane, D. Russell; Johnson, Susan M.; Schwallie, Linda

2007-01-01

In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The…

Transforming family practice in British Columbia

PubMed Central

Cavers, William J.R.; Tregillus, Valerie H.F.; Micco, Angela; Hollander, Marcus J.

2010-01-01

ABSTRACT OBJECTIVE To describe a new approach to primary care reform developed in British Columbia (BC) under the leadership of the General Practice Services Committee (GPSC). COMPOSITION OF THE COMMITTEE The GPSC is a joint committee of the BC Ministry of Health Services, the BC Medical Association, and the Society of General Practitioners of BC. Representatives of BC’s health authorities also attend as guests. METHOD This paper is based on the 2008–2009 annual report of the GPSC. It summarizes the history and main activities of the GPSC. REPORT The GPSC is currently supporting a number of key activities to transform primary care in BC. These activities include the Full Service Family Practice Incentive Program, which provides incentive payments to promote enhanced primary care; the Practice Support Program, which provides family physicians and their medical office assistants with various practical evidence-based strategies and tools for managing practice enhancement; the Family Physicians for BC Program to develop family practices in areas of identified need; the Shared Care Committee, which supports and enables the determination of appropriate scopes of practice among GPs, specialists, and other health care professionals; the Divisions of Family Practice, which are designed to facilitate interactions among family doctors and between doctors and their respective health authorities; and the Community Healthcare and Resource Directory, a Web-based resource to help health care providers find appropriate mental health resources. CONCLUSION Early results indicate that the GPSC’s initiatives are enhancing the delivery of primary care services in BC. PMID:21156899

Developing family practice to respond to global health challenges: The Besrour Papers: a series on the state of family medicine in the world.

PubMed

Arya, Neil; Dahlman, Bruce; Gibson, Christine; Ponka, David; Haq, Cynthia; Rouleau, Katherine; Hansel, Stephanie

2017-08-01

To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally. Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts. With the failure of vertical, disease-oriented models to provide sustained improvements in health outcomes, the need to develop integrated primary care involving the most appropriate health professionals for differing contexts is becoming apparent worldwide. Health system planning is required to develop policies on health professional training to achieve this. Advocating and offering appropriate incentives for, and coordination of, local opportunities within the health system also becomes paramount. The adaptability and generalist nature of family medicine allows it to respond to the unique needs of a given population. Family physicians with adequate financial and physical resources can function most effectively as members of interdisciplinary teams, thus providing valuable, comprehensive health services in any area of the world. Copyright© the College of Family Physicians of Canada.

"So we would all help pitch in:" The family literacy practices of low-income African American mothers of preschoolers.

PubMed

Jarrett, Robin L; Hamilton, Megan-Brette; Coba-Rodriguez, Sarai

2015-01-01

The development of emergent literacy skills are important for the development of later literacy competencies and affect school readiness. Quantitative researchers document race- and social class-based disparities in emergent literacy competence between low-income African American and middle-income White children. Some researchers suggest that deficits in parenting practices account for limited literacy skills among low-income African American children. A small body of qualitative research on low-income African American families finds that despite economic challenges, some African American families were actively engaged in promoting child literacy development. Using qualitative interviews that emphasize family strengths, we add to this small body of research to highlight positive family practices obscured in many quantitative analyses that concentrate on family shortcomings. Specifically, we examine in-home literacy practices and child literacy development with a sample of low-income African American mothers (families) of preschoolers. Key findings include identification of various literacy activities promoting child literacy development and inclusion of multiple family members assisting in literacy activities. These findings add to substantive discussions of emergent literacy and resilience. Insights from the qualitative interviews also provide culturally-sensitive recommendations to childhood educators and speech-language pathologists (SLP) who work with low-income African American families and children. Reader should recognize that (1) there is not a 'right' phenotype and therefore not a right form of environmental input and (2) that context matters (at both the level of the cell and the individual organism). Copyright © 2015 Elsevier Inc. All rights reserved.

Effects of Patient-centered Medical Home Transformation on Child Patient Experience.

PubMed

Harder, Valerie S; Krulewitz, Julianne; Jones, Craig; Wasserman, Richard C; Shaw, Judith S

2016-01-01

Patient experience, 1 of 3 aims for improving health care, is rarely included in studies of patient-centered medical home (PCMH) transformation. This study examines the association between patient experience and National Committee on Quality Assurance (NCQA) PCMH transformation. This was a cross-sectional study of parent-reported child patient experience from PCMH and non-PCMH practices. It used randomly sampled experience surveys completed by 2599 patients at 29 pediatric and family medicine PCMH (n = 21) and non-PCMH (n = 8) practices in Vermont from 2011 to 2013. Patient experiences related to child development and prevention were assessed using the Consumer Assessment of Health care Providers and Systems (CAHPS). A 10-point increase in NCQA score at PCMH practices is associated with a 3.1% higher CAHPS child prevention score (P = .004). Among pediatric practices, PCMH recognition is associated with 7.7% (P < .0005) and 7.2% (P < .0005) higher CAHPS child development and prevention composite scores, respectively. Among family medicine practices, PCMH recognition is associated with 7.4% (P = .001) and 11.0% (P < .0005) lower CAHPS child development and prevention composite scores, respectively. Our results suggest that PCMH recognition may improve child patient experience at pediatric practices and worsen experience at family medicine practices. These findings warrant further investigation into the differential influence of NCQA PCMH transformation on family medicine and pediatric practices. © Copyright 2016 by the American Board of Family Medicine.

Connecting Schools and Families: Understanding the Influence of Home Literacy Practices

ERIC Educational Resources Information Center

Curry, Daphney L.; Reeves, Emily; Mcintyre, Christina J.

2016-01-01

Home literacy practices are extremely important in developing early language and literacy skills. Children from lower socioeconomic status (SES) backgrounds may be at risk, not because their family literacy practices are inferior, but because their culturally defined literacy practices may not be consistent with school literacy expectations. To…

Convention of Hope--Communicating Positive, Realistic Messages to Families at the Time of a Child's Diagnosis with Disabilities

ERIC Educational Resources Information Center

Harnett, Alison; Tierney, Edel; Guerin, Suzanne

2009-01-01

As part of a larger study to develop best practice recommendations for informing families of their child's disabilities, this study researched the elements of best practice required when communicating this news to families. It traced the convergence between these practice recommendations and the UN Convention on the Rights of Persons with…

Developing family practice to respond to global health challenges

PubMed Central

Arya, Neil; Dahlman, Bruce; Gibson, Christine; Ponka, David; Haq, Cynthia; Rouleau, Katherine; Hansel, Stephanie

2017-01-01

Abstract Objective To assess family medicine’s role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. Composition of the committee A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird’s eye view of family medicine internationally. Methods Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts. Report With the failure of vertical, disease-oriented models to provide sustained improvements in health outcomes, the need to develop integrated primary care involving the most appropriate health professionals for differing contexts is becoming apparent worldwide. Health system planning is required to develop policies on health professional training to achieve this. Advocating and offering appropriate incentives for, and coordination of, local opportunities within the health system also becomes paramount. The adaptability and generalist nature of family medicine allows it to respond to the unique needs of a given population. Family physicians with adequate financial and physical resources can function most effectively as members of interdisciplinary teams, thus providing valuable, comprehensive health services in any area of the world. PMID:28807953

Paraprofessionals in Infant/Family Practice.

ERIC Educational Resources Information Center

Fenichel, Emily, Ed.

2002-01-01

"Zero to Three is a single focus bulletin of the National Center for Infants, Toddlers, and Families providing insight from multiple disciplines on the development of infants, toddlers, and their families. Noting that sometimes practice needs to be "translated" into research, as with understanding the phenomenon of paraprofessional…

Personal Development Resource Guide. A Resource for Teaching the Personal Development Core Course Area of Ohio's Work and Family Life Program.

ERIC Educational Resources Information Center

Kister, Joanna; And Others

This Personal Development Resource Guide is intended to help teachers implement Ohio's Work and Family Life Program. Course content focuses on the practical problems faced by adolescents at the critical stage of their development. These practical problems are posed through case studies and shared experiences and examined using critical questions…

[Development of nursing pratice in family medecine groups].

PubMed

D'Amour, Danielle; Goudreau, Johanne; Hudon, Eveline; Beaulieu, Marie-Dominique; Lamothe, Lise; Jobin, Guy; Gilbert, Frédéric

2008-01-01

The purpose of the study was to analyze the development of nursing practice in family medicine groups (FMGs). The two-year case study consisted of 73 semi-directed interviews ofnurses, physicians and managers in five FMGs. The findings led to three main observations: nursing practice varies considerably from one FMG to another, the development of nurses' practice seems to be associated with the development of a collaborative relationship, and the satisfaction of the professionals in the FMG, nurses in particular, depends on the type of practice. It is important to implement measures to encourage the optimal use ofnurses' skills in a FMG.

Exploring the Literacy Practices of Refugee Families Enrolled in a Book Distribution Program and an Intergenerational Family Literacy Program

ERIC Educational Resources Information Center

Singh, Sunita; Sylvia, Monica R.; Ridzi, Frank

2015-01-01

This ethnographic study presents findings of the literacy practices of Burmese refugee families and their interaction with a book distribution program paired with an intergenerational family literacy program. The project was organized at the level of Bronfenbrenner's exosystem (in "Ecology of human development". Cambridge, Harvard…

Geriatrics in family practice residency education: an unmet challenge.

PubMed

Gazewood, John D; Vanderhoff, Bruce; Ackermann, Richard; Cefalu, Charles

2003-01-01

The aging of the US population poses one of the greatest future challenges for family practice residency graduates. At a time when our discipline should be strengthening geriatric education to address the needs of our aging population, the Group on Geriatric Education of the Society of Teachers of Family Medicine believes that recent guidelines from important family medicine organizations suggest that our discipline's interest in geriatric education may be waning. Barriers to improving geriatric education in family practice residencies include limited geriatric faculty, changes in geriatric fellowship training, competing curricular demands, and limited diversity of geriatric training sites. Improving geriatric education in family practice residencies will require greater emphasis on faculty development and integration of geriatric principles throughout family practice residency education. The Residency Review Committee for Family Practice should review the Program Requirements for Residency Education to ensure that geriatric training requirements are consistent with current educational needs. The leadership of family medicine organizations should collaboratively address the need for continued improvement in training our residents to care for older patients and the chronically ill.

Communities of Caring: Developing Curriculum That Engages Latino/a Students' Diverse Literacy Practices

ERIC Educational Resources Information Center

Ordoñez-Jasis, Rosario; Dunsmore, KaiLonnie; Herrera, George; Ochoa, Carlos; Diaz, Laura; Zuniga-Rios, Elizabeth

2016-01-01

This study investigates the learning and work of a community of practice that engaged in a specific inquiry around family/community literacy and the development of a culture of caring that would connect family/community/school literacies in ways that allowed their mostly Latino/a students to develop positive student identities, enhanced personal…

What Families Need: Validation of the Family Needs Assessment for Taiwanese Families of Children with Intellectual Disability and Developmental Delay

ERIC Educational Resources Information Center

Chiu, Chun-Yu; Turnbull, Ann P.; Summers, Jean Ann

2013-01-01

This study documented the process of developing and validating the Family Needs Assessment (FNA), a seven-factor 73-item measure developed for research and practice, using a sample of Taiwanese families. In developing the FNA, the research team identified a theoretical basis for family needs, used literature and qualitative results in generating…

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

PubMed Central

Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.

2013-01-01

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287

Development of a family nursing model for prevention of cancer and other noncommunicable diseases through an appreciative inquiry.

PubMed

Jongudomkarn, Darunee; Macduff, Colin

2014-01-01

Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

Impact of managed MediCal on California family practice programs.

PubMed

Zweifler, J A

2001-05-01

An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. A cross-sectional, retrospective descriptive survey. A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.

Child-Rearing Practices and Delinquency in Children and Adolescents

ERIC Educational Resources Information Center

Kiriakidis, Stavros P.

2010-01-01

The present paper is an overview of studies examining the way family influences the development of delinquency in adolescents. The review focused on published papers dealing with the association of adolescent delinquency and their families. The association between family practices and juvenile delinquency, with potent predictive value is…

Strategies for Developing Family Nursing Communities of Practice Through Social Media.

PubMed

Isaacson, Kris; Looman, Wendy S

2017-02-01

This discussion article presents communities of practice (CoPs) and bridging social capital as conceptual frameworks to demonstrate how social media can be leveraged for family nursing knowledge, scholarship, and practice. CoPs require a shared domain of interest, exchange of resources, and dedication to expanding group knowledge. Used strategically and with a professional presence, mainstream social media channels such as Twitter, Facebook, and YouTube can support the family nurse in developing and contributing to CoPs related to family nursing. This article presents four strategies-curate, connect, collaborate, and contribute-for establishing and growing a social media presence that fits one's professional goals and time availability. Family nurses who leverage social media using these strategies can strengthen existing CoPs and at the same time bridge networks to reach new audiences, such as family advocacy groups, policy makers, educators, practitioners, and a wide array of other extended networks.

Putting the "family" back into family therapy.

PubMed

Breunlin, Douglas C; Jacobsen, Elizabeth

2014-09-01

In this article, we examine the field of family therapy by drawing a distinction between two forms of practice: Whole Family Therapy (WFT), defined as treating the whole family, and Relational Family Therapy (RFT), defined as working with a subsystem of the family or an individual while retaining a systemic lens. Our thesis is that the practice of WFT has been in decline for some time and steps must be taken to keep it from becoming a defunct practice. We consider the trajectory of WFT and RFT throughout the development of family therapy through reference to the people, the literature, training, and practice patterns associated with family therapy. We remind the reader of the many benefits of WFT and suggest that today WFT is likely to be practiced in conjunction with RFT and individual therapy. Since training of family therapists today is largely located in degree-granting programs, we identify constraints to including WFT in such programs. We conclude by offering suggestions that can enhance a program's ability to train students in WFT. © 2014 FPI, Inc.

Application of theory to family-centered care: a role for social workers.

PubMed

Miller, Gary

2012-01-01

Family-centered care is an emerging trend in health care settings today. An explanation, principles, and a definition of family-centered care are offered and discussed. A theoretical framework, Balance Theory of Coordination, which can be utilized by social workers to develop and enhance family-centered care practices, is explained and discussed. Various family-centered care practices are examined within the context of Balance Theory of Coordination as examples.

Socializing Identity Through Practice: A Mixed Methods Approach to Family Medicine Resident Perspectives on Uncertainty.

PubMed

Ledford, Christy J W; Cafferty, Lauren A; Seehusen, Dean A

2015-01-01

Uncertainty is a central theme in the practice of medicine and particularly primary care. This study explored how family medicine resident physicians react to uncertainty in their practice. This study incorporated a two-phase mixed methods approach, including semi-structured personal interviews (n=21) and longitudinal self-report surveys (n=21) with family medicine residents. Qualitative analysis showed that though residents described uncertainty as an implicit part of their identity, they still developed tactics to minimize or manage uncertainty in their practice. Residents described increasing comfort with uncertainty the longer they practiced and anticipated that growth continuing throughout their careers. Quantitative surveys showed that reactions to uncertainty were more positive over time; however, the difference was not statistically significant. Qualitative and quantitative results show that as family medicine residents practice medicine their perception of uncertainty changes. To reduce uncertainty, residents use relational information-seeking strategies. From a broader view of practice, residents describe uncertainty neutrally, asserting that uncertainty is simply part of the practice of family medicine.

Feminism Lives On: Incorporating Contemporary Feminism into Counseling Practice with Families and Youth

ERIC Educational Resources Information Center

Bordeau, Wendy Charkow; Briggs, Michele Kielty; Staton, A. Renee; Wasik, Suzan Zuljani

2008-01-01

Feminist contributions to counseling practice with families and children are reviewed, with a focus on the Third Wave feminist movement and its implications for family development and intervention. Recommendations for empowering young clients and their support systems as well as current challenges and research needs are also considered.

Understanding Families: Applying Family Systems Theory to Early Childhood Practice

ERIC Educational Resources Information Center

Christian, Linda Garris

2006-01-01

Working with families is one of the most important aspects of being an early childhood professional, yet it is an area in which many educators have received little preparation (Nieto 2004). Teachers spend hours learning about child development, developmentally appropriate practices, health and safety, playgrounds, and play. At times it seems that…

Family-witnessed resuscitation in emergency departments: doctors' attitudes and practices.

PubMed

Gordon, E D; Kramer, E; Couper, Ian; Brysiewicz, P

2011-09-27

Resuscitation of patients occurs daily in emergency departments. Traditional practice entails family members remaining outside the resuscitation room. We explored the introduction of family witnessed resuscitation (FWR) as it has been shown to allow closure for the family when resuscitation is unsuccessful and helps them to better understand the last moments of life. Attending medical doctors have concerns about this practice, such as traumatisation of family members, increased pressure on the medical team, interference by the family, and potential medico-legal consequences. There was not complete acceptance of the practice of FWR among the sample group. Short-course training such as postgraduate advanced life support and other continued professional development activities should have a positive effect on this practice.The more experienced doctors are and the longer they work in emergency medicine, the more comfortable they appear to be with the concept of FWR and therefore the more likely they are to allow it. Further study and course attendance by doctors has a positive influence on the practice of FWR.

The Family's Influence on Adolescent and Young Adult Career Development: Theory, Research and Practice.

ERIC Educational Resources Information Center

Hughes, Cathy; Thomas, Trang

2003-01-01

A research review identified a range of family process variables associated with enhanced career development for adolescents and young adults. Findings were consistent with the theories of Roe (personality development and career choice) and Super (life-span, life-space) regarding the influence of family processes on career development. (Contains…

Factors Associated With the Perception of Family Nursing Practice Among Mental Health Nurses in Taiwan.

PubMed

Hsiao, Chiu-Yueh; Tsai, Yun-Fang

2015-11-01

The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness. © The Author(s) 2015.

The Ottawa Model of Research Use: a guide to clinical innovation in the NICU.

PubMed

Hogan, Debora L; Logan, Jo

2004-01-01

To improve performance of a neonatal transport team by implementing a research-based family assessment instrument. Objectives included providing a structure for evaluating families and fostering the healthcare relationship. Neonatal transports are associated with family crises. Transport teams require a comprehensive framework to accurately assess family responses to adversity and tools to guide their practice toward parental mastery of the event. Currently, there are no assessment tools that merge family nursing expertise with neonatal transport. A family assessment tool grounded in contemporary family nursing theory and research was developed by a clinical nurse specialist. The Ottawa Model of Research Use guided the process of piloting the innovation with members of a transport team. Focus groups, interviews, and surveys were conducted to create profiles of barriers and facilitators to research use by team members. Tailored research transfer strategies were enacted based on the profile results. Formative evaluations demonstrated improvements in team members' perceptions of their knowledge, family centeredness, and ability to assess and intervene with families. The family assessment tool is currently being incorporated into Clinical Practice Guidelines for Transport and thus will be considered standard care. Use of a family assessment tool is an effective way of appraising families and addressing suffering. The Ottawa Model of Research Use provided a framework for implementing the clinical innovation. A key role of the clinical nurse specialist is to influence nursing practice by fostering research use by practitioners. When developing and implementing a clinical innovation, input from end users and consumers is pivotal. Incorporating the innovation into a practice guideline provides a structure to imbed research evidence into practice.

Developing family planning nurse practitioner protocols.

PubMed

Hawkins, J W; Roberto, D

1984-01-01

This article focuses on the process of development of protocols for family planning nurse practitioners. A rationale for the use of protocols, a definition of the types and examples, and the pros and cons of practice with protocols are presented. A how-to description for the development process follows, including methods and a suggested tool for critique and evaluation. The aim of the article is to assist nurse practitioners in developing protocols for their practice.

Australian Chinese Parents' Language Attitudes and Practices Relating to Their Children's Bilingual Development Prior to School

ERIC Educational Resources Information Center

Hu, Jiangbo; Torr, Jane; Whiteman, Peter

2014-01-01

This article reports on a deep investigation of five Australian Chinese families regarding their preschool-aged children's bilingual experiences and development. Each family was visited 3 to 5 times by the first author. The mothers were interviewed about their attitudes toward their child's bilingualism and their practices to promote it. A…

Influences of Family-Systems Intervention Practices on Parent-Child Interactions and Child Development

ERIC Educational Resources Information Center

Trivette, Carol M.; Dunst, Carl J.; Hamby, Deborah W.

2010-01-01

The extent to which the influences of family-systems intervention practices could be traced to variations in parent-child interactions and child development was investigated by meta-analytic structural equation modeling (MASEM). MASEM is a procedure for producing a weighted pooled correlation matrix and fitting a structural equation model to the…

Parental Beliefs Concerning Development and Education, Family Educational Practices and Children's Intellectual and Academic Performances

ERIC Educational Resources Information Center

Tazouti, Youssef; Malarde, Amelie; Michea, Aurelie

2010-01-01

The present study examines the relationships between parental beliefs relating to development and education, parenting practices, and the intellectual and academic performances of children. Data were collected for 128 families with a child in the second or third year of primary school. Investigations of the factors affecting the children's…

Parental Influence on Children's Talent Development: A Case Study with Three Chinese American Families

ERIC Educational Resources Information Center

Wu, Echo H.

2008-01-01

This paper explores the influence of parenting beliefs and practices on children's talent development through a specific perspective of several Chinese American families with gifted children. In-depth interviews were employed to collect data from the parents, and research questions focused on the daily practice of parenting and parents' beliefs…

A Delphi approach to developing a core competency framework for family practice registered nurses in Ontario.

PubMed

Moaveni, Azadeh; Gallinaro, Anna; Conn, Lesley Gotlib; Callahan, Sheilagh; Hammond, Melanie; Oandasan, Ivy

2010-12-01

This paper describes the results of a Delphi panel process to gain consensus on a role description and competency framework for family practice registered nurses (FP-RNs) in Ontario. Based on the findings from interviews and focus groups with family practice registered nurses and their inter-professional colleagues throughout Ontario, a core competency framework for FP-RNs emerged consisting of six distinct roles - Professional, Expert, Communicator, Synergist, Health Educator and Lifelong Learner - with accompanying enabling competency statements. This framework was refined and validated by a panel of experts from various nursing and family medicine associations and organizations through a Delphi consensus process. This core competency framework for FP-RNs was developed as a stepping stone for clarifying this very important and poorly understood role in family practice. As a result of this research, we expect a greater acknowledgement of the contributions and expertise of the FP-RN as well as the need to celebrate and profile this role. This work has already led to the establishment of a network of stakeholders from nursing organizations in Ontario who are considering opportunities to move the development and use of the competency framework forward.

A Five-Year Comparison of Actual and Recommended Parental Practices for Promoting Children's Literacy Development.

ERIC Educational Resources Information Center

Baker, Linda; Sonnenschein, Susan; Serpell, Robert

This report details a 5-year study comparing family literacy practices of families from preschool to Grade 3 with recommendations from the position statement of the National Association for the Education of Young Children and the International Reading Association (NAEYC-IRA). Participating were African- and European-American families of children…

Understanding Family Involvement in the Preparation of Graduate Students: Measuring Family-Centered Beliefs, Skills, Systems, and Practices

ERIC Educational Resources Information Center

Giallourakis, Angie; Kent, Kristie Pretti-Frontczak; Cook, Bryan

2005-01-01

This research project sought to develop a measure to examine the family-centered beliefs, skills, work systems, and work practices of early childhood intervention, (ECI) and early childhood education (ECE) graduate students. The study was guided by four research questions: (1) To what extent do graduate students from preservice preparation…

Family-focused practices in addictions: a scoping review protocol

PubMed Central

Ashcroft, Rachelle

2018-01-01

Introduction Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evidence available examining family interventions in addictions and identify gaps to guide future research, policy and practice. Methods and analysis This is a scoping review using the five-stage framework developed by Arksey and O’Malley. We will include published and unpublished empirical studies focusing on any type of family interventions in addiction treatment between 2000 and the present in English or French. A reviewer will search for literature that meets the inclusion criteria through the following electronic databases: MEDLINE, PsycINFO and Social Services Abstracts. For a comprehensive search, we will also hand-search reference lists, web sites and key journals. Data will be charted and sorted using a thematic analysis approach. Ethics and dissemination This review will be the first to examine all forms of family-focused practices for both substance use and problem gambling treatment for adults. It will provide information about existing service provisions and gaps in practice. This review can be used to start moving towards the development of best practices for families in addiction treatment. The results will be disseminated through a peer-reviewed journal and at mental health and addiction conferences. PMID:29331973

Family physicians in Switzerland: transition from residency to family practice.

PubMed

Buddeberg-Fischer, Barbara; Klaghofer, Richard; Stamm, Martina

2011-01-01

The study is concerned with family physicians in the transition phase from residency to practice. Factors relating to the decision to take up a career in family medicine rather than a different medical career are investigated. Further, incentives and disincentives for starting a family practice as well as factors influencing the decision about practice location and practice model are addressed. In a prospective cohort study on physicians' career development, 88 family physicians and 437 physicians aspiring to a different medical career participated in a questionnaire survey on the reasons for their choice of specialty and career, their mentoring support, and their work-life balance aspirations. Quantitative and qualitative data were analyzed using hierarchical logistic regression and content analysis, respectively. Family physician tutors should actively approach trainees in medical school and residency, pointing out the advantages of family medicine in terms of continuity of patient contact and the wide range of illnesses and patients, as well as the prospect of a work-life balance tailored to personal needs. Unlike other countries, Switzerland started its structured residency-training programs only recently.

Rural Idaho family physicians' scope of practice.

PubMed

Baker, Ed; Schmitz, David; Epperly, Ted; Nukui, Ayaka; Miller, Carissa Moffat

2010-01-01

Scope of practice is an important factor in both training and recruiting rural family physicians. To assess rural Idaho family physicians' scope of practice and to examine variations in scope of practice across variables such as gender, age and employment status. A survey instrument was developed based on a literature review and was validated by physician educators, practicing family physicians and executives at the state hospital association. This survey was mailed to rural family physicians practicing in Idaho counties with populations of less than 50,000. Descriptive, bivariate and multivariate analyses were employed to describe and compare scope of practice patterns. Responses were obtained from 92 of 248 physicians (37.1% response rate). Idaho rural family physicians reported providing obstetrical services in the areas of prenatal care (57.6%), vaginal delivery (52.2%) and C-sections (37.0%); other operating room services (43.5%); esophagogastroduodenoscopy (EGD) or colonoscopy services (22.5%); emergency room coverage (48.9%); inpatient admissions (88.9%); mental health services (90.1%); nursing home services (88.0%); and supervision to midlevel care providers (72.5%). Bivariate analyses showed differences in scope of practice patterns across gender, age group and employment status. Binomial logistic regression models indicated that younger physicians were roughly 3 times more likely to provide prenatal care and perform vaginal deliveries than older physicians in rural areas. Idaho practicing rural family physicians report a broad scope of practice. Younger, employed and female rural family medicine physicians are important subgroups for further study.

The Development of Children's Ethnic Identity in Immigrant Chinese Families in Canada: The Role of Parenting Practices and Children's Perceptions of Parental Family Obligation Expectations

ERIC Educational Resources Information Center

Su, Tina F.; Costigan, Catherine L.

2009-01-01

Parents' role in children's ethnic identity development was examined among 95 immigrant Chinese families with young adolescents living in Canada. Children reported their feelings of ethnic identity and perceptions of parental family obligation expectations. Parents reported their family obligation expectations; parents and children reported on…

The effect of families on the process of outpatient visits in family practice.

PubMed

Main, D S; Holcomb, S; Dickinson, P; Crabtree, B F

2001-10-01

Our goal was to describe how physician knowledge of patients' families affects the processes of patient care in family practices. Using a multimethod comparative case study design, detailed dictated field notes were recorded after direct observation of patient encounters and the office environment as part of the Prevention and Competing Demands in Primary Care Study. We identified domains of outpatient visits in which patients were accompanied by a family member or in which family-oriented content was discussed. Outpatient encounters with 1637 patients presenting in 18 family practices in the Midwest were analyzed using an editing style. We developed a typology for ways in which family context affects outpatient visits. Patients were accompanied during 35% of all outpatient visits, the vast majority of these visits involving children. Family history or a family member's problems were discussed during 35% of visits during which no family member was present. An analysis of these "family-oriented" visits resulted in a typology of 6 ways that family context informs and affects the outpatient visit: (1) using family social context to illuminate patient disease, illness, and health; (2) using family to discover the source of an illness; (3) discussing and managing the health and illness of family members; (4) family concern for patient's health; (5) using the family as a care resource and care collaborator; and, (6) giving family members unscheduled care. Family context is an important feature of family practice that influences the processes of patient care. Since family-oriented care is an essential feature of family practice, outcomes of this largely hidden part of care deserve further study.

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong

PubMed Central

Lai, Agnes Y.; Mui, Moses W.; Wan, Alice; Stewart, Sunita M.; Yew, Carol; Lam, Tai-hing; Chan, Sophia S.

2016-01-01

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the “train-the-trainer” workshop (TTT) for the first large scale, community-based, family intervention projects, entitled “Happy Family Kitchen Project” (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers’ competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees’ reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities. PMID:26808541

Development and Two-Year Follow-Up Evaluation of a Training Workshop for the Large Preventive Positive Psychology Happy Family Kitchen Project in Hong Kong.

PubMed

Lai, Agnes Y; Mui, Moses W; Wan, Alice; Stewart, Sunita M; Yew, Carol; Lam, Tai-Hing; Chan, Sophia S

2016-01-01

Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the "train-the-trainer" workshop (TTT) for the first large scale, community-based, family intervention projects, entitled "Happy Family Kitchen Project" (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers' competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees' reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities.

Family presence during cardiopulmonary resuscitation: using evidence-based knowledge to guide the advanced practice nurse in developing formal policy and practice guidelines.

PubMed

Doolin, Christopher T; Quinn, Lisa D; Bryant, Lesley G; Lyons, Ann A; Kleinpell, Ruth M

2011-01-01

To provide advanced practice nurses (APNs) with the best available evidence for implementation of policies and procedures to allow family presence during cardiopulmonary resuscitation (CPR) in the acute care environment. A comprehensive review of research-based articles from Ebsco Host, CINAHL, Pre-CINAHL, and Medline Plus, as well as statement alerts from nursing credentialing bodies, and practice guidelines were reviewed. Kolcaba's Theory of Comfort and Lewin's Three Step Change Theory provide a framework for implementation of formal policies and procedures. Best available evidence showed more support in favor of allowing families at the bedside during CPR. Implementation of policies and procedures allowing family presence enables facilities to change and grow in a holistic and family-oriented atmosphere. With this evidence-based knowledge the APN will be able to disseminate information to facilitate collaborative change in current practices surrounding staff education, decision making, and self-governance. The APN can then address controversial changes when developing formal policies and procedures, which will increase patient satisfaction and outcomes. ©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.

Family presence during resuscitation (FPDR): Perceived benefits, barriers and enablers to implementation and practice.

PubMed

Porter, Joanne E; Cooper, Simon J; Sellick, Ken

2014-04-01

There are a number of perceived benefits and barriers to family presence during resuscitation (FPDR) in the emergency department, and debate continues among health professionals regarding the practice of family presence. This review of the literature aims to develop an understanding of the perceived benefits, barriers and enablers to implementing and practicing FPDR in the emergency department. The perceived benefits include; helping with the grieving process; everything possible was done, facilitates closure and healing and provides guidance and family understanding and allows relatives to recognise efforts. The perceived barriers included; increased stress and anxiety, distracted by relatives, fear of litigation, traumatic experience and family interference. There were four sub themes that emerged from the literature around the enablers of FPDR, these included; the need for a designated support person, the importance of training and education for staff and the development of a formal policy within the emergency department to inform practice. In order to ensure that practice of FPDR becomes consistent, emergency personnel need to understand the need for advanced FPDR training and education, the importance of a designated support person role and the evidence of FPDR policy as enablers to implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Preservation and Modification of Culture in Family Socialization: Development of Parenting Measures for Korean Immigrant Families

PubMed Central

Choi, Yoonsun; Kim, You Seung; Drankus, Dina; Kim, Hyun Jee

2012-01-01

This study aims to describe the family socialization beliefs and practices of Korean immigrant parents through testing psychometric properties of several newly developed items and scales to assess the major components of the Korean traditional concept of family socialization, ga-jung-kyo-yuk. These new measures were examined for validity and reliability. The findings show that Korean immigrant parents largely preserve their traditional and core parenting values, while also showing meaningful, yet not very dramatic, signs of adopting new cultural traits. The results also suggest that the acculturative process may not be simply bilinear but may generate a new, unique and blended value and behavior set from the two (or more) cultures involved. Culturally appropriate practice requires not only further validation of existing knowledge with minority groups, but the development of a theoretical framework of family socialization that recognizes the cultural uniqueness of immigrant families. PMID:24765236

Training in interprofessional collaboration: pedagogic innovation in family medicine units.

PubMed

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-04-01

A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.

Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings

ERIC Educational Resources Information Center

Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.

2015-01-01

Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have…

LGBT Family Lawyers and Same-Sex Marriage Recognition: How Legal Change Shapes Professional Identity and Practice.

PubMed

Baumle, Amanda K

2018-01-10

Lawyers who practice family law for LGBT clients are key players in the tenuous and evolving legal environment surrounding same-sex marriage recognition. Building on prior research on factors shaping the professional identities of lawyers generally, and activist lawyers specifically, I examine how practice within a rapidly changing, patchwork legal environment shapes professional identity for this group of lawyers. I draw on interviews with 21 LGBT family lawyers to analyze how the unique features of LGBT family law shape their professional identities and practice, as well as their predictions about the development of the practice in a post-Obergefell world. Findings reveal that the professional identities and practice of LGBT family lawyers are shaped by uncertainty, characteristics of activist lawyering, community membership, and community service. Individual motivations and institutional forces work to generate a professional identity that is resilient and dynamic, characterized by skepticism and distrust coupled with flexibility and creativity. These features are likely to play a role in the evolution of the LGBT family lawyer professional identity post-marriage equality.

Implementing family nursing: how do we translate knowledge into clinical practice? Part II: The evolution of 20 years of teaching, research, and practice to a Center of Excellence in Family Nursing.

PubMed

Duhamel, Fabie

2010-02-01

The author's reflections on knowledge transfer/translation highlight the importance of the circular process between science and practice knowledge, leading to the notion of "knowledge exchange." She addresses the dilemmas of translating knowledge into clinical practice by describing her academic contributions to knowledge exchange within Family Systems Nursing (FSN). Teaching and research strategies are offered that address the circularity between science and practice knowledge. The evolution of 20 years of teaching, research, and clinical experience has resulted in the recent creation of a Center of Excellence in Family Nursing at the University of Montreal. The three main objectives of the Center uniquely focus on knowledge exchange by providing (a) a training context for skill development for nurses specializing in FSN, (b) a research milieu for knowledge "creation" and knowledge "in action" studies to further advance the practice of FSN, and (c) a family healing setting to support families who experience difficulty coping with health issues.

Development and Validation of a Primary Care-Based Family Health History and Decision Support Program (MeTree)

PubMed Central

Orlando, Lori A.; Buchanan, Adam H.; Hahn, Susan E.; Christianson, Carol A.; Powell, Karen P.; Skinner, Celette Sugg; Chesnut, Blair; Blach, Colette; Due, Barbara; Ginsburg, Geoffrey S.; Henrich, Vincent C.

2016-01-01

INTRODUCTION Family health history is a strong predictor of disease risk. To reduce the morbidity and mortality of many chronic diseases, risk-stratified evidence-based guidelines strongly encourage the collection and synthesis of family health history to guide selection of primary prevention strategies. However, the collection and synthesis of such information is not well integrated into clinical practice. To address barriers to collection and use of family health histories, the Genomedical Connection developed and validated MeTree, a Web-based, patient-facing family health history collection and clinical decision support tool. MeTree is designed for integration into primary care practices as part of the genomic medicine model for primary care. METHODS We describe the guiding principles, operational characteristics, algorithm development, and coding used to develop MeTree. Validation was performed through stakeholder cognitive interviewing, a genetic counseling pilot program, and clinical practice pilot programs in 2 community-based primary care clinics. RESULTS Stakeholder feedback resulted in changes to MeTree’s interface and changes to the phrasing of clinical decision support documents. The pilot studies resulted in the identification and correction of coding errors and the reformatting of clinical decision support documents. MeTree’s strengths in comparison with other tools are its seamless integration into clinical practice and its provision of action-oriented recommendations guided by providers’ needs. LIMITATIONS The tool was validated in a small cohort. CONCLUSION MeTree can be integrated into primary care practices to help providers collect and synthesize family health history information from patients with the goal of improving adherence to risk-stratified evidence-based guidelines. PMID:24044145

Methodology and outcomes of a family medicine research fellowship.

PubMed

Cronholm, Peter F; Straton, Joseph B; Bowman, Marjorie A

2009-08-01

There has not been a strong tradition of training researchers to provide the great amount of new evidence needed for the practice of family medicine. Few models for creating successful family medicine researchers have been presented in the literature. The authors report on the methodology and outcomes of a faculty development research fellowship in the University of Pennsylvania's Department of Family Medicine and Community Health. The fellowship focuses on the two domains-intensive research training and academic career development-and frames them with coursework in a content-appropriate master's degree program and clinical practice in an underserved community. Fifteen fellows have completed the program, which began in 1997. Most fellows' research work has been related to primary care and health disparities. Program completers have been the principal investigators on 39 funded studies and coinvestigators on 24 funded studies. They have, at the time this article was written, described their work in 236 publications, 114 of them peer reviewed. All but one program completer hold academic faculty positions, and 12 practice in underserved areas. In a research-intense institution, the fellowship program successfully trained family physicians to be independent clinical researchers and leaders who have substantially contributed to the national effort to mitigate health disparities through practice and research. The authors suggest that the outcomes strongly support the development of similar training opportunities in family medicine departments in other resource- and research-rich institutions.

Family-focused practices in addictions: a scoping review protocol.

PubMed

Kourgiantakis, Toula; Ashcroft, Rachelle

2018-01-13

Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evidence available examining family interventions in addictions and identify gaps to guide future research, policy and practice. This is a scoping review using the five-stage framework developed by Arksey and O'Malley. We will include published and unpublished empirical studies focusing on any type of family interventions in addiction treatment between 2000 and the present in English or French. A reviewer will search for literature that meets the inclusion criteria through the following electronic databases: MEDLINE, PsycINFO and Social Services Abstracts. For a comprehensive search, we will also hand-search reference lists, web sites and key journals. Data will be charted and sorted using a thematic analysis approach. This review will be the first to examine all forms of family-focused practices for both substance use and problem gambling treatment for adults. It will provide information about existing service provisions and gaps in practice. This review can be used to start moving towards the development of best practices for families in addiction treatment. The results will be disseminated through a peer-reviewed journal and at mental health and addiction conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients.

PubMed

Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

Family medicine research capacity building: five-weekend programs in Ontario.

PubMed

Rosser, Walter; Godwin, Marshall; Seguin, Rachelle

2010-03-01

Research is not perceived as an integral part of family practice by most family physicians working in community practices. OBJECTIVE OF THE PROGRAM To assist community-based practitioners in answering research questions that emerge from their practices in order for them to gain a better understanding of research and its value. The Ontario College of Family Physicians developed a program consisting of 5 sets of weekend workshops, each 2 months apart. Two pilots of the 5-weekend program occurred between 2000 and 2003. After the pilots, thirteen 5-weekend programs were held in 2 waves by 20 facilitators, who were trained in one of two 1-day seminars. This 5-weekend program, developed and tested in Ontario, stimulates community practitioners to learn how to answer research questions emerging from their practices. A 1-day seminar is adequate to train facilitators to successfully run these programs. Evaluations by both facilitators and program participants were very positive, with many participants stating that their clinical practices were improved as a result of the program. The program has been adapted for residency training, and it has already been used internationally.

Indicators of Family Care for Development for Use in Multicountry Surveys

PubMed Central

Kariger, Patricia; Engle, Patrice; Britto, Pia M. Rebello; Sywulka, Sara M.; Menon, Purnima

2012-01-01

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of each candidate item as well as in-country focus groups to test the content validity of the items. The quantitative methods included analyses of item-response distributions, using bivariate techniques. The selected items measured two family care practices (support for learning/stimulating environment and limit-setting techniques) and caregiving resources (adequacy of the alternate caregiver when the mother worked). Six play-activity items, indicative of support for learning/stimulating environment, were included in the core module of UNICEF's Multiple Cluster Indictor Survey 3. The other items were included in optional modules. This project provided, for the first time, a globally-relevant set of items for assessing family care practices and resources in epidemiological surveys. These items have multiple uses, including national monitoring and cross-country comparisons of the status of family care for development used globally. The obtained information will reinforce attention to efforts to improve the support for development of children. PMID:23304914

The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy.

PubMed

Vatcher, C A; Bogo, M

2001-01-01

Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.

Solo and Small Practices: A Vital, Diverse Part of Primary Care.

PubMed

Liaw, Winston R; Jetty, Anuradha; Petterson, Stephen M; Peterson, Lars E; Bazemore, Andrew W

2016-01-01

Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices. A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice. More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas. Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices. © 2016 Annals of Family Medicine, Inc.

Emotion Socialization and Ethnicity: An Examination of Practices and Outcomes in African American, Asian American, and Latin American Families

PubMed Central

Morelen, Diana; Thomassin, Kristel

2013-01-01

The current review paper summarizes the literature on parental emotion socialization in ethnically diverse families in the United States. Models of emotion socialization have been primarily developed using samples of European American parents and children. As such, current categorizations of “adaptive” and “maladaptive” emotion socialization practices may not be applicable to individuals from different ethnic backgrounds. The review examines current models of emotion socialization, with particular attention paid to the demographic breakdown of the studies used to develop these models. Additionally, the review highlights studies examining emotion socialization practices in African American, Asian American, and Latin American families. The review is synthesized with summarizing themes of similarities and differences across ethnic groups, and implications for culturally sensitive research and practice are discussed. PMID:23766738

Family medicine education in Canada, 1983.

PubMed

Hennen, B K

1983-12-01

We now have good information about family medicine in terms of content, principles, and practice load. Undergraduate, residency and continuing education are improving, but some family medicine programs still have limited support from their university's faculty and governments. Residency in-training assessment and the certification process are better developed than is evaluation of new family doctors' practice performance. Research in the family medicine base is expanding, and residents are increasingly involved in projects. Family medicine teachers are now on a par with other clinical faculty, because they must meet tougher criteria for appointment and promotion. The political leadership of family medicine education, shared by the College of Family Physicians of Canada and academic departments, requires strong consensus and persistent activity.

Bending the cost curve and increasing revenue: a family medicine model that works!

PubMed

Katz, Bernard J; Needham, Mark R

2012-12-01

This article attempts to illustrate ways in which family physician practices are able to demonstrate high value, enhanced quality, and streamlined costs, essential components of practice sustainability. Specific examples are provided to assist practices to consider questions and information that allow for skillful engagement during contract negotiations, consider increasing practice revenues by adopting practice enhancements that make sense for the location of the practice and community needs, develop workflow analyses, and review opportunities for expense reduction. Copyright © 2012 Elsevier Inc. All rights reserved.

The central city site: an urban underserved family medicine training track.

PubMed

Bade, Elizabeth; Baumgardner, Dennis; Brill, John

2009-01-01

We describe the development of an urban track in family medicine residency designed to recruit a high percentage of minority students and promote their future practice in urban, underserved areas of Milwaukee. We report here on the residents and their first practice location and compared this information to what occurred in our original "main" residency program. Information about the program's development was obtained through testimonials from faculty and residency graduates and review of the original accreditation application to the Residency Review Committee. Information about the residents and their practice locations was obtained from the National Resident Matching Program and graduate placement data. The goal of training more minority doctors in Milwaukee was met, with eight of 16 (50%) residents at our urban-track site from minority groups. This compared to only 12% at our main program. Thirty-eight percent of graduates stayed to practice in an underserved area, compared to only 21% in our main program. Development of an urban track for our family medicine residency increased the number of minority physicians trained and the number of physicians practicing in underserved areas after graduation.

Family Child Care Learning Environments: Caregiver Knowledge and Practices Related to Early Literacy and Mathematics

ERIC Educational Resources Information Center

Phillips, Beth M.; Morse, Erika E.

2011-01-01

This paper presents findings from a stratified-random survey of family child care providers' backgrounds, caregiving environments, practices, attitudes, and knowledge related to language, literacy, and mathematics development for preschool children. Descriptive results are consistent with prior studies suggesting that home-based providers are…

Teaching interpersonal skills in family practice: results of a national survey.

PubMed

Kahn, G; Cohen, B; Jason, H

1979-02-01

The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.

A purposeful Yet Nonimposing Approach: How Japanese Home Care Nurses Establish Relationships With Older Clients and Their Families.

PubMed

Iwasaki, Takako; Yamamoto-Mitani, Noriko; Sato, Kana; Yumoto, Yoshie; Noguchi-Watanabe, Maiko; Ogata, Yasuko

2017-11-01

Relationship development is crucial to nursing practice with families. However, little is known about the process of building relationships with multiple family members in home care settings and in various cultures. The objective of this study was to explore the experiences of home care nurses about how they established relationships with older clients and their families in Japan. Grounded theory was used to guide the research. Twenty-three expert home care nurses participated in semistructured interviews concerning their family nursing practice. The establishment of relationships with clients/family members was based on a purposeful yet nonimposing approach composed of four aspects: keeping a mindful distance from the family, not being a threat to family life, being a comfortable neighbor, and gaining trust as a competent nurse. Through a purposeful nonimposing approach, Japanese home care nurses promoted and nurtured nurse-family relationships and became involved in the life of the family. These findings provide a useful foundation to guide practice with families and grow knowledge about the process of establishing relationships with multiple family members in home settings.

The Role of the Family Context in the Development of Emotion Regulation

PubMed Central

Morris, Amanda Sheffield; Silk, Jennifer S.; Steinberg, Laurence; Myers, Sonya S.; Robinson, Lara Rachel

2008-01-01

This article reviews current literature examining associations between components of the family context and children and adolescents’ emotion regulation (ER). The review is organized around a tripartite model of familial influence. Firstly, it is posited that children learn about ER through observational learning, modeling and social referencing. Secondly, parenting practices specifically related to emotion and emotion management affect ER. Thirdly, ER is affected by the emotional climate of the family via parenting style, the attachment relationship, family expressiveness and the marital relationship. The review ends with discussions regarding the ways in which child characteristics such as negative emotionality and gender affect ER, how socialization practices change as children develop into adolescents, and how parent characteristics such as mental health affect the socialization of ER. PMID:19756175

Medical University of South Carolina Environmental Hazards Assessment Program annual report, July 1, 1993--June 30, 1994

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Institute of Medicine and the Pew Health Profession Commission have advocated that physicians broaden their participation in the envirorunental aspects of medical care. Accordingly, both organizations recommend training of future primary care physicians for greater competencies and appreciation of this area of medicine. The extent to which family practice educators are receptive to incorporating this topic into the residency curriculum is not known. A national survey of directors of family practice programs was conducted to assess their attitudes about environmental health education in family practice residency training. The ultimate goal of this study was to provide information that willmore » guide the development of an environmental health curriculum for family practice residency programs. Videotapes supporting this program have been indexed individually.« less

Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients: Consensus Recommendations from a Children’s Oncology Group Expert Panel

PubMed Central

Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P.; Bhatia, Smita; Bingen, Kristin M.; Bondurant, Patricia G.; Cohn, Susan L.; Dobrozsi, Sarah K.; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C.; Martin, Melissa; Murphy, Kathryn; Newman, Amy R.; Rodgers, Cheryl C.; Ruccione, Kathleen S.; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

2016-01-01

There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children’s Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology. PMID:27385664

The Family Impact Lens: A Family-Focused, Evidence-Informed Approach to Policy and Practice

ERIC Educational Resources Information Center

Bogenschneider, Karen; Little, Olivia M.; Ooms, Theodora; Benning, Sara; Cadigan, Karen; Corbett, Thomas

2012-01-01

Families have long been recognized for the contributions they make to their members and to society. Yet families are seldom substantively incorporated into the normal course of policy and program development, implementation, and evaluation. We propose the family impact lens as one way to shift the rhetoric from appreciating families to…

[Mental health in primary health care: practices of the family health team].

PubMed

Correia, Valmir Rycheta; Barros, Sônia; Colvero, Luciana de Almeida

2011-12-01

The inclusion of mental health care actions in the context of the Brazilian Public Health System (SUS; Sistema Único de Saúde) contributes to the consolidation of the Brazilian Psychiatric reform and demands redirecting the practices of family health teams with users with mental health needs. The objective of this study is to identify and analyze the scientific production and actions developed by family health team professionals in mental health care. Systematic analysis originated the following themes: home visits to mentally ill patients and their relatives; attachment and welcoming; referrals; therapeutic workshops. In conclusion, the mental health actions developed in primary care are not performed consistently and depend on the professional or on the political decision of the administrator, which shows that professionals should use new practices to develop comprehensive care, and, therefore, there is a need to invest in improving the qualification of the professionals.

Family-Centered Early Intervention for Communication Disorders: Prevention and Treatment. Excellence in Practice Series.

ERIC Educational Resources Information Center

Donahue-Kilburg, Gail

This book is designed to provide a broad range of information on family structure and function in an increasingly multicultural society, family system characteristics and the implications for intervention, communication development in the family context, the nature and delivery of family centered-services, specific requirements of Public Law…

Family Therapy and Children of Alcoholics Implications for Continuing Education and Certification in Substance Abuse Practice

ERIC Educational Resources Information Center

Crespi, Tony D.; Rueckert, Quentin H.

2006-01-01

Clinicians involved in family therapy are increasingly concerned with the impact of parental alcoholism on individual development and family functioning. With more than 20 million adults raised within an alcoholic family, and with widespread problems associated with parental alcoholism, clinicians providing family treatment have a potentially…

Counseling Patients with Senile Dementia of the Alzheimer Type and Their Families.

ERIC Educational Resources Information Center

LaBarge, Emily

1981-01-01

Discusses symptoms of Alzheimer Disease and suggests client-centered counseling techniques to use with patients and family. Considers the disease's effect on family relationships relative to stage of family development. Examines the adjustment of the caregiving spouse. Offers practical suggestions for coping. (RC)

Health care professionals' concerns regarding in-hospital family-witnessed cardiopulmonary resuscitation implementation into clinical practice.

PubMed

Sak-Dankosky, Natalia; Andruszkiewicz, Paweł; Sherwood, Paula R; Kvist, Tarja

2018-05-01

In-hospital, family-witnessed cardiopulmonary resuscitation of adults has been found to help patients' family members deal with the short- and long-term emotional consequences of resuscitation. Because of its benefits, many national and international nursing and medical organizations officially recommend this practice. Research, however, shows that family-witnessed resuscitation is not widely implemented in clinical practice, and health care professionals generally do not favour this recommendation. To describe and provide an initial basis for understanding health care professionals' views and perspectives regarding the implementation of an in-hospital, family-witnessed adult resuscitation practice in two European countries. An inductive qualitative approach was used in this study. Finnish (n = 93) and Polish (n = 75) emergency and intensive care nurses and physicians provided written responses to queries regarding their personal observations, concerns and comments about in-hospital, family-witnessed resuscitation of an adult. Data were analysed using inductive thematic analysis. The study analysis yielded five themes characterizing health care professionals' main concerns regarding family-witnessed resuscitation: (1) family's horror, (2) disturbed workflow (3) no support for the family, (4) staff preparation and (5) situation-based decision. Despite existing evidence revealing the positive influence of family-witnessed resuscitation on patients, relatives and cardiopulmonary resuscitation process, Finnish and Polish health care providers cited a number of personal and organizational barriers against this practice. The results of this study begin to examine reasons why family-witnessed resuscitation has not been widely implemented in practice. In order to successfully apply current evidence-based resuscitation guidelines, provider concerns need to be addressed through educational and organizational changes. This study identified important implementation barriers for allowing families in critical care settings to be present during resuscitation efforts. These results can be further used in developing and adjusting clinical practice policies, protocols and guidelines related to family-witnessed resuscitation. © 2017 British Association of Critical Care Nurses.

Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools

ERIC Educational Resources Information Center

Jacobson, Linda; Rollins, S. Kwesi; Brown, Janet; Naviasky, Heather

2016-01-01

This "Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools" report updates the community school case studies through a description of ongoing developments in Cincinnati, OH; Evansville, IN; Multnomah County, OR; and Tulsa, OK and adds to that knowledge base of early learning and…

Family Violence: An Insight Into Perspectives and Practices of Australian Health Practitioners.

PubMed

Soh, Han Jie; Grigg, Jasmin; Gurvich, Caroline; Gavrilidis, Emmy; Kulkarni, Jayashri

2018-03-01

Family violence is threatening behavior carried out by a person to coerce or control another member of the family or causes the family member to be fearful. Health practitioners are well placed to play a pivotal role in identifying and responding to family violence; however, their perceived capacity to respond to patients experiencing family violence is not well understood. We aim to explore Australian health practitioners' current perspectives, practices, and perceived barriers in working with family violence, including perceived confidence in responding effectively to cases of family violence encountered during their work with patients. A total of 1,707 health practitioners primarily practicing in the wider Melbourne region were identified, and 114 health practitioners participated in the study between March 2016 and August 2016 by completing an investigator-developed questionnaire. Descriptive, qualitative, and thematic analyses were performed. The majority of participants recognized family violence to be a health issue and that family violence would impact the mental health of afflicted persons. Despite this, only a fifth of participants felt they were very confident in screening, supporting, and referring patients with family violence experiences. Perceived barriers to inquire about family violence included time constraints and greater importance placed on screening for other health issues. Health practitioners reported that additional training on screening, supporting, and referring patients would be beneficial. Australian health practitioners need to be upskilled. Recently, in Australia, state-relevant toolkits have been developed to provide succinct information about responding to initial patient presentations of family violence, how to inquire about family violence, and how to handle disclosures (and nondisclosures) by patients. Further resources could be developed to aid health practitioners in providing assistance to their patients as indicated. These initiatives would be a step toward addressing the concerns with regard to the lack of training and could possibly optimize outcomes for patients experiencing family violence.

Understanding partnership practice in primary health as pedagogic work: what can Vygotsky's theory of learning offer?

PubMed

Hopwood, Nick

2015-01-01

Primary health policy in Australia has followed international trends in promoting models of care based on partnership between professionals and health service users. This reform agenda has significant practice implications, and has been widely adopted in areas of primary health that involve supporting families with children. Existing research shows that achieving partnership in practice is associated with three specific challenges: uncertainty regarding the role of professional expertise, tension between immediate needs and longer-term capacity development in families, and the need for challenge while maintaining relationships based on trust. Recently, pedagogic or learning-focussed elements of partnership practice have been identified, but there have been no systematic attempts to link theories of learning with the practices and challenges of primary health-care professionals working with families in a pedagogic role. This paper explores key concepts of Vygotsky's theory of learning (including mediation, the zone of proximal development, internalisation, and double stimulation), showing how pedagogic concepts can provide a bridge between the policy rhetoric of partnership and primary health practice. The use of this theory to address the three key challenges is explicitly discussed.

Language Policy and Literacy Practices in the Family: The Case of Ethiopian Parental Narrative Input

ERIC Educational Resources Information Center

Stavans, Anat

2012-01-01

The present study analyses the Family Language Policy (FLP) in regards language literacy development of children in Ethiopian immigrant families. Bridging the gap between linguistic literacy at home and at school hinders a smooth societal integration and a normative literacy development. This study describes the home literacy patterns shaped by…

Development and Validation of the Family Feedback on Child Welfare Services (FF-CWS)

ERIC Educational Resources Information Center

Ayala-Nunes, Lara; Jiménez, Lucía; Hidalgo, Victoria; Dekovic, Maja; Jesus, Saul

2018-01-01

Objective: The measurement of Family Feedback on Child Welfare Services (FF-CWS) is gaining prominence as an efficacy indicator and is coherent with concerns about family-centered practice and empowerment. The aim of this study was to develop and validate an instrument that would overcome the scarcity of psychometrically sound measures in this…

Exploring the role of classroom-based learning in professional identity formation of family practice residents using the experiences, trajectories, and reifications framework.

PubMed

Chen, Luke Y C; Hubinette, Maria M

2017-08-01

Classroom-based learning such as academic half day has undervalued social aspects. We sought to explore its role in the professional identity development of family medicine residents. In this case study, residents and faculty from four training sites in the University of British Columbia Department of Family Practice were interviewed. The "experiences, trajectories, and reifications (ETR) framework" was used as a sensitizing tool for modified inductive (thematic) analysis of the transcripts. Classroom-based learning provided a different context for residents' interpretation of their clinical experiences, characterized as a "home base" for rotating urban residents, and a connection to a larger academic community for residents in rural training sites. Both these aspects were important in creating a positive trajectory of professional identity formation. Teaching directed at the learning needs of family physicians, and participation of family practice faculty as teachers and role models was a precipitation of a curriculum "centered in family medicine." Interactions between family medicine residents and faculty in the classroom facilitated the necessary engagements to reify a shared understanding of the discipline of family practice. Classroom-based learning has substantial impact on professional identity formation at an individual and collective level.

Parent-child feeding practices in a developing country: Findings from the Family Diet Study.

PubMed

Yang, Wai Yew; Burrows, Tracy; MacDonald-Wicks, Lesley; Williams, Lauren T; Collins, Clare E; Chee, Winnie Siew Swee

2018-06-01

Given the increasing prevalence of childhood obesity in Malaysia, examination of family environmental factors is warranted. Reviews from developed countries report inconsistent findings on the relationship between parental-child feeding practices and child weight-related health outcomes. The current study aimed to examine parent-child feeding practices by familial-child characteristics in Malaysia. The Family Diet Study was conducted with urban Malay families and included a child aged 8-12 years and their main carer(s). Seven domains of parent-child feeding practices were assessed using the child feeding questionnaire and familial demographics, including socio-economic status, child anthropometry and dietary intake were collected. Inferential statistics were used to explore the relationships between variables. Of the 315 families enrolled, 236 completed all measures, with the majority of parent-reporters being mothers (n = 182). One-third of the children were classified as overweight/obese. Three domains of parent-child feeding practices had median scores of 4.0 out of 5.0 [concern about child overweight (CCO) (Interquartile range (IQR): 3.3, 4.7); pressure-to-eat (PTE) (IQR: 3.3, 4.5) and food monitoring (IQR: 3.0, 5.0)]. The domain of 'perceived child overweight' was positively associated with child age (r = 0.45, p < 0.001). Children who were overweight (F = 37.4; p < 0.001) and under-reported energy intake (F = 13.1; p = 0.001) had higher median scores for the parental perception of risk of child being overweight. Median scores for the CCO and PTE domains were significantly higher in low-income families (F = 7.87; F = 9.75; p < 0.05, respectively). Malay parents in this present study are concerned about their child's weight, particularly for those overweight. Family size, household income, and child weight status significantly influence parent-child feeding practices. Further research examining the cultural context of family environmental factors related to childhood obesity is warranted within Malaysia. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Development of Family Policy in Canada.

ERIC Educational Resources Information Center

Abernathy, Thomas J., Jr.

Understanding the family life behavior of any society requires understanding its family policy. This involves knowing the history of that policy, what it was intended to accomplish, how it was put into practice, and its consequences. The relationship between family policy and behavior was investigated by examining the experience of Canadian law…

Family Life Education in Multicultural Classrooms. Practical Guidelines.

ERIC Educational Resources Information Center

Abbey, Nancy; And Others

This guide presents approaches and guidelines for developing culturally appropriate and relevant family life education. It begins with a definition of culture and a look at different types of acculturation. A section on cultural relevance in family life education briefly explains the challenge of a multicultural approach in family life education…

What can family medicine practices do to facilitate knowledge management?

PubMed

Orzano, A John; Ohman-Strickland, Pamela A; Patel, Meghal

2008-01-01

Family medicine practices face increasing demands to enhance efficiency and quality of care. Current solutions propose major practice redesign and investment in sophisticated technology. Knowledge management (KM) is a process that increases the capacity of a practice to deliver effective care by finding and sharing information and knowledge among practice members or by developing new knowledge for use by the practice. Our preliminary research in family medicine practices has suggested improved patient outcomes with greater and more effective KM. Research in other organizational settings has suggested that KM can be facilitated by certain organizational characteristics. To identify those organizational characteristics within a family medicine practice that management can effect to enhance KM. We performed a cross-sectional secondary analysis of second-year data from 13 community family medicine practices participating in a practice improvement project. Practice KM, leaderships' promotion of participatory decision making, existence of activities supportive of human resource processes, and effective communication were derived from clinician's, nurses', and staff's responses to a survey eliciting responses on practice organizational characteristics. Hierarchical linear modeling examined relationships between individual practice members' perception of KM and organizational characteristics of the practice, controlling for practice covariates (solo-group, electronic medical record use, and perception of a chaotic practice environment) and staff-level covariates (gender, age, and role). Practices with greater participatory decision making and human resources' processes and effective communication significantly (p < .019, p < .0001, and p < .004) increased odds of reporting satisfactory KM (odds ratio = 2.48, 95% confidence interval = 1.32-4.65; odds ratio = 10.84, 95% confidence interval = 4.04-29.12; and odds ratio = 4.95, 95% confidence interval = 2.02-12.16). The sizes of these effects were not substantially changed even when practice members perceived their practice environment as more chaotic. Steps to facilitate KM should be considered when evaluating more intensive and costly organizational solutions for enhancing family medicine practice performance.

Different concepts and models of information for family-relevant genetic findings: comparison and ethical analysis.

PubMed

Lenk, Christian; Frommeld, Debora

2015-08-01

Genetic predispositions often concern not only individual persons, but also other family members. Advances in the development of genetic tests lead to a growing number of genetic diagnoses in medical practice and to an increasing importance of genetic counseling. In the present article, a number of ethical foundations and preconditions for this issue are discussed. Four different models for the handling of genetic information are presented and analyzed including a discussion of practical implications. The different models' ranges of content reach from a strictly autonomous position over self-governed arrangements in the practice of genetic counseling up to the involvement of official bodies and committees. The different models show a number of elements which seem to be very useful for the handling of genetic data in families from an ethical perspective. In contrast, the limitations of the standard medical attempt regarding confidentiality and personal autonomy in the context of genetic information in the family are described. Finally, recommendations for further ethical research and the development of genetic counseling in families are given.

Emotional effects of continuity of care on family physicians and the therapeutic relationship.

PubMed

Schultz, Karen; Delva, Dianne; Kerr, Jonathan

2012-02-01

To explore conceptions of continuity of care among family physicians in traditional practices, family medicine-trained physicians working in episodic care, and family medicine residents to better understand the emotional effects on physicians of establishing long-term relationships with patients as a starting point for developing a tool to measure the qualitative connections between physicians and their patients. Qualitative descriptive study using focus groups. Traditional family practice, family medicine residency training, and episodic-care settings in Kingston, Ont. Three groups of first-year family medicine residents (n = 18), 2 groups of family physicians in established traditional practice (n = 9), and 2 groups of family physicians working in episodic-care settings (n = 10). Using focus groups, a semistructured discussion guide, and a phenomenologic approach, we explored residents' and practising physicians' conceptions about continuity of care, predominantly exploring the emotional effects on physicians of providing care for a group of patients over time. Providing care for patients over time and developing a deep knowledge of, and often a deep connection to, patients affected physicians in various ways. Most of these effects were rewarding: feelings of connection, trust, curiosity, enhanced professional competence (diagnostically and therapeutically), personal growth, and being cared for and respected. Some, however, were distressing: anxiety, grief, frustration, boundary issues, and negative effects on personal life. Family physicians experience myriad emotions connected with providing care to patients. Knowledge of what physicians find rewarding from their long-term connections with patients, and of the difficulties that arise, might be useful in further understanding interpersonal continuity of care and the therapeutic relationship, and in informing resident education about developing therapeutic relationships, evaluating resident educational experiences with continuity of care, and addressing physician burnout.

Emotional effects of continuity of care on family physicians and the therapeutic relationship

PubMed Central

Schultz, Karen; Delva, Dianne; Kerr, Jonathan

2012-01-01

Abstract Objective To explore conceptions of continuity of care among family physicians in traditional practices, family medicine–trained physicians working in episodic care, and family medicine residents to better understand the emotional effects on physicians of establishing long-term relationships with patients as a starting point for developing a tool to measure the qualitative connections between physicians and their patients. Design Qualitative descriptive study using focus groups. Setting Traditional family practice, family medicine residency training, and episodic-care settings in Kingston, Ont. Participants Three groups of first-year family medicine residents (n = 18), 2 groups of family physicians in established traditional practice (n = 9), and 2 groups of family physicians working in episodic-care settings (n = 10). Methods Using focus groups, a semistructured discussion guide, and a phenomenologic approach, we explored residents’ and practising physicians’ conceptions about continuity of care, predominantly exploring the emotional effects on physicians of providing care for a group of patients over time. Main findings Providing care for patients over time and developing a deep knowledge of, and often a deep connection to, patients affected physicians in various ways. Most of these effects were rewarding: feelings of connection, trust, curiosity, enhanced professional competence (diagnostically and therapeutically), personal growth, and being cared for and respected. Some, however, were distressing: anxiety, grief, frustration, boundary issues, and negative effects on personal life. Conclusion Family physicians experience myriad emotions connected with providing care to patients. Knowledge of what physicians find rewarding from their long-term connections with patients, and of the difficulties that arise, might be useful in further understanding interpersonal continuity of care and the therapeutic relationship, and in informing resident education about developing therapeutic relationships, evaluating resident educational experiences with continuity of care, and addressing physician burnout. PMID:22337743

Family physicians' attitude and practice of infertility management at primary care--Suez Canal University, Egypt.

PubMed

Eldein, Hebatallah Nour

2013-01-01

The very particular natures of infertility problem and infertility care make them different from other medical problems and services in developing countries. Even after the referral to specialists, the family physicians are expected to provide continuous support for these couples. This place the primary care service at the heart of all issues related to infertility. to improve family physicians' attitude and practice about the approach to infertility management within primary care setting. This study was conducted in the between June and December 2010. The study sample comprised 100 family physician trainees in the family medicine department and working in family practice centers or primary care units. They were asked to fill a questionnaire about their personal characteristics, attitude, and practice towards support, investigations, and treatment of infertile couples. Hundred family physicians were included in the study. They were previously received training in infertility management. Favorable attitude scores were detected among (68%) of physicians and primary care was considered a suitable place for infertility management among (77%) of participants. There was statistically significant difference regarding each of age groups, gender and years of experience with the physicians' attitude. There was statistically significant difference regarding gender, perceiving PHC as an appropriate place to manage infertility and attitude towards processes of infertility management with the physicians' practice. Favorable attitude and practice were determined among the study sample. Supporting the structure of primary care and evidence-based training regarding infertility management are required to improve family physicians' attitude and practice towards infertility management.

Family physicians’ attitude and practice of infertility management at primary care - Suez Canal University, Egypt

PubMed Central

Eldein, Hebatallah Nour

2013-01-01

Introduction The very particular natures of infertility problem and infertility care make them different from other medical problems and services in developing countries. Even after the referral to specialists, the family physicians are expected to provide continuous support for these couples. This place the primary care service at the heart of all issues related to infertility. The aim of the work: to improve family physicians' attitude and practice about the approach to infertility management within primary care setting. Methods This study was conducted in the between June and December 2010. The study sample comprised 100 family physician trainees in the family medicine department and working in family practice centers or primary care units. They were asked to fill a questionnaire about their personal characteristics, attitude, and practice towards support, investigations, and treatment of infertile couples. Results Hundred family physicians were included in the study. They were previously received training in infertility management. Favorable attitude scores were detected among (68%) of physicians and primary care was considered a suitable place for infertility management among (77%) of participants. There was statistically significant difference regarding each of age groups, gender and years of experience with the physicians′ attitude. There was statistically significant difference regarding gender, perceiving PHC as an appropriate place to manage infertility and attitude towards processes of infertility management with the physicians′ practice. Conclusion Favorable attitude and practice were determined among the study sample. Supporting the structure of primary care and evidence-based training regarding infertility management are required to improve family physicians' attitude and practice towards infertility management. PMID:24244792

Solo and Small Practices: A Vital, Diverse Part of Primary Care

PubMed Central

Liaw, Winston R.; Jetty, Anuradha; Petterson, Stephen M.; Peterson, Lars E.; Bazemore, Andrew W.

2016-01-01

PURPOSE Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices. METHODS A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice. RESULTS More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas. CONCLUSIONS Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices. PMID:26755778

Evolutionary medicine: update on the relevance to family practice.

PubMed

Naugler, Christopher T

2008-09-01

To review the relevance of evolutionary medicine to family practice and family physician training. Articles were located through a MEDLINE search, using the key words evolution, Darwin, and adaptation. Most references presented level III evidence (expert opinion), while a minority provided level II evidence (epidemiologic studies). Evolutionary medicine deals with the interplay of biology and the environment in the understanding of human disease. Yet medical schools have virtually ignored the need for family physicians to have more than a cursory knowledge of this topic. A review of the main trends in this field most relevant to family practice revealed that a basic knowledge of evolutionary medicine might help in explaining the causation of diseases to patients. Evolutionary medicine has also proven key to explaining the reasons for the development of antibiotic resistance and has the potential to explain cancer pathogenesis. As an organizing principle, this field also has potential in the teaching of family medicine. Evolutionary medicine should be studied further and incorporated into medical training and practice. Its practical utility will be proven through the generation of testable hypotheses and their application in relation to disease causation and possible prevention.

Why Can't Families Be More Like Us?: Henry Higgins Confronts Eliza Doolittle in the World of Early Intervention.

ERIC Educational Resources Information Center

Vacca, John; Feinberg, Edward

2000-01-01

Discussion of problems faced by early interventionists in working with families offers practical guidelines for developing effective collaborations between early intervention programs and families. These include establishing family-centered services and rules for clinician/parent communication, encouraging the family to be a genuine coparticipant,…

Guide to Parent Involvement: Parents as Adult Learners. The Family Academy Model of the Family as Educator.

ERIC Educational Resources Information Center

American Univ., Washington, DC. Adult Learning Potential Inst.

This document is the second of a series of four reports developed to provide a comprehensive overview of parent involvement, encompassing the family, parenting needs, and existing resources, in addition to current parent education approaches and practices. This "Family Academy Model" provides one interpretation of how the family functions as…

Advancing family health through the Garden of Eatin': on-site food gardens in early childhood education.

PubMed

Chaufan, Claudia; Yeh, Jarmin; Sigal, Byron

2015-04-01

Nutritional practices develop over the life course. Developing healthy habits at an early age can contribute to combating increasing child obesity rates. Through a range of activities that rely on the presence of an on-site food garden, North Bay Children's Center (NBCC), an early childhood education program, has enacted a "culture of health" into all aspects of the curriculum to promote healthy eating practices among children, families, teachers and staff. NBCC's garden program serves as a model in early childhood education and as a community-based intervention to improve family health and prevent child obesity.

Implementing Family-Centered Care Through Facilitated Sensemaking.

PubMed

Davidson, Judy E; Zisook, Sidney

2017-01-01

The Society of Critical Care Medicine has released updated recommendations for care of the family in neonatal, pediatric, and adult intensive care units. Translation of the recommendations into practice may benefit from a supporting theoretical framework. Facilitated sensemaking is a mid-range theory built from the same literature that formed the basis for recommendations within the guidelines. The process of facilitated sensemaking may be used to help nurses adopt the SCCM recommendations into practice through the development of caring relationships, promoting family presence, teaching family engagement strategies, and supporting families with communication, information gathering, and participation in decision-making. ©2017 American Association of Critical-Care Nurses.

Consent process for US-based family reference DNA samples.

PubMed

Katsanis, Sara H; Snyder, Lindsey; Arnholt, Kelly; Mundorff, Amy Z

2018-01-01

DNA collection from family members of the missing is a tenet for missing persons' and mass fatality investigations. Procedures for consenting family members are disparate, depending on the context supporting the reason for sample collection. While guidelines and best practices have been developed for handling mass fatalities and for identification of the missing, these guidelines do not address standard consent practices for living family members of potential victims. We examined the relevant U.S. laws, international guidelines and best practices, sampled consent forms currently used for DNA collection of family members, and drafted model language for a consent form to communicate the required and recommended information. We modeled the consent form on biobank consenting practices and tested the consent language among students and the general population for constructive feedback and readability. We also asked respondents to consider the options for DNA collection and either hypothetically agree or disagree. The model language presented here highlights information important to relay in consent processes and can serve as a foundation for future consent practices in mass fatalities and missing persons' investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

A Digital Divide? Class and Gender in the Computer Practices of Two Mexicano Families.

ERIC Educational Resources Information Center

Menard-Warwick, Julia; Dabach, Dafney Blanca

The purpose of this paper is to critically re-examine the popular concept of a developing "digital divide." Based on qualitative studies of the computer practices of two Mexicano families resident in California, the paper argues with Warschauer (2001) that the "digital divide" should be seen as a continuum of varying degrees of…

Practical Concerns of Limited Income Families: An Adult Home Economics Curriculum.

ERIC Educational Resources Information Center

Williams, Sally K.; Bertelson, Laura Winslow

Based on focus group research in five locations in Iowa, this curriculum guide was developed to help meet the educational needs of families facing economic problems as a result of job or farm loss. The curriculum guide, which is organized in three modules that cover self-esteem, parenting, and resource management, uses a practical problem-solving…

Learning Together: Creating a Community of Practice to Support English Language Learner Literacy

ERIC Educational Resources Information Center

Peercy, Megan Madigan; Martin-Beltran, Melinda; Daniel, Shannon M.

2013-01-01

This qualitative case study examines an after-school, bilingual family literacy programme that brought together several groups to form a community of practice (CoP) that worked to support the literacy development of English language learners and their families. We explored the following question: How do parents, teachers, students, and other…

Improved nurse-parent communication in neonatal intensive care unit: evaluation and adjustment of an implementation strategy.

PubMed

Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

2014-12-01

To evaluate and adjust systematic implementation of guided family-centred care in a neonatal intensive care unit. Family-centred care is valued in neonatal intensive care units internationally, but innovative strategies are needed to realise the principles. Guided family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. Qualitative and quantitative data were used to monitor participatory implementation of a systematic approach to training and certification of nurses delivering guided family-centred care. Systematic implementation of guided family-centred care included workshops, supervised delivery and certification. Evaluation and adjustment of nurse adherence to guided family-centred care was conducted by monitoring (1) knowledge, (2) delivery, (3) practice uptake and (4) certification. Implementation was improved by the development of a strategic framework and by adjusting the framework according to the real-life context of a busy neonatal care unit. Promoting practice uptake was initially underestimated, but nurse guided family-centred care training was improved by increasing the visibility of the study in the unit, demonstrating intervention progress to the nurses and assuring a sense of ownership among nurse leaders and nonguided-family-centred-care-trained nurses. An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. Insights gained from our pioneering work might help nurses in a similar context to reach their goals of improving family-centred care. © 2014 John Wiley & Sons Ltd.

The Connections Project: a relational approach to engaging birth parents in visitation.

PubMed

Gerring, Charyl E; Kemp, Susan P; Marcenko, Maureen O

2008-01-01

This paper presents a practical framework for relational practice with birth families, organized around parental visitation. The approach was developed in the Birth Family-Foster Family Connections Project, a three-year collaborative research demonstration project between a large private agency and the Washington State Department of Child and Family Services. The overall goal of the Connections Project, which served young children from infancy to age 6, was to create supportive connections among birth families, foster families, children, and the child welfare system. Although engaging parents in child welfare services is a challenging task for social workers, the Connections Project resulted in strong parent-worker relationships, very high participation in weekly visitation by birth parents, and quite extensive contact between birth and foster families. The paper describes relational strategies used by Connections social workers before and during visits, with the goal of providing child welfare social workers with a practical and effective framework for engaging parents through this core child welfare service.

Development and Psychometric Testing of the Iceland-Family Illness Beliefs Questionnaire.

PubMed

Gisladottir, Margret; Svavarsdottir, Erla Kolbrun

2016-08-01

Illness beliefs affect how individuals and families deal with illness. A valid and reliable instrument has not yet been developed to measure "illness beliefs" in family nursing research and clinical practice. This article describes the purpose, reliability, validity, and the potential clinical and research applications of a new instrument, the Iceland-Family Illness Beliefs Questionnaire (ICE-FIBQ). The ICE-FIBQ is a short, self-report measure of an individual's beliefs about illness. Drawing from an advanced nursing practice model called the Illness Beliefs Model, the instrument was developed to measure illness beliefs about (a) cause of illness, that is, etiology; (b) control of illness on family and control of family on illness; (c) effect of illness on the individual and family; (d) illness suffering; and (e) support received from health care professionals during illness. The instrument was tested on 139 family caregivers of adolescents/youth with an illness or a disorder. Exploratory factor analysis reduced the original questionnaire from eight to seven items with a one-factor solution (Cronbach's α = .780). Confirmatory factor analysis supported the one-factor solution (Cronbach's α = .789). Further research is needed to determine concurrent validity with other illness belief/illness perception scales and if the instrument is sensitive to capture change in illness beliefs following family nursing intervention. © The Author(s) 2016.

Parenting and Child Development in "Nontraditional" Families.

ERIC Educational Resources Information Center

Lamb, Michael E., Ed.

Selections in this volume discuss the ways in which various "deviations" from traditional family styles affect childrearing practices and child development. Contributors attempt to illustrate the dynamic developmental processes that characterize parenting in nontraditional contexts. The collection contains the following chapters: (1)…

The effect of family and peer communication on college students' communication with dating partners about HIV and AIDS.

PubMed

Powell, Heather L; Segrin, Chris

2004-01-01

As family and peers are primary socializing agents in the lives of young adults, a social learning based model of communication about HIV/AIDS among dating partners was developed and tested, examining the role of interactions with family and peers in this type of communication. Specifically, the model describes relationships between general communication, communication about sexuality, and communication about HIV/AIDS with parents, peers, and dating partners. Participants were 153 young adult couples who completed measures of their communication practices, as well as their communication with family and peers. Communication practices in the family of origin appear to influence both general communication and communication about HIV/AIDS with dating partners. Communication practices with peers influenced general communication, communication about sexuality, and communication about HIV/AIDS with dating partners. Participants and their dating partners exhibited relative agreement about their general communication practices and their communication about HIV/AIDS, but showed less agreement in reports of their communication about sexuality. Implications for understanding the role of family and peer interactions in communication about HIV/AIDS with dating partners are discussed.

A Workshop on Family Impact Analysis for the Research Forum of the White House Conference on Families.

ERIC Educational Resources Information Center

Hubbell, Ruth

Family impact analyses are focused on one basic question: What will a given law, policy or practice do to families? There are two major activities in the process of analyzing family impact that has been developed by participants in the Family Impact Seminar: the first involves figuring out exactly how a law, policy, or system under study actually…

The Future of Family Medicine: A Collaborative Project of the Family Medicine Community

PubMed Central

2004-01-01

BACKGROUND Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to transform and renew the discipline of family medicine to meet the needs of patients in a changing health care environment. METHODS A national research study was conducted by independent research firms. Interviews and focus groups identified key issues for diverse constituencies, including patients, payers, residents, students, family physicians, and other clinicians. Subsequently, interviews were conducted with nationally representative samples of 9 key constituencies. Based in part on these data, 5 task forces addressed key issues to meet the project goal. A Project Leadership Committee synthesized the task force reports into the report presented here. RESULTS The project identified core values, a New Model of practice, and a process for development, research, education, partnership, and change with great potential to transform the ability of family medicine to improve the health and health care of the nation. The proposed New Model of practice has the following characteristics: a patient-centered team approach; elimination of barriers to access; advanced information systems, including an electronic health record; redesigned, more functional offices; a focus on quality and outcomes; and enhanced practice finance. A unified communications strategy will be developed to promote the New Model of family medicine to multiple audiences. The study concluded that the discipline needs to oversee the training of family physicians who are committed to excellence, steeped in the core values of the discipline, competent to provide family medicine’s basket of services within the New Model, and capable of adapting to varying patient needs and changing care technologies. Family medicine education must continue to include training in maternity care, the care of hospitalized patients, community and population health, and culturally effective and proficient care. A comprehensive lifelong learning program for each family physician will support continuous personal, professional, and clinical practice assessment and improvement. Ultimately, systemwide changes will be needed to ensure high-quality health care for all Americans. Such changes include taking steps to ensure that every American has a personal medical home, promoting the use and reporting of quality measures to improve performance and service, advocating that every American have health care coverage for basic services and protection against extraordinary health care costs, advancing research that supports the clinical decision making of family physicians and other primary care clinicians, and developing reimbursement models to sustain family medicine and primary care practices. CONCLUSIONS The leadership of US family medicine organizations is committed to a transformative process. In partnership with others, this process has the potential to integrate health care to improve the health of all Americans. PMID:15080220

The Future of Family Medicine: a collaborative project of the family medicine community.

PubMed

Martin, James C; Avant, Robert F; Bowman, Marjorie A; Bucholtz, John R; Dickinson, John R; Evans, Kenneth L; Green, Larry A; Henley, Douglas E; Jones, Warren A; Matheny, Samuel C; Nevin, Janice E; Panther, Sandra L; Puffer, James C; Roberts, Richard G; Rodgers, Denise V; Sherwood, Roger A; Stange, Kurt C; Weber, Cynthia W

2004-01-01

Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to transform and renew the discipline of family medicine to meet the needs of patients in a changing health care environment. A national research study was conducted by independent research firms. Interviews and focus groups identified key issues for diverse constituencies, including patients, payers, residents, students, family physicians, and other clinicians. Subsequently, interviews were conducted with nationally representative samples of 9 key constituencies. Based in part on these data, 5 task forces addressed key issues to meet the project goal. A Project Leadership Committee synthesized the task force reports into the report presented here. The project identified core values, a New Model of practice, and a process for development, research, education, partnership, and change with great potential to transform the ability of family medicine to improve the health and health care of the nation. The proposed New Model of practice has the following characteristics: a patient-centered team approach; elimination of barriers to access; advanced information systems, including an electronic health record; redesigned, more functional offices; a focus on quality and outcomes; and enhanced practice finance. A unified communications strategy will be developed to promote the New Model of family medicine to multiple audiences. The study concluded that the discipline needs to oversee the training of family physicians who are committed to excellence, steeped in the core values of the discipline, competent to provide family medicine's basket of services within the New Model, and capable of adapting to varying patient needs and changing care technologies. Family medicine education must continue to include training in maternity care, the care of hospitalized patients, community and population health, and culturally effective and proficient care. A comprehensive lifelong learning program for each family physician will support continuous personal, professional, and clinical practice assessment and improvement. Ultimately, systemwide changes will be needed to ensure high-quality health care for all Americans. Such changes include taking steps to ensure that every American has a personal medical home, promoting the use and reporting of quality measures to improve performance and service, advocating that every American have health care coverage for basic services and protection against extraordinary health care costs, advancing research that supports the clinical decision making of family physicians and other primary care clinicians, and developing reimbursement models to sustain family medicine and primary care practices. The leadership of US family medicine organizations is committed to a transformative process. In partnership with others, this process has the potential to integrate health care to improve the health of all Americans.

Parenting practices and the transmission of ethnic identity.

PubMed

Davey, Maureen; Fish, Linda Stone; Askew, Julie; Robila, Mihaela

2003-04-01

Three years after being interviewed, a nonrandom, purposeful subsample of 14 Jewish families from a larger sample of 48 families living in Central New York was reinterviewed. The primary aim of this follow-up study was to develop a descriptive understanding of parenting practices and the transmission of ethnic identity. Semistructured family interviews were conducted and coded using grounded-theory techniques, in particular the constant comparative method of analysis. Four main qualitative categories emerged from this study: Individual differences in teenagers, stages of ethnic identity development, parenting practices, and parental role models. Findings suggest that clear expectations, a type of authoritative parenting, could be associated with the positive transmission of Jewish ethnic identity. This type of parenting style was direct as parents expressed clear expectations for participation in Jewish activities both at home and in the community.

Issues in Differential Response

ERIC Educational Resources Information Center

Hughes, Ronald C.; Rycus, Judith S.; Saunders-Adams, Stacey M.; Hughes, Laura K.; Hughes, Kelli N.

2013-01-01

Differential response (DR), also referred to as alternative response (AR), family assessment response (FAR), or multiple track response, was developed to incorporate family-centered, strengths-based practices into child protective services (CPS), primarily by diverting lower risk families into an assessment track rather than requiring the…

Policies and Practices in Canadian Family Child Care Agencies. You Bet I Care!

ERIC Educational Resources Information Center

Doherty, Gillian; Lero, Donna S.; Tougas, Jocelyne; LaGrange, Annette; Goelman, Hillel

Four Canadian provinces license or contract with family child care agencies, which in turn recruit and monitor child care providers. These family child care agencies have two primary roles: monitoring and supervising providers, and supplying their affiliated family child care providers with professional development opportunities and other types of…

Bridging the School-Home Divide in the Middle Grades: A Process for Strengthening School-Family Partnerships

ERIC Educational Resources Information Center

Kyzar, Kathleen; Jimerson, Jo Beth

2018-01-01

Evidence around adolescent learning and development is clear: School-family partnerships matter. However, traditional methods for engaging families that narrowly define who is involved and what constitutes involvement fall short of promoting optimal outcomes. Meaningful family engagement practices involve reciprocal, two-way interactions between…

Recent Developments in Family Psychoeducation as an Evidence-Based Practice

ERIC Educational Resources Information Center

Lucksted, Alicia; McFarlane, William; Downing, Donna; Dixon, Lisa

2012-01-01

Among potential resources for people with serious mental illnesses (SMI) and their families, professionally delivered family psychoeducation (FPE) is designed to engage, inform, and educate family members, so that they can assist the person with SMI in managing their illness. In this article, we review research regarding FPE outcomes and…

Clinician Telephone Training to Reduce Family Tobacco Use: Analysis of Transcribed Recordings

PubMed Central

Walters, Bethany Hipple; Ossip, Deborah J.; Drehmer, Jeremy E.; Nabi-Burza, Emara; Whitmore, Regina; Gorzkowski, Julie; Winickoff, Jonathan P.

2018-01-01

Background Family tobacco use and exposure are significant threats to the health of children and their families. However, few pediatric clinicians address family tobacco use and exposure in a routine and effective manner. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention was developed to tackle this gap between clinical need and clinical practice. Objective To review the main considerations and questions that clinicians and office staff expressed during telephone training to participate in CEASE. Methods This study was conducted in pediatric practices in 5 US states. Practices were recruited by the American Academy of Pediatrics (10 intervention, 10 control). Ten training calls were recorded and transcribed. The data was then coded inductively based on themes found in the transcripts. Results The data revealed that clinicians and staff were concerned about prescribing, dosing, and insurance coverage of nicotine replacement therapy; motivation for and methods to help families become tobacco-free; and the impact of the intervention on practice operations. Conclusion While the majority of clinicians and office staff were interested and enthusiastic about helping families become tobacco-free, they expressed concerns that could threaten implementation of family tobacco control strategies. PMID:29497272

Development and evaluation of a training workshop for lay health promoters to implement a community-based intervention program in a public low rent housing estate: The Learning Families Project in Hong Kong

PubMed Central

Lai, Agnes Y.; Stewart, Sunita M.; Wan, Alice; Fok, Helen; Lai, Hebe Y. W.; Lam, Tai-hing; Chan, Sophia S.

2017-01-01

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov NCT02844244 PMID:28841677

Development and evaluation of a training workshop for lay health promoters to implement a community-based intervention program in a public low rent housing estate: The Learning Families Project in Hong Kong.

PubMed

Lai, Agnes Y; Stewart, Sunita M; Wan, Alice; Fok, Helen; Lai, Hebe Y W; Lam, Tai-Hing; Chan, Sophia S

2017-01-01

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled "Learning Families Project", under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees' knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees' reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents' survey results before and after participating in the community activities delivered by the trainees. The trainees' learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen's d: 0.5-1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen's d: 0.4-0.6). The application of planning skills to implement community activities was higher at one year (Cohen's d: 0.4), compared with baseline. At one year, the residents' survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. ClinicalTrials.gov NCT02844244.

Task Force 1. Report of the Task Force on Patient Expectations, Core Values, Reintegration, and the New Model of Family Medicine

PubMed Central

Green, Larry A.; Graham, Robert; Bagley, Bruce; Kilo, Charles M.; Spann, Stephen J.; Bogdewic, Stephen P.; Swanson, John

2004-01-01

BACKGROUND To lay the groundwork for the development of a comprehensive strategy to transform and renew the specialty of family medicine, this Future of Family Medicine task force was charged with identifying the core values of family medicine, developing proposals to reform family medicine to meet consumer expectations, and determining systems of care to be delivered by family medicine in the future. METHODS A diverse, multidisciplinary task force representing a broad spectrum of perspectives and expertise analyzed and discussed published literature; findings from surveys, interviews, and focus groups compiled by research firms contracted to the Future of Family Medicine project; and analyses from The Robert Graham Center, professional societies in the United States and abroad, and others. Through meetings, conference calls, and writing, and revision of a series of subcommittee reports, the entire task force reached consensus on its conclusions and recommendations. These were reviewed by an external panel of experts and revisions were made accordingly. MAJOR FINDINGS After delivering on its promise to reverse the decline of general practice in the United States, family medicine and the nation face additional challenges to assure all people receive care that is safe, effective, patient-centered, timely, efficient, and equitable. Challenges the discipline needs to address to improve family physicians’ ability to make important further contributions include developing a broader, more accurate understanding of the specialty among the public and other health professionals, addressing the wide scope and variance in practice types within family medicine, winning respect for the specialty in academic circles, making family medicine a more attractive career option, and dealing with the perception that family medicine is not solidly grounded in science and technology. The task force set forth a proposed identity statement for family medicine, a basket of services that should be reliably provided in family medicine practices, and an itemization of key attributes and core values that define the specialty. It also proposed and described a New Model of family medicine for people of all ages and both genders that emphasizes patient-centered, evidence-based, whole-person care provided through a multidisciplinary team approach in settings that reduce barriers to access and use advanced information systems and other new technologies. The task force recommended a time of active experimentation to redesign the work and workplace of family physicians; the development of revised financial models for family medicine, and a national resource to provide assistance to individual practices moving to New Model practice; and cooperation with others pursuing the transformation of frontline medicine to better serve the public. CONCLUSIONS Unless there are changes in the broader health care system and within the specialty, the position of family medicine in the United States will be untenable in a 10- to 20-year time frame. Even within the constraints of today’s flawed health care system, there are major opportunities for family physicians to realize improved results for patients and economic success. A period of aggressive experimentation and redevelopment of family medicine is needed now. The future success of the discipline and its impact on public well-being depends in large measure on family medicine’s ability to rearticulate its vision and competencies in a fashion that has greater resonance with the public while substantially revising the organization and processes by which care is delivered. When accomplished, family physicians will achieve more fully the aspirations articulated by the specialty’s core values and contribute to the solution of the nation’s serious health care problems.

Family physicians and dementia in Canada: Part 2. Understanding the challenges of dementia care.

PubMed

Pimlott, Nicholas J G; Persaud, Malini; Drummond, Neil; Cohen, Carole A; Silvius, James L; Seigel, Karen; Hollingworth, Gary R; Dalziel, William B

2009-05-01

To explore the challenges Canadian family physicians face in providing dementia care. Qualitative study using focus groups. Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont. Eighteen family physicians. We conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Focus group transcripts were analyzed using the principles of thematic analysis. Five major themes related to the provision of dementia care by family physicians emerged: 1) diagnostic uncertainty; 2) the complexity of dementia; 3) time as a paradox in the provision of dementia care; 4) the importance of patients' families; 5) and familiarity with patients. Participants expressed uncertainty about diagnosing dementia and a strong need for expert verification of diagnoses owing to the complexity of dementia. Time, patients' family members, and familiarity with patients were seen as both barriers and enablers in the provision of dementia care. Family physicians face many challenges in providing dementia care. The results of this study and the views of family physicians should be considered in the development and dissemination of future dementia guidelines, as well as by specialist colleagues, policy makers, and those involved in developing continuing physician education about dementia.

Influences on Adolescents' Vocational Development.

ERIC Educational Resources Information Center

Mortimer, Jeylan T.; And Others

A study charted family, school, workplace, and community experiences that are relevant to the vocational development of high school students, focusing on five areas of influence: allowance practices within the family, economic status, paid work experience, volunteerism, and gender differences. The data were from the "Youth Development…

Development of a Competency Framework for Quality Improvement in Family Medicine: A Qualitative Study

ERIC Educational Resources Information Center

Czabanowska, Katarzyna; Klemenc-Ketis, Zalika; Potter, Amanda; Rochfort, Andree; Tomasik, Tomasz; Csiszar, Judit; Van den Bussche, Piet

2012-01-01

Objective: The aim of this study was to develop a comprehensive framework of quality improvement competencies for use in continuing professional development (CPD) and continuing medical education (CME) for European general practice/family medicine physicians (GPs/FDs). Methods: The study was carried out in three phases: literature review,…

Literacy Engagement and Parental Development through Even Start Family Literacy Participation

ERIC Educational Resources Information Center

Robinson, Petra A.

2012-01-01

This study examined how parental participation in Even Start programs contributes to family literacy engagement and parental development. More specifically, its primary aim was to develop an understanding of how parental participation in the program influences their reading behaviors and other literacy practices as well as to highlight observed…

Theory Development: A Bridge between Practice and Research

ERIC Educational Resources Information Center

Southern, Stephen; Devlin, James

2010-01-01

Theory development is an intentional process by which marriage and family counselors may bridge the gap between research and practice. The theory building process includes inductive and deductive forms of reasoning, qualitative and quantitative approaches to knowledge development, and diffusion of innovations. Grounded theory provides an…

Patient and family psychoeducation: Service development and implementation in a center in Iran.

PubMed

Mirsepassi, Zahra; Tabatabaee, Maryam; Sharifi, Vandad; Mottaghipour, Yasaman

2018-02-01

Family and patient psychoeducation have demonstrated significant improvement in clinical and social outcomes for patients suffering from severe mental disorders and their families. However, these evidence-based practices are not widely implemented at service delivery level and into routine clinical practice, especially in less developed countries. The aim of this article is to report the processes of development and implementation of a psychoeducational service for patients with severe mental illnesses and their families in Iran. The program was developed at Roozbeh Hospital in Tehran, Iran. A group of clinicians worked on the development phase of the program and drafting the manuals. Then, a series of workshops and supervision sessions were held to train group leaders for implementation of the group psychoeducation for patients and families. In the pilot phase, the services were delivered to two groups of patients and families, and then the manual was revised based on the feedback from group leaders and participants. The program consisted of eight 90-minute weekly patient group sessions and 6 weekly multiple family group sessions. Two manuals for patient education (schizophrenia and bipolar disorder) were developed. Several information sheets were developed and distributed during different sessions of family and patient psychoeducation related to the content of each session. Despite providing the hospital clinicians with the information regarding these new services, less than 10% of the admitted patients were referred by their clinicians. Feasibility and sustainability of the program are affected by a number of factors. Low referral rate of clinicians, limited resources of the hospital, issues related to stigma and logistic issues are barriers in implementation of these services. Administrators' and clinicians' understanding of the importance of patient and family psychoeducation seems to be crucial in sustainability of such programs in routine service delivery.

Making child mental health 'everybody's business': a training course for family support workers.

PubMed

Harborne, Alex; Van Roosmalen, Marc

2008-01-01

This article provides an overview of the development and delivery of a mental health teaching and training programme offered to Family Support Workers (FSWs) working in a range of schools in an economically deprived part of Bedfordshire. The FSWs had received no prior teaching in the area of child mental health, or in ways of engaging and communicating with children and families. Both topics were considered crucial to their role. The training was delivered in two phases. Phase 1 consisted of 4 full days of teaching. Topics covered included (1) engaging children and families, (2) child development, (3) self-awareness, and (4) systemic thinking. Phase 2 was delivered through 'practice sets', which were held monthly for 4 months, and lasted 2 hours. These were used to develop the FSWs' theoretical understanding of the issues, and link this with their practice. The training was evaluated using a semistructured questionnaire. Results suggested that participants had changed the ways in which they engaged families and children. They were more able to adopt a collaborative, nonexpert, position which focused on empowering families to make decisions for themselves. This represented a significant shift in the way they worked. This process was enhanced by their more sophisticated level of understanding of child development and behaviour problems, which took into account the impact of wider systemic and relational factors and moved away from locating problems within individuals. Participants also demonstrated the ability to reflect on how their personal beliefs and experiences impacted on the work they undertook, and why this was important. Recommendations following the training included the need for regular, ongoing practice support, the need for the training to be more widely disseminated (e.g. to school staff), and the benefits of having clear descriptions of the roles and responsibilities of Family Support Workers.

Men and family planning in Africa. Les hommes et la planification familiale en Afrique.

PubMed

Diallo, A

1984-09-01

Male responsibility with regard to family planning and its practice is a major action focus of the International Planned Parenthood Federation. The campaign has been aimed at developing programs to educate men about family planning, encouraging men to practice contraception, and changing the attitudes of male opinion leaders. Since the African male's opinion is paramount within the family unit, the village, and the broader society, this approach is considered essential to the success of family planning efforts in Africa. Although a wide range of programs in Anglophone Africa are now oriented toward men, little progress has been made in the Francophone countries. Obstacles include traditionalism, pro-natalism, illiteracy, religion, and a hostility to Western concepts. Efforts have further been hindered by the way that family planning has been promoted in the region in the past: as a birth spacing method to improve maternal and child health. Medical and paramedical personnel in the region have been trained to treat only mothers and children, not couples or families. However, women's changing status and increased awareness of the connection between demography and development have created an atmosphere more favorable to well designed family welfare programs that are integrated with other development activities. If family planning is to become entrenched in the African region, attention must be given to 3 areas: information and education, integrated development, and research and training. Within the framework of educational activities, men can be made aware that they may practice contraception without any threat to their virility. Given the complexity of the task of introducing family planning on a broad scale in Africa, an integrated appraoch (social, cultural, health, economic, political, and legislative), involving both governments and voluntary organizations as well as the population, is required. Decision makers must be convinced to give family planning a central role in primary health care. Key to the implementation of this strategy is the selection of promoters who have a knowledge of the area in which they work, a commitment to family planning, and the necessary communication skills.

24 CFR 35.500 - Purpose and applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES HUD-Owned Single Family... eliminate as far as practicable lead-based paint hazards in HUD-owned single family properties that have...

24 CFR 35.500 - Purpose and applicability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES HUD-Owned Single Family... eliminate as far as practicable lead-based paint hazards in HUD-owned single family properties that have...

24 CFR 35.500 - Purpose and applicability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES HUD-Owned Single Family... eliminate as far as practicable lead-based paint hazards in HUD-owned single family properties that have...

24 CFR 35.500 - Purpose and applicability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES HUD-Owned Single Family... eliminate as far as practicable lead-based paint hazards in HUD-owned single family properties that have...

24 CFR 35.500 - Purpose and applicability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Development LEAD-BASED PAINT POISONING PREVENTION IN CERTAIN RESIDENTIAL STRUCTURES HUD-Owned Single Family... eliminate as far as practicable lead-based paint hazards in HUD-owned single family properties that have...

An ethical perspective on caregiving in the family.

PubMed

Post, Stephen

1988-01-01

The emphasis on intra-family caregiving that prevailed from ancient until relatively recent times, in both philosophy and practice, was substantially displaced under the influence of the Eighteenth Century Enlightenment by an emphasis on individual independence. The ethics of familial relationships ceased to be at the center of philosophical interest. A consequence was growing inattention to the social conditions and practical arrangements needed to support family efforts to take care of the very young, the very old, the physically or mentally ill or disabled, and others in need of care. The myth of the self-sufficient family must be exploded to permit the development of a public policy that will make such support possible.

Birth Control Practices and Levels of Development in India.

ERIC Educational Resources Information Center

Karan, P.P.; And Others

1978-01-01

Analyzes the spatial patterns of acceptance of birth control practices in India and examines the relationship between these patterns and levels of economic development. Suggests implications of the area differences in acceptance patterns for family planning program policymakers. (Author)

National Foster Care and Adoption Directory Search

MedlinePlus

... Home Topics Family-Centered Practice Philosophy and Key Elements of Family-Centered Practice Family-Centered Practice Across the Service Continuum Engaging Families Family-Centered Casework Practice Family Group Decision-Making Engaging Communities to Support Families Creating a Family- ...

Restructuring African American Families in the 1990s.

ERIC Educational Resources Information Center

Barker, Narviar Cathcart; Hill, Joseph

1996-01-01

Examines family life factors that contribute to, or inhibit, the development of a child's emotional health and social well-being. Special problems in the socialization of African Americans are discussed, and the goals and practices these families should strive for to help them survive are explored. (GR)

Postgraduate Medical Education for Rural Family Practice in Canada.

ERIC Educational Resources Information Center

Rourke, James T. B.

2000-01-01

To produce more rural physicians, the College of Family Physicians of Canada recommends providing earlier and more extensive rural medicine experience for all undergraduate medical students, developing rural postgraduate training programs, providing third-year optional special and advanced rural family-medicine skills training, and making advanced…

Working Respectfully with Families: A Practical Guide for Educators and Human Service Workers. Training Module I: The Child, the Family, and the Community.

ERIC Educational Resources Information Center

Connard, Christie; And Others

Educators and service providers often have little opportunity to work cooperatively with families to enhance outcomes for children. This document is the first in a four-part training module that was developed by Northwest Regional Educational Laboratory's Child, Family, and Community Program. The modules are based on an ecological, family-centered…

Living Gerontology: Providing Long-Distance, Long-term Care.

PubMed

Kivnick, Helen Q

2017-02-01

My own living and working through normative family transitions of parent care (as both a professional gerontologist and an intergenerational family member) facilitated five important kinds of growth: (a) providing parent care with optimal integrity; (b) understanding, elaborating, and teaching life-cycle theory with increasing depth; (c) using this theory to enrich practice approaches to long-term care; (d) identifying valuable new research directions; and (e) creating a multidimensional professional life that furthers theoretical development and identifies practice principles that promote individual, familial, and societal experiences of a "good old age." This reflective essay addresses these different kinds of growth, as they emerged from and contribute to the ever-developing gerontological domains of theory and practice. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

["Nicht von schlechten Eltern - NischE": A Family Orientated Collaborative Care Approach to Support Children in Families with Mentally Ill Parents].

PubMed

Wabnitz, Pascal; Kronmüller, Klaus-Thomas; Wieskus-Friedemann, Erwin; Kliem, Sabine; Hoppmann, Johannes; Burek, Monika; Löhr, Michael; Kemper, Ulrich; Nienaber, André

2016-11-01

"Nicht von schlechten Eltern - NischE": A Family Orientated Collaborative Care Approach to Support Children in Families with Mentally Ill Parents The present work describes the setting- and multi-professional offer "NischE" in Gütersloh, a systemic approach for the care of children and their mentally ill parents. Children of mentally ill parents are a special risk group for developing their own mental illness. The aim of the collaborative care model between child and adolescent psychiatry, youth services and adult psychiatry is to enable affected families in terms of family-focused practice a low threshold access to different services. For this purpose, two positions have been created to advise the affected families and support access to the help system in the sense of a systemic case management in a project. The article describes the background and the need for the development of the offer, the current scientific knowledge base on the subject and illustrates the procedure using a case study from practice.

Residents' perceptions of an integrated longitudinal curriculum: a qualitative study.

PubMed

Lubitz, Rebecca; Lee, Joseph; Hillier, Loretta M

2015-01-01

The purpose of this study was to explore family medicine residents' perceptions of a newly restructured integrated longitudinal curriculum. A purposeful sample of 16 family medicine residents participated in focus group interviews conducted from a grounded theory perspective to identify the characteristics of this training model that contribute to and that challenge learning. Eight key themes were identified: continuity of care, relevance to family medicine, autonomy, program-focused preparation, professional development as facilitated by role modeling, patient volume, clarity of expectations for learners, and logistics. Positive learning experiences were marked by high levels of autonomy, continuity, and relevance to family medicine. Less favorable learning experiences were characterized by limited opportunities for continuity of care, limited relevance to family medicine practice and unclear expectations for the resident's role. Family physician-led learning experiences contributed to residents' understanding of the full scope of family medicine practice, more so than specialist-led experiences. The logistics of implementing the integrated block were challenging and negatively impacted continuity and learning. This study suggests that an integrated longitudinalized family medicine block training model has the potential to support the principles of a longitudinal integrated competency-based curriculum to effectively prepare residents for family medicine practice.

School, Family, and Community Partnerships: Your Handbook for Action. Second Edition.

ERIC Educational Resources Information Center

Epstein, Joyce L.; Sanders, Mavis G.; Simon, Beth S.; Salinas, Karen Clark; Jansorn, Natalie Rodriguez; Van Voorhis, Frances L.

Despite strong agreement on the importance of parent involvement, most schools, districts, and states still need help in developing comprehensive programs of school, family, and community partnerships. This revised handbook translates lessons learned over 20 years of research and fieldwork into practical solutions for program development. The book…

Portraits of Partnership: The Hopes and Dreams Project

ERIC Educational Resources Information Center

Giovacco-Johnson, Tricia

2009-01-01

This article describes an innovative practice in family involvement developed by one early care and education center engaged in professional development. The Hopes and Dreams Project documented family involvement in children's lives and education through the pairing of pictures and narratives about their lives, histories, priorities, goals, and…

[Development of "assessment guideline of family power for healthy life"].

PubMed

Fukushima, M; Shimanouchi, S; Kamei, T; Takagai, E; Hoshino, Y; Sugiyama, I

1997-12-01

The purpose of this study is to develop "assessment guideline of family power for healthy life" aiming at expanding self-care power of family in community nursing practice. The subjects of this study covered those families in one hundred and fifty six instances that we had seized as subject for nursing care and study. The method of this study had constructed assessment guideline inductively out of each case, and modified it by applying to cases of families with health problems and others. As a result, we had formed nine items of "family power for healthy life" and three items of "conditions influencing family power for healthy life" for "assessment guideline of family power for healthy life".

Ready for practice: what child and family health nurses say about education.

PubMed

Fowler, Cathrine; Schmied, Virginia; Psaila, Kim; Kruske, Sue; Rossiter, Chris

2015-02-01

Australia has a well-established universal child and family health service predominately staffed by specialist/qualified child and family health nurses. Two common and interrelated concerns are the need for nurses to be ready for practice after completing a nursing education program and the means to ensure ongoing nursing competence. To investigate the readiness of CFH nurses to practise after qualification and their continuing engagement with learning. The study used an interpretive descriptive approach. This paper presents data from four questions from a larger survey of child and family health nurses across Australia. 1098 child and family health nurses responded to the survey. Qualitative survey responses from the four education questions were analysed using inductive thematic content analysis. Five significant themes were identified: hands-on experience (student clinical practice/placement); drawing on prior experience; learning on the job; learning (learning over time); and barriers to learning. This paper provides insights into nurses' readiness for practice at the completion of a postgraduate child and family health nursing qualification and their maintenance of competence and specialist knowledge. It highlights: the need for clinical placement to be retained and enhanced; the significant contribution of more experienced child and family health nurses mentoring newly graduated child and family health nurses; the need for minimum education standards; the importance of reviewing education courses in relation to graduates' readiness for child and family health nursing practice; the importance of supporting ongoing professional development; and the removal of barriers to accessing education opportunities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Contrasting approaches to 'doing' family meals: a qualitative study of how parents frame children's food preferences.

PubMed

Thompson, Claire; Cummins, Steven; Brown, Tim; Kyle, Rosemary

2016-05-26

Family meals, as acts of domestic food provisioning, are shaped by the competing influences of household resources, food preferences and broader cultural norms around dietary practices. The place of children's food tastes in family meal practices is particularly complex. Food tastes stand in a reciprocal relationship with family food practices: being both an influence on and a product of them. This paper explores how parents think about and respond to their children's food preferences in relation to family meal practices. A qualitative study was conducted with residents of Sandwell, UK. The results presented here are based on the responses of nine key participants and their families. Photo elicitation methods generated participant food photo diaries that were used to inform subsequent interviews. A thematic analysis revealed two contrasting ways of incorporating children's tastes into family meal routines: (1) 'what we fancy' and (2) 'regulated'. The former entails repeatedly consulting and negotiating with children over what to cook for each meal. It is supported by the practical strategies of multiple and individually modified meals. The latter relies upon parents developing a repertoire of meals that 'work' for the family. This repertoire is performed as a series of 'set meals' in which any requests for variation are strongly resisted. Our findings add to the small body of literature on household food provisioning and suggest that achieving the idealised ritual of the family meal is underpinned by a range of values and strategies, some of which may run counter to health messages about nutrition.

Organizational Merger and Cultural Change for Better Outcomes: The First Five Years of the New York State Office of Children and Family Services

ERIC Educational Resources Information Center

Johnson, Jack

2004-01-01

Since its creation, New York State Office of Children and Family Services (OCFS) has used child and family development research to bridge the chasm between child welfare and juvenile justice policy and practice. OCFS's major challenges have been to help the staff and stakeholders of the merged child welfare and juvenile justice agencies develop a…

Training in interprofessional collaboration

PubMed Central

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-01-01

Abstract Problem addressed A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. Objective of the program The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Program description Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. Conclusion The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training. PMID:22611607

"Goodest" Guidance: Teachers and Families Together

ERIC Educational Resources Information Center

Gartrell, Dan

2012-01-01

Early childhood professionals can build partnerships with families that allow them together to guide the learning and development of the children whose lives they share. In this article, the author shares a system of indicators in professional practice that might be helpful in building partnerships with families that enable the full effectiveness…

Work and Family Life: Middle School Content Competencies.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Career-Technical and Adult Education.

This document, which lists the middle school content competencies for the Work and Family Studies curriculum within Family and Consumer Sciences in Ohio, is intended to help middle school students develop self-responsibility and competence dealing with the practical problems of early adolescence. (Career awareness and career choice options are…

Brain science and illness beliefs: an unexpected explanation of the healing power of therapeutic conversations and the family interventions that matter.

PubMed

Wright, Lorraine M

2015-05-01

Paradigm families and paradigm practice moments have shown me that therapeutic conversations between nurses and families can profoundly and positively change illness beliefs in family members and nurses and contribute to healing from serious illness. The integration of brain science into nursing practice offers further understanding of the importance of illness beliefs and the role they may play in helping individual and family healing. Brain science offers explanations that connect how certain family nursing interventions that soften suffering and challenge constraining illness beliefs may result in changes in brain structure and functioning. New illness beliefs may result in new neural pathways in the brain, and therefore, possibilities for a new way of being in relationship with illness and in relationship with others can also develop. Newly acquired practice skills and interventions that have emerged from an understanding of brain science plus the reemphasis of other interventions utilized in the Illness Beliefs Model are offered to enhance our care of families suffering with illness. © The Author(s) 2015.

State of the practice for pediatric surgery--career satisfaction and concerns. A report from the American Pediatric Surgical Association Task Force on Family Issues.

PubMed

Katz, Aviva; Mallory, Baird; Gilbert, James C; Bethel, Colin; Hayes-Jordan, Andrea A; Saito, Jacqueline M; Tomita, Sandra S; Walsh, Danielle S; Shin, Cathy E; Wesley, John R; Farmer, Diana

2010-10-01

There has been increasing interest and concern raised in the surgical literature regarding changes in the culture of surgical training and practice, and the impact these changes may have on surgeon stress and the appeal of a career in surgery. We surveyed pediatric surgeons and their partners to collect information on career satisfaction and work-family balance. The American Pediatric Surgical Association Task Force on Family Issues developed separate survey instruments for both pediatric surgeons and their partners that requested demographic data and information regarding the impact of surgical training and practice on the surgeon's opportunity to be involved with his/her family. We found that 96% of pediatric surgeons were satisfied with their career choice. Of concern was the lack of balance, with little time available for family, noted by both pediatric surgeons and their partners. The issues of work-family balance and its impact on surgeon stress and burnout should be addressed in both pediatric surgery training and practice. The American Pediatric Surgical Association is positioned to play a leading role in this effort. Copyright © 2010 Elsevier Inc. All rights reserved.

Translating learning into practice

PubMed Central

Armson, Heather; Kinzie, Sarah; Hawes, Dawnelle; Roder, Stefanie; Wakefield, Jacqueline; Elmslie, Tom

2007-01-01

PROBLEM ADDRESSED The need for effective and accessible educational approaches by which family physicians can maintain practice competence in the face of an overwhelming amount of medical information. OBJECTIVE OF PROGRAM The practice-based small group (PBSG) learning program encourages practice changes through a process of small-group peer discussion—identifying practice gaps and reviewing clinical approaches in light of evidence. PROGRAM DESCRIPTION The PBSG uses an interactive educational approach to continuing professional development. In small, self-formed groups within their local communities, family physicians discuss clinical topics using prepared modules that provide sample patient cases and accompanying information that distils the best evidence. Participants are guided by peer facilitators to reflect on the discussion and commit to appropriate practice changes. CONCLUSION The PBSG has evolved over the past 15 years in response to feedback from members and reflections of the developers. The success of the program is evidenced in effect on clinical practice, a large and increasing number of members, and the growth of interest internationally. PMID:17872876

Developing a Parent-Centered Obesity Prevention Program for 4-H Families: Implications for Extension Family Programming

ERIC Educational Resources Information Center

Benke, Carrie J.; Bailey, Sandra J.; Martz, Jill; Paul, Lynn; Lynch, Wesley; Eldridge, Galen

2013-01-01

Planning youth and family programming in the 21st century is daunting given family members' busy schedules. This is even more challenging when planning programs in rural areas, where there are vast distances between communities. This article discusses a research and educational outreach project that uses best practices in program development…

Practice development for midwifery education: an innovative way forward.

PubMed

Donsante, Jackie; Edgar, Denise; Gill, Leeanne; Thomson, Ceri; Williamson, Moira; Walsh, Kenneth

2013-01-01

Within workplaces there can be several different cultures operating, and it is widely recognised that this occurs in health services. Midwifery and maternity care has, and continues to face many challenges as services continually change and develop to meet the needs of women and their families. To help meet these challenges a practice development initiative was undertaken within a large maternity service in Australia to improve the learning and workplace culture. This service consisted of four separate units providing care for women and their families in the antenatal, birthing, postnatal and neonatal periods. The coming together of these four units as a service began with the creation of a shared values statement which was adopted by all midwifery staff. To obtain evidence of the current workplace, observations of practice, the review of women's stories, and audits of clinical data were undertaken. Nine midwives were trained and supported to facilitate critical discussions of the data. These critical discussions, reflections and analysis of the data, led to the identification of four domains or key areas the staff prioritised for change. This led to practice development groups being formed within the maternity service, who developed collaborative and creative ways of thinking about the issues or problems identified. This paper highlights how the processes of practice development were implemented to improve one of these domains "the learning and workplace culture", especially in relation to educational information and resources for women, their families and staff. The journey began over three years ago and continues to evolve. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Transforming Training to Build the Family Physician Workforce Our Country Needs.

PubMed

Hughes, Lauren S; Tuggy, Michael; Pugno, Perry A; Peterson, Lars E; Brungardt, Stacy H; Hoekzema, Grant; Jones, Samuel; Weida, Jane; Bazemore, Andrew

2015-09-01

The Affordable Care Act has spurred significant change in the US health care system, including expansion of Medicaid and private insurance coverage to millions of Americans. As a result, the need for the medical education continuum to produce a family physician workforce that is sizable enough and highly skilled is significant. These two interdependent goals have emerged as top priorities for Family Medicine for America's Health, a new, 5-year, $21 million collaborative strategic effort of the eight US family medicine organizations to lead continued change in the US health care system. To achieve these important goals, reforms are needed across the entire educational continuum, including how we recruit, train, and help practicing family physicians refresh their skills. Such reforms must provide opportunities to acquire skills needed in new practice and payment environments, to incorporate new educational standards that reflect the public's expectations of family physicians, to collaborate with our primary care colleagues to develop effective interprofessional training, and to design educational programs that are socially accountable to the patients, families, and communities we serve. Through Family Medicine for America's Health, the discipline is well positioned to emerge as a leader in primary care workforce development and educational quality.

Racial/Ethnic Socialization and Identity Development in Black Families: The Role of Parent and Youth Reports

ERIC Educational Resources Information Center

Peck, Stephen C.; Brodish, Amanda B.; Malanchuk, Oksana; Banerjee, Meeta; Eccles, Jacquelynne S.

2014-01-01

Racial/ethnic (R/E) socialization is widely practiced in R/E minority families. However, only recently have models been developed to understand how parents' R/E socialization messages influence adolescent development. The primary goal of the present study was to clarify and extend existing work on R/E socialization in African American (Black)…

Evaluation of family-centred practices in the early intervention programmes for infants and young children in Singapore with Measure of Processes of Care for Service Providers and Measure of Beliefs about Participation in Family-Centred Service.

PubMed

Tang, H N; Chong, W H; Goh, W; Chan, W P; Choo, S

2012-01-01

The primary purpose of this study was to report on an evaluation of the perceptions and beliefs of service providers towards family-centred practices in 11 early intervention programmes for infants and young children in Singapore. The Measure of Processes of Care for Service Providers (MPOC-SP) and Measure of Beliefs about Participation in Family-Centred Service (MBP-FCS) were administered to 213 service providers made up of teachers, therapists, psychologists and social workers providing centre-based therapy to children with special needs who were below the age of 6 years. Exploratory factor analyses were performed with both scales. Nineteen of the 27 MPOC-SP items were retained and supported the original four-factor structure model. The exploratory factor analyses on MBP-FCS provided a less satisfactory outcome. Fourteen of the 28 items were retained and these loaded onto four factors. The two factors relating to Beliefs about benefits of FCS and Beliefs about the absence of negative outcomes from FCS failed to emerge as separate factors. Further multiple regressions indicated that more direct work with families and positive self-efficacy in implementing FCS contributed significantly to explaining service providers' positive perception towards family-centred practice in service delivery. This is the first time MPOC-SP and MBP-FCS were administered to a population in an Asian context. While MBP-FCS would benefit from further development work on its construct, MPOC-SP offered important insights into service providers' perspectives about family-centred practices that would have useful implications for professional and service development. © 2011 Blackwell Publishing Ltd.

How Work-Family Research Can Finally Have an Impact in Organizations.

PubMed

Kossek, Ellen Ernst; Baltes, Boris B; Matthews, Russell A

2011-09-01

Although work-family research has mushroomed over the past several decades, an implementation gap persists in putting work-family research into practice. Because of this, work-family researchers have not made a significant impact in improving the lives of employees relative to the amount of research that has been conducted. The goal of this article is to clarify areas where implementation gaps between work-family research and practice are prevalent, discuss the importance of reducing these gaps, and make the case that both better and different research should be conducted. We recommend several alternative but complementary actions for the work-family researcher: (a) work with organizations to study their policy and practice implementation efforts, (b) focus on the impact of rapid technological advances that are blurring work-family boundaries, (c) conduct research to empower the individual to self-manage the work-family interface, and (d) engage in advocacy and collaborative policy research to change institutional contexts and break down silos. Increased partnerships between industrial-organizational (I-O) psychology practitioners and researchers from many industries and disciplines could break down silos that we see as limiting development of the field.

How Work–Family Research Can Finally Have an Impact in Organizations

PubMed Central

Kossek, Ellen Ernst; Baltes, Boris B.; Matthews, Russell A.

2011-01-01

Although work–family research has mushroomed over the past several decades, an implementation gap persists in putting work–family research into practice. Because of this, work–family researchers have not made a significant impact in improving the lives of employees relative to the amount of research that has been conducted. The goal of this article is to clarify areas where implementation gaps between work–family research and practice are prevalent, discuss the importance of reducing these gaps, and make the case that both better and different research should be conducted. We recommend several alternative but complementary actions for the work–family researcher: (a) work with organizations to study their policy and practice implementation efforts, (b) focus on the impact of rapid technological advances that are blurring work–family boundaries, (c) conduct research to empower the individual to self-manage the work–family interface, and (d) engage in advocacy and collaborative policy research to change institutional contexts and break down silos. Increased partnerships between industrial–organizational (I–O) psychology practitioners and researchers from many industries and disciplines could break down silos that we see as limiting development of the field. PMID:22247737

Point-of-care cluster randomized trial in stroke secondary prevention using electronic health records.

PubMed

Dregan, Alex; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Ashworth, Mark; Charlton, Judith; Wolfe, Charles D A; Rudd, Anthony; Yardley, Lucy; Gulliford, Martin C; Trial Steering Committee

2014-07-01

The aim of this study was to evaluate whether the remote introduction of electronic decision support tools into family practices improves risk factor control after first stroke. This study also aimed to develop methods to implement cluster randomized trials in stroke using electronic health records. Family practices were recruited from the UK Clinical Practice Research Datalink and allocated to intervention and control trial arms by minimization. Remotely installed, electronic decision support tools promoted intensified secondary prevention for 12 months with last measure of systolic blood pressure as the primary outcome. Outcome data from electronic health records were analyzed using marginal models. There were 106 Clinical Practice Research Datalink family practices allocated (intervention, 53; control, 53), with 11 391 (control, 5516; intervention, 5875) participants with acute stroke ever diagnosed. Participants at trial practices had similar characteristics as 47,887 patients with stroke at nontrial practices. During the intervention period, blood pressure values were recorded in the electronic health records for 90% and cholesterol values for 84% of participants. After intervention, the latest mean systolic blood pressure was 131.7 (SD, 16.8) mm Hg in the control trial arm and 131.4 (16.7) mm Hg in the intervention trial arm, and adjusted mean difference was -0.56 mm Hg (95% confidence interval, -1.38 to 0.26; P=0.183). The financial cost of the trial was approximately US $22 per participant, or US $2400 per family practice allocated. Large pragmatic intervention studies may be implemented at low cost by using electronic health records. The intervention used in this trial was not found to be effective, and further research is needed to develop more effective intervention strategies. http://www.controlled-trials.com. Current Controlled Trials identifier: ISRCTN35701810. © 2014 American Heart Association, Inc.

Using electronic clinical practice audits as needs assessment to produce effective continuing medical education programming.

PubMed

Klein, Doug; Staples, John; Pittman, Carmen; Stepanko, Cheryl

2012-01-01

The traditional needs assessment used in developing continuing medical education programs typically relies on surveying physicians and tends to only capture perceived learning needs. Instead, using tools available in electronic medical record systems to perform a clinical audit on a physician's practice highlights physician-specific practice patterns. The purpose of this study was to test the feasibility of implementing an electronic clinical audit needs assessment process for family physicians in Canada. A clinical audit of 10 preventative care interventions and 10 chronic disease interventions was performed on family physician practices in Alberta, Canada. The physicians used the results from the audit to produce personalized learning needs, which were then translated into educational programming. A total of 26 family practices and 4489 patient records were audited. Documented completion rates for interventions ranged from 13% for ensuring a patient's tetanus vaccine is current to 97% of pregnant patients receiving the recommended prenatal vitamins. Electronic medical record-based needs assessments may provide a better basis for developing continuing medical education than a more traditional survey-based needs assessment. This electronic needs assessment uses the physician's own patient outcome information to assist in determining learning objectives that reflect both perceived and unperceived needs.

Poor Parents, Teachers, and the Schools: Comments about Practice, Policy, and Research.

ERIC Educational Resources Information Center

Davies, Don

Research has shown that family and community involvement in education is linked to healthy child development and to children's academic and social success in school. Family participation can also enhance adult personal development and empowerment, aid community problem-solving through collaboration, and advance the prospects for a more democratic…

Financial Literacy and Family Learning--Tutor Resources. Financial Literacy in Context

ERIC Educational Resources Information Center

Basic Skills Agency, 2008

2008-01-01

This publication contains a series of sessions developed and used by Newcastle City Council Family Learning Service and now published to share practice. The sessions were developed specifically to support "Skills for Life" tutors to deliver the adult literacy and numeracy curricula but can also be used by other practitioners. There are…

Communication Interventions for Families of Pre-School Deaf Children in the UK

ERIC Educational Resources Information Center

Rees, Rachel; Mahon, Merle; Herman, Rosalind; Newton, Caroline; Craig, Gordon; Marriage, Josephine

2015-01-01

UK professionals use a range of intervention approaches to promote communication development in pre-school deaf children by influencing the familys' interaction style. This investigation surveyed the approaches used and explored how these translated into specific practices. An online questionnaire was developed and reviewed by a panel of experts.…

Effects of continuing professional development on clinical performance

PubMed Central

Goulet, François; Hudon, Eveline; Gagnon, Robert; Gauvin, Eliane; Lemire, Francine; Arsenault, Isabelle

2013-01-01

Abstract Objective To evaluate the link between the quantity and quality of continuing professional development (CPD) activities completed by family physicians in Quebec and the quality of their practice. Design Retrospective analysis of data collected during professional inspection visits (PIVs). Setting Quebec. Participants Three groups were created from among Quebec family physicians who had been subject to PIVs (peer evaluation) by the Collège des médecins du Québec between 1998 and 2005. Group 1 was composed of physicians who were members of the College of Family Physicians of Canada, which requires participation in 250 hours of CPD in every 5-year cycle. Group 2 was composed of family physicians who were not members of the College of Family Physicians of Canada but who had declared at least 50 hours a year of CPD on their Collège des médecins du Québec annual notice of assessment for the same period. Group 3 was composed of family physicians who had declared fewer than 10 hours of CPD a year. Main outcome measures During the PIV, the following characteristics were examined: record keeping, quality and number of hours of CPD activities, and quality of professional practice based on 3 components— clinical investigation, accuracy of diagnosis, and appropriateness of treatment plan and follow-up. Results The factors associated with a high quality of practice were privileges in a hospital or local community health centre (institution) and a substantial number of accredited CPD hours (Mainpro-M1, Credit I, or Mainpro-C). The factors associated with a poor quality of practice were advanced age of the physician, absence of privileges in an institution (hospital or local community health centre), and participation in CPD activities that were more informal, such as reading and non-accredited activities (Mainpro-M2). Conclusion This study supports earlier research showing that CPD activities of sufficient quality and quantity are correlated with a high quality of professional practice by family physicians. PMID:23673591

Mentorship perceptions and experiences among academic family medicine faculty: Findings from a quantitative, comprehensive work-life and leadership survey.

PubMed

Stubbs, Barbara; Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola

2016-09-01

To collect information about the types, frequency, importance, and quality of mentorship received among academic family medicine faculty, and to identify variables associated with receiving high-quality mentorship. Web-based survey of all faculty members of an academic department of family medicine. The Department of Family and Community Medicine of the University of Toronto in Ontario. All 1029 faculty members were invited to complete the survey. Receiving mentorship rated as very good or excellent in 1 or more of 6 content areas relevant to respondents' professional lives, and information about demographic and practice characteristics, faculty ratings of their local departments and main practice settings, teaching activities, professional development, leadership, job satisfaction, and health. Bivariate and multivariate analyses identified variables associated with receiving high-quality mentorship. The response rate was 66.8%. Almost all (95.0%) respondents had received mentorship in several areas, with informal mentorship being the most prevalent mode. Approximately 60% of respondents rated at least 1 area of mentoring as very good or excellent. Multivariate logistic regression identified 5 factors associated with an increased likelihood of rating mentorship quality as very good or excellent: positive perceptions of their local department (odds ratio [OR] = 4.02, 95% CI 2.47 to 6.54, P < .001); positive ratings of practice infrastructure (OR = 1.86, 95% CI 1.23 to 2.80, P = .003); increased frequency of receiving mentorship (OR = 2.78, 95% CI 1.59 to 4.89, P < .001); fewer years in practice (OR = 1.93, 95% CI 1.19 to 3.12, P = .007); and practising in a family practice teaching unit (OR = 1.51, 95% CI 1.01 to 2.27, P = .040). With increasing emphasis on distributed education and community-based teachers, family medicine faculties will need to develop strategies to support effective mentorship across a range of settings and career stages. Copyright© the College of Family Physicians of Canada.

Children's exposure to sustainability practices during the transition from preschool into school and their learning and socioemotional development.

PubMed

Benner, Aprile D; Thornton, Anna; Crosnoe, Robert

2017-01-01

Evidence that the learning gains of preschool fade as children transition into elementary school has led to increased efforts to sustain preschool advantages during this key transitional period. This study explores whether the observed benefits of sustainability practices for a range of child outcomes are explained and/or moderated by family and school mechanisms selecting children into experiencing these practices. Analyses of the Early Childhood Longitudinal Study-Birth Cohort revealed that both family and school factors predicted children's exposure to several PK-3 sustainability practices. PK-3 sustainability practices were associated with reading (but not math) gains and better interpersonal skills (but not fewer externalizing behaviors) following the transition into kindergarten. These links were not conditioned by the selection mechanisms. The findings highlight who is more likely to seek out (at the family level) or offer (at the school level) sustainability practices and how relevant they are to fighting preschool fadeout.

Children’s exposure to sustainability practices during the transition from preschool into school and their learning and socioemotional development

PubMed Central

Benner, Aprile D.; Thornton, Anna; Crosnoe, Robert

2017-01-01

Evidence that the learning gains of preschool fade as children transition into elementary school has led to increased efforts to sustain preschool advantages during this key transitional period. This study explores whether the observed benefits of sustainability practices for a range of child outcomes are explained and/or moderated by family and school mechanisms selecting children into experiencing these practices. Analyses of the Early Childhood Longitudinal Study-Birth Cohort revealed that both family and school factors predicted children’s exposure to several PK-3 sustainability practices. PK-3 sustainability practices were associated with reading (but not math) gains and better interpersonal skills (but not fewer externalizing behaviors) following the transition into kindergarten. These links were not conditioned by the selection mechanisms. The findings highlight who is more likely to seek out (at the family level) or offer (at the school level) sustainability practices and how relevant they are to fighting preschool fadeout. PMID:28794610

A longitudinal study of aspects of a hospital's family-centred nursing: changing practice through data translation.

PubMed

White, Chris; Wilson, Valerie

2015-01-01

To examine how results and data from multiple Family Centred Nursing Index surveys help the development of family-centred nursing at organizational and ward levels. A critical analysis of survey data. The Family Centred Nursing Index provides a valid and reliable assessment of aspects of nursing, through a comprehensive survey of traditional indicators of practice development and a broader range of aspects of practice. A survey with 113 questions, each to be answered on 7-point Likert scale conducted six times in the last 7 years. Surveys have been in 2006, 2008, 2009, 2010, 2011/2012 and 2012/2013. All nurses employed by the organization can participate. These are reported as means across 19 constructs linked to five key domains and their significance is examined by year and (in the clinical settings) and compared against the organizational (whole population) averages. Ongoing survey and analysis of nurses' views of their work is providing a valuable source of developmental data. The results show unexpected associations between constructs e.g. - a high level of work stress does not correlate with a lower level of job satisfaction (and vice versa). A clear historical picture of many elements of developing family-centred care is emerging at both the organizational and individual-ward levels. This study provides insights into aspects of organizational and wards working environment for nurses and how these aspects of nurses' work interact in unexpected ways. It is appropriate for providing information to organizations and ward teams in relation to their development towards family-centred cultures. © 2014 Commonwealth of Australia. Journal of Advanced Nursing © 2014 John Wiley & Sons Ltd.

Impact of rural training on physician work force: the role of postresidency education.

PubMed

Acosta, D A

2000-01-01

Many innovative strategies have been developed over the years to improve the recruitment and retention of physicians in the shortage areas of rural America. These strategies have met with varying success. Postresidency education, or fellowship training, for family physicians is yet another strategy that has been developed for the same purpose. Most applicants have been interested in obstetrical and rural health fellowship programs as a means for preparing for rural practice. This paper describes these programs (demographics, funding, applicant pool, curriculum) and reviews their graduate outcomes (practice location after matriculation, clinical privileges). Twenty-nine obstetrical and nine rural health fellowships are currently operational in the United States. Fellows who complete a rural health fellowship have a higher tendency to locate in rural settings. Almost all graduates from obstetrical and rural health programs attain general hospital privileges in family practice, including low-risk obstetrics. A significant number of graduates from both types of programs attain privileges in high-risk and operative obstetrics as well. Fellowship training can play an integral role in the preparation of family physicians for rural practice.

The Effects of Teacher Training on Teachers' Family Engagement Practices, Attitudes, and Knowledge: A Meta-Analysis

ERIC Educational Resources Information Center

Smith, Tyler E.

2017-01-01

Despite decades of research supporting family engagement's benefits on children's social, emotional, behavioral, and academic development (Hill & Tyson, 2009; Jeynes, 2012; Patall et al., 2010; Sheridan et al., 2010), teachers are not always adequately prepared to work with families (Chavkin & Williams, 1988; Epstein & Sanders, 2006;…

Resilience across Contexts: Family, Work, Culture, and Community.

ERIC Educational Resources Information Center

Taylor, Ronald D., Ed.; Wang, Margaret C., Ed.

Noting that much is known from research and practice regarding what works to promote resilience of children and families in a variety of high-risk life situations, this book considers the impact of culture, economy, employment, poverty, family structure, and social policy on parenting, child development, education, and the life success of youth.…

Family Environment and Parent-Child Relationships as Related to Executive Functioning in Children

ERIC Educational Resources Information Center

Schroeder, Valarie M.; Kelley, Michelle L.

2010-01-01

The present study examines the associations between family environment, parenting practices and executive functions in normally developing children. One hundred parents of children between the ages of 5 and 12 completed the Behavior Rating Inventory of Executive Functions from the Family Environment Scale and the Parent-Child Relationship…

Working with Families of Young Children with Special Needs

ERIC Educational Resources Information Center

McWilliam, R. A., Ed.

2010-01-01

This user-friendly book presents research-based best practices for serving families of children with special needs from birth to age 6. Expert contributors demonstrate how early intervention and early childhood special education can effectively address a wide range of family concerns, which in turn optimizes children's development and learning.…

Extending Face-to-Face Interactions: Understanding and Developing an Online Teacher and Family Community

ERIC Educational Resources Information Center

Zhang, Chun; Du, Jianxia; Sun, Li; Ding, Yi

2018-01-01

Technology has been quickly changing human interactions, traditional practices, and almost every aspect of our lives. It is important to maintain effective face-to-face communication and interactions between teachers and families. Nonetheless, technology and its tools can also extend and enhance family-teacher relationships and partnerships. This…

Evaluating the Acceptability and Effectiveness of Family Assessment Portfolios

ERIC Educational Resources Information Center

Meadan, Hedda; Thompson, James R.; Hagiwara, Mayumi; Herold, Julie; Hoekstra, Sarah; Manser, Samantha

2009-01-01

The Family Assessment Portfolio (FAP) is a new tool that includes scrapbooks, web-based profiles, and movies that families create to introduce their children to educators. FAP was developed to promote good home/school communication and collaboration. Although FAPs appear to be a promising practice for the field of special education, there is…

Defining Crisis in Families of Individuals with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Weiss, Jonathan A.; Wingsiong, Aranda; Lunsky, Yona

2014-01-01

Parents of children diagnosed with autism spectrum disorder often report higher levels of depression, anxiety, and mental health-related issues. The combination of stressors and family adjustment difficulties can cause distress which may develop into a crisis. Understanding crisis in the family is important to mental health practice since it can…

Family Life Education Grade 9. Optional Health Unit. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education, Winnipeg.

This family life instructional unit is organized around four themes: (1) the importance of families; (2) human growth and development; (3) dilemmas and issues; and (4) promoting positive lifestyle practices. Lessons in the dilemmas and issues section include more in-depth information on subjects such as marriage and issues related to sexuality and…

Practice-Informed Approaches to Addressing Substance Abuse and Trauma Exposure in Urban Native Families Involved with Child Welfare.

PubMed

Lucero, Nancy M; Bussey, Marian

2015-01-01

Similar to families from other groups, urban-based American Indian and Alaska Native ("Native") family members involved with the child welfare system due to substance abuse issues are also often challenged by untreated trauma exposure. The link between these conditions and the history of genocidal policies aimed at destroying Native family ties, as well as experiences of ongoing discrimination, bring added dimensions for consideration when pro- viding services to these families. Practice-based evidence indicates that the trauma-informed and culturally responsive model developed by the Denver Indian Family Resource Center (DIFRC) shows promise in reducing out-of-home placements and re-referrals in urban Native families with substance abuse and child welfare concerns, while also increasing caregiver capabilities, family safety, and child well-being. This article provides strategies from the DIFRC approach that non-Native caseworkers and supervisors can utilize to create an environment in their own agencies that supports culturally based practice with Native families while incorporating a trauma-informed understanding of service needs of these families. Casework consistent with this approach demonstrates actions that meet the Active Efforts requirement of the Indian Child Welfare Act (ICWA) as well as sound clinical practice. Intensive and proactive case management designed specifically for families with high levels of service needs is a key strategy when combined with utilizing a caseworker brief screening tool for trauma exposure; training caseworkers to recognize trauma symptoms, making timely referrals to trauma treatment by behavioral health specialists experienced in working with Native clients, and providing a consistent service environment that focuses on client safety and worker trustworthiness. Finally, suggestions are put forth for agencies seeking to enhance their cultural responsiveness and include increasing workers' understanding of cultural values, worldview, and historical issues; working from a relational perspective; listening deeply to families' experiences; and being open to incorporating traditional healing and cultural practice into service plans.

Knowledge, Attitudes, and Practices of Family Physicians and Nurses Regarding Unintentional Injuries among Children under 15 Years in Cairo, Egypt

PubMed Central

Elboray, Shereen; Elawdy, Mohamed Yehia; Dewedar, Sahar; Elezz, Nahla Abo; El-Setouhy, Maged; Smith, Gordon S.; Hirshon, Jon Mark

2015-01-01

Unintentional injuries are a leading cause of death among children, especially in developing countries. Lack of reliable data regarding primary health care professionals’ role in childhood unintentional injury prevention hinders development of effective prevention strategies. A survey of 99 family physicians and nurses from 10 family health centres sought to develop insight into their knowledge, attitudes and practices regarding unintentional injury prevention for children <15 in Cairo, Egypt. Approximately 60% were familiar with the terms unintentional injuries and injury prevention. Falls and road traffic crashes were identified as primary causes of childhood injuries by 54.5%. While > 90% agreed injury prevention counselling (IPC) could be effective, only 50.5% provided IPC. Lack of time and educational materials were the leading barriers to provision of IPC (91.9%, 85.9%, respectively), while thinking counseling is not part of their clinical duties was the least perceived barrier (9.1%). There is a large disconnect between providers’ knowledge, attitudes and practices regarding IPC, more training and provision of counseling tools are essential for improving IPC by Egyptian medical providers. PMID:26176681

Smart Choices for Healthy Families: A Pilot Study for the Treatment of Childhood Obesity in Low-Income Families

ERIC Educational Resources Information Center

Pinard, Courtney A.; Hart, Michael H.; Hodgkins, Yvonne; Serrano, Elena L.; McFerren, Mary M.; Estabrooks, Paul A.

2012-01-01

This pre-post study used a mixed-methods approach to examine the impact of a family-based weight management program among a low-income population. Smart Choices for Healthy Families was developed through an integrated research-practice partnership and piloted with 26 children and parents (50% boys; mean age = 10.5 years; 54% Black) who were…

A teaching bank of audiovisual materials for family practice.

PubMed

Geyman, J P; Brown, T C

1975-10-01

Although increasing emphasis has been placed in recent years on the production and use of audiovisual materials in medical education, little work has yet been done on the identification and application of these materials in family practice teaching programs. This paper describes the content, uses, limitations, and initial experience of a Teaching Bank developed to support family practice teaching in varied settings. Video cassette and tape-slide units are most useful; audio cassettes alone are less likely to be selected. The evaluation of content, quality, and effectiveness of audiovisual media poses a particular problem. Although audiovisual materials can enhance learning based on different individual learning needs and styles, they cannot stand alone and usually must be supplemented by other teaching methods.

A Preliminary Investigation of the Relationship between Parenting, Parent-Child Shared Reading Practices, and Child Development in Low-Income Families

ERIC Educational Resources Information Center

Dexter, Casey A.; Stacks, Ann M.

2014-01-01

This study examined relations between parenting, shared reading practices, and child development. Participants included 28 children (M = 24.66 months, SD = 8.41 months) and their parents. Measures included naturalistic observations of parenting and shared reading quality, assessments of child cognitive and language development, and home reading…

The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

PubMed Central

2014-01-01

Background The potential of clinical practice guidelines has not been realized due to inconsistent adoption in clinical practice. Optimising intrinsic characteristics of guidelines (e.g., its wording and format) that are associated with uptake (as perceived by their end users) may have potential. Using findings from a realist review on guideline uptake and consultation with experts in guideline development, we designed a conceptual version of a future tool called Guideline Implementability Tool (GUIDE-IT). The tool will aim to involve family physicians in the guideline development process by providing a process to assess draft guideline recommendations. This feedback will then be given back to developers to consider when finalizing the recommendations. As guideline characteristics are best assessed by end-users, the objectives of the current study were to explore how family physicians perceive guideline implementability, and to determine what components should comprise the final GUIDE-IT prototype. Methods We conducted a qualitative study with family physicians inToronto, Ontario. Two experienced investigators conducted one-hour interviews with family physicians using a semi-structured interview guide to 1) elicit feedback on perceptions on guideline implementability; 2) to generate a discussion in response to three draft recommendations; and 3) to provide feedback on the conceptual GUIDE-IT. Sessions were audio taped and transcribed verbatim. Data collection and analysis were guided by content analyses. Results 20 family physicians participated. They perceived guideline uptake according to facilitators and barriers across 6 categories of guideline implementability (format, content, language, usability, development, and the practice environment). Participants’ feedback on 3 draft guideline recommendations were grouped according to guideline perception, cognition, and agreement. When asked to comment on GUIDE-IT, most respondents believed that the tool would be useful, but urged to involve “regular” or community family physicians in the process, and suggested that an online system would be the most efficient way to deliver it. Conclusions Our study identified facilitators and barriers of guideline implementability from the perspective of community and academic family physicians that will be used to build our GUIDE-IT prototype. Our findings build on current knowledge by showing that family physicians perceive guideline uptake mostly according to factors that are in the control of guideline developers. PMID:24476491

76 FR 41501 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

... of infant feeding practices in the development and progression of food allergy and childhood... development; the child's family medical history; the mother's height and weight, physical activity, depression... Request; Followup Study for Infant Feeding Practices Study II AGENCY: Food and Drug Administration, HHS...

Maternal depressive symptoms and early childhood cognitive development: a review of putative environmental mediators.

PubMed

Ahun, Marilyn N; Côté, Sylvana M

2018-06-06

Despite the abundance of research investigating the associations between maternal depressive symptoms (MDS) and children's cognitive development, little is known about the putative mechanisms through which depressive symptoms are associated with children's cognitive development. The aim of this review was to summarize the literature on family mediators (i.e., maternal parenting behaviors, mother-child interactions, and family stress) involved in this association in early childhood. The review includes seven studies, five longitudinal and two cross-sectional, which tested putative mediators of the association between MDS and children's cognitive development. Studies were selected from online databases (PubMed, PsycNet) and manual searches. Only studies which quantitatively assessed associations between MDS in the postnatal period and child cognitive development in early childhood (i.e., 0-5 years) and included mediator variables were included in the review. Six out of seven studies identified mediating variables. The mediators included maternal responsiveness, parenting style, family dysfunction, the quality of the home environment, and maternal caregiving practices. Different mediators were identified across the reviewed studies. Maternal depressive symptoms are partly associated with child cognitive development via family processes and parenting practices. Various mediating processes are at play. Further research is needed on the role of maternal and paternal mental health and gene-environment correlations in this association. A better understanding of the mediating pathways is needed for the design of preventative intervention targeting specific family processes.

The current state of cancer family history collection tools in primary care: a systematic review.

PubMed

Qureshi, Nadeem; Carroll, June C; Wilson, Brenda; Santaguida, Pasqualina; Allanson, Judith; Brouwers, Melissa; Raina, Parminder

2009-07-01

Systematic collection of family history is a prerequisite for identifying genetic risk. This study reviewed tools applicable to the primary care assessment of family history of breast, colorectal, ovarian, and prostate cancer. MEDLINE, EMBASE, CINAHL, and Cochrane Central were searched for publications. All primary study designs were included. Characteristics of the studies, the family history collection tools, and the setting were evaluated. Of 40 eligible studies, 18 relevant family history tools were identified, with 11 developed for use in primary care. Most collected information on more than one cancer and on affected relatives used self-administered questionnaires and paper-based formats. Eleven tools had been evaluated relative to current practice, demonstrating 46-78% improvement in data recording over family history recording in patient charts and 75-100% agreement with structured genetic interviews. Few tools have been developed specifically for primary care settings. The few that have been evaluated performed well. The very limited evidence, which depends in part on extrapolation from studies in settings other than primary care, suggests that systematic tools may add significant family health information compared with current primary care practice. The effect of their use on health outcomes has not been evaluated.

Family history in primary care: understanding GPs' resistance to clinical genetics--qualitative study.

PubMed

Mathers, Jonathan; Greenfield, Sheila; Metcalfe, Alison; Cole, Trevor; Flanagan, Sarah; Wilson, Sue

2010-05-01

National and local evaluations of clinical genetics service pilots have experienced difficulty in engaging with GPs. To understand GPs' reluctance to engage with clinical genetics service developments, via an examination of the role of family history in general practice. Qualitative study using semi-structured one-to-one interviews. The West Midlands, UK. Interviews with 21 GPs working in 15 practices, based on a stratified random sample from the Midlands Research Practices Consortium database. Thematic analysis proceeded alongside data generation. Framework grids were constructed for comparative analytical questioning. Interpretation was framed by two explanatory models: a knowledge deficit model, and practice and professional identity model. There is a clear distinction between the routine use and function of family history in GPs' clinical decision making, and contrasting conceptualisations of genetics and 'genetic conditions'. Although genetics is clearly a part of current GP practice, with acknowledgement of genetic components to multifactorial disease, this is distinguished from 'genetic conditions' which are seen as rare, complex single-gene disorders. Importantly, family history takes its place within a broader notion of the 'family doctor' that interviewees identified as a key aspect of their role. In contrast, clinical genetics was not identified as a core component of generalist practice. The likely effectiveness of educational policy interventions aimed at GPs that focus solely on knowledge deficit models, is questionable. There is a need to acknowledge how appropriate practice is constructed by GPs, within the context of accepted generalist roles and related identities.

Influence of Obstetric Practice on Workload and Practice Patterns of Family Physicians and Obstetrician-Gynecologists

PubMed Central

Dresden, Graham M.; Baldwin, Laura-Mae; Andrilla, C. Holly A.; Skillman, Susan M.; Benedetti, Thomas J.

2008-01-01

PURPOSE Obstetric practice among family physicians has declined in recent years. This study compared the practice patterns of family physicians and obstetrician-gynecologists with and without obstetric practices to provide objective information on one potential reason for this decline—the impact of obstetrics on physician lifestyle. METHODS In 2004, we surveyed all obstetrician-gynecologists, all rural family physicians, and a random sample of urban family physicians identified from professional association lists (N =2,564) about demographics, practice characteristics, and obstetric practices. RESULTS A total of 1,197 physicians (46.7%) overall responded to the survey (41.5% of urban family physicians, 54.7% of rural family physicians, and 55.0% of obstetrician-gynecologists). After exclusions, 991 were included in the final data set. Twenty-seven percent of urban family physicians, 46% of rural family physicians, and 79% of obstetrician-gynecologists practiced obstetrics. The mean number of total professional hours worked per week was greater with obstetric practice than without for rural family physicians (55.4 vs 50.2, P=.005) and for obstetrician-gynecologists (58.3 vs 43.5, P = .000), but not for urban family physicians (47.8 vs 49.5, P = .27). For all 3 groups, physicians practicing obstetrics were more likely to provide inpatient care and take call than physicians not practicing obstetrics. Large proportions of family physicians, but not obstetrician-gynecologists, took their own call for obstetrics. Concerns about the litigation environment and personal issues were the most frequent reasons for stopping obstetric practice. CONCLUSIONS Practicing obstetrics is associated with an increased workload for family physicians. Organizing practices to decrease the impact on lifestyle may support family physicians in practicing obstetrics. PMID:18195307

Family influences on the development of aggression and violence.

PubMed

Labella, Madelyn H; Masten, Ann S

2018-02-01

Recent research confirms that many of the most salient risk and protective factors for the development of aggression and violence reside in the family system. Family-based risks begin before birth, encompassing genetic and epigenetic processes. Contextual stressors (e.g., poverty, conflict) may impact development directly or indirectly through disrupted parenting behavior, including high negativity, low warmth, harshness, and exposure to violence. The family can also serve as a powerful adaptive system counteracting the risk of aggression and violence. Parents can promote healthy behavioral development through warmth, structure, and prosocial values, as well as by fostering adaptive resources in the child and community. Successful interventions often reduce aggression and violence by supporting parents and families. Recent insights and future directions for research and practice are discussed. Copyright © 2017. Published by Elsevier Ltd.

Milestones in the development of Nordic general practice*

PubMed Central

2013-01-01

Abstract The common history and development of Nordic family medicine is important and interesting. This paper looks back on the aspects and factors influencing academic family medicine in the Nordic countries and especially the central position of the Nordic Congresses and the Scandinavian Journal of Primary Health Care. The importance of pioneers and bringing people together is emphasized. More than 30 years of Nordic academic family medicine has indeed had an incredible impact and has initiated development from only a few people to become world leading. PMID:23336114

Opportunities to Practice What Is Locally Valued: An Ecocultural Perspective on Quality in Family Child Care Homes

ERIC Educational Resources Information Center

Tonyan, Holli A.

2017-01-01

Research Findings: Drawing from cultural approaches to human development (Rogoff, 2003; Weisner, 2002, 2005) and cognition (Quinn & Holland, 1987), this article presents a working model and theory of change for quality in family child care by defining quality as the alignment of children's opportunities for learning and development with…

A Practice Guide for Working with Families from Pre-Birth to Eight Years: Engaging Families in the Early Childhood Development Story

ERIC Educational Resources Information Center

Benveniste, Jodie

2013-01-01

This guide was created because parents revealed, through extensive social research, that they often received inconsistent and confusing parenting information from different professionals and practitioners across different disciplines, leading to misunderstandings and a lack of confidence about how best to support their children's development. In…

Pilot Study for the Active TV Viewer Scholar Education. Final Report. Years 1984-1985.

ERIC Educational Resources Information Center

Torres, Miguel Reyes

The purposes of the "Pilot Study for the Active TV Viewer Scholar Education" project were to find low cost teaching methods that developed critical television viewing skills among elementary and secondary students, and to develop a parallel program of family education in an effort to modify family viewing practices to encourage critical…

Sacred practices in highly religious families: Christian, Jewish, Mormon, and Muslim perspectives.

PubMed

Marks, Loren

2004-06-01

Quantitative research examining linkages between family relationships and religious experience has increased substantially in recent years. However, related qualitative research, including research that examines the processes and meanings behind recurring religion-family correlations, remains scant. To address this paucity, a racially diverse sample (N = 24) of married, highly religious Christian, Jewish, Mormon, and Muslim parents of school-aged children were interviewed regarding the importance of religious family interactions, rituals, and practices in their families. Mothers and fathers discussed several religious practices that were meaningful to them and explained why these practices were meaningful. Parents also identified costs and challenges associated with these practices. Interview data are presented in connection with three themes: (1) "practicing [and parenting] what you preach," (2) religious practices, family connection, and family communion, and (3) costs of family religious practices. The importance of family clinicians and researchers attending to the influence of religious practice in the lives of highly religious individuals and families is discussed.

Medical Home Transformation in Pediatric Primary Care—What Drives Change?

PubMed Central

McAllister, Jeanne W.; Cooley, W. Carl; Van Cleave, Jeanne; Boudreau, Alexy Arauz; Kuhlthau, Karen

2013-01-01

PURPOSE The aim of this study was to characterize essential factors to the medical home transformation of high-performing pediatric primary care practices 6 to 7 years after their participation in a national medical home learning collaborative. METHODS We evaluated the 12 primary care practice teams having the highest Medical Home Index (MHI) scores after participation in a national medical home learning collaborative with current MHI scores, a clinician staff questionnaire (assessing adaptive reserve), and semistructured interviews. We reviewed factors that emerged from interviews and analyzed domains and subdomains for their agreement with MHI and adaptive reserve domains and subthemes using a process of triangulation. RESULTS At 6 to 7 years after learning collaborative participation, 4 essential medical home attributes emerged as drivers of transformation: (1) a culture of quality improvement, (2) family-centered care with parents as improvement partners, (3) team-based care, and (4) care coordination. These high-performing practices developed comprehensive, family-centered, planned care processes including flexible access options, population approaches, and shared care plans. Eleven practices evolved to employ care coordinators. Family satisfaction appeared to stem from better access, care, and safety, and having a strong relationship with their health care team. Physician and staff satisfaction was high even while leadership activities strained personal time. CONCLUSIONS Participation in a medical home learning collaborative stimulated, but did not complete, medical home changes in 12 pediatric practices. Medical home transformation required continuous development, ongoing quality improvement, family partnership skills, an attitude of teamwork, and strong care coordination functions. PMID:23690392

To integrate family planning into the building up of mental civilization by offering comprehensive services.

PubMed

1988-03-01

The government of Nangong City, a newly instituted city with a relatively large proportion of agricultural workers has integrated family planning into the building up of mental civilization. As a result, in 1986, the family planning practice rate was 98.4%. One way the government accomplished this was by developing production to eliminate poverty, to show that population development has a significant impact on socioeconomic development. To help change people's attitudes about family planning, the government 1) used publicity, such as speechmaking, mass media, and courses in population theory; 2) awarded those who made contributions; 3) carried out publicity and education in accordance with characteristics of different groups of people; and 4) encouraged bridegrooms to live with their wives' families if the wives' parents had had no son. Another technique the government used as the popularization of scientific knowledge about population theory, physiology and hygiene, birth control, and eugenics and health in births. A 4th method was to popularize knowledge of laws and regulations, such as of early marriage and consanguineous marriage. 5th, the government developed social security undertakings: 1) giving priority to single-child families and 2) taking care of the elderly. Finally, the government improved maternal and child care by 1) providing premarital health care; 2) creating a project for healthier births and better upbringing; 3) family planning workers showing warm concern for reproductive women; and 4) controlling women's diseases and providing health care knowledge, as well as family planning services. These 6 activities have resulted in 1) the decreasing momentum of per capita arable land being controlled, 2) 1-child couples having more time to learn, 3) the development of educational undertakings, 4) a change in people's traditional practices, and 5) improvement in the understanding of patriotism.

Developing Evidence-Based Child Protection Practice: A View from Germany

ERIC Educational Resources Information Center

Kindler, Heinz

2008-01-01

The child welfare system in Germany has been described as family service-oriented because families in need are entitled to request family support services. If there is any form of child maltreatment, there may be some kind of mandatory state intervention to protect the child. Using trends in the number of children affected by maltreatment, the…

Qualities of an Effective Successor: the Role of Education and Training

ERIC Educational Resources Information Center

Ibrahim, A.B.; Soufani, K.; Poutziouris, P.; Lam, J.

2004-01-01

Small family firms represent the predominant organizational form in Canada. They are perceived to be crucial to the development and growth of the Canadian economy. Despite this, scant attention is given to the study of human resource management practices in the specialist family business literature. A key human resource issue in family firms,…

Raising and Educating a Deaf Child.

ERIC Educational Resources Information Center

Marschark, Marc

This book discusses the development of children who are deaf or hard of hearing and the educational and practical issues that face them and their families. Chapters discuss: (1) the effect of a child with deafness on a family, and family adjustment to early childhood hearing loss; (2) the population of people who are deaf, the causes of early…

Support for traumatic brain injury patients' family members in neurosurgical nursing: a systematic review.

PubMed

Coco, Kirsi; Tossavainen, Kerttu; Jääskeläinen, Juha Erik; Turunen, Hannele

2011-12-01

This systematic literature review describes how adult traumatic brain injury (TBI) patients' family members received support. The research question was "What in healthcare constitutes support for a TBI patient's family members?" The data for this review were based on 22 empirical studies published in scientific journals in 2004-2010, which were found in the Cinahl, PsychINFO, and ISI Web of Knowledge databases. The review includes the study design, sample, method, and main results. The data were analyzed using content analysis. Social support for brain injury patients' family members was divided into 3 main categories: informational, emotional, and practical support. The subcategories of informational support were information about the patient's symptoms, information about care, quality of information, and information about the prognosis. The subcategories of emotional support were taking emotions into account, caring, listening, and respecting. The subcategories of practical support were support in decision making, promoting the welfare of the family, encouraging family members to participate in care, cooperation with the family members, and counseling services. The results are available for nurses in practical work. The review offers nurses a structure for supporting TBI patients' families, and according to this review, supporting TBI patients' families appears to have many dimensions. The results suggest that nurses should be informed that it is important for family members to know the facts about TBI to understand the condition and to receive practical advice on how to help their significant other with TBI with daily activities. In addition, the results provide a basis for further research and development of interventions that support brain injury patients and their family members.

Family and child-care provider influences on preschool children's fruit, juice, and vegetable consumption.

PubMed

Nicklas, T A; Baranowski, T; Baranowski, J C; Cullen, K; Rittenberry, L; Olvera, N

2001-07-01

Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases. Because children's food preferences and practices are initiated early in life (e.g., 2-5 years of age), early dietary intervention programs may have immediate nutritional benefit, as well as reduce chronic disease risk when learned healthful habits and preferences are carried into adulthood. Families and child-care settings are important social environments within which food-related behaviors among young children are developed. FJV preferences, the primary predictor of FJV consumption in children, are influenced by availability, variety, and repeated exposure. Caregivers (parents and child-care providers) can influence children's eating practices by controlling availability and accessibility of foods, meal structure, food modeling, food socialization practices, and food-related parenting style. Much remains to be learned about how these influences and practices affect the development of FJV preferences and consumption early in life.

Peer support and peer-led family support for persons living with schizophrenia.

PubMed

Duckworth, Kenneth; Halpern, Lisa

2014-05-01

Peer support and peer-led family psychoeducation represent two distinct and complementary recovery-oriented models to support individuals who live with schizophrenia and their families, respectively. The goals of these models focus on improving knowledge, coping, self-care, social support, and self-management strategies. These models represent important capacity-building strategies for people who live with the illness and the people who love them. This brief article is intended to provide the practicing clinician, person living with schizophrenia, and policy maker with a working knowledge of the current state of the literature in these two related fields. Practitioners should consider these resources and integrate them into their care. A person living with schizophrenia could use this review to advocate for appropriate resources and to identify career opportunities. Policy makers could benefit from an understanding of the literature to mitigate financial and cultural barriers to adopting these practices. The last 5 years have seen a dramatic expansion of the application of randomized controlled trials (RCTs) to give evidence to match the experience of people in these programs. The field has seen Wellness Recovery Action Plan (WRAP) named as evidence-based practice by the National Registry of Evidence-Based Practices. A RCT was also conducted for another peer-developed and led program called Building Recovery of Individual Dreams & Goals through Education & Support. Family to Family, the largest peer-led family psychoeducation course, was also found to have significant impact after the study and also 6 months later in RCT. Family to Family has also been named as an evidence-based practice. The field of people who are living well with schizophrenia working as resources and supports to others living with the illness is an idea that is growing momentum. This momentum has been matched by the RCT evidence. Peer support as a professional role has an emerging literature that needs to be grown. WRAP and National Alliance on Mental Illness's Family to Family program are evidence-based practices and widely available. Peer support and peer-led family support for persons living with schizophrenia is a nascent field with much potential.

Roundtable on Constructing and Coping with Incarceration and Family Re-Entry: Perspectives from the Field (Philadelphia, Pennsylvania, November 15-16, 2001). Fathers and Families Second-Tier Roundtable Series.

ERIC Educational Resources Information Center

Pennsylvania Univ., Philadelphia. National Center on Fathers and Families.

Issues of incarceration and its effects on parents, children, families, and communities are as much human development concerns as policy dilemmas. This report synthesizes the discussion of these concerns and their implications for policy, practice, and research as presented at the National Center on Fathers and Families'"Roundtable on…

Pedagogic Practices in the Family Socializing Context and Children's School Achievement

ERIC Educational Resources Information Center

Neves, Isabel P.; Morais, Ana M.

2005-01-01

This paper describes a qualitative study about pedagogic practices in the family. The pedagogic code underlying family practices is characterized and related to specific social groups. Students' achievement is discussed in relation to family and school pedagogic practices. The analysis of family pedagogic practice was based on a model derived from…

Comparison of glaucoma knowledge and referral practices among family physicians with ophthalmologists' expectations.

PubMed

Basilious, Alfred; Cheng, Jason; Buys, Yvonne M

2015-06-01

To compare family physicians' glaucoma knowledge and clinical skills with ophthalmologists' expectations. An electronic cross-sectional survey of family physicians and ophthalmologists. Participants included members of the Canadian Ophthalmological Society, Canadian Glaucoma Society, and the American Glaucoma Society, as well as family physicians in the Canadian Medical Directory and the Society of Rural Physicians of Canada listserv. Two complementary surveys were developed to evaluate family physicians' glaucoma knowledge and basic examination skills, and ophthalmologists' expected level of family physician clinical knowledge and skills. χ(2) tests identified differences between family physician and ophthalmologist responses. Differences in family physician knowledge based on practice location and frequency of patient visits with a diagnosis of glaucoma were also evaluated. A total of 142 ophthalmologists and 110 family physicians completed the survey. The majority (82%) of family physicians reported seeing patients with diagnosed glaucoma weekly, monthly, or semiannually. Significantly fewer family physicians than expected (p < 0.001) identified African descent (46%) and corticosteroid use (84%) as glaucoma risk factors. Family physicians were significantly less likely to refer based on risk factors (72%) than expected by ophthalmologists (91%; p < 0.001). Only 28% of family physicians were comfortable performing direct ophthalmoscopy, and 37% were comfortable checking for a relative afferent pupillary defect. A significant percentage of family physicians lacked knowledge of glaucoma medications (30%) and side effects (57%). This study revealed significant disparities in family physician glaucoma knowledge, clinical examination skills, and referral practices. Educational materials should target these knowledge gaps. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Bonding and Bridging Social and Cultural Capitals: Perceived Factors Associated With Family Eating Practices Among Hmong, Latino, and White Mothers and Fathers.

PubMed

Roche, Abigail; Goto, Keiko; Zhao, Yanling; Wolff, Cindy

2015-01-01

To examine perceived social and cultural capitals associated with family eating practices among Hmong, Latino, and white mothers and fathers. Six focus groups composed of 52 Hmong, Latino, and white mothers and fathers of young children were conducted to examine parental perceptions of social and cultural capitals associated with eating practices. Whereas Hmong participants unanimously emphasized the healthfulness of their traditional food, Latino groups had divergent views on their traditional foods' healthfulness. Hmong parents highly valued their traditional foods whereas white and Latino mothers were more accepting of new foods from other cultures. Participants noted divergent views on gender roles in family eating practices and food culture preservation efforts. Identifying and promoting bonding and bridging of cultural assets for healthy dietary practices among different cultural groups may be important for developing successful nutrition education programs across ethnicities in the community. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Beginning science teachers' strategies for communicating with families

NASA Astrophysics Data System (ADS)

Bloom, Nena E.

Science learning occurs in both formal and informal spaces. Families are critical for developing student learning and interest in science because they provide important sources of knowledge, support and motivation. Bidirectional communication between teachers and families can be used to build relationships between homes and schools, leverage family knowledge of and support for learners, and create successful environments for science learning that will support both teaching and student learning. To identify the communication strategies of beginning science teachers, who are still developing their teaching practices, a multiple case study was conducted with seven first year secondary science teachers. The methods these teachers used to communicate with families, the information that was communicated and shared, and factors that shaped these teachers' continued development of communication strategies were examined. Demographic data, interview data, observations and documentation of communication through logs and artifacts were collected for this study. Results indicated that the methods teachers had access to and used for communication impacted the frequency and efficacy of their communication. Teachers and families communicated about a number of important topics, but some topics that could improve learning experiences and science futures for their students were rarely discussed, such as advancement in science, student learning in science and family knowledge. Findings showed that these early career teachers were continuing to learn about their communities and to develop their communication strategies with families. Teachers' familiarity with their school community, opportunities to practice strategies during preservice preparation and student teaching, their teaching environment, school policies, and learning from families and students in their school culture continued to shape and influence their views and communication strategies. Findings and implications for teacher preparation programs, teachers, schools and organizations are discussed.

Evaluation of an educational intervention for farming families to protect their children from pesticide exposure.

PubMed

Farahat, T M; Farahat, F M; Michael, A A

2009-01-01

A culturally appropriate educational intervention was developed and directed towards farming families in Menoufia governorate, Egypt, to improve their knowledge and practices in protecting their children from exposure to pesticides. Parents were randomly assigned to either a lecture or videotape training group. Ability to recall information or improve practices among parents was evaluated in 3 sessions: pretraining and 2 weeks and 1 month after training. Knowledge and practice scores after training of younger and more educated participants were significantly higher than older, less educated participants. Knowledge and practice performance of the videotape group was better than the lecture group and in both groups the improvement of knowledge scores after training was significantly higher than that of practice scores.

Mothers' Perceptions of Citizenship, Practices for Developing Citizenship Conscience of Their Children and Problems They Encountered

ERIC Educational Resources Information Center

Ersoy, A. Figen

2012-01-01

Family plays an important role in the development of citizenship awareness of children. The purpose of the present study is to figure out the citizenship perceptions of mothers, their practices for developing citizenship conscience of their children and to explore the problems they have encountered. In this study, critical case sampling method has…

Family planning: the unfinished agenda.

PubMed

Cleland, John; Bernstein, Stan; Ezeh, Alex; Faundes, Anibal; Glasier, Anna; Innis, Jolene

2006-11-18

Promotion of family planning in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. It would also contribute substantially to women's empowerment, achievement of universal primary schooling, and long-term environmental sustainability. In the past 40 years, family-planning programmes have played a major part in raising the prevalence of contraceptive practice from less than 10% to 60% and reducing fertility in developing countries from six to about three births per woman. However, in half the 75 larger low-income and lower-middle income countries (mainly in Africa), contraceptive practice remains low and fertility, population growth, and unmet need for family planning are high. The cross-cutting contribution to the achievement of the Millennium Development Goals makes greater investment in family planning in these countries compelling. Despite the size of this unfinished agenda, international funding and promotion of family planning has waned in the past decade. A revitalisation of the agenda is urgently needed. Historically, the USA has taken the lead but other governments or agencies are now needed as champions. Based on the sizeable experience of past decades, the key features of effective programmes are clearly established. Most governments of poor countries already have appropriate population and family-planning policies but are receiving too little international encouragement and funding to implement them with vigour. What is currently missing is political willingness to incorporate family planning into the development arena.

A Primer for the Design of Practice Manuals: Four Stages of Development

ERIC Educational Resources Information Center

Galinsky, Maeda J.; Fraser, Mark W.; Day, Steven H.; Richman, Jack M.

2013-01-01

Treatment manuals are increasingly being used to guide interventions with individuals, families, groups, organizations, and communities. However, little is known about best practices in designing manuals. We describe a process that provides for the development of manuals and specifies the means by which manuals can be adapted for practice…

Sturdy for common things: cultivating moral sensemaking on the front lines of practice.

PubMed

Browning, David M

2012-04-01

This essay argues that the field of bioethics should concern itself especially with the process of making moral sense that unfolds among clinicians, patients and family members during common but high-stakes conversations occurring on the front lines of practice. The essay outlines the parameters of a bioethics grounded in the moral experience of patients, families and practitioners. It challenges ethicists, educators, and clinician leaders to commit themselves to advocating and developing creative approaches to learning that will cultivate the moral sensibilities of frontline clinicians in this critically important domain of practice.

Health issues and the practicing radiologist: defining concepts and developing recommendations for leave options and policies.

PubMed

Heilbrun, Marta E; Bender, Claire E; Truong, Hang B; Bluth, Edward I

2013-09-01

Radiologists today are faced with the challenges of maintaining and balancing individual and family health needs and the demands of the workplace. To provide the highest quality and safest care of our patients, a corresponding ethos of support for a healthy workforce is required. There is a paucity of targeted information describing protections for and maintenance of the health of the practicing radiologist, in both private and academic settings. However, a review of existing family and medical leave policies may be helpful to practice leaders and practicing radiologists as a platform for the development of strategic workforce plans. This writing, by members of the ACR Commission on Human Resources, addresses the following areas: (1) medical leave, (2) maternity and/or paternity leave, and (3) disability. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

How do carers of disabled children cope? The Ugandan perspective.

PubMed

Hartley, S; Ojwang, P; Baguwemu, A; Ddamulira, M; Chavuta, A

2005-03-01

Community-based rehabilitation (CBR) was recommended by the World Health Organization in 1989 as the strategy for improving the quality of life of disabled people and their families, which should be built on local knowledge and practices. In Uganda, there is no documentation on how services relate to local knowledge. There is a need for increased knowledge and understanding of how family members cope with their disabled children to provide the basis for future service development. A qualitative phenomenological design was used to develop an in-depth understanding of how Ugandan families cope with their disabled children in their own communities. Data were collected from 52 families with children with disabilities from five impairment groups, through interviews and observations in three districts of Uganda, one urban, two rural. There are many children with disabilities who are included, loved and cared for by their families. A lot of time and money is spent on seeking a cure. The extended family systems are breaking down and the main burden of caring for a disabled family member generally falls on one, sometimes two, female carers. Male members act as gatekeepers, controlling the key decisions concerning the child and the associated resources. CBR should move the focus of their services away from the disabled individual towards the whole family. It is important to provide accurate information about causes and prevention of impairments, the realities of a cure, support and respite for the female carers, and opportunities for the involvement of fathers. This methodology is a practical mechanism for collecting data that have the potential to positively influence and guide the development of CBR practice in the locality. At a conceptual level the data support the philosophy of inclusion, social integration, the importance of trust and respect, and utilizing a holistic approach. These are eminently transferable to other settings.

Barriers of modern contraceptive practices among Asian women: a mini literature review.

PubMed

Najafi-Sharjabad, Fatemeh; Zainiyah Syed Yahya, Sharifah; Abdul Rahman, Hejar; Hanafiah Juni, Muhamad; Abdul Manaf, Rosliza

2013-07-22

Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women.

Barriers of Modern Contraceptive Practices among Asian Women: A Mini Literature Review

PubMed Central

Najafi-Sharjabad, Fatemeh; Syed Yahya, Sharifah Zainiyah; Rahman, Hejar Abdul; Hanafiah, Muhamad; Abdul Manaf, Rosliza

2013-01-01

Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women. PMID:23985120

Mentorship perceptions and experiences among academic family medicine faculty

PubMed Central

Stubbs, Barbara; Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola

2016-01-01

Abstract Objective To collect information about the types, frequency, importance, and quality of mentorship received among academic family medicine faculty, and to identify variables associated with receiving high-quality mentorship. Design Web-based survey of all faculty members of an academic department of family medicine. Setting The Department of Family and Community Medicine of the University of Toronto in Ontario. Participants All 1029 faculty members were invited to complete the survey. Main outcome measures Receiving mentorship rated as very good or excellent in 1 or more of 6 content areas relevant to respondents’ professional lives, and information about demographic and practice characteristics, faculty ratings of their local departments and main practice settings, teaching activities, professional development, leadership, job satisfaction, and health. Bivariate and multivariate analyses identified variables associated with receiving high-quality mentorship. Results The response rate was 66.8%. Almost all (95.0%) respondents had received mentorship in several areas, with informal mentorship being the most prevalent mode. Approximately 60% of respondents rated at least 1 area of mentoring as very good or excellent. Multivariate logistic regression identified 5 factors associated with an increased likelihood of rating mentorship quality as very good or excellent: positive perceptions of their local department (odds ratio [OR] = 4.02, 95% CI 2.47 to 6.54, P < .001); positive ratings of practice infrastructure (OR = 1.86, 95% CI 1.23 to 2.80, P = .003); increased frequency of receiving mentorship (OR = 2.78, 95% CI 1.59 to 4.89, P < .001); fewer years in practice (OR = 1.93, 95% CI 1.19 to 3.12, P = .007); and practising in a family practice teaching unit (OR = 1.51, 95% CI 1.01 to 2.27, P = .040). Conclusion With increasing emphasis on distributed education and community-based teachers, family medicine faculties will need to develop strategies to support effective mentorship across a range of settings and career stages. PMID:27629688

Influence of home care services on caregivers' burden and satisfaction.

PubMed

Kim, Eun-Young; Yeom, Hyun-E

2016-06-01

To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. A cross-sectional study. A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning. © 2016 John Wiley & Sons Ltd.

Worker, workplace or families: What influences family focused practices in adult mental health?

PubMed

Maybery, D; Goodyear, M; Reupert, A E; Grant, A

2016-04-01

WHAT IS KNOWN ON THE SUBJECT?: Family focused practice leads to positive outcomes for parents and children. There are barriers and enablers for practitioners being family focused. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Worker skill, knowledge and confidence about family work are the most important factors associated with family focused practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses require specific skill training in family focused practices, time to engage with clients on parenting issues and that there are adequate services to refer family members to. Introduction Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions. Aim The aim of this study was to examine the relative importance of worker, workforce and family factors to predict family focused practices (FFPs) in adult mental health services. Method Three hundred and seven adult mental health workers completed a 45 items family focused practice measure of 16 family focused practices. Thesis It was found that worker skill and knowledge about family work and an ability to assess the degree of parental insight into the child's connections to other family members and the community were important predictors of FFP, along with the closely related-worker confidence. While aspects of the worker, workplace and family each contribute to FFPs, this study highlighted the importance of worker skill, knowledge and confidence as central issues for adult mental health workers. Implications for practice Study implications include the need for training in specific FFPs, the provision of time to engage with clients on parenting issues and the need 5 to ensure that there are adequate services for workers to refer family members to. © 2016 John Wiley & Sons Ltd.

Scaling up Evidence-based Practices for Children and Families in New York State: Towards Evidence-based Policies on Implementation for State Mental Health Systems

PubMed Central

Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael

2014-01-01

Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

Using practice development methodology to develop children's centre teams: ideas for the future.

PubMed

Hemingway, Ann; Cowdell, Fiona

2009-09-01

The Children's Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, evaluation and evolution. This paper introduces the Children's Centre Programme and practice development methods and aims to discuss the relevance of using this method to develop teams in children's centres through considering the findings from an evaluation of a two-year project to develop inter-agency public health teams. The evaluation showed that practice development methods can enable successful team development and showed that through effective facilitation, teams can change their practice to focus on areas of local need. The team came up with their own process to develop a strategy for their locality.

Ethics of infant relinquishment, cultural considerations, and obstetric conveniences.

PubMed

Callister, Lynn Clark

2011-01-01

Ethical issues relating to infant relinquishment, caring for culturally diverse women, the importance of shared power between women and their caregivers, and the provision of evidence-based practice versus reliance on obstetric conveniences are addressed in this article. Respectful care of women relinquishing their infants including use of appropriate language demonstrates moral and ethical nursing practice; providing cultural competent care of multilinguistic, multicultural, and multiethnic childbearing women and their families is an ethical imperative. Nurses practicing ethically will foster adoption of best practices on perinatal and neonatal units, and generate a clearly articulated vision of woman and family centered organizational culture. In ethical terms, this demonstrates respect for others as well as beneficence. Promoting the use of ethical nursing practice and evidence-based practice requires that nurses identify change agents, those who are champions and facilitators of evidence-based practice, and then reward such innovators and make sure that clinical guidelines be developed based on best practices.

Life Management: Moving Out! Solving Practical Problems for Independent Living. Utah Home Economics and Family Life Curriculum Guide.

ERIC Educational Resources Information Center

Utah State Office of Education, Salt Lake City.

This guide, which has been developed for Utah's home economics and family life education program, contains materials for use in teaching a life management course emphasizing the problem-solving skills required for independent living. Discussed first are the assumptions underlying the curriculum, development of the guide, and suggestions for its…

End-of-life practices at a Lebanese hospital: courage or knowledge?

PubMed

Gebara, Jouhayna; Tashjian, Hera

2006-10-01

End-of-life care requires knowledgeable and culturally sensitive clinicians to assist patients and families dealing with the difficult journey of death. The authors present important end-of-life considerations for health care providers dealing with culturally diversified patients. A case study approach is used illustrating two case vignettes derived from the practice of an intensive care setting of a tertiary teaching facility in a large urban area in Lebanon. In a multidisciplinary fashion, practices of end of life were explored and a protocol developed to guide health care providers. Special cultural values were identified such as importance of family involvement and religious beliefs. Implications for practice are described.

Application of Lorenz curve to interpret concentration of contraception and fertility in a population.

PubMed

Ghanma, M A; Rider, R V; Sirageldin, I

1984-01-01

The Lorenz Curve, originally developed to measure the concentration of wealth in a population, was used to describe the distribution of contraceptive practice in Jordan. Data from the 1976 Jordan Fertility Study, carried out as part of the World Fertility Survey program, was used in the analysis. The application of the Automatic Interaction Detector program to the survey's sample population of 3611 women of reproductive age divided the sample into 6 mutually exclusive groups on the basis of residence, education, and whether desired family size was attained or not attained. These 3 characteristics accounted for a major portion of the variation in contraceptive practice. These subgroups, in ascending order by the proportion practicing contraception, were: 1) rural women with unattained desired family size; 2) urban, illiterate women with unattained desired family size; 3) rural women with attained desired family size; 4) urban, literate women with unattained desired family size; 5) urban, illiterate women with attained desired family size; and 6) urban, literate women with attained desired family size. The cumulative proportion of the sample in each ordered subdivision was plotted on the X axis of a graph, and the cumulative proportion of those practicing contraception was plotted on the Y axis of the graph. A line connecting the intersection of the points on the X and Y axis was then drawn. The resultant line was a concave ascending line. If contraceptive practice was evenly distributed in the population, the line would be a straight diagonal line. The plotted curved line indicated that contraceptive practice was unevenly distributed in the population. 2 indexes for measuring the area between the diagonal and the line resulting from plotting the observed distribution for each subgroup was used to assess the degree of concentration of contraceptive practice in the population. The indexes also indicated that contraceptive practice was unequally distributed. When separate curves were plotted for the subgroups with attained desired family size and the subgroups without attained desired family size, it was apparent that the distribution of contraceptive practice was more uniform among those with attained desired family size than among the other 3 subgroups. A curve for the distribution of births was then plotted on the same graph. This curve was not a true application of the Lorenz Curve since it was based on the order of the subdivisions by birth rates. The resultant line approached the straight diagonal line and indicated that the distribution of births was fairly evenly distributed in the population. The uneven distribution of contraceptive practice and the uniform distribution of births suggests that contraceptive practice in this population is ineffective. This may be a characteristic of populations in the early stages of fertility control.

Quality assessment and improvement of post graduate family medicine training in the USA.

PubMed

Hoekzema, Grant S; Maxwell, Lisa; Gravel, Joseph W; Mills, Walter W; Geiger, William; Honeycutt, J David

2016-09-01

In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting.

PubMed

Smith, Katherine; Firth, Kimberly; Smeeding, Sandra; Wolever, Ruth; Kaufman, Joanna; Delgado, Roxana; Bellanti, Dawn; Xenakis, Lea

2016-01-01

Research suggests that the development of mind-body skills can improve individual and family resilience, particularly related to the stresses of illness, trauma, and caregiving. To operationalize the research evidence that mind-body skills help with health and recovery, Samueli Institute, in partnership with experts in mind-body programming, created a set of guidelines for developing and evaluating mind-body programs for service members, veterans, and their families. The Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting outline key strategies and issues to consider when developing, implementing, and evaluating a mind-body focused family empowerment approach in a military healthcare setting. Although these guidelines were developed specifically for a military setting, most of the same principles can be applied to the development of programs in the civilian setting as well. The guidelines particularly address issues unique to mind-body programs, such as choosing evidence-based modalities, licensure and credentialing, safety and contraindications, and choosing evaluation measures that capture the holistic nature of these types of programs. The guidelines are practical, practice-based guidelines, developed by experts in the fields of program development and evaluation, mind-body therapies, patient- and family-centered care, as well as, experts in military and veteran's health systems. They provide a flexible framework to create mind-body family empowerment programs and describe important issues that program developers and evaluators are encouraged to address to ensure the development of the most impactful, successful, evidence-supported programs possible. Copyright © 2016 Elsevier Inc. All rights reserved.

Developing an integrated evidence-based medicine curriculum for family medicine residency at the University of Alberta.

PubMed

Allan, G Michael; Korownyk, Christina; Tan, Amy; Hindle, Hugh; Kung, Lina; Manca, Donna

2008-06-01

There is general consensus in the academic community that evidence-based medicine (EBM) teaching is essential. Unfortunately, many postgraduate programs have significant weakness in their EBM programs. The Family Medicine Residency committee at the University of Alberta felt their EBM curriculum would benefit from critical review and revision. An EBM Curriculum Committee was created to evaluate previous components and develop new strategies as needed. Input from stakeholders including faculty and residents was sought, and evidence regarding the teaching and practical application of EBM was gathered. The committee drafted goals and objectives, the primary of which were to assist residents to (1) become competent self-directed, lifelong learners with skills to effectively and efficiently keep up to date, and 2) develop EBM skills to solve problems encountered in daily practice. New curriculum components, each evidence based, were introduced in 2005 and include a family medicine EBM workshop to establish basic EBM knowledge; a Web-based Family Medicine Desktop promoting easier access to evidence-based Internet resources; a brief evidence-based assessment of the research project enhancing integration of EBM into daily practice; and a journal club to support peer learning and growth of rapid appraisal skills. Issues including time use, costs, and change management are discussed. Ongoing evaluation of the curriculum and its components is a principal factor of the design, allowing critical review and adaptation of the curriculum. The first two years of the curriculum have yielded positive feedback from faculty and statistically significant improvement in multiple areas of residents' opinions of the curriculum and comfort with evidence-based practice.

Families and Futures. A Resource for Developing Home and Family Life Education Programs. Revised Working Materials.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

This curriculum guide was designed to help teachers in strengthening the ability of students from middle school through grade 12 to recognize complex problems, examine competing points of view, and engage in dialogue leading to practical solutions for issues that affect individuals and families and ultimately the world. The course integrates the…

Module 3: Workplace Policy, Practice and Culture--Employer and Employee Perspectives. Work-Family Curriculum Guide

ERIC Educational Resources Information Center

Kossek, Ellen Ernst; Leana, Carrie; MacDermid, Shelley; Pitt-Catsouphes, Marcie; Raskin, Patricia; Secret, Mary; Sweet, Stephen

2006-01-01

The contents of this module have been prepared to address some of challenges associated with teaching about work-family issues from a human resource management and employment perspective. The goals of this module are: (1) To develop an understanding that work-family policies are part of a human resource management system and the employment…

Parental feeding practices in Mexican American families: initial test of an expanded measure

PubMed Central

2013-01-01

Background Although obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP) Questionnaire for use with Mexican American parents. Items reflected both parent’s use of control over child eating and child-centered feeding practices. Methods In the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8–10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members. Results Confirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI) percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles. Conclusions Results indicate good initial validity and reliability for the PFP. It can be used to increase understanding of parental feeding practices, children’s eating, and obesity among Mexican Americans, a population at high risk of obesity. PMID:23324120

Parental feeding practices in Mexican American families: initial test of an expanded measure.

PubMed

Tschann, Jeanne M; Gregorich, Steven E; Penilla, Carlos; Pasch, Lauri A; de Groat, Cynthia L; Flores, Elena; Deardorff, Julianna; Greenspan, Louise C; Butte, Nancy F

2013-01-17

Although obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP) Questionnaire for use with Mexican American parents. Items reflected both parent's use of control over child eating and child-centered feeding practices. In the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8-10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members. Confirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI) percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles. Results indicate good initial validity and reliability for the PFP. It can be used to increase understanding of parental feeding practices, children's eating, and obesity among Mexican Americans, a population at high risk of obesity.

Making the links between domestic violence and child safeguarding: an evidence-based pilot training for general practice.

PubMed

Szilassy, Eszter; Drinkwater, Jess; Hester, Marianne; Larkins, Cath; Stanley, Nicky; Turner, William; Feder, Gene

2017-11-01

We describe the development of an evidence-based training intervention on domestic violence and child safeguarding for general practice teams. We aimed - in the context of a pilot study - to improve knowledge, skills, attitudes and self-efficacy of general practice clinicians caring for families affected by domestic violence. Our evidence sources included: a systematic review of training interventions aiming to improve professional responses to children affected by domestic violence; content mapping of relevant current training in England; qualitative assessment of general practice professionals' responses to domestic violence in families; and a two-stage consensus process with a multi-professional stakeholder group. Data were collected between January and December 2013. This paper reports key research findings and their implications for practice and policy; describes how the research findings informed the training development and outlines the principal features of the training intervention. We found lack of cohesion and co-ordination in the approach to domestic violence and child safeguarding. General practice clinicians have insufficient understanding of multi-agency work, a limited competence in gauging thresholds for child protection referral to children's services and little understanding of outcomes for children. While prioritising children's safety, they are more inclined to engage directly with abusive parents than with affected children. Our research reveals uncertainty and confusion surrounding the recording of domestic violence cases in families' medical records. These findings informed the design of the RESPONDS training, which was developed in 2014 to encourage general practice clinicians to overcome barriers and engage more extensively with adults experiencing abuse, as well as responding directly to the needs of children. We conclude that general practice clinicians need more support in managing the complexity of this area of practice. We need to integrate and further evaluate responses to the needs of children exposed to domestic violence into general practice-based domestic violence training. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Developing a Family-Centered, Hospital-Based Perinatal Education Program

PubMed Central

Westmoreland, Marcia Haskins; Zwelling, Elaine

2000-01-01

The development of a family-centered, comprehensive perinatal education program for a large, urban hospital system is described. This program was developed in conjunction with the building of a new women's center and, although the authors were fortunate that several opportunities for educational program development were linked to this project, many of the steps taken and the lessons learned can be helpful to anyone desiring to develop a similar program. This article relates perinatal education to the principles of family-centered maternity care, outlines the criteria for a quality educational program, gives rationale for this type of program development, and offers practical suggestions for starting or enhancing a perinatal education program within a hospital system. PMID:17273228

A hugh marketing research task: birth control.

PubMed

Simon, J L

1968-02-01

Research in underdeveloped countries to sell family planning is discussed. The article also aims at pinpointing other possible research areas. Census reports were actually the earliest work relevant to birth control. Later came the research on psychosocial factors affecting family size in developed countries. After World War I, client oriented research into family planning began. The history of this type of research is discussed with more emphasis on the surveys of the knowledge, attitude and contraception practices (KAP) in various countries. The author claims the KAP surveys to be the largest worldwide market research job ever done. Propagands campaigns, contraceptive costs, bonuses for contraceptive practices, and effectiveness of persuasion techniques are discussed.

EKG analysis skills of family practice residents in the United Arab Emirates: a comparison with US data.

PubMed

Margolis, S; Reed, R

2001-06-01

Concern has been raised about the electrocardiogram (EKG) analysis skills of family practice residents in the United States. This study examined EKG analysis skills of family practice residents, medical students, interns, and general practitioners (GPs) in the United Arab Emirates (UAE), a different environment. The measurement instrument was a set of 10 EKGs, used in a study of US family practice residents. Two of the EKGs were normal, and there were 14 clinical abnormalities in the remainder. There was no significant difference in the correct diagnosis of acute myocardial infarction between US family practice residents and UAE family practice residents, medical students, or GPs. Interns' diagnoses were significantly poorer. The mean score for correctly identifying acute myocardial infarction and both normal EKGs was not significantly different between groups: 2.50 medical students, 2.35 interns, 2.58 UAE family practice residents, 2.67 FD, and 2.55 US family practice residents. However, the US family practice resident mean score of 11.26 for all 16 clinical findings was significantly higher than any group in the UAE: 5.35 medical students, 5.87 interns, 6.08 UAE family practice residents, 5.69 family physicians. Difficulty in EKG interpretation transcends geographic boundaries, suggesting that new approaches to teaching these skills need to be explored. Improved EKG reading skills by family physicians are generally needed in both the United States and the UAE.

Validation: a family-centered communication skill.

PubMed

Harvey, Pat; Ahmann, Elizabeth

2014-01-01

Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging" to deal with. Yet nurses can develop skills to effectively interact with families in a wide variety of circumstances and then become able to practice family-centered care in any situation that might arise. One particularly useful skill is "validation," which means accepting what the family member says or does as a valid expression of thoughts and feelings in that particular circumstance at that particular time. Validation does not mean there is agreement or acceptance of unsafe behaviors, only that the nurse acknowledges that the family member's concerns and feelings are important and should be listened to and taken seriously, even in the presence of disagreement. Validation, which should be individualized, can take many forms, ranging from providing complete attention to reflection of statements, identification of possible unexpressed emotions, normalization, and finally, a full and genuine sense of connection. Understanding and practicing validation can empower nurses and family members, as well as support effective family-centered communication and problem solving, even in challenging circumstances.

An introduction to using children's drawings as an assessment tool.

PubMed

Wilson, D; Ratekin, C

1990-03-01

This article is intended to familiarize the ambulatory care provider with possible uses of children's drawings as assessment tools. Drawings can be a useful adjunct in detecting perceptual-motor difficulties and developmental delay, and can provide clues to self-image and family dynamics. Piaget's theory of cognitive development provides a framework to evaluate the child's intellectual development as reflected in drawings. The developmental scales of Koppitz are presented as a practical screening tool. The Koppitz scales include both developmental norms and items that might indicate emotional problems. Observing the child's drawing of the family provides clues to family dynamics. Becoming highly skilled in the evaluation of children's drawings requires a familiarity with neurophysiology, education, psychology, and psychoanalytic and developmental theory, along with intuition and practice. This article presents an introduction to evaluating children's drawings.

Balance of trade: export-import in family medicine.

PubMed

Pust, Ronald E

2007-01-01

North American family physicians leaving for less-developed countries (LDCs) may not be aware of internationally validated diagnostic and treatment technologies originating in LDCs. Thus they may bring with them inappropriate models and methods of medical care. More useful "exports" are based in sharing our collaborative vocational perspective with dedicated indigenous generalist clinicians who serve their communities. More specifically, Western doctors abroad can promote local reanalyses of international evidence-based medicine (EBM) studies, efficient deployment of scarce clinical resources, and a family medicine/generalist career ladder, ultimately reversing the "brain drain" from LDCs. Balancing these exports, we should import the growing number of EBM best practices originated in World Health Organization and other LDCs research that are applicable in developed nations. Many generalist colleagues, expatriate and indigenous, with long-term LDC experience stand ready to help us import these practices and perspectives.

Family Literacy Report.

ERIC Educational Resources Information Center

Illinois Literacy Resource Development Center, Rantoul.

Seven model family literacy programs in Illinois were monitored for one year to determine successful program components and characteristics and to assist local programs in developing and implementing practical evaluation systems. Six were networking programs each of which involved several agencies, and one program was designed on a center-based…

Involvement of Family Members and Professionals in Older Women's Post-Fall Decision Making.

PubMed

Bergeron, Caroline D; Hilfinger Messias, DeAnne K; Friedman, Daniela B; Spencer, S Melinda; Miller, Susan C

2018-03-01

This exploratory, descriptive study examined involvement of family members and professionals in older women's post-fall decision making. We conducted semistructured interviews with 17 older women who had recently fallen and 11 individuals these women identified as being engaged in their post-fall decision-making processes. Qualitative data analysis involved open and axial coding and development of themes. After experiencing a fall, these older women's openness to others' opinions and advice; their assessments of types and credibility of potential information sources; and the communication practices they established with these sources influenced how they accessed, accepted, or rejected information from family members and professionals. Increased awareness of the involvement of others in post-fall decision making could enhance communication with older women who fall. Developing and implementing practical strategies to help family members and professionals initiate and engage in conversations about falls and their consequences could lead to more open decision making and improved post-fall quality of life among older women.

Psychological Trauma in the Context of Familial Relationships: A Concept Analysis.

PubMed

Isobel, Sophie; Goodyear, Melinda; Foster, Kim

2017-01-01

Many forms of psychological trauma are known to develop interpersonally within important relationships, particularly familial. Within the varying theoretical constructs of psychological traumas, and distinct from the processes of diagnosis, there is a need to refine the scope and definitions of psychological traumas that occur within important familial relationships to ensure a cohesive evidence base and fidelity of the concept in application to practice. This review used a philosophical inquiry methodology of concept analysis to identify the definitions, antecedents, characteristics, and consequences of the varying conceptualizations of psychological trauma occurring within important relationships. Interactions between concepts of interpersonal trauma, relational trauma, betrayal trauma, attachment trauma, developmental trauma, complex trauma, cumulative trauma, and intergenerational trauma are presented. Understanding of the discrete forms and pathways of transmission of psychological trauma between individuals, including transgenerationally within families, creates opportunities for prevention and early intervention within trauma-focused practice. This review found that concepts of psychological trauma occurring within familial relationships are not exclusive of each other but overlap in their encompassment of events and circumstances as well as the effect on individuals of events in the short term and long term. These traumas develop and are transmitted in the space between people, both purposefully and incidentally, and have particularly profound effects when they involve a dependent infant or child. Linguistic and conceptual clarity is paramount for trauma research and practice.

Predictors and enablers of mental health nurses' family-focused practice.

PubMed

Grant, Anne; Reupert, Andrea; Maybery, Darryl; Goodyear, Melinda

2018-06-27

Family-focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family-focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family-focused behaviours and other factors that impact family-focused activities. Hierarchical multiple regression identified 14 predictors of family-focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family-focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family-focused practice. This study extends current research by clearly highlighting predictors of family-focused practice and reporting how various enablers promoted family-focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere. © 2018 Australian College of Mental Health Nurses Inc.

An integration programme of poverty alleviation and development with family planning.

PubMed

1997-04-01

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors. full text

Risk Stratification Methods and Provision of Care Management Services in Comprehensive Primary Care Initiative Practices.

PubMed

Reddy, Ashok; Sessums, Laura; Gupta, Reshma; Jin, Janel; Day, Tim; Finke, Bruce; Bitton, Asaf

2017-09-01

Risk-stratified care management is essential to improving population health in primary care settings, but evidence is limited on the type of risk stratification method and its association with care management services. We describe risk stratification patterns and association with care management services for primary care practices in the Comprehensive Primary Care (CPC) initiative. We undertook a qualitative approach to categorize risk stratification methods being used by CPC practices and tested whether these stratification methods were associated with delivery of care management services. CPC practices reported using 4 primary methods to stratify risk for their patient populations: a practice-developed algorithm (n = 215), the American Academy of Family Physicians' clinical algorithm (n = 155), payer claims and electronic health records (n = 62), and clinical intuition (n = 52). CPC practices using practice-developed algorithm identified the most number of high-risk patients per primary care physician (282 patients, P = .006). CPC practices using clinical intuition had the most high-risk patients in care management and a greater proportion of high-risk patients receiving care management per primary care physician (91 patients and 48%, P =.036 and P =.128, respectively). CPC practices used 4 primary methods to identify high-risk patients. Although practices that developed their own algorithm identified the greatest number of high-risk patients, practices that used clinical intuition connected the greatest proportion of patients to care management services. © 2017 Annals of Family Medicine, Inc.

Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum.

PubMed

Seale, J Paul; Shellenberger, Sylvia; Clark, Denice Crowe

2010-05-11

This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008), presents a model curriculum for Family Medicine residency training in substance abuse. The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME) and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME. The curriculum provides basic training in high risk substance use to all residents, while also addressing current training challenges presented by U.S. work hour regulations, increasing international diversity of Family Medicine resident trainees, and emerging new primary care practice models. This paper offers a core curriculum, focused on screening, brief intervention and referral to treatment, which can be adapted by residency programs to meet their individual needs. The curriculum encourages direct observation of residents to ensure that core skills are learned and trains residents with several "new skills" that will expand the basket of substance abuse services they will be equipped to provide as they enter practice. Broad-based implementation of a comprehensive Family Medicine residency curriculum should increase the ability of family physicians to provide basic substance abuse services in a primary care context. Such efforts should be coupled with faculty development initiatives which ensure that sufficient trained faculty are available to teach these concepts and with efforts by major Family Medicine organizations to implement and enforce residency requirements for substance abuse training.

Aircraft family design using enhanced collaborative optimization

NASA Astrophysics Data System (ADS)

Roth, Brian Douglas

Significant progress has been made toward the development of multidisciplinary design optimization (MDO) methods that are well-suited to practical large-scale design problems. However, opportunities exist for further progress. This thesis describes the development of enhanced collaborative optimization (ECO), a new decomposition-based MDO method. To support the development effort, the thesis offers a detailed comparison of two existing MDO methods: collaborative optimization (CO) and analytical target cascading (ATC). This aids in clarifying their function and capabilities, and it provides inspiration for the development of ECO. The ECO method offers several significant contributions. First, it enhances communication between disciplinary design teams while retaining the low-order coupling between them. Second, it provides disciplinary design teams with more authority over the design process. Third, it resolves several troubling computational inefficiencies that are associated with CO. As a result, ECO provides significant computational savings (relative to CO) for the test cases and practical design problems described in this thesis. New aircraft development projects seldom focus on a single set of mission requirements. Rather, a family of aircraft is designed, with each family member tailored to a different set of requirements. This thesis illustrates the application of decomposition-based MDO methods to aircraft family design. This represents a new application area, since MDO methods have traditionally been applied to multidisciplinary problems. ECO offers aircraft family design the same benefits that it affords to multidisciplinary design problems. Namely, it simplifies analysis integration, it provides a means to manage problem complexity, and it enables concurrent design of all family members. In support of aircraft family design, this thesis introduces a new wing structural model with sufficient fidelity to capture the tradeoffs associated with component commonality, but of appropriate fidelity for aircraft conceptual design. The thesis also introduces a new aircraft family concept. Unlike most families, the intent is not necessarily to produce all family members. Rather, the family includes members for immediate production and members that address potential future market conditions and/or environmental regulations. The result is a set of designs that yield a small performance penalty today in return for significant future flexibility to produce family members that respond to new market conditions and environmental regulations.

The economic impact of rural family physicians practicing obstetrics.

PubMed

Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

2014-01-01

The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.

A Role-Playing Game for a Software Engineering Lab: Developing a Product Line

ERIC Educational Resources Information Center

Zuppiroli, Sara; Ciancarini, Paolo; Gabbrielli, Maurizio

2012-01-01

Software product line development refers to software engineering practices and techniques for creating families of similar software systems from a basic set of reusable components, called shared assets. Teaching how to deal with software product lines in a university lab course is a challenging task, because there are several practical issues that…

Patient Satisfaction in Adjacent Family Practice and Non-Family Practice Navy Outpatient Clinics

DTIC Science & Technology

1982-11-29

approach to health care promotes the economic concepts of supply and demand and recasts the patient into a more active role as a consumer in the...34""van den Heuvel WJA: The role of the consumer in health policy. Soc Sci Med 14A:423, 1980 Martin JF: The active patient : A necessary development...Outpatient Clinics Interest in patient satisfaction is based largely on the changing roles of the . patient in the health care system. This change from

Brazilian Immigrant Mothers' Beliefs and Practices Related to Infant Feeding: A Qualitative Study.

PubMed

Lindsay, Ana Cristina; Wallington, Sherrie F; Greaney, Mary L; Hasselman, Maria Helena; Tavares Machado, Marcia Maria; Mezzavilla, Raquel S

2017-08-01

Exclusive breastfeeding for the first 6 months of life and timely introduction of appropriate solid foods are important determinants of weight status in infancy and later life stages. Disparities in obesity rates among young children suggest that maternal feeding practices during the first 2 years of life may contribute to these disparities. Brazilians are a growing immigrant group in the United States, yet little research has focused on parental beliefs and behaviors affecting the health of Brazilian immigrant children in the United States. Research aim: This study aimed to explore beliefs and infant-feeding practices of Brazilian immigrant mothers in the United States. Focus group discussions were conducted with Brazilian immigrant mothers. Transcripts were analyzed using thematic analysis and themes categorized using the socioecological model. Twenty-nine immigrant Brazilian mothers participated in the study. Analyses revealed that all participants breastfed their infants. The majority initiated breastfeeding soon after childbirth. However, most mothers did not exclusively breastfeed. They used formula and human milk concomitantly. Family and culture influenced mothers' infant-feeding beliefs and practices in early introduction of solid foods. As the number of children in the United States growing up in families of immigrant parents increases, understanding influences on Brazilian immigrant mothers' infant-feeding practices will be important to the development of effective interventions to promote healthy infant feeding and weight status among Brazilian children. Interventions designed for Brazilian immigrant families should incorporate an understanding of social context, family, and cultural factors to develop health promotion messages tailored to the needs of this ethnic group.

Celebrating indigenous communities compassionate traditions.

PubMed

Prince, Holly

2018-01-01

Living in a compassionate community is not a new practice in First Nations communities; they have always recognized dying as a social experience. First Nations hold extensive traditional knowledge and have community-based practices to support the personal, familial, and community experiences surrounding end-of-life. However, western health systems were imposed and typically did not support these social and cultural practices at end of life. In fact, the different expectations of western medicine and the community related to end of life care has created stress and misunderstanding for both. One solution is for First Nations communities to develop palliative care programs so that people can receive care at home amongst their family, community and culture. Our research project "Improving End-of-Life Care in First Nations Communities" (EOLFN) was funded by the Canadian Institutes of Health Research [2010-2015] and was conducted in partnership with four First Nations communities in Canada (see www.eolfn.lakeheadu.ca). Results included a community capacity development approach to support Indigenous models of care at end-of-life. The workshop will describe the community capacity development process used to develop palliative care programs in First Nations communities. It will highlight the foundation to this approach, namely, grounding the program in community values and principles, rooted in individual, family, community and culture. Two First Nations communities will share stories about their experiences developing their own palliative care programs, which celebrated cultural capacity in their communities while enhancing medical palliative care services in a way that respected and integrated with their community cultural practices. This workshop shares the experiences of two First Nations communities who developed palliative care programs by building upon community culture, values and principles. The underlying model guiding development is shared.

One program, multiple training sites: does site of family medicine training influence professional practice location?

PubMed

Jamieson, Jean L; Kernahan, Jill; Calam, Betty; Sivertz, Kristin S

2013-01-01

Numerous strategies have been suggested to increase recruitment of family physicians to rural communities and smaller regional centers. One approach has been to implement distributed postgraduate education programs where trainees spend substantial time in such communities. The purpose of the current study was to compare the eventual practice location of family physicians who undertook their postgraduate training through a single university but who were based in either metropolitan or distributed, non-metropolitan communities. Since 1998, the Department of Family Practice at the University of British Columbia in Canada has conducted an annual survey of its residents at 2, 5, and 10 years after completion of training. The authors received Ethics Board approval to use this anonymized data to identify personal and educational factors that predict future practice location. The overall response rate was 45%. At 2 years (N=222), residents trained in distributed sites were 15 times more likely to enter practice in rural communities, small towns and regional centers than those who trained in metropolitan teaching centers. This was even more predictive for retention in non-urban practice sites. Among the subgroup of physicians who remained in a single practice location for more than a year preceding the survey, those who trained in smaller sites were 36 times more likely to choose a rural or regional practice setting. While the vast majority of those trained in metropolitan sites chose an urban practice location, a subgroup of those with some rural upbringing were more likely to practice in rural or regional settings. Trainees from distributed sites considered themselves more prepared for practice regardless of ultimate practice location. Participation in a distributed postgraduate family medicine training site is an important predictor of a non-urban practice location. This effect persists for 10 years after completion of training and is independent of other predictors of non-urban practice including gender, rural upbringing, and rural undergraduate training. It is hypothesized that this is due not only to a curriculum that supports preparedness for this type of practice but also to opportunities to develop personal and professional roots in these communities.

The uses of emotion maps in research and clinical practice with families and couples: methodological innovation and critical inquiry.

PubMed

Gabb, Jacqui; Singh, Reenee

2015-03-01

We explore how "emotion maps" can be productively used in clinical assessment and clinical practice with families and couples. This graphic participatory method was developed in sociological studies to examine everyday family relationships. Emotion maps enable us to effectively "see" the dynamic experience and emotional repertoires of family life. Through the use of a case example, in this article we illustrate how emotion maps can add to the systemic clinicians' repertoire of visual methods. For clinicians working with families, couples, and young people, the importance of gaining insight into how lives are lived, at home, cannot be understated. Producing emotion maps can encourage critical personal reflection and expedite change in family practice. Hot spots in the household become visualized, facilitating dialogue on prevailing issues and how these events may be perceived differently by different family members. As emotion maps are not reliant on literacy or language skills they can be equally completed by parents and children alike, enabling children's perspective to be heard. Emotion maps can be used as assessment tools, to demonstrate the process of change within families. Furthermore, emotion maps can be extended to use through technology and hence are well suited particularly to working with young people. We end the article with a wider discussion of the place of emotions and emotion maps within systemic psychotherapy. © 2014 The Authors. Family Process published by Wiley Periodicals, Inc. on behalf of Family Process Institute.

Family presence during resuscitation: A Canadian Critical Care Society position paper.

PubMed

Oczkowski, Simon John Walsh; Mazzetti, Ian; Cupido, Cynthia; Fox-Robichaud, Alison E

2015-01-01

Recent evidence suggests that patient outcomes are not affected by the offering of family presence during resuscitation (FPDR), and that psychological outcomes are neutral or improved in family members of adult patients. The exclusion of family members from the resuscitation area should, therefore, be reassessed. The present Canadian Critical Care Society position paper is designed to help clinicians and institutions decide whether to incorporate FPDR as part of their routine clinical practice, and to offer strategies to implement FPDR successfully. The authors conducted a literature search of the perspectives of health care providers, patients and families on the topic of FPDR, and considered the relevant ethical values of beneficence, nonmaleficence, autonomy and justice in light of the clinical evidence for FPDR. They reviewed randomized controlled trials and observational studies of FPDR to determine strategies that have been used to screen family members, select appropriate chaperones and educate staff. FPDR is an ethically sound practice in Canada, and may be considered for the families of adult and pediatric patients in the hospital setting. Hospitals that choose to implement FPDR should develop transparent policies regarding which family members are to be offered the opportunity to be present during the resuscitation. Experienced chaperones should accompany and support family members in the resuscitation area. Intensive educational interventions and increasing experience with FPDR are associated with increased support for the practice from health care providers. FPDR should be considered to be an important component of patient and family-centred care.

Mental health practice and attitudes of family physicians can be changed!

PubMed

MacCarthy, Dan; Weinerman, Rivian; Kallstrom, Liza; Kadlec, Helena; Hollander, Marcus J; Patten, Scott

2013-01-01

An adult mental health module was developed in British Columbia to increase the use of evidence-based screening and cognitive behavioral self-management tools as well as medications that fit within busy family physician time constraints and payment systems. Aims were to enhance family physician skills, comfort, and confidence in diagnosing and treating mental health patients using the lens of depression; to improve patient experience and partnership; to increase use of action or care plans; and to increase mental health literacy and comfort of medical office assistants. The British Columbia Practice Support Program delivered the module using the Plan-Do-Study-Act cycle for learning improvement. Family physicians were trained in adult mental health, and medical office assistants were trained in mental health first aid. Following initial testing, the adult mental health module was implemented across the province. More than 1400 of the province's 3300 full-service family physicians have completed or started training. Family physicians reported high to very high success implementing self-management tools into their practices and the overall positive impact this approach had on patients. These measures were sustained or improved at 3 to 6 months after completion of the module. An Opening Minds Survey for health care professionals showed a decrease in stigmatizing attitudes of family physicians. The adult mental health module is changing the way participants practice. Office-based primary mental health care can be improved through reimbursed training and support for physicians to implement practical, time-efficient tools that conform to payment schemes. The module provided behavior-changing tools that seem to be changing stigmatizing attitudes towards this patient population. This unexpected discovery has piqued the interest of stigma experts at the Mental Health Commission of Canada.

Social media beliefs and usage among family medicine residents and practicing family physicians.

PubMed

Klee, David; Covey, Carlton; Zhong, Laura

2015-03-01

Incorporation of social media (SM) use in medicine is gaining support. The Internet is now a popular medium for people to solicit medical information. Usage of social networks, such as Facebook and Twitter, is growing daily and provides physicians with nearly instantaneous access to large populations for both marketing and patient education. The benefits are myriad, but so are the inherent risks. We investigated the role providers' age and medical experience played in their beliefs and use of SM in medicine. Using multiple state-wide and national databases, we assessed social media use by family medicine residents, faculty, and practicing family physicians with a 24-question online survey. Descriptive data is compared by age and level of medical experience. A total of 61 family medicine residents and 192 practicing family physicians responded. There is a trend toward higher SM utilization in the younger cohort, with 90% of resident respondents reporting using SM, half of them daily. A total of 64% of family physician respondents over the age of 45 have a SM account. An equal percentage of senior physicians use SM daily or not at all. Practicing physicians, more than residents, agree that SM can be beneficial in patient care. The vast majority of residents and physicians polled believe that SM should be taught early in medical education. The high utilization of SM by younger providers, high prevalence of patient use of the Internet, and the countless beneficial opportunities SM offers should be catalysts to drive curriculum development and early implementation in medical education. This curriculum should focus around four pillars: professional standards for SM use, SM clinical practice integration, professional networking, and research.

Jamaican child-rearing practices: the role of corporal punishment.

PubMed

Smith, Delores E; Mosby, Gail

2003-01-01

The family is the most prominent social group that exists. It prepares its members for the various roles they will perform in society. Yet, the literature has unequivocally singled out the family as the most violent social group, with parental violence against children being the most prevalent type of family violence. While societies like the United States, Japan, and Sweden have taken a hard line on physical punishment and shifted to a gentler approach to discipline, harsh disciplining of children persists elsewhere. In the Caribbean, and Jamaica in particular, child-rearing and disciplinary practices that would warrant child abuse charges in other Western societies are rampant. This article examines the child-rearing techniques of Jamaican adults and their assumed effects on child outcomes. It also examines the plausibility of the assumption that the harsh physical punishment meted out to children is partially responsible for the current social problems of that island nation. We recommend approaches to tackle the broad goals of addressing familial and societal practices that compromise children's development and well-being.

Inclusive Early Childhood Development: Ensuring the Rights and Well-Being of Infants and Toddlers with Disabilities and Their Families

ERIC Educational Resources Information Center

Wertlieb, Donald

2018-01-01

The science and practice of early childhood development now stands ready to address the needs and ensure the rights of infants and young children with disabilities and their families, among the most underserved and marginalized in all regions of the world. Synergies in global policies such as the "United Nations Convention on the Rights of…

Psychosocial Well-Being and the Relationship between Divorce and Children's Academic Achievement

ERIC Educational Resources Information Center

Potter, Daniel

2010-01-01

As an unprecedented number of children live in families experiencing divorce, researchers have developed increasingly complex explanations for the consequences associated with marital dissolution. Current accounts focus on changes to family finances, destabilized parenting practices, elevated parental conflict, and deterioration of the…

School Counselor Technology Use and School-Family-Community Partnerships

ERIC Educational Resources Information Center

Cronin, Sarah; Ohrtman, Marguerite; Colton, Emily; Crouse, Brita; Depuydt, Jessica; Merwin, Camille; Rinn, Megan

2018-01-01

Research in understanding effective strategies to develop stakeholder engagement is needed to further define the school counselor role and best outreach practices. School counselors are increasing their daily technology use. This study explores how school counselor technology use is related to school-family-community partnerships. School…

The Uses of Emotion Maps in Research and Clinical Practice with Families and Couples: Methodological Innovation and Critical Inquiry

PubMed Central

Gabb, Jacqui; Singh, Reenee

2015-01-01

We explore how “emotion maps” can be productively used in clinical assessment and clinical practice with families and couples. This graphic participatory method was developed in sociological studies to examine everyday family relationships. Emotion maps enable us to effectively “see” the dynamic experience and emotional repertoires of family life. Through the use of a case example, in this article we illustrate how emotion maps can add to the systemic clinicians’ repertoire of visual methods. For clinicians working with families, couples, and young people, the importance of gaining insight into how lives are lived, at home, cannot be understated. Producing emotion maps can encourage critical personal reflection and expedite change in family practice. Hot spots in the household become visualized, facilitating dialogue on prevailing issues and how these events may be perceived differently by different family members. As emotion maps are not reliant on literacy or language skills they can be equally completed by parents and children alike, enabling children's perspective to be heard. Emotion maps can be used as assessment tools, to demonstrate the process of change within families. Furthermore, emotion maps can be extended to use through technology and hence are well suited particularly to working with young people. We end the article with a wider discussion of the place of emotions and emotion maps within systemic psychotherapy. PMID:25091031

Validation: A Family-Centered Communication Skill.

PubMed

Harvey, Pat; Ahmann, Elizabeth

2016-01-01

Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging" to deal with. Yet nurses can develop skills to effectively interact with families in a wide variety of circumstances and then become able to practice family-centered care in any situation that might arise. One particularly useful skill is "validation," which means accepting what the family member says or does as a valid expression of thoughts and feelings in that particular circumstance at that particular time. Validation does not mean there is agreement or acceptance of unsafe behaviors, only that the nurse acknowledges that the family member's concerns and feelings are important and should be listened to and taken seriously, even in the presence of disagreement. Validation, which should be individualized, can take many forms, ranging from providing complete attention to reflection of statements, identification of possible unexpressed emotions, normalization, and finally, a full and genuine sense of connection. Understanding and practicing validation can empower nurses and family members, as well as support effectivefamily-centered communication and problem solving even in challenging circumstances.

Segmenting a general practitioner market to improve recruitment outcomes.

PubMed

Hemphill, Elizabeth; Kulik, Carol T

2011-05-01

Recruitment is an ongoing challenge in the health industry with general practitioner (GP) shortages in many areas beyond rural and Indigenous communities. This paper suggests a marketing solution that identifies different segments of the GP market for recruitment strategy development. In February 2008, 96 GPs in Australia responded to a mail questionnaire (of which 85 questionnaires were useable). A total of 350 GPs were sent the questionnaire. Respondents considered small sets of attributes in the decision to accept a new job at a general practice and selected the most and least important attribute from each set. We identified latent class clusters (cohorts) of GPs from the most-least important data. Three cohorts were found in the GP market, distinguishing practitioners who emphasised job, family or practice attributes in their decision to join a practice. Few significant demographic differences exist between the cohorts. A segmented GP market suggests two alternative recruitment strategies. One option is for general practices to target members of a single cohort (family-, job-, or practice-focussed GPs). The other option is for general practices to diversify their recruitment strategies to target all three cohorts (family-, job- and practice-focussed GPs). A single brand (practice) can have multiple advertising strategies with each strategy involving advertising activities targeting a particular consumer segment.

Differentiation of Self and Spirituality: Empirical Explorations

ERIC Educational Resources Information Center

Jankowski, Peter J.; Vaughn, Marsha

2009-01-01

This study explored the relationships between an individual's interpersonal functioning, perceived spirituality, and selected spiritual practices. Using Bowen's family systems theory, the authors proposed that an individual's level of spiritual development and level of differentiation are correlated and that certain spiritual practices are…

Family welfare and health practices increase after exposure to population education.

PubMed

1994-01-01

Since 1987, the State Resource Center of Jamia Millia Islamia of New Delhi has been implementing a program which integrates population education contents into its literacy education classes for adult learners. Using the core messages on family size, spacing of children, responsible parenthood, right age of marriage, population-related beliefs and customs and population and development, the Center undertook many activities such as: i) integrating population contents in literacy primers, readers and supplementary reading books; ii) development of teaching aids and instructor's resource materials; iii) organization of training for instructors and iv) holding outreach activities such as street corner plays, fairs, etc. To evaluate the impact of the program, the Center undertook an impact survey to measure the level of knowledge, attitude and practices of randomly selected beneficiaries of the project, i.e. 934 learners from 85 literacy learning centers, 5 years after the introduction of the population education program. The study used pre-test and post-test method for collecting data and to compare results. In terms of practice, the study has shown that the respondents having knowledge about family planning methods increased from 67 to 87%, after being exposed to the project's activities. There was also an increase of 61% in cases adopting family planning methods over the pre-measurement level. More importantly, there was not only an increase in awareness of public health and family welfare services but a 137% increase was registered in the use of public health and family welfare facilities for family planning counseling and services. With regard to knowledge and attitude on the various population education messages promoted by the project, the study has shown a 40% increase in "high" knowledge category and 25% increase in favorable attitude after the exposure to the project. full text

Simulation videos presented in a blended learning platform to improve Australian nursing students' knowledge of family assessment.

PubMed

Coyne, Elisabeth; Frommolt, Valda; Rands, Hazel; Kain, Victoria; Mitchell, Marion

2018-07-01

The provision of simulation to enhance learning is becoming common practice as clinical placement becomes harder to secure within Bachelor of Nursing programs. The use of simulation videos within a blended learning platform enables students to view best practice and provides relevant links between theory and practice. Four simulation videos depicting family assessment viewed by a cohort of Australian undergraduate nursing students were evaluated. These videos were professionally developed using actors and experienced family nurses. Surveys were used to explore the students' self-assessed knowledge, confidence and learning preferences before and after exposure to blended learning resources. Students' engagement with the simulated videos was captured via the Learning Management System. Time 1 survey was completed by 163 students and Time 2 by 91 students. There was a significant increase in students' perceived knowledge of family theory Item 1 from a mean 4.13 (SD = 1.04) at Time 1 to 4.74 (SD = 0.89) (Z = -4.54 p < 0.001) at Time 2; Item 2- Knowledge of family assessment improved from mean 3.91 (SD = 1.02) at Time 1 to 4.90 (SD = 0.67) (Z = -7.86 p < 0.001) at Time 2. Also a significant increase in their confidence undertaking family assessment Item 5 from a mean 3.55 (SD = 1.14) at Time 1 to 4.44 (SD = 0.85) (Z = -6.12 p < 0.001) at Time 2. The students watched the videos an average of 1.9 times. The simulated videos as a blended learning resource increases the students' understanding of family assessment and is worth incorporating into future development of courses. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Framework for Engaging Parents in Prevention

ERIC Educational Resources Information Center

Randolph, Karen A.; Fincham, Frank; Radey, Melissa

2009-01-01

The literature on engaging families in prevention programs is informed by the Health Beliefs Model (HBM), Theory of Reasoned Action (TRA), and Family Systems theory. Although useful, these frameworks have not facilitated the development of prevention-based practice strategies that recognize different levels of prevention (i.e., universal,…

The LSS Review. Volume 2, Number 1

ERIC Educational Resources Information Center

Rohland, Mark, Ed.

2003-01-01

School-family partnerships (SFPs) have been the focus of research, policy, and practice efforts for several years. Increasing the interest in SFPs has been the finding that when schools and families cooperate closely, children benefit. The more supportive links there are between settings, the more potential there is for healthy development. Such…

Human Resource Management Issues. Symposium 22. [AHRD Conference, 2001].

ERIC Educational Resources Information Center

2001

This symposium on human resource management issues consists of three presentations. "Work and Family Conflict: A Review of the Theory and Literature" (Susan R. Madsen) explores the literature related to work and family conflict and its possible implications to human resource development (HRD) theory and practice. It presents four existing…

New Strategies for Improving Rural Family Life.

ERIC Educational Resources Information Center

Coombs, Philip H.

Presented in capsule form for the convenience of busy policy makers, planners, and program managers, this booklet summarizes major findings of a three-year study on practical aspects of rural development, with particular emphasis on ways of alleviating extreme poverty among disadvantaged rural families. Using case studies from Bangladesh, India,…

An Application of Force Aggregate Theory in Family Communication Networks.

ERIC Educational Resources Information Center

Fontes, Norm; And Others

This study explores the effect that divorce has upon interpersonal influence in family communication directed at children. A paradigm utilizing Woefel's Forced Aggregate theory was developed for exploration of the problem area. A number of practical and theoretical implications are presented. The research is intended to have far-reaching…

Parents as Policy-Makers: A Handbook for Effective Participation.

ERIC Educational Resources Information Center

Hunter, Richard W.

This manual, developed by the Families in Action Project, is intended to provide parents and other family members of children with emotional disorders some practical ideas and tools with which they can become effective partners with professionals in the policy-making process. The first section, "Understanding the Board Process," describes…

Educating Gerontologists for Cultural Proficiency in End-of-Life Care Practice

ERIC Educational Resources Information Center

Stein, Gary L.; Sherman, Patricia A.; Bullock, Karen

2009-01-01

An educational program was developed to train practitioners to provide care for patients and families that are responsive to cultural concerns. The aim was to increase knowledge and improve attitudes toward providing culturally proficient and culturally sensitive care for patients and families facing life-threatening illnesses. The program…

Family therapy: critique from a feminist perspective.

PubMed

Penfold, P S

1989-05-01

Family therapy is a powerful modality which, all too often, is used without awareness of its possible constricting, or even crippling, effects. Textbooks and articles about family therapy focus soley or mainly on the family system alone, thus obscuring the influence of school, workplace, neighborhood, peer group, class, race and sex. Theorists, who are predominantly male, have developed rigid and mechanical concepts which encourage formulations encompassing the family system alone. Power inequalities between men and women are ignored and socially programmed sex roles are reflected and reinforced by theory and practice. Thus family therapy may function to locate and contain, within the family, difficulties and distress derived from stresses outside the family. The negative effects of traditional sex roles on emotional growth, sexuality and the development of mutually gratifying male-female relationships are never dealt with. As a result, family therapy may contribute to men's straitjacketing and women's oppression. To fulfill its promise, family therapy research and teaching must move beyond shortsighted and narrowly conceptualized theories which could damage, rather than heal, families who are suffering.

Family-Centered Practice with Non-Attending Students in Hong Kong

ERIC Educational Resources Information Center

Lau, Yuk King

2009-01-01

In this article, the author talks about a family-centered practice model for working with students with non-attendance problems. Family-centered practice positions the family at the center of attention or field of action. Its focus is on those transactions occurring between a person, family, and environment, which affect individuals, families and…

Defining competency-based evaluation objectives in family medicine

PubMed Central

Allen, Tim; Brailovsky, Carlos; Rainsberry, Paul; Lawrence, Katherine; Crichton, Tom; Carpentier, Marie-Pierre; Visser, Shaun

2011-01-01

Abstract Objective To develop a definition of competence in family medicine sufficient to guide a review of Certification examinations by the Board of Examiners of the College of Family Physicians of Canada. Design Delphi analysis of responses to a 4-question postal survey. Setting Canadian family practice. Participants A total of 302 family physicians who have served as examiners for the College of Family Physicians of Canada’s Certification examination. Methods A survey comprising 4 short-answer questions was mailed to the 302 participating family physicians asking them to list elements that define competence in family medicine among newly certified family physicians beginning independent practice. Two expert groups used a modified Delphi consensus process to analyze responses and generate 2 basic components of this definition of competence: first, the problems that a newly practising family physician should be competent to handle; second, the qualities, behaviour, and skills that characterize competence at the start of independent practice. Main findings Response rate was 54%; total number of elements among all responses was 5077, for an average 31 per respondent. Of the elements, 2676 were topics or clinical situations to be dealt with; the other 2401 were skills, behaviour patterns, or qualities, without reference to a specific clinical problem. The expert groups identified 6 essential skills, the phases of the clinical encounter, and 99 priority topics as the descriptors used by the respondents. More than 20% of respondents cited 30 of the topics. Conclusion Family physicians define the domain of competence in family medicine in terms of 6 essential skills, the phases of the clinical encounter, and priority topics. This survey represents the first level of definition of evaluation objectives in family medicine. Definition of the interactions among these elements will permit these objectives to become detailed enough to effectively guide assessment. PMID:21918130

Building physician resilience.

PubMed

Jensen, Phyllis Marie; Trollope-Kumar, Karen; Waters, Heather; Everson, Jennifer

2008-05-01

To explore the dimensions of family physician resilience. Qualitative study using in-depth interviews with family physician peers. Hamilton, Ont. Purposive sample of 17 family physicians. An iterative process of face-to-face, in-depth interviews that were audiotaped and transcribed. The research team independently reviewed each interview for emergent themes with consensus reached through discussion and comparison. Themes were grouped into conceptual categories. Four main aspects of physician resilience were identified: 1) attitudes and perspectives, which include valuing the physician role, maintaining interest, developing self-awareness, and accepting personal limitations; 2) balance and prioritization, which include setting limits, taking effective approaches to continuing professional development, and honouring the self;3) practice management style, which includes sound business management, having good staff, and using effective practice arrangements; and 4) supportive relations, which include positive personal relationships, effective professional relationships, and good communication. Resilience is a dynamic, evolving process of positive attitudes and effective strategies.

A Qualitative Study of the Communication Process for Medical Acupuncture in Family Medicine.

PubMed

Ledford, Christy J W; Fisher, Carla L; Crawford, Paul

2018-05-01

As evidence establishes the efficacy of medical acupuncture, more family physicians and family medicine residents may receive medical acupuncture training and need to know how to effectively communicate about the treatment option with patients. By identifying how physicians talk about acupuncture treatment with their patients, we aimed to develop a model for physician training that could enhance their ability to integrate and practice medical acupuncture in conventional clinical settings. To capture the communication process that family physicians engage in when integrating acupuncture treatment into a clinical environment, we sought both physicians' and patients' perspectives. We conducted interviews with 17 family physicians and 15 patients in a US family medicine clinic that has integrated medical acupuncture into its practice. Audio recordings were transcribed and analyzed by two members of the study team in ATLAS.ti, using the constant comparative method. Integrating acupuncture into family medicine entailed a three-phase communication process: (1) introduce acupuncture, (2) explain the medical process, and (3) evaluate treatment outcomes. The emerging three-phase process of communicating acupuncture described here provides an initial model for teaching communication in the context of medical acupuncture. Given the exploratory nature of this initial study and the rarity of acupuncture treatment integrated into family medical settings, this is a first step in building knowledge in this realm of practice. Future research is needed to better understand the experience of patients who do not report notable results of acupuncture and to extend this study into other family medicine settings.

WHEN INFANTS GROW UP IN MULTIPERSON RELATIONSHIP SYSTEMS

PubMed Central

McHale, James P.

2010-01-01

Despite prompts from the field of family therapy since its inception, contemporary infant mental health theory and practice remain firmly rooted in and guided by dyadic-based models. Over the past 10 years, a groundswell of new empirical studies of triadic and family group dynamics during infancy have substantiated that which family theory has contended for decades: looking beyond mother-infant or father-infant dyads reveals a myriad of critically important socialization influences and dynamics that are missed altogether when relying on informant reports or dyad-based interactions. Such family-level dynamics emerge within months after infants are born, show coherence through time, and influence the social and emotional adjustment of children as early as the toddler and preschool years. This report summarizes key findings from the past decade of empirical family studies, highlights several areas in need of further conceptual development and empirical study by those who work with infants and their families, and outlines important implications of this body of work for all practicing infant mental health professionals. PMID:21512615

Paediatric nurses' perceptions and practices of family-centred care in Saudi hospitals: A mixed methods study.

PubMed

Alabdulaziz, Hawa; Moss, Cheryle; Copnell, Beverley

2017-04-01

Family-centred care is widely accepted as the underlying philosophy of paediatric nursing. Studies of family-centred care have mainly been conducted in western countries and little is known of its practice in other contexts. No studies have been undertaken in the Middle East. To explore family-centred care in the Saudi context from the perspectives of paediatric nurses. A mixed methodology was utilised with an explanatory sequential design. In the quantitative phase a convenience sample of 234 nurses from six hospitals in Jeddah, Saudi Arabia completed the Family Centred Care Questionnaire. The qualitative phase took place in one hospital and involved 140h of non-participant observation of paediatric nurses' practice. A convenience sample of 14 nurses was involved. Additionally, 10 face-to-face semi-structured interviews were conducted with key staff members. A purposeful sample of 10 nurses was involved. The findings from both phases were integrated in the final analysis. The survey results indicated that participants identified most elements of family-centred care as necessary for its practice. They were less likely to incorporate them into their practice (p<0.001, paired t-tests, all subscales). These findings were supported by the observation data, which revealed that, while several elements of family-centred care were frequently practised, others were implemented either inconsistently or not at all. Findings from the interview data indicated that participants had limited and superficial understanding of what family-centred care means as a model of care; rather, they worked with the elements as a set of core tasks. In the current study, there were similarities between what has been found in the Saudi context and findings from other studies using the same tool in western contexts. There is general agreement regarding the differences between theory and practice. Nurses do believe and acknowledge the importance of family-centred care; however, they struggle with practising this model in their everyday work. In the current study, many factors contributed to this issue, including language barriers, communication issues, cultural issues and hospital policies. Western concepts of family-centred care appear to be accepted by paediatric nurses in Saudi Arabia. However, full adoption of family-centred care in keeping with western values is likely not to be appropriate or successful in the Saudi context where both nurses and families have a non-western culture. The western model of family-centred care requires cultural modification and further development to fit Saudi and Middle Eastern cultures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is work-family balance more than conflict and enrichment?

PubMed

Carlson, Dawn S; Grzywacz, Joseph G; Zivnuska, Suzanne

2009-10-01

This study deepens our theoretical and practical understanding of work-family balance, defined as the 'accomplishment of role-related expectations that are negotiated and shared between an individual and his/her role-related partners in the work and family domains' (Grzywacz & Carlson, 2007: 458). We develop a new measure of work-family balance and establish discriminant validity between it, work-family conflict, and work-family enrichment. Further, we examine the relationship of work-family balance with six key work and family outcomes. Results suggest that balance explains variance beyond that explained by traditional measures of conflict and enrichment for five of six outcomes tested: job satisfaction, organizational commitment, family satisfaction, family performance, and family functioning. We conclude with a discussion of the applications of our work.

[The social hygienic factors of the prevalence of children's breast feeding].

PubMed

Amirov, N Kh; Mingazova, E N; Gaĭnutdinova, L I

2008-01-01

The study of the impact of family social hygienic factors on the breast feeding process was carried out on the basis of the sociological survey of 394 women of fertilization age from the "Kazanorgsintez" staff. The influence on the breast feeding duration of such factors as the family structure, the living conditions, the family income level is revealed. The ensued characteristics of breast feeding resulted from the impact of the practice of breast feeding developed in families.

Early community-based family practice elective positively influences medical students' career considerations--a pre-post-comparison.

PubMed

Deutsch, Tobias; Hönigschmid, Petra; Frese, Thomas; Sandholzer, Hagen

2013-02-21

Demographic change and recruitment problems in family practice are increasingly threatening an adequate primary care workforce in many countries. Thus, it is important to attract young physicians to the field. The purpose of the present study was to examine the effect of an early community-based 28-h family practice elective with one-to-one mentoring on medical students' consideration of family practice as a career option, their interest in working office-based, and several perceptions with regard to specific aspects of a family physician's work. First- and second-year medical students completed questionnaires before and after a short community-based family practice elective, consisting of a preparatory course and a community-based practical experience with one-to-one mentoring by trained family physicians. We found a significantly higher rate of students favoring family practice as a career option after the elective (32.7% vs. 26.0%, p = 0.039). Furthermore, the ranking of family practice among other considered career options improved (p = 0.002). Considerations to work office-based in the future did not change significantly. Perceptions regarding a family physician's job changed positively with regard to the possibility of long-term doctor-patient relationships and treatment of complex disease patterns. The majority of the students described identification with the respective family physician tutor as a professional role model and an increased interest in the specialty. Our results indicate that a short community-based family practice elective early in medical education may positively influence medical students' considerations of a career in family practice. Furthermore, perceptions regarding the specialty with significant impact on its attractiveness may be positively adjusted. Further research is needed to evaluate the influence of different components of a family practice curriculum on the de facto career decisions of young physicians after graduation.

Towards integrated practices in early detection of and intervention for deaf and hard of hearing children.

PubMed

Storbeck, Claudine; Calvert-Evers, Jennifer

2008-01-01

It is well documented that undetected hearing loss can have a profound effect on a child's holistic development, including communicative, language and cognitive development. It is crucial therefore that deaf and hard of hearing infants are detected as early as possible so that appropriate intervention services and support can be initiated. To assist parents in enabling their child's optimal growth and development, HI HOPES-the first South African home-based early intervention project-was launched in August 2006, offering families weekly home-based support that is both child-centred and family-directed. A critical overview of the pilot implementation of HI HOPES is presented, from inception to implementation, focusing on its innovative services and practices, and issues that influence the intervention process including a reflection on the challenges and areas for development.

Early childhood caries and infant oral health: Paediatricians’ and family physicians’ knowledge, practices and training

PubMed Central

Prakash, Preeti; Lawrence, Herenia P; Harvey, Bart J; McIsaac, Warren J; Limeback, Hardy; Leake, James L

2006-01-01

OBJECTIVES To assess the knowledge of early childhood caries and to examine the current preventive oral health-related practices and training among Canadian paediatricians and family physicians who provide primary care to children younger than three years. METHODS A cross-sectional, self-administered survey was mailed to a random sample of 1928 paediatricians and family physicians. RESULTS A total of 1044 physicians met the study eligibility criteria, and of those, 537 returned completed surveys, resulting in an overall response rate of 51.4% (237 paediatricians and 300 family physicians). Six questions assessed knowledge of early childhood caries; only 1.8% of paediatricians and 0.7% of family physicians answered all of these questions correctly. In total, 73.9% of paediatricians and 52.4% of family physicians reported visually inspecting children’s teeth; 60.4% and 44.6%, respectively, reported counselling parents or caregivers regarding teething and dental care; 53.2% and 25.6%, respectively, reported assessing children’s risk of developing tooth decay; and 17.9% and 22.3%, respectively, reported receiving no oral health training in medical school or residency. Respondents who felt confident and knowledgeable and who considered their role in promoting oral health as “very important” were significantly more likely to carry out oral health-related practices. CONCLUSION Although the majority of paediatricians and family physicians reported including aspects of oral health in children’s well visits, a reported lack of dental knowledge and training appeared to pose barriers, limiting these physicians from playing a more active role in promoting the oral health of children in their practices. PMID:19030271

Developing family-centred care in a neonatal intensive care unit: An action research study.

PubMed

Skene, Caryl; Gerrish, Kate; Price, Fiona; Pilling, Elizabeth; Bayliss, Pauline; Gillespie, Siobhan

2018-06-21

To develop, implement and evaluate family-centred interventions to promote parental involvement in caregiving in a Neonatal Intensive Care Unit. A participatory action research approach was used to implement two changes in practice a) improved skin-to-skin contact b) unlimited parental presence at the cot-side. The changes were underpinned by a family-centred philosophy of care and education. Data were collected from staff using a questionnaire, focus groups and interviews, and from parents using focus groups and interviews. Qualitative data were analysed using Framework and quantitative data analysed using descriptive and t-test statistics. A Neonatal Intensive Care Unit in England. Changes in practice were successfully implemented. Nurses reported positively on improvements in Family Centred Care; most notably information-sharing with parents, providing family support, enabling parental participation in care and improved competence supporting parents in care-giving. These changes were reflected in parental feedback. Understanding the context of the neonatal unit can support cultural change when change is actively facilitated and owned by the staff concerned. Acknowledging parents as the main caregiver can be challenging for nurses and they require support and education to enable them to manage the changes necessary to provide Family-Centred Care. Copyright © 2018 Elsevier Ltd. All rights reserved.

Teen Pregnancy Prevention Programs: Linking Research and Practice.

ERIC Educational Resources Information Center

Johns, Marilyn J.; Moncloa, Fe; Gong, Elizabeth J.

2000-01-01

Assessments of schools and community agencies with teen pregnancy prevention programs (n=23) in three California counties were conducted using surveys, interviews, and site visits. Best practices identified included youth development programs, Involvement of family and other caring adults, and culturally appropriate and locally relevant…

Strengthening Family Capacity to Provide Young Children Everyday Natural Learning Opportunities

ERIC Educational Resources Information Center

Swanson, Jennifer; Raab, Melinda; Dunst, Carl J.

2011-01-01

A capacity-building approach to natural learning environment intervention practices was the focus of the study. Capacity-building early childhood intervention promotes parents' or other caregivers' skills, abilities, and confidence to provide children development-enhancing learning opportunities. Natural environment practices use everyday…

Parenting and Digital Media.

PubMed

Coyne, Sarah M; Radesky, Jenny; Collier, Kevin M; Gentile, Douglas A; Linder, Jennifer Ruh; Nathanson, Amy I; Rasmussen, Eric E; Reich, Stephanie M; Rogers, Jean

2017-11-01

Understanding the family dynamic surrounding media use is crucial to our understanding of media effects, policy development, and the targeting of individuals and families for interventions to benefit child health and development. The Families, Parenting, and Media Workgroup reviewed the relevant research from the past few decades. We find that child characteristics, the parent-child relationship, parental mediation practices, and parents' own use of media all can influence children's media use, their attitudes regarding media, and the effects of media on children. However, gaps remain. First, more research is needed on best practices of parental mediation for both traditional and new media. Ideally, this research will involve large-scale, longitudinal studies that manage children from infancy to adulthood. Second, we need to better understand the relationship between parent media use and child media use and specifically how media may interfere with or strengthen parent-child relationships. Finally, longitudinal research on how developmental processes and individual child characteristics influence the intersection between media and family life is needed. The majority of children's media use takes place within a wider family dynamic. An understanding of this dynamic is crucial to understanding child media use as a whole. Copyright © 2017 by the American Academy of Pediatrics.

An Integrated Pest Management Intervention Improves Knowledge, Pest Control, and Practices in Family Child Care Homes.

PubMed

Stephens, Michelle; Hazard, Kimberly; Moser, Debra; Cox, Dana; Rose, Roberta; Alkon, Abbey

2017-10-26

To reduce young children's exposure to pesticides when attending family child care homes (FCCHs), we developed an integrated pest management (IPM) intervention for FCCH directors. First, we developed IPM educational materials and resources to provide the foundation for an IPM educational intervention for FCCHs. Next, we conducted and evaluated a six-month nurse child care health consultant (CCHC)-led education and consultation IPM intervention to increase IPM knowledge, IPM practices, IPM policies, and decrease the presence or evidence of pests. The pilot intervention study was conducted by three CCHCs in 20 FCCHs in three counties in California. Pre- and post-intervention measures were completed by the FCCH directors and observation measures were completed by the CCHCs. Results indicated significant increases in IPM knowledge, ( t -statistic (degrees of freedom), ( t (df) = 2.55(10), p < 0.05), increases in IPM practices ( t (df) = -6.47(17), p < 0.05), and a 90% reduction in the prevalence of pests. There were no significant differences in changes in IPM practices based on director education, FCCH county, or IPM intervention intensity or duration. A nurse-led IPM education and consultation intervention can reduce exposures of young children attending family child care homes to harmful chemicals.

Emergency Room Practice among Family Physicians.

ERIC Educational Resources Information Center

Hansel, Nancy K.; And Others

1985-01-01

A self-report questionnaire of graduates of a family practice residency program obtained information on their practices, professional and emergency medicine experiences, and attitudes toward the practice of emergency medicine by family practioners. (Author/MLW)

Promotion of family planning services in practice leaflets.

PubMed

Marshall, M N; Gray, D J; Pearson, V; Phillips, D R; Owen, M

1994-10-08

Providing 75% of family planning services in the United Kingdom, general practitioners are required to produce leaflets which describe the contraceptive services they provide. The authors analyzed information about family planning provided to clients through practice leaflets. 88% of practice leaflets from the 198 practices in Devon were available from the Devon Family Health Services Authority for analysis. It was determined that the leaflets are not being best used to advertise the range and potential of family planning services. Although all practices in Devon offer contraceptive services, only 90% of leaflets mentioned that the services are available. Reference to postcoital contraception and information about services outside the practice for people who might not want to see their family doctor are also sorely lacking. A clear need exists to provide patients with more information. Finally, the authors found that group practices and those with female partners are most likely to give high priority to family planning issues in their leaflets.

Challenges to parenting in a new culture: Implications for child and family welfare.

PubMed

Lewig, Kerry; Arney, Fiona; Salveron, Mary

2010-08-01

Increasing numbers of families arriving through Australia's humanitarian settlement scheme are coming into contact with Australian child protection systems. A large number of these families come from African and Middle Eastern countries and have common experiences of trauma, dislocation, loss and many are victims of genocide, war, and torture. Pre-migration experiences together with the considerable challenges of settling into a new country can significantly affect family well-being and parenting practices. It is therefore important that child and family welfare service planners are well informed about how best to support refugee families using culturally competent family intervention and community development practices. This paper draws on the findings of a research project designed to examine why recently arrived families from refugee backgrounds are presenting in the South Australian child protection system and to identify culturally appropriate strategies for intervention. The paper presents findings from the project that relate to (1) refugee parents', community members' and child protection practitioners' perspectives on the challenges to being a refugee parent in Australia and (2) strategies and resources relevant to prevention and early intervention in refugee families before statutory child protection intervention becomes necessary. Copyright (c)2009 Elsevier Ltd. All rights reserved.

Using a High-Performance Planning Model to Increase Levels of Functional Effectiveness Within Professional Development.

PubMed

Winter, Peggi

2016-01-01

Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.

Depression screening and management among adolescents in primary care: factors associated with best practice.

PubMed

Taliaferro, Lindsay A; Hetler, Joel; Edwall, Glenace; Wright, Catherine; Edwards, Anne R; Borowsky, Iris W

2013-06-01

To compare depression identification and management perceptions and practices between professions and disciplines in primary care and examine factors that increase the likelihood of administering a standardized depression screening instrument, asking about patients' depressive symptoms, and using best practice when managing depressed adolescents. Data came from an online survey of clinicians in Minnesota (20% response rate). Analyses involved bivariate tests and linear regressions. The analytic sample comprised 260 family medicine physicians, 127 pediatricians, 96 family nurse practitioners, and 54 pediatric nurse practitioners. Overall, few differences emerged between physicians and nurse practitioners or family and pediatric clinicians regarding addressing depression among adolescents. Two factors associated with administering a standardized instrument included having clear protocols for follow-up after depression screening and feeling better prepared to address depression among adolescents. Enhancing clinicians' competence to address depression and developing postscreening protocols could help providers implement universal screening in primary care.

How Do Families Matter? Age and Gender Differences in Family Influences on Delinquency and Drug Use

PubMed Central

Fagan, Abigail A.; Van Horn, M. Lee; Antaramian, Susan; Hawkins, J. David

2010-01-01

Parenting practices, age, and gender all influence adolescent delinquency and drug use, but few studies have examined how these factors interact to affect offending. Using data from 18,512 students in Grades 6, 8, 10 and 12, this study found that across grades, parents treated girls and boys differently, but neither sex received preferential treatment for all practices assessed, and younger children reported more positive parenting than older students. Family factors were significantly related to delinquency and drug use for both sexes and for all grades. However, particular parenting practices showed gender and age differences in the degree to which they were related to outcomes, which indicates complexities in parent/child interactions that must be taken into account when investigating the causes of adolescent offending and when planning strategies to prevent the development of problem behaviors. PMID:21499537

State of family medicine practice in Lebanon

PubMed Central

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

State of family medicine practice in Lebanon.

PubMed

Helou, Mariana; Rizk, Grace Abi

2016-01-01

Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.

Family-centered depression treatment for older men in primary care: a qualitative study of stakeholder perspectives.

PubMed

Hinton, Ladson; Sciolla, Andrés F; Unützer, Jürgen; Elizarraras, Edward; Kravitz, Richard L; Apesoa-Varano, Ester Carolina

2017-09-29

Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men's depression treatment and potential strategies to overcome those challenges. A cross-sectional, qualitative descriptive interview study was conducted in a safety-net, Federally Qualified Health Center in California's Central Valley. A total of 37 stakeholders were recruited, including 15 depressed older (i.e. age ≥ 60) men, 12 family members, and 10 clinic staff. Depressed men were identified through mail outreach, waiting room screening, and referral. Depressed men identified family members who were later approached to participate. We also recruited a purposeful sample of clinic staff. Interviews explored stakeholder perspectives on family involvement in men's depression treatment as part of a primary care intervention. Interviews were conducted using a semi-structured interview guide, tape-recorded, transcribed verbatim, and translated if the interview was conducted in Spanish. Four themes were identified representing core challenges: engaging men at the right time; preserving men's sense of autonomy; managing privacy concerns; and navigating family tensions. Stakeholders also provided practical suggestions and advice about how each of these challenges might be addressed. While engaging family is a promising approach to strengthen depression care for older men in primary care settings, several potential challenges exist. Family- centered depression intervention development and clinical practice need to anticipate these challenges and to develop approaches and guidelines to address them.

The Role of Mothers' and Fathers' Religiosity in African American Adolescents' Religious Beliefs and Practices

PubMed Central

Halgunseth, Linda C.; Jensen, Alexander C.; Sakuma, Kari-Lyn; McHale, Susan M.

2015-01-01

Objectives To advance understanding of youth religiosity in its sociocultural context, this study examined the associations between parents' and adolescents' religious beliefs and practices and tested the roles of parent and youth gender and youth ethnic identity in these linkages. Methods The sample included 130, two-parent, African American families. Adolescents (49% female) averaged 14.43 years old. Mothers, fathers, and adolescents were interviewed in their homes about their family and personal characteristics, including their religious beliefs. In a series of seven nightly phone calls, adolescents reported on their daily practices , including time spent in religious practices (e.g., attending services, prayer), and parents reported on their time spent in religious practices with their adolescents. Results Findings indicated that mothers' beliefs were linked to the beliefs of sons and daughters, but fathers' beliefs were only associated with the beliefs of sons. Mothers' practices were associated with youths' practices, but the link was stronger when mothers' held moderately strong religious beliefs. Fathers' practices were also linked to youth practices, but the association was stronger for daughters than for sons. Conclusions Findings highlight the understudied role of fathers in African American families, the importance of examining religiosity as a multidimensional construct, and the utility of ethnic homogeneous designs for illuminating the implications of sociocultural factors in the development of African American youth. PMID:26414002

The role of mothers' and fathers' religiosity in African American adolescents' religious beliefs and practices.

PubMed

Halgunseth, Linda C; Jensen, Alexander C; Sakuma, Kari-Lyn; McHale, Susan M

2016-07-01

To advance understanding of youth religiosity in its sociocultural context, this study examined the associations between parents' and adolescents' religious beliefs and practices and tested the roles of parent and youth gender and youth ethnic identity in these linkages. The sample included 130 two-parent, African American families. Adolescents (49% female) averaged 14.43 years old. Mothers, fathers, and adolescents were interviewed in their homes about their family and personal characteristics, including their religious beliefs. In a series of 7 nightly phone calls, adolescents reported on their daily practices, including time spent in religious practices (e.g., attending services, prayer), and parents reported on their time spent in religious practices with their adolescents. Findings indicated that mothers' beliefs were linked to the beliefs of sons and daughters, but fathers' beliefs were only associated with the beliefs of sons. Mothers' practices were associated with youths' practices, but the link was stronger when mothers' held moderately strong religious beliefs. Fathers' practices were also linked to youth practices, but the association was stronger for daughters than for sons. Findings highlight the understudied role of fathers in African American families, the importance of examining religiosity as a multidimensional construct, and the utility of ethnic homogeneous designs for illuminating the implications of sociocultural factors in the development of African American youth. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The increase in international medical graduates in family practice residency programs.

PubMed

Koehn, Nerissa N; Fryer, George E; Phillips, Robert L; Miller, John B; Green, Larry A

2002-06-01

The number of filled positions in family practice residency programs decreased by 18.6% from 1997-2001. This study sought to determine the degree of reliance on international medical graduates (IMGs) to fill family practice residency positions and the relative proportion of US citizen IMGs. We analyzed the 1992-2001 National Resident Matching Program results, the 2000 American Medical Association Masterfile, and the 1992-2001 American Academy of Family Physicians Annual Survey of Family Practice Residency Programs. The percentage of IMGs matching in family practice remained stable between the years of 1992-1996 (10.0%-11.8%) but since 1997 has increased to a high of 21.4% in 2001. This rise in IMGs corresponds with a drop in the total percentage of family practice residency positions filled in the Match from 90.5% in 1996 to 76.3% in 2001. Despite the drop in Match numbers, the percentage of first-year family practice positions filled in July has remained in the range of 95.5%-97.8% since 1996. IMGs account for an increasing percentage of post-Match fills from 16.7% in 1996 to 47.9% in 2001. In 1999, a majority of family practice programs (279 [55.6%]), had at least one IMG. Of these, 48 programs (9.6%) had at least 50% of residents who were IMGs, and eight programs (1.6%) were entirely composed of IMGs. In five states (Connecticut, Illinois, Michigan, New Jersey, and New York), more than 25% of family practice residents were IMGs. Family practice is becoming increasingly reliant on IMGs to fill residency positions.

Familial correlates of social anxiety in children and adolescents.

PubMed

Bögels, S M; van Oosten, A; Muris, P; Smulders, D

2001-03-01

Retrospective studies suggest a relationship between parental rearing practices and social phobia. The present study investigated whether socially anxious children perceive their current parental rearing as rejecting, overprotective, and lacking emotional warmth, and as emphasizing the importance of other's opinion, and de-emphasizing social initiatives and family sociability. Furthermore, we examined whether parents of socially anxious children report to rely on such rearing practices, and suffer themselves from social fears. A regression analysis as well as extreme group comparisons were applied. Little support was found for the presumed role of the assessed family rearing aspects in the development of social anxiety in children. Solely family sociability (children's and mothers' report) and children's perception of overprotection of the mother predicted social anxiety in the regression analysis. Given the influence of the mentioned rearing practices, social anxiety of the mother still significantly predicted social anxiety of the child. In the extreme group comparisons, differences in the expected direction were found between socially anxious and normal children on parental rejection, emotional warmth, and family sociability. However, the lack of differences between socially anxious and clinical control children suggests that these variables do not form a specific pathway to social fears.

Identified Palliative Care Approach Needs with SPICT in Family Practice: A Preliminary Observational Study.

PubMed

Hamano, Jun; Oishi, Ai; Kizawa, Yoshiyuki

2018-02-09

Identifying patients who require palliative care approach is challenging for family physicians, even though several identification tools have been developed for this purpose. To explore the prevalence and characteristics of family practice patients who need palliative care approach as determined using Supportive and Palliative Care Indicators Tool (SPICT™, April 2015) in Japan. Single-center cross-sectional study. We enrolled all patients ≥65 years of age who visited the chief researcher's outpatient clinic in October 2016. We used Japanese version of SPICT (SPICT-J) to identify patients who need palliative care approach. We assessed patients' backgrounds and whether they had undergone advance care planning with their family physicians. This study included 87 patients (61 females) with a mean age of 79.0 ± 7.4 years. Eight patients (9.2%) were identified as needing palliative care approach. The mean age of patients who needed this approach was 82.3 ± 8.3 years and main underlying conditions were heart/vascular disease (37.5%), dementia/frailty (25.0%), and respiratory disease (12.5%). Only two of eight patients identified as needing palliative care approach had discussed advance care planning with their family physicians. In family practice, 9.2% of outpatients ≥65 years of age were identified as needing palliative care approach. Family physicians should carefully evaluate whether outpatients need palliative care approach.

From Communication Skills to Skillful Communication: A Longitudinal Integrated Curriculum for Critical Care Medicine Fellows.

PubMed

Roze des Ordons, Amanda L; Doig, Christopher J; Couillard, Philippe; Lord, Jason

2017-04-01

Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication. A departmental needs assessment informed curriculum development. Five 4-hour classroom sessions were developed: basic communication principles, family meetings about goals and transitions of care, discussing patient safety incidents, addressing conflict, and offering organ donation. Teaching methods-including instructor-led presentations incorporating a consistent framework for approaching challenging conversations, simulation and clinical practice, and feedback from peers, trained facilitators, family members, and clinicians-supported integration of skills into the clinical setting and longitudinal development of skillful communication. Seven fellows participated during the first year of the curriculum. CCM fellows engaged enthusiastically in the program, commented that the framework provided was helpful, and highly valued the opportunity to practice challenging communication scenarios, learn from observing their peers, and receive immediate feedback. More detailed accounts of fellows', patients', and family members' experiences will be obtained to guide curricular development. The curriculum will be expanded to involve other members of the multidisciplinary intensive care unit team, and faculty education initiatives will be offered to enhance the quality of the feedback provided. The impact of the curriculum on initial skill development, retention, and progression will be assessed.

Maternity and family leave policies in rural family practices.

PubMed

Mainguy, S; Crouse, B J

1998-09-01

To help recruit and retain physicians, especially women, rural family practice groups need to establish policies regarding maternity and other family leaves. Also important are policies regarding paternity leave, adoptive leave, and leave to care for elderly parents. We surveyed members of the American Academy of Family Physicians in rural practice in 1995 to assess the prevalence of leave policies, the degree to which physicians are taking family leave, and the characteristics of ideal policies. Currently, both men and women physicians are taking family leaves of absence, which indicates a need for leave policies. Furthermore, a lack of family leave policies may deter women from entering rural practice.

Family Medicine Research in the United States From the late 1960s Into the Future.

PubMed

Bowman, Marjorie A; Lucan, Sean C; Rosenthal, Thomas C; Mainous, Arch G; James, Paul A

2017-04-01

When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field's inception, there have been notable research successes for which family medicine organizations, researchers, and leaders-assisted by federal and state governments and private foundations-can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships. Family physicians have developed practice-based research networks (PBRNs) to conduct investigations and generate new knowledge. The field of family medicine has seen the creation of new journals to support the publication of research relevant to practicing family physicians. Nonetheless, in spite of much growth and many successes, family physicians and their research have been underrepresented in research funding. Clinical presentations in family medicine are often complex, poorly-differentiated, and exist as one of several patient complaints and diagnoses, and are not well-covered by the narrow basic-science and specialty research that defines most of the biomedical research enterprise. Overall health in the United States would benefit from a more robust research participation and greater support for family medicine research.

FAMILY MEDICINE RESEARCH IN THE UNITED STATES: FROM THE LATE 1960’S INTO THE FUTURE

PubMed Central

Bowman, Marjorie A.; Lucan, Sean C.; Rosenthal, Thomas; Mainous, Arch; James, Paul

2017-01-01

When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field’s inception, there have been notable research successes for which family medicine organizations, researchers, and leaders – assisted by federal and state governments and private foundations - can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships. Family physicians have developed practice-based research networks (PBRNs) to conduct investigations and generate new knowledge. The field of family medicine has seen the creation of new journals to support the publication of research relevant to practicing family physicians. Nonetheless, in spite of much growth and many successes, family physicians and their research have been underrepresented in research funding. Clinical presentations in family medicine are often complex, poorly-differentiated, and often exist as one of several patient complaints and diagnoses, and are not well-covered by the narrow basic-science and specialty research that defines most of the biomedical research enterprise. Overall health in the United States would benefit from a more robust research participation and greater support for family medicine research. PMID:28414408

Minority and Immigrant Youth Exposure to Community Violence: The Differential Effects of Family Management and Peers.

PubMed

Antunes, Maria João Lobo; Ahlin, Eileen M

2018-02-01

Experiences with neighborhood violence can produce negative consequences in youth, including stress, anxiety, and deviant behavior. Studies report that immigrant and minority youth are more likely to be exposed to violence but less likely to perpetrate it. Similarly, research shows parenting practices are differentially adopted by Blacks, Whites, and Hispanics. Although family management strategies can often act as a barrier to the detrimental effects of exposure to community violence (ETV-C), there is a paucity of investigation on how Hispanic subgroups (e.g., Puerto Rican, Mexican) and immigrant families employ such practices in protecting their children against victimization and violence in the community. Applying an ecological framework, we use data from the Project on Human Development in Chicago Neighborhoods to examine the role of parenting and peer relationships on youth ETV-C, across race/ethnicity and immigrant generational status. Our sample is drawn from Cohorts 9, 12, and 15, and is over 40% Hispanic-Latino. We investigate the differences in within and outside the home family management strategies in terms of both race/ethnicity and immigrant generational status. Our work also seeks to determine the effects of race/ethnicity and immigrant status on youth ETV-C, while examining the influence of family management and peer relations. Results indicate that the adoption of family management practices is not homogeneous across Hispanic subgroups or immigrant generational status, and parenting practices seem to mediate the relationship between these characteristics and exposure to violence. Variations in parenting practices underscore the need to disentangle the cultural plurality of racial/ethnic grouping and how immigrant generational status influences parenting choices that protect children from exposure to violence in the community.

People Without Choice. Report of the 21st Anniversary Conference of the International Planned Parenthood Federation.

ERIC Educational Resources Information Center

Abel-Smith, Brian

Based on the premise that all people have a right to free choice in matters of family planning, the International Planned Parenthood Federation (IPPF) Conference proceedings included discussions on worldwide contraceptive practices, planned parenthood and socio-economic development, legal influences, and cultural barriers to family planning. Over…

Fostering Solutions: Bringing Brief-Therapy Principles and Practices to the Child Welfare System

ERIC Educational Resources Information Center

Flemons, Douglas; Liscio, Michele; Gordon, Arlene Brett; Hibel, James; Gutierrez-Hersh, Annette; Rebholz, Cynthia L.

2010-01-01

This article describes a 15-month university-community collaboration that was designed to fast-track children out of foster care. The developers of the project initiated resource-oriented "systems facilitations," allowing wraparound professionals and families to come together in large meetings to solve problems and find solutions. Families also…

The Contributions of Parenting and Postnatal Depression on Emergent Language of Children in Low-Income Families

ERIC Educational Resources Information Center

Zajicek-Farber, Michaela L.

2010-01-01

Children's emergent language develops in a rich context of varied influences afforded by their familial and social environments. Using data collected during a longitudinal prospective service project, this study examined the direct and indirect contributions of parenting knowledge and practices and maternal postnatal depression on emergent…

The Impact of Teachers and Families on Young Children's Eating Behaviors

ERIC Educational Resources Information Center

Eliassen, Erin K.

2011-01-01

Young children depend on their families and teachers to support their well-being and promote positive development, including eating behaviors. Children's food preferences and willingness to try new foods are influenced by the people around them. The eating behaviors children practice early in life affect their health and nutrition--significant…

A Tiered Model for Linking Students to the Community

ERIC Educational Resources Information Center

Meyer, Laura Landry; Gerard, Jean M.; Sturm, Michael R.; Wooldridge, Deborah G.

2016-01-01

A tiered practice model (introductory, pre-internship, and internship) embedded in the curriculum facilitates community engagement and creates relevance for students as they pursue a professional identity in Human Development and Family Studies. The tiered model integrates high-impact teaching practices (HIP) and student engagement pedagogies…

Evidence Synthesis for Knowledge Exchange: Balancing Responsiveness and Quality in Providing Evidence for Policy and Practice

ERIC Educational Resources Information Center

Morton, Sarah; Seditas, Karen

2018-01-01

Barriers to using research in practice are well documented. This paper describes an innovative process developed by the Centre for Research on Families and Relationships to address these barriers. We supported people to define what they needed to know; how existing evidence could help; and how to use evidence in practice. An action-focused…

Health is primary: Family medicine for America's health.

PubMed

Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

2014-10-01

More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support effective care; improving research underpinning primary care; and actively engaging patients, policy makers, and payers to develop an understanding of the value of primary care. The communications plan, called Health is Primary, will complement these strategies. Eight family medicine organizations have pledged nearly $20 million and committed representatives to a multiyear implementation team that will coordinate these plans in a much more systematic way than occurred with FFM. Family Medicine for America's Health is a new commitment by 8 family medicine organizations to strategically align work to improve practice models, payment, technology, workforce and education, and research to support the Triple Aim. It is also a humble invitation to patients and to clinical and policy partners to collaborate in making family medicine even more effective. © 2014 Annals of Family Medicine, Inc.

Nurses' Experiences of End-of-life Photography in NICU Bereavement Support.

PubMed

Martel, Sara; Ives-Baine, Lori

2018-06-07

To qualitatively explore neonatal intensive care nurses' experiences with end-of-life photography as part of their bereavement support work with families. An Interpretive Phenomenological Analysis with data collected through a focus group (n = 6) and one semi-structured interview (n = 1) with neonatal nurses from a Level 3/4 NICU in a Canadian pediatric hospital. Participants' comfort with EOL photography developed over time through exposure to bereavement scenarios and positive experiences with families. Participants' experienced a feeling of pressure to balance the photography with clinical responsibilities and find the right time to introduce photography while being sensitive to family experiences. Participants experienced EOL photography as something tangible to give families and were satisfied knowing the images might play an important role in the family's healing after the NICU. All participants had come to value EOL photography as a positive and meaningful part of their work with bereaved families. Identified challenges related to balancing the practice with the unpredictable flow and demands of critical care and to developing an appreciation for and comfort with the photography as part of their healing and the families' healing. Findings contribute insight into care-provider experience that can inform best practices, training, and staff support for palliative and bereavement work in neonatal and pediatric settings. The findings suggest a need to support nurses emotionally and clinically in carrying out this photography as part of their care for families. Copyright © 2018 Elsevier Inc. All rights reserved.

What is the evidence for using family based interventions to prevent stroke recurrence?

PubMed

Lawrence, Maggie; McVey, Caroline; Kerr, Susan

Stroke has a devastating impact on individuals and families. Risk factors for recurrence include lifestyle behaviours such as smoking, excessive alcohol consumption, an unhealthy diet and physical inactivity. This article describes a programme of research that aims to gather and synthesise the evidence required to inform the development and evaluation of a family centred, behavioural intervention designed to address lifestyle risk factors for recurrent stroke. We present an overview of the research undertaken to develop the evidence base. This included a survey of stroke nurse practice, a focus group study with people who had had a stroke as well as their family members, and a systematic review of the efficacy of lifestyle interventions.

Obstetrical Practice and Training in Canadian Family Medicine: Conserving an Endangered Species

PubMed Central

Klein, Michael; Reynolds, J. L.; Boucher, Francois; Malus, Michael; Rosenberg, Ellen

1984-01-01

Family practice obstetricians are an endangered species. Our practices and teaching sites must provide the correct attitudinal as well as technical messages to result in a practitioner who will be able to meet the psychosocial and medical needs of the pregnant couple. Family practice obstetrics can be as safe as care given by obstetricians provided that the family practice group functions well, that obstetrical consultants are available and supportive, and assuming that technical approaches are reserved for those truly in need. In rural areas, obstetrical ability is essential, whilst in the urban setting it helps the family physician maintain a practice involving young families. Those trainees who fail to learn basic obstetrical skills (including family centered attitudes and approaches) may in any setting come to feel, belatedly, that their training programs failed in this respect. PMID:21279123

Ethnic and Gender Differences in Family Social Support among Black Adolescents

PubMed Central

Taylor, Robert Joseph; Chatters, Linda M.

2018-01-01

This study examines black adolescents’ reports of the most helpful types of social support that they receive from and provide to family members, and whether family support exchanges vary by ethnicity (African American vs. Black Caribbean) and gender. Data for this study are from the National Survey of American Life Adolescent Supplement (NSAL-A), a national, probability sample of African American and Black Caribbean youth (ages 13–17). Overall, youth reported financial support, followed by emotional assistance and practical support as the most helpful types of support that they received. Practical and emotional assistance characterized the most commonly reported types of support that they provided to family members. Black Caribbean adolescents were more likely than African American adolescents to report financial and practical assistance as the most helpful types of support that they received from family members; no ethnic differences were observed in the provision of support to relatives. There were no significant gender differences in the receipt of support, but adolescent girls reported greater involvement in providing emotional support and caregiving than adolescent boys. The results of this paper reveal that African American and Black Caribbean adolescents are involved in a complex pattern of reciprocal support exchanges with their extended family members. Study findings also reinforce the importance of research focused on racial/ethnic and gender differences in family support exchanges in order to develop a more nuanced understanding of family support behaviors within these groups. PMID:29498638

The economic benefit for family/general medicine practices employing physician assistants.

PubMed

Grzybicki, Dana M; Sullivan, Paul J; Oppy, J Miller; Bethke, Anne-Marie; Raab, Stephen S

2002-07-01

To measure the economic benefit of a family/general medicine physician assistant (PA) practice. Qualitative description of a model PA practice in a family/general medicine practice office setting, and comparison of the financial productivity of a PA practice with that of a non-PA (physician-only) practice. The study site was a family/general medicine practice office in southwestern Pennsylvania. The description of PA practice was obtained through direct observation and semistructured interviews during site visits in 1998. Comparison of site practice characteristics with published national statistics was performed to confirm the site's usefulness as a model practice. Data used for PA productivity analyses were obtained from site visits, interviews, office billing records, office appointment logs, and national organizations. The PA in the model practice had a same-task substitution ratio of 0.86 compared with the supervising physician. The PA was economically beneficial for the practice, with a compensation-to-production ratio of 0.36. Compared with a practice employing a full-time physician, the annual financial differential of a practice employing a full-time PA was $52,592. Sensitivity analyses illustrated the economic benefit of a PA practice in a variety of theoretical family/general medicine practice office settings. Family/general medicine PAs are of significant economic benefit to practices that employ them.

Relationships, environment, and the brain: how emerging research is changing what we know about the impact of families on human development.

PubMed

Patterson, Jo Ellen; Vakili, Susanna

2014-03-01

Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development. © 2013 FPI, Inc.

Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey.

PubMed

Vaughn, Amber E; Dearth-Wesley, Tracy; Tabak, Rachel G; Bryant, Maria; Ward, Dianne S

2017-02-01

Parents' food parenting practices influence children's dietary intake and risk for obesity and chronic disease. Understanding the influence and interactions between parents' practices and children's behavior is limited by a lack of development and psychometric testing and/or limited scope of current measures. The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) was created to address this gap. This article describes development and psychometric testing of the HomeSTEAD family food practices survey. Between August 2010 and May 2011, a convenience sample of 129 parents of children aged 3 to 12 years were recruited from central North Carolina and completed the self-administered HomeSTEAD survey on three occasions during a 12- to 18-day window. Demographic characteristics and child diet were assessed at Time 1. Child height and weight were measured during the in-home observations (following Time 1 survey). Exploratory factor analysis with Time 1 data was used to identify potential scales. Scales with more than three items were examined for scale reduction. Following this, mean scores were calculated at each time point. Construct validity was assessed by examining Spearman rank correlations between mean scores (Time 1) and children's diet (fruits and vegetables, sugar-sweetened beverages, snacks, sweets) and body mass index (BMI) z scores. Repeated measures analysis of variance was used to examine differences in mean scores between time points, and single-measure intraclass correlations were calculated to examine test-retest reliability between time points. Exploratory factor analysis identified 24 factors and retained 124 items; however, scale reduction narrowed items to 86. The final instrument captures five coercive control practices (16 items), seven autonomy support practices (24 items), and 12 structure practices (46 items). All scales demonstrated good internal reliability (α>.62), 18 factors demonstrated construct validity (significant association with child diet, P<0.05), and 22 demonstrated good reliability (intraclass correlation coefficient>0.61). The HomeSTEAD family food practices survey provides a brief, yet comprehensive and psychometrically sound assessment of food parenting practices. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A perfect fit: connecting family therapy skills to family business needs.

PubMed

Cole, Patricia M; Johnson, Kit

2012-06-01

The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to couples therapy; (c) discussing how family therapists already have the practice wisdom to be effective in working with family business clients. Limitations of this practice are also discussed along with suggestions for overcoming them. © 2012 American Association for Marriage and Family Therapy.

The progress of family health nursing in remote and rural Scotland.

PubMed

Macduff, Colin

2005-12-01

Since 2001 the World Health Organization Europe's family health nurse (FHN) role has been developing in remote and rural areas of Scotland. In 2003, an independent evaluation identified a need for facilitation of the FHN role and family-health orientated approaches with local primary health care teams. The Scottish Executive Health Department appointed three part-time, regionally-based family health practice development facilitators (FHPDFs) in December 2003 to work over an 18-month period. This article presents findings from a small study which sought these FHPDFs' judgements on individual FHN autonomy and supportive colleague action at 24 sites where FHNs were practising. These judgements reveal a picture of mixed progress that is consistent with findings from other related research. This collective overview is presented in the form of a new typology and the resultant implications for future development of family health nursing are discussed.

Family Planning Policy Environment in the Democratic Republic of the Congo: Levers of Positive Change and Prospects for Sustainability.

PubMed

Mukaba, Thibaut; Binanga, Arsene; Fohl, Sarah; Bertrand, Jane T

2015-06-17

Building on expressed support from the Prime Minister to the Ministries of Health and Planning, the country's new family planning commitment grew out of: (1) recognition of the impact of family planning on maternal mortality and economic development; (2) knowledge sharing of best practices from other African countries; (3) participatory development of a national strategic plan; (4) strong collaboration between stakeholders; (5) effective advocacy by champions including country and international experts; and (6) increased donor support. The question becomes: Will the favorable policy environment translate into effective local programming?

Is work–family balance more than conflict and enrichment?

PubMed Central

Carlson, Dawn S.; Grzywacz, Joseph G.; Zivnuska, Suzanne

2009-01-01

This study deepens our theoretical and practical understanding of work–family balance, defined as the ‘accomplishment of role-related expectations that are negotiated and shared between an individual and his/her role-related partners in the work and family domains’ (Grzywacz & Carlson, 2007: 458). We develop a new measure of work–family balance and establish discriminant validity between it, work–family conflict, and work–family enrichment. Further, we examine the relationship of work–family balance with six key work and family outcomes. Results suggest that balance explains variance beyond that explained by traditional measures of conflict and enrichment for five of six outcomes tested: job satisfaction, organizational commitment, family satisfaction, family performance, and family functioning. We conclude with a discussion of the applications of our work. PMID:20148121

The balance and harmony of control power for a combat aircraft in tactical maneuvering

NASA Technical Reports Server (NTRS)

Bocvarov, Spiro; Cliff, Eugene M.; Lutze, Frederick H.

1992-01-01

An analysis is presented for a family of regular extremal attitude-maneuvers for the High Angle-of-Attack Research Vehicle that has thrust-vectoring capability. Different levels of dynamic coupling are identified in the combat aircraft attitude model, and the characteristic extremal-family motion is explained. It is shown why the extremal-family trajectories develop small sideslip-angles, a highly desirable feature from a practical viewpoint.

A Qualitative Study of the Impact of the London 2012 Olympics on Families in the East Midlands of England: Lessons for Sports Development Policy and Practice

ERIC Educational Resources Information Center

Mackintosh, Chris; Darko, Natalie; Rutherford, Zoe; Wilkins, Hetty-May

2015-01-01

The dynamics and culture of families are central to individual and community sport and physical activity participation. This research project examined the lived experiences and day-to-day realities of the London 2012 Olympics from the perspectives of five families in the East Midlands region of England. The aims of the project were to assess the…

Improving the nutrition and screen time environment through self-assessment in family childcare homes in Nebraska.

PubMed

Dev, Dipti A; Williams, Natalie; Iruka, Iheoma; Garcia, Aileen S; Guo, Yage; Patwardhan, Irina; Cummings, Katrina; Rida, Zainab; Hulse, Emily; Sedani, Ami

2018-06-01

To determine if family childcare homes (FCCH) in Nebraska meet best practices for nutrition and screen time, and if focusing on nutrition and screen time policies and practices improves the FCCH environment. A pre-post evaluation was conducted using the Go Nutrition and Physical Activity Self-Assessment for Childcare (Go NAP SACC). FCCH in Nebraska, USA. FCCH enrolled in the Child and Adult Care Food Program (CACFP; n 208) participated in a pre-post evaluation using Go NAP SACC. At baseline, all FCCH met the minimum childcare standards for fifty-four of fifty-six practices in nutrition and screen time. After the intervention, FCCH demonstrated significant improvement in fourteen of the forty-four Child Nutrition items and eleven of the twelve Screen Time items. However, FCCH providers did not meet best practices at post-intervention. Lowest scores were found in serving meals family-style, promoting visible support for healthy eating, planned nutrition education and written policy on child nutrition. For screen time, lowest scores were reported on the availability of television, offering families education on screen time and having a written policy on screen time. FCCH in Nebraska were able to strengthen their policies and practices after utilizing Go NAP SACC. Continued professional development and participation in targeted interventions may assist programmes in sustaining improved practices and policies. Considering the varying standards and policies surrounding FCCH, future studies comparing the current findings with childcare centres and non-CACFP programmes are warranted.

Health Is Primary: Family Medicine for America’s Health

PubMed Central

Phillips, Robert L.; Pugno, Perry A.; Saultz, John W.; Tuggy, Michael L.; Borkan, Jeffrey M.; Hoekzema, Grant S.; DeVoe, Jennifer E.; Weida, Jane A.; Peterson, Lars E.; Hughes, Lauren S.; Kruse, Jerry E.; Puffer, James C.

2014-01-01

PURPOSE More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to “renew the specialty to meet the needs of people and society,” some of which bore important fruit. Family Medicine for America’s Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). METHODS Family Medicine for America’s Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. RESULTS The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support effective care; improving research underpinning primary care; and actively engaging patients, policy makers, and payers to develop an understanding of the value of primary care. The communications plan, called Health is Primary, will complement these strategies. Eight family medicine organizations have pledged nearly $20 million and committed representatives to a multiyear implementation team that will coordinate these plans in a much more systematic way than occurred with FFM. CONCLUSIONS Family Medicine for America’s Health is a new commitment by 8 family medicine organizations to strategically align work to improve practice models, payment, technology, workforce and education, and research to support the Triple Aim. It is also a humble invitation to patients and to clinical and policy partners to collaborate in making family medicine even more effective. PMID:25352575

Invisible players: a family systems model.

PubMed

Hellstedt, Jon

2005-10-01

This article attempts to demonstrate that the family is a key player in the athlete's development and performance, sometimes invisible, but often all too visible. The practice of clinical sport psychology is enriched by a family-based orientation to the assessment and treatment of athletes. Creating a workable family system is a challenge for parents. They have many difficult decisions to make, and are often without support and direction in making those choices. Sport psychiatrists and psychologists can be helpful to parents as well as athletes by using family-based assessments and treatment interventions that provide education, challenge, and support as they negotiate the tasks and transitions in the family life cycle.

Opening the Black Box: Cognitive Strategies in Family Practice

PubMed Central

Christensen, Robert E.; Fetters, Michael D.; Green, Lee A.

2005-01-01

PURPOSE We wanted to describe the cognitive strategies used by family physicians when structuring the decision-making tasks of an outpatient visit. METHODS This qualitative study used cognitive task analysis, a structured interview method in which a trained interviewer works individually with expert decision makers to capture their stages and elements of information processing. RESULTS Eighteen family physicians of varying levels of experience participated. Three dominant themes emerged: time pressure, a high degree of variation in task structuring, and varying degrees of task automatization. Based on these data and previous research from the cognitive sciences, we developed a model of novice and expert approaches to decision making in primary care. The model illustrates differences in responses to unexpected opportunity in practice, particularly the expert’s use of attentional surplus (reserve capacity to handle problems) vs the novice’s choice between taking more time or displacing another task. CONCLUSIONS Family physicians have specific, highly individualized cognitive task-structuring approaches and show the decision behavior features typical of expert decision makers in other fields. This finding places constraints on and suggests useful approaches for improving practice. PMID:15798041

How family influences practice of obstetrics. Do married women family physicians make different choices?

PubMed

Brown, J B; Carroll, J; Reid, A

1996-07-01

To examine the influence of family, past and current, on married women family physicians' and to understand why and how some women continue to practise obstetrics. Purposive sample of nine married women family physicians who currently practise obstetrics. Qualitative in-depth interviews. Analysis identified four main influences of family on participants' practice of obstetrics: family of origin, transitions in the life cycle, children, and the marital relationship. These women described how they combined the roles of wife, mother, daughter, sister, and doctor. Family was a powerful influence throughout their practice lives. Finding a balance between the demands of practice, particularly obstetrics, and family relationships was an ongoing process. The process was also influenced by transitions in the life cycle.

The pond is wider than you think! Problems encountered when searching family practice literature.

PubMed Central

Rosser, W. W.; Starkey, C.; Shaughnessy, R.

2000-01-01

OBJECTIVE: To explain differences in the results of literature searches in British general practice and North American family practice or family medicine. DESIGN: Comparative literature search. SETTING: The Department of Family and Community Medicine at the University of Toronto in Ontario. METHOD: Literature searches on MEDLINE demonstrated that certain search strategies ignored certain key words, depending on the search engine and the search terms chosen. Literature searches using the key words "general practice," "family practice," and "family medicine" combined with the topics "depression" and then "otitis media" were conducted in MEDLINE using four different Web-based search engines: Ovid, HealthGate, PubMed, and Internet Grateful Med. MAIN OUTCOME MEASURES: The number of MEDLINE references retrieved for both topics when searched with each of the three key words, "general practice," "family practice," and "family medicine" using each of the four search engines. RESULTS: For each topic, each search yielded very different articles. Some search engines did a better job of matching the term "general practice" to the terms "family medicine" and "family practice," and thus improved retrieval. The problem of language use extends to the variable use of terminology and differences in spelling between British and American English. CONCLUSION: We need to heighten awareness of literature search problems and the potential for duplication of research effort when some of the literature is ignored, and to suggest ways to overcome the deficiencies of the various search engines. Images Figure 1 Figure 2 PMID:10660792

Issues in bilingualism and heritage language maintenance: perspectives of minority-language mothers of children with autism spectrum disorders.

PubMed

Yu, Betty

2013-02-01

The author investigated the language practices of 10 bilingual, Chinese/English-speaking, immigrant mothers with their children with autism spectrum disorders. The aim was to understand (a) the nature of the language practices, (b) their constraints, and (c) their impact. The author employed in-depth phenomenological interviews with thematic and narrative analyses to yield themes. Interviewees reported that they adopted language practices perceived to be advantageous to intervention access and wellness. They valued Chinese language but did not pursue its use if it was believed to hinder the children's overall development of English acquisition. All of the mothers believed that bilingualism made learning more challenging. Many believed that it caused confusion or exacerbated disabilities. These deficit views of bilingualism were commonly reinforced by professionals. All of the mothers were motivated to help their children learn English but had no assistance to do so. Practices were sustainable only when they were aligned with families' preferred communication patterns. There is an urgent need for practitioners to be better informed about issues related to intergenerational language practices in minority-language families. Language use between parents and children is a complex matter that is unique to each family. Parents need to be supported to make language use decisions that are self-enhancing and congruent with their families' needs.

Trends along the debt-income axis: implications for medical students' selections of family practice careers.

PubMed

Rosenthal, M P; Marquette, P A; Diamond, J J

1996-06-01

To examine whether medical students' levels of debt have an influence on selection of family practice careers, independent of other factors. Data from the Jefferson Longitudinal Study were analyzed for 1,350 graduates from the classes of 1987-1993 at Jefferson Medical College of Thomas Jefferson University; a focused analysis for 326 graduates from the classes of 1992 and 1993 was specifically performed to identify recent trends. A binary logistic regression equation was used to predict the probability of a graduate's entrance into a family practice residency based on first-year preference for family practice, income expectation, debt level, age, and gender. A high level of indebtedness (at least $75,000) was a significant independent predictor of specialty choice (away from family practice); first-year preference for family practice and income expectation were also significant independent predictors. Combining these three factors (debt, specialty preference, and income expectation) led to a greater than 12-fold difference in specialty selection of family practice. Notably, 36% of the students graduating in 1992-1993 had debts of at least $75,000, more than three times the percentage in the classes graduating in 1987-1989. High levels of debt had a significant negative effect on family practice specialty, choice among recent Jefferson graduates. An increase in the number of students with such debt carries strong implications for the selection of careers in family practice.

Caught in a dilemma: why do non-smoking women in China support the smoking behaviors of men in their families?

PubMed

Mao, Aimei; Bristow, Katie; Robinson, Jude

2013-02-01

Intimate relationships influence family members' health practices. Although cigarette smoking in China is predominantly a male behavior, (non-smoking) women's roles should be taken into account for the development of home-smoking interventions. Drawing on ethnographic interviews with 22 families in a rural area of China, this article explores non-smoking women's attitudes towards male smoking. The findings suggest that women's ability to influence male behavior is largely determined by culturally defined gender roles, underpinned by ideologies of familism and collectivism. Despite concerns about the adverse results of smoking to their family members and households, non-smoking women ultimately maintain the (male) smokers' argument that smoking plays an important role in construction and maintenance of intra- and extra-family relationships. By accepting male smoking and men's engagement in the social practice of smoking and cigarette exchanges, women maintain their identities as supportive wives, filial daughters/in-law and responsible family members who pursue family collective interests at the expense of their own personal beliefs. Future smoking control initiatives that target non-smoking women to influence male smoking should take into account the women's overarching need to maintain the status and harmony of their families.

Best practices in family-centered early intervention for children who are deaf or hard of hearing: an international consensus statement.

PubMed

Moeller, Mary Pat; Carr, Gwen; Seaver, Leeanne; Stredler-Brown, Arlene; Holzinger, Daniel

2013-10-01

A diverse panel of experts convened in Bad Ischl, Austria, in June of 2012 for the purpose of coming to consensus on essential principles that guide family-centered early intervention with children who are deaf or hard of hearing (D/HH). The consensus panel included parents, deaf professionals, early intervention program leaders, early intervention specialists, and researchers from 10 nations. All participants had expertise in working with families of children who are D/HH, and focus was placed on identifying family-centered practice principles that are specific to partnering with these families. Panel members reported that the implementation of family-centered principles was uneven or inconsistent in their respective nations. During the consensus meeting, they identified 10 agreed-upon foundational principles. Following the conference, they worked to refine the principles and to develop a document that described the principles themselves, related program and provider behaviors, and evidence supporting their use (drawing upon studies from multiple disciplines and nations). The goal of this effort was to promote widespread implementation of validated, evidence-based principles for family-centered early intervention with children who are deaf and hard of hearing and their families.

Validity and reliability of the Family Empowerment Scale for caregivers of adults with mental health issues.

PubMed

Kageyama, M; Nakamura, Y; Kobayashi, S; Yokoyama, K

2016-10-01

WHAT IS KNOWN ON THE SUBJECT?: Empowerment of family caregivers of adults with mental health issues has received increasing attention among mental health nurses in Japan and has been recognized as a new goal of family interventions. The Family Empowerment Scale (FES) was originally developed to measure the empowerment status of parents of children with emotional disorders. However, it was later applied to broader health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a Japanese version of the FES for family caregivers of adults with mental health issues (FES-AMJ) and examined the validity and reliability among parents. Results showed that the FES-AMJ had acceptable concurrent validity and reliability; however, insufficient construct validity was found, especially for the subscale regarding the service system. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important. Introduction The Family Empowerment Scale (FES) was originally developed for parents of children with emotional disorders. In Japan, family empowerment is gaining increasing attention and may be one goal of nursing interventions. Aim To develop a Japanese version of the FES for family caregivers of adults with mental health issues and to study the validity and reliability of this scale among parents. Method We translated the FES into Japanese and administered this self-report questionnaire to 275 parents. Results The multitrait scaling analysis revealed acceptable convergent validity and insufficient discriminant validity among all subscales. In particular, all items of the Service system subscale had insufficient discriminant and/or convergent validity. Each subscale significantly correlated with the indicator of empowerment. The intraclass correlation coefficients of each subscale were .855-.917. Cronbach's alpha of each factor ranged from .867 to .895. Discussion The Service system subscale may not linearly reflect family empowerment, and instead may depend on unclear roles of family caregivers of adults, disorder severity or insufficient services. Implications for practice Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important. © 2016 John Wiley & Sons Ltd.

Is a practice-based rural research network feasible in Europe?

PubMed

Klemenc-Ketis, Zalika; Kurpas, Donata; Tsiligianni, Ioanna; Petrazzuoli, Ferdinando; Jacquet, Jean-Pierre; Buono, Nicola; Lopez-Abuin, Jose; Lionis, Christos

2015-01-01

Research in family medicine is a well-established entity nationally and internationally, covering all aspects of primary care including remote and isolated practices. However, due to limited capacity and resources in rural family medicine, its potential is not fully exploited yet. An idea to foster European rural primary care research by establishing a practice-based research network has been recently put forward by several members of the European Rural and Isolated Practitioners Association (EURIPA) and the European General Practice Research Network (EGPRN). Two workshops on why, and how to design a practice-based research network among rural family practices in Europe were conducted at two international meetings. This paper revisits the definition of practice-based research in family medicine, reflects on the current situation in Europe regarding the research in rural family practice, and discusses a rationale for practice-based research in rural family medicine. A SWOT analysis was used as the main tool to analyse the current situation in Europe regarding the research in rural family practice at both meetings. The key messages gained from these meetings may be employed by the Wonca Working Party on research, the International Federation of Primary Care Research Network and the EGPRN that seek to introduce a practice-based research approach. The cooperation and collaboration between EURIPA and EGPRN creates a fertile ground to discuss further the prospect of a European practice-based rural family medicine research network, and to draw on the joint experience.

Science, Policy, and Practice: Three Cultures in Search of a Shared Mission.

ERIC Educational Resources Information Center

Shonkoff, Jack P.

2000-01-01

Discusses how child development research, social policy design, and human service delivery for children and families reflect three separate yet related cultures. Argues that transmitting knowledge from the academy to social policy and practice could be facilitated by a simple taxonomy differentiating established knowledge from both reasonable…

Maternal Belief Systems: The Discourse of Cultural Practice as Evidence

ERIC Educational Resources Information Center

Mastergeorge, Ann M.

2007-01-01

Fully developed definitions of evidence-based practice incorporate evidence from family perspectives, as well as evidence from research on the effectiveness of particular interventions. Systems for appraising research evidence typically place qualitative analyses at lower levels. The argument in this article is that qualitative data offer a…

Integrating Women's Issues in the Social Work Curriculum: A Proposal.

ERIC Educational Resources Information Center

Carter, Carolyn; And Others

1994-01-01

Social work faculty revising courses at Arizona State University's School of Social Work attempting to integrate content on women propose that development of new models reflecting women's experiences are required. Examples of curricular changes made using this approach are offered. They address direct practice, family practice,…

Parenting Latino Toddlers and Preschoolers: Clinical and Nonclinical Samples

ERIC Educational Resources Information Center

Perez, Maria E.; Fox, Robert A.

2008-01-01

Parenting practices contribute significantly to the social-emotional development of young children. There is limited literature that addresses the role of culture in parenting, particularly among Latino families who have very young children with significant behavior problems. The current study compared the parenting practices of 30 low-income…

Mental Health Practice Guidelines for Child Welfare

ERIC Educational Resources Information Center

Annie E. Casey Foundation, 2009

2009-01-01

The guidelines and supporting rationale presented in this paper were developed from the October 2007 "Best Practices for Mental Health in Child Welfare Consensus Conference" sponsored by Casey Family Programs, the Annie E. Casey Foundation and the REACH Institute (REsource for Advancing Children's Health). The purpose of the conference was to…

Kinship support and maternal and adolescent well-being in economically disadvantaged African-American families.

PubMed

Taylor, R D; Roberts, D

1995-12-01

This study tested a conceptual model developed to explain the link between kinship support and the psychological well-being of economically disadvantaged African-American adolescents. The relation of kinship support with maternal and adolescent well-being and mothers' child-rearing practices was assessed in 51 African-American families whose incomes placed them at or below the poverty threshold. Findings revealed that kinship social support to mothers/female guardians was positively associated with adolescent psychological well-being, maternal well-being, and more adequate maternal parenting practices (acceptance, firm control and monitoring of behavior, autonomy granting). Maternal well-being and more adequate maternal parenting practices were positively related to adolescent well-being. Evidence of the mediational role of maternal well-being and parenting practices was revealed. When the effects of maternal well-being and maternal parenting practices were controlled, significant relations between kinship support and adolescent well-being were no longer apparent.

[Development of standards for education and training in family and community medicine - contributions by WONCA IberoAmerica (CIMF)].

PubMed

Demarzo, Marcelo Marcos Piva; Marin, Anibal; Padula Anderson, Maria Inez; De Castro Filho, Eno Dias; Kidd, Michael

2011-02-01

The WONCA Education Working Party (WEP) is developing a set of standards for medical student education, postgraduate training in family medicine / general practice and continuing professional development for family doctors. At this point the contributions by WONCA world regions are very important, and for this reason the main objective of this report is to present the standards developed by the Iberoamerican WONCA Region (CIMF). To be comprehensive and effective, standards should reflect regional realities and so the contributions from CIMF may reinforce and strengthen the key initiative of WEP and the implementation of the standards throughout the world. Copyright © 2010 Elsevier España, S.L. All rights reserved.

PubMed Central

Baril, J.; Théoret, J.

1997-01-01

PROBLEM BEING ADDRESSED: Family medicine residents have difficulty developing the complex skills needed to work with families. OBJECTIVE OF PROGRAM: To develop an educational program to teach family medicine residents at Laval University a new type of family intervention technique, based on the systems approach, using a practical and interactive method. MAIN COMPONENTS OF PROGRAM: Using Brien's systematic planning model, the authors developed and tested a series of six interactive workshops on three themes. The first theme aims to motivate residents by showing them why it is important to use a systems approach with their patients. The second theme explores a family situation in an individual interview. The third enables residents to conduct a family interview. The whole program has been tested and evaluated. All of the materials needed to teach these skills are contained in a trainer's guide and a video cassette. CONCLUSION: This educational program's originality lies in its combination of the systems approach and interactive training for residents. The program could easily be presented as a continuing medical education activity. PMID:9333406

Educational role of nurse practitioners in a family practice centre: perspectives of learners and nurses.

PubMed

Walsh, Allyn; Moore, Ainsley; Barber, Anne; Opsteen, Joanne

2014-06-01

To examine the role of nurse practitioners (NPs) as educators of family medicine residents in order to better understand the interprofessional educational dynamics in a clinical teaching setting. A qualitative descriptive approach, using purposive sampling. A family practice centre that is associated with an academic department of family medicine and is based in an urban area in southern Ontario. First-year (8 of 9) and second-year (9 of 10) family medicine residents whose training program was based at the family practice centre, and all NPs (4 of 4) who worked at the centre. Semistructured interviews were conducted, which were audiotaped and transcribed. An iterative approach was used for coding and analysis. Data management software guided organization and analysis of the data. Four interconnected themes were identified: role clarification, professional identity formation, factors that enhance the educational role of NPs, and factors that limit the educational role of NPs. Although residents recognized NPs' value in team functioning and areas of specialized knowledge, they were unclear about NPs' scope of practice. Depending on residents' level of training, residents tended to respond differently to teaching by NPs. More of the senior residents believed they needed to think like physicians and preferred clinical teaching from physician teachers. Junior residents valued the step-by-step instructional approach used by NPs, and they had a decreased sense of vulnerability when being taught by NPs. Training in teaching skills was helpful for NPs. Barriers to providing optimal education included opportunity, time, and physician attitudes. The lack of an intentional orientation of family medicine residents to NPs' scope of practice and educational role can lead to difficulties in interprofessional education. More explicit recognition of the evolving professional identity of family medicine residents might decrease resistance to teaching by NPs and ensure that interprofessional teaching and learning strategies are effective. Faculty development opportunities for all educators are required to manage these issues, both to ensure teaching competencies and to reinforce positive interprofessional collaboration. Copyright© the College of Family Physicians of Canada.

Relationship between attention deficit hyperactive disorder symptoms and perceived parenting practices of school-age children.

PubMed

Kim, Dong Hee; Yoo, Il Young

2013-04-01

To examine the relationship between the perception on parenting practices and attention deficit hyperactivity disorder (ADHD) symptoms in school-age children. Psychosocial attention deficit hyperactivity disorder intervention approaches emphasise environmental risk factors at the individual, family and community level. Parenting variables are strongly related to attention deficit hyperactivity disorder symptom severity. A cross-sectional questionnaire survey. The participants were 747 children and their parents in two elementary schools. The instruments used were Korean Conners Abbreviated Parent Questionnaire and Korean version Maternal Behavior Research Instrument (measuring four dimensions of parenting practices: affection, autonomy, rejection, control). Descriptive and logistic regression analyses were performed. The rejective parenting practice was statistically significant in logistic regression controlling gender and age of children, family structure, maternal education level and socio-economic status. The rejection parenting is associated with attention deficit hyperactivity disorder symptoms in children (OR=1.356). These results suggest the importance of specific parenting educational programmes for parents to prevent and decrease attention deficit hyperactivity disorder symptoms. It would be more effective rather than focusing only on the child's attention deficit hyperactivity disorder symptoms, developing educational programmes for parents to prevent rejection parenting practice and improve parenting skills in the family system. When developing a treatment programme for children with attention deficit hyperactivity disorder, healthcare providers should consider not only the child's attention deficit hyperactivity disorder symptoms, but also the parenting practices. Comprehensive interventions designed to prevent rejection and improve parenting skills may be helpful in mitigating attention deficit hyperactivity disorder symptoms. © 2012 Blackwell Publishing Ltd.

A preliminary taxonomy of medical errors in family practice

PubMed Central

Dovey, S; Meyers, D; Phillips, R; Green, L; Fryer, G; Galliher, J; Kappus, J; Grob, P

2002-01-01

Objective: To develop a preliminary taxonomy of primary care medical errors. Design: Qualitative analysis to identify categories of error reported during a randomized controlled trial of computer and paper reporting methods. Setting: The National Network for Family Practice and Primary Care Research. Participants: Family physicians. Main outcome measures: Medical error category, context, and consequence. Results: Forty two physicians made 344 reports: 284 (82.6%) arose from healthcare systems dysfunction; 46 (13.4%) were errors due to gaps in knowledge or skills; and 14 (4.1%) were reports of adverse events, not errors. The main subcategories were: administrative failures (102; 30.9% of errors), investigation failures (82; 24.8%), treatment delivery lapses (76; 23.0%), miscommunication (19; 5.8%), payment systems problems (4; 1.2%), error in the execution of a clinical task (19; 5.8%), wrong treatment decision (14; 4.2%), and wrong diagnosis (13; 3.9%). Most reports were of errors that were recognized and occurred in reporters' practices. Affected patients ranged in age from 8 months to 100 years, were of both sexes, and represented all major US ethnic groups. Almost half the reports were of events which had adverse consequences. Ten errors resulted in patients being admitted to hospital and one patient died. Conclusions: This medical error taxonomy, developed from self-reports of errors observed by family physicians during their routine clinical practice, emphasizes problems in healthcare processes and acknowledges medical errors arising from shortfalls in clinical knowledge and skills. Patient safety strategies with most effect in primary care settings need to be broader than the current focus on medication errors. PMID:12486987

A preliminary taxonomy of medical errors in family practice.

PubMed

Dovey, S M; Meyers, D S; Phillips, R L; Green, L A; Fryer, G E; Galliher, J M; Kappus, J; Grob, P

2002-09-01

To develop a preliminary taxonomy of primary care medical errors. Qualitative analysis to identify categories of error reported during a randomized controlled trial of computer and paper reporting methods. The National Network for Family Practice and Primary Care Research. Family physicians. Medical error category, context, and consequence. Forty two physicians made 344 reports: 284 (82.6%) arose from healthcare systems dysfunction; 46 (13.4%) were errors due to gaps in knowledge or skills; and 14 (4.1%) were reports of adverse events, not errors. The main subcategories were: administrative failure (102; 30.9% of errors), investigation failures (82; 24.8%), treatment delivery lapses (76; 23.0%), miscommunication (19; 5.8%), payment systems problems (4; 1.2%), error in the execution of a clinical task (19; 5.8%), wrong treatment decision (14; 4.2%), and wrong diagnosis (13; 3.9%). Most reports were of errors that were recognized and occurred in reporters' practices. Affected patients ranged in age from 8 months to 100 years, were of both sexes, and represented all major US ethnic groups. Almost half the reports were of events which had adverse consequences. Ten errors resulted in patients being admitted to hospital and one patient died. This medical error taxonomy, developed from self-reports of errors observed by family physicians during their routine clinical practice, emphasizes problems in healthcare processes and acknowledges medical errors arising from shortfalls in clinical knowledge and skills. Patient safety strategies with most effect in primary care settings need to be broader than the current focus on medication errors.

Interviews of living kidney donors to assess donation-related concerns and information-gathering practices.

PubMed

Ruck, Jessica M; Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Massie, Allan B; Segev, Dorry L

2018-06-08

Efforts are underway to improve living kidney donor (LKD) education, but current LKD concerns and information-gathering preferences have not been ascertained to inform evidence-based resource development. As a result, prior studies have found that donors desire information that is not included in current informed consent and/or educational materials. We conducted semi-structured interviews with 50 LKDs who donated at our center to assess (1) concerns about donation that they either had personally before or after donation or heard from family members or friends, (2) information that they had desired before donation, and (3) where they sought information about donation. We used thematic analysis of verbatim interview transcriptions to identify donation-related concerns. We compared the demographic characteristics of participants reporting specific concerns using Fisher's exact test. We identified 19 unique concerns that participants had or heard about living kidney donation. 20% of participants reported having had no pre-donation concerns; 38% reported no post-donation concerns. The most common concern pre-donation was future kidney failure (22%), post-donation was the recovery process (24%), and from family was endangering their family unit (16%). 44% of participants reported being less concerned than family. 26% of participants wished they had had additional information prior to donating, including practical advice for recovery (10%) and information about specific complications (14%). Caucasian participants were more likely to hear at least one concern from family (76% vs. 33%, p = 0.02). The most commonly consulted educational resources were health care providers (100%) and websites (79% of donors since 2000). 26% of participants had had contact with other donors; an additional 20% desired contact with other LKDs. Potential donors not only have personal donation-related concerns but frequently hear donation-related concerns from family members and friends. Current gaps in donor education include an absence of practical, peer-to-peer advice about donation from other prior donors and materials directed and potential donors' family members and friends. These findings can inform the development of new educational practices and resources targeted not only at LKDs but at their social networks.

Factors influencing the provision of long-acting reversible contraception in California.

PubMed

Biggs, M Antonia; Harper, Cynthia C; Malvin, Jan; Brindis, Claire D

2014-03-01

To assess long-acting reversible contraception (LARC) beliefs and practices among site directors who represent the family planning services delivered in their practices. Medical directors from 1,000 sites listed in the Family Planning Access Care and Treatment program (California's family planning Medicaid program) provider database were mailed a survey in the fall of 2011 regarding their LARC beliefs and practices. Participants responded by mail, online, or telephone. Data on family planning clients served and LARC dispensing were obtained from administrative claims data. All analyses were limited to advanced practice clinician respondents. General estimating equation models identified the respondent and practice characteristics associated with LARC provision. After three follow-up mailings and telephone calls, 68% of eligible sites responded to the survey (636/939). Most respondents were physicians (448/587). They were most likely to consider women with a history of pelvic inflammatory disease unsuitable for hormonal (27%, n=161) and copper (26%, n=154) intrauterine devices. Smokers were the most likely to be considered unsuitable for the implant (16%, n=96). Nearly three fourths of respondents routinely discussed intrauterine devices (413/561) and half (271/558) discussed implants with their contraceptive patients. Characteristics that predicted onsite LARC provision included LARC training, beliefs, and health care provider type. Although there has been significant progress in expanding access and understanding about LARC, many clinicians from sites offering family planning services held beliefs limiting the provision of intrauterine devices and were unfamiliar with the implant, suggesting the need for targeted trainings aimed at informing clinicians of recent developments in LARC recommendations.

Environmental health training: a survey of family practice residency program directors.

PubMed

Musham, C; Bellack, J P; Graber, D R; Holmes, D

1996-01-01

The Institute of Medicine and the American College of Physicians have advocated that physicians broaden their participation in the environmental aspects of medical care. Accordingly, both organizations recommend training of future primary care physicians for greater competency in and appreciation of this area of medicine. This study assessed the present emphasis on environmental health in family practice residency programs by examining the extent program directors expect graduates to have specific competencies in environmental medicine. A written survey was mailed to directors of all 393 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs. Respondents were asked to indicate the extent to which each of eight environmental health competencies was expected of their graduates. The list of environmental health competencies was based on the literature and on interviews with family practice educators. Perceptions about the "present" and "ideal" environmental health emphasis in their programs were also measured. A total of 262 completed surveys were returned for a response rate of 67%. Respondents reported that they expected their graduates to have general knowledge of and competence in environmental health areas that pertain to patient care. Competencies with social and political implications were least likely to be expected. Two thirds of respondents indicated that "minimal emphasis" is presently placed on environmental health. Seventy percent indicated that the "ideal" amount of emphasis placed on this topic is "moderate." This survey's results suggest that family practice residency program directors expect their graduates to know basic environmental health concepts and be skilled in related aspects of patient care. The development of environmental health training programs must take into account that environmental health may be viewed as a topic of secondary importance and that in most residencies, faculty expertise in this area is limited. For this reason, a self-tutoring strategy, aimed toward the educational needs of both faculty and residents, is recommended.

A Patient Record-Filing System for Family Practice

PubMed Central

Levitt, Cheryl

1988-01-01

The efficient storage and easy retrieval of quality records are a central concern of good family practice. Many physicians starting out in practice have difficulty choosing a practical and lasting system for storing their records. Some who have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems. This article describes a new filing system installed simultaneously with a new computer system in a family-practice teaching centre. The approach adopted solved all identifiable problems and is applicable in family practices of all sizes.

Linkage between Graduate Medical Education Training Practice Profiles in Psychiatry, Obstetrics/Gynecology, and Family Practice. Appendices.

ERIC Educational Resources Information Center

SysteMetrics, Inc., Santa Barbara, CA.

Provided are appendices for a study which examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Appendix A includes materials related to methodology of the study. Appendices B-D include supplementary materials for family practice,…

Maternal Food-Related Practices, Quality of Diet, and Well-Being: Profiles of Chilean Mother-Adolescent Dyads.

PubMed

Schnettler, Berta; Grunert, Klaus G; Lobos, Germán; Miranda-Zapata, Edgardo; Denegri, Marianela; Hueche, Clementina

2018-04-03

To identify mother-adolescent dyad profiles according to food-related parenting practices and to determine differences in diet quality, family meal frequency, life satisfaction, and sociodemographic characteristics. Cross-sectional study. Mothers and children were surveyed in their homes or at schools in Temuco, Chile. A total of 300 mothers (average age, 41.6 years) and their adolescent children (average age, 13.2 years; 48.7% female). Maternal feeding practices using the abbreviated Family Food Behavior Survey (AFFBS), life satisfaction, food-related and family life satisfaction, diet quality, and eating habits. Principal component factor analysis and confirmatory factor analysis were used to verify Family Food Behavior Survey components in mother and adolescent subsamples. Hierarchical cluster analysis was used to identify profiles. Three AFFBS components were detected: maternal control of child snacking behavior, maternal presence during eating, and child involvement in food consumption. Cluster analysis identified 3 mother-adolescent dyad profiles with different food-related parenting practices (P ≤ .001), mother (P ≤ .05) and child (P ≤ .001) diet quality, frequency of shared family meals (P ≤ .001), and mother (P ≤ .001) and child (P ≤ .05) life satisfaction levels. Results indicated that maternal well-being increased with an increased frequency of shared mealtime. Significantly, in contrast to the findings of previous studies, greater control over child eating habits was shown to affect adolescent well-being positively. These findings, among others, may contribute to the development of strategies for improving diet quality, overall well-being, and well-being in the food and family domains for all family members. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Utilization of the Family and Medical Leave Act in Radiology Practices According to the 2016 ACR Commission on Human Resources Workforce Survey.

PubMed

Arleo, Elizabeth Kagan; Parikh, Jay R; Wolfman, Darcy; Gridley, Daniel; Bender, Claire; Bluth, Edward

2016-12-01

To assess gender utilization of the Family and Medical Leave Act (FMLA) in radiology practices across the United States. The Practice of Radiology Environment Database was utilized to identify U.S. practice leaders, who were asked to complete an electronic survey developed by the ACR Human Resources (HR) Commission. In 2016, new survey questions asked about number of radiologists in each practice who took FMLA, the reasons why, the average number of weeks taken, and how such absences were covered. Thirty-two percent (579/1815) of practice group leaders responded to the survey and of these, 73% (432/579) answered FMLA questions, with 15% of those (64/432) answering affirmatively that a radiologist in their practice had taken FMLA leave. Reasons for this in 2015 included to care for a newborn/adopted child (49%), because of a personal serious health condition (42%), to care for an immediate family member (8%), or for active military duty (1%). Women took a greater number of weeks of FMLA leave than men for all reasons (care of newborn/adopted child: 10.7 versus 4.7; personal serious health condition: 10.3 versus 8.0; care of immediate family member: 9.7 versus 8.7) except for military duty (24 weeks taken, all by men). At least 69% of leave time was paid, irrespective of reason for leave or gender of person taking it. Most practices (82%) made no workforce changes to cover FMLA leave. Both genders of radiologists needed absences from work for FMLA-sanctioned reasons. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Peer support for families of children with complex needs: Development and dissemination of a best practice toolkit.

PubMed

Schippke, J; Provvidenza, C; Kingsnorth, S

2017-11-01

Benefits of peer support interventions for families of children with disabilities and complex medical needs have been described in the literature. An opportunity to create an evidence-informed resource to synthesize best practices in peer support for program providers was identified. The objective of this paper is to describe the key activities used to develop and disseminate the Peer Support Best Practice Toolkit. This project was led by a team of knowledge translation experts at a large pediatric rehabilitation hospital using a knowledge exchange framework. An integrated knowledge translation approach was used to engage stakeholders in the development process through focus groups and a working group. To capture best practices in peer support, a rapid evidence review and review of related resources were completed. Case studies were also included to showcase practice-based evidence. The toolkit is freely available online for download and is structured into four sections: (a) background and models of peer support, (b) case studies of programs, (c) resources, and (d) rapid evidence review. A communications plan was developed to disseminate the resource and generate awareness through presentations, social media, and champion engagement. Eight months postlaunch, the peer support website received more than 2,400 webpage hits. Early indicators suggest high relevance of this resource among stakeholders. The toolkit format was valuable to synthesize and share best practices in peer support. Strengths of the work include the integrated approach used to develop the toolkit and the inclusion of both the published research literature and experiential evidence. © 2017 John Wiley & Sons Ltd.

Community pharmacist-delivered Medicare Annual Wellness Visits within a family medicine practice.

PubMed

Evans, Taylor A; Fabel, Patricia H; Ziegler, Bryan

To identify the steps to implement a community pharmacist into a family medicine practice to deliver Medicare Annual Wellness Visits (AWVs). Medicine Mart Pharmacy is a locally owned and operated pharmacy that has served the West Columbia, SC, area for over 30 years. The services offered by the pharmacy have expanded over the past 3 years through the addition of a community pharmacy resident. A stepwise approach was developed for a community pharmacist to identify, market, and establish an AWV service through a collaborative practice agreement with a local family medicine practice. The pharmacy team contacted each office and obtained information about the physician practices and their willingness to participate in the program. Two financial models were created and evaluated to determine budget implications. Many patients were seen at the physician offices; they were eligible for AWV, but had not received them. Meetings were scheduled with 3 of the 6 offices; however, none of the offices moved forward with the proposed program. Integrating a pharmacist into the AWV role may be profitable to both the pharmacy and the medical office with persistence and time to have a successful collaboration. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Knowledge, Attitude and Practice of Family Physicians Regarding Smoking Cessation Counseling in Family Practice Centers, Suez Canal University, Egypt

PubMed Central

Eldein, Hebatallah Nour; Mansour, Nadia M.; Mohamed, Samar F.

2013-01-01

Introduction: Family physicians are the first point of medical contact for most patients, and they come into contact with a large number of smokers. Also, they are well suited to offer effective counseling to people, because family physicians already have some knowledge of patients and their social environments. Aims: The present study was conducted to assess family physicians’ knowledge, attitude and practice of smoking cessation counseling aiming to improve quality of smoking cessation counseling among family physicians. Materials and Methods: The study was descriptive analytic cross sectional study. It was conducted within family medicine centers. Sample was comprehensive. it included 75 family physicians. They were asked to fill previously validated anonymous questionnaire to collect data about their personal characteristics, knowledge, attitude and practice of smoking cessation counseling, barriers and recommendations of physicians. Equal or above the mean scores were used as cut off point of the best scores for knowledge, attitude and practice. Statistical Analysis: SPSS version 18 was used for data entry and statistical analysis. Results: The best knowledge, attitude and practice scores among family physicians in the study sample were (45.3 %, 93.3% and 44% respectively). Age (P = 0.039) and qualification of family physicians (P = 0.04) were significant variables regarding knowledge scores while no statistically significance between personal characteristics of family physicians and their attitude or practice scores regarding smoking cessation counseling. More than half of the family physicians recommended training to improve their smoking cessation counseling. Conclusions: Favorable attitude scores of family physicians exceed passing knowledge scores or practice scores. Need for knowledge and training are stimulus to design an educational intervention to improve quality of smoking cessation counseling. PMID:24479071

Knowledge, attitude and practice of family physicians regarding smoking cessation counseling in family practice centers, suez canal university, egypt.

PubMed

Eldein, Hebatallah Nour; Mansour, Nadia M; Mohamed, Samar F

2013-04-01

Family physicians are the first point of medical contact for most patients, and they come into contact with a large number of smokers. Also, they are well suited to offer effective counseling to people, because family physicians already have some knowledge of patients and their social environments. The present study was conducted to assess family physicians' knowledge, attitude and practice of smoking cessation counseling aiming to improve quality of smoking cessation counseling among family physicians. The study was descriptive analytic cross sectional study. It was conducted within family medicine centers. Sample was comprehensive. it included 75 family physicians. They were asked to fill previously validated anonymous questionnaire to collect data about their personal characteristics, knowledge, attitude and practice of smoking cessation counseling, barriers and recommendations of physicians. Equal or above the mean scores were used as cut off point of the best scores for knowledge, attitude and practice. SPSS version 18 was used for data entry and statistical analysis. The best knowledge, attitude and practice scores among family physicians in the study sample were (45.3 %, 93.3% and 44% respectively). Age (P = 0.039) and qualification of family physicians (P = 0.04) were significant variables regarding knowledge scores while no statistically significance between personal characteristics of family physicians and their attitude or practice scores regarding smoking cessation counseling. More than half of the family physicians recommended training to improve their smoking cessation counseling. Favorable attitude scores of family physicians exceed passing knowledge scores or practice scores. Need for knowledge and training are stimulus to design an educational intervention to improve quality of smoking cessation counseling.

Design and development of a family of explosive ordnance disposal (EOD) robots

NASA Astrophysics Data System (ADS)

Reichard, Karl; Simpson, Tim; Rogan, Chris; Merenich, John; Brennan, Sean; Crow, Ed

2008-10-01

Across many consumer product industries, the prevailing practice is to design families of product variants that exploit commonality to provide the ability to easily customize a base platform for particular uses and to take advantage of commonality for streamlining design, manufacturing, maintenance and logistic; examples include Black & Decker, Seagate, and Volkswagen. This paper describes the application of product family concepts to the design and development of a family of robots to satisfy requirements for explosive ordnance disposal. To facilitate this process, we have developed a market segmentation grid that plots the desired capabilities and cost versus the target use cases. The product family design trade space is presented using a multi-dimensional trade space visualization tool which helps identify dependencies between different design variables and identify Pareto frontiers along which optimal design choices will lie. The EOD robot product family designs share common components and subsystems yet are modularized and scalable to provide functionality to satisfy a range of user requirements. This approach has been shown to significantly reduce development time and costs, manufacturing costs, maintenance and spare parts inventory, and operator and maintainer training.

Discrimination concerns and expectations as explanations for gendered socialization in African American families.

PubMed

Varner, Fatima; Mandara, Jelani

2013-01-01

Discrimination concerns and parental expectations were examined as mediators of the relations between gender and parenting practices among 796 African American mothers of 11- to 14-year-olds from the Maryland Adolescent Development in Context Study. Mothers of sons had more concerns about racial discrimination impacting their adolescents' future, whereas mothers of daughters had more gender discrimination concerns. Racial discrimination concerns, but not gender discrimination concerns, were related to lower maternal academic and behavioral expectations. Maternal expectations were related to mothers' responsiveness, rule enforcement, monitoring, and parent-adolescent conflict. The relations between gender and parenting practices were partially explained through mothers' racial discrimination concerns and expectations. These findings demonstrate the importance of contextual factors on African American family processes. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

Rural exposure during medical education and student preference for future practice location - a case of Botswana.

PubMed

Arscott-Mills, Tonya; Kebaabetswe, Poloko; Tawana, Gothusang; Mbuka, Deogratias O; Makgabana-Dintwa, Orabile; Sebina, Kagiso; Kebaetse, Masego; Mokgatlhe, Lucky; Nkomazana, Oathokwa

2016-06-10

Botswana's medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum. This study explored the impact of rural training on students' attitudes towards rural practice. The University of Botswana family medicine rural training sites, Maun and Mahalapye. The study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis. The thirty-six participants' age averaged 23 years and 48.6% were male. Thirtythree desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice. The majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.Keyords: rural health, student perceptions.

Pets in the family: practical approaches.

PubMed

Hodgson, Kate; Darling, Marcia

2011-01-01

Adapting family life cycle theory to include pets provides veterinarians with a framework for understanding and reinforcing the human-animal bond. The family genogram with pets is a practice tool that identifies all people and pets in the family, enhancing the practice of One Health at the community level.

Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

PubMed

Fries, Christopher J

2008-11-01

ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not.

Preparing for an influenza pandemic: model of an immunization clinic in an urban family practice

PubMed Central

Bourgeois, Nicole; Franke, Carolyn; O’Connor, Shirlee A.; Shaw, Holly; Hum, Susan; Dunn, Sheila

2011-01-01

Abstract Problem addressed The surge in patient demand for the H1N1 influenza vaccine during the 2009 pandemic. Objective of the program To facilitate timely delivery of the 2009 H1N1 influenza vaccine to a family practice population while preserving regular clinic function and to create a model of effective vaccination delivery for future outbreaks. Program description An academic family practice in Toronto, Ont, adopted a process-improvement approach and implemented 3 Saturday stand-alone H1N1 vaccination clinics to accommodate increased demand for the vaccine. Medical directives were developed to give nurses the authority to vaccinate patients. Consent forms with eligibility criteria and risks versus benefits sheets were provided to patients in the waiting area to make optimal use of time. The clinic with “appointment blocks” for patients had improved efficiency (ie, fewer bottlenecks from waiting area to vaccination room), which was satisfactory to both staff and patients. Conclusion During a pandemic, when patient demand for vaccination is high, such stand-alone vaccination clinics in conjunction with family practices can deliver vaccines to patients in a timely and acceptable manner while promoting continuity of care. This model requires the commitment of extra staffing resources if regular primary care delivery is to be maintained. PMID:21998244

ASSESSING PARENTING IN THE CONTEXT OF REUNIFICATION OF INFANTS/TODDLERS AND THEIR FAMILIES: HOW TO FACE THE CHALLENGES?

PubMed

Vischer, Anne-Fleur W K; Grietens, Hans; Knorth, Erik J; Mulder, Hans

2017-05-01

Since a substantial portion of infants and toddlers reenter care after reunification, the question of whether family reunification is feasible needs to be answered very cautiously. How parenting is assessed is of major importance in answering this question, but the quality of these assessments is often poor. With an eye to improving current practice, we conducted an integrative review, in which we analyzed the challenges related to the assessment of parenting vis-à-vis reunification and linked relevant knowledge from research with significant know-how from practice. The challenges appear to be embedded in the struggle to define (especially good enough) parenting and the complex context of child protection. As an answer to the challenges, the integrative review resulted in a framework of four key components required for sufficient parenting-assessment practice: (a) the use and development of expertise; and (b) providing families aiming for reunification with an intervention that is intensive, (c) flexible, and (d) organized as teamwork. Providing families with such an intervention gives them the opportunity to make substantial changes in their parenting and helps professionals assess the capacity of parents to grow to an acceptable level of caretaking for their child. Further implications for research and practice are discussed. © 2017 Michigan Association for Infant Mental Health.

Organization of professional practices against intrafamily violence against children and adolescents in the institutional context 1

PubMed Central

Schek, Gabriele; da Silva, Mara Regina Santos; Lacharité, Carl; Bueno, Maria Emília Nunes

2017-01-01

ABSTRACT Objective: to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. Method: qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. Results: the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. Conclusion: the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents. PMID:28591297

Results of the peer assessment program of the College of Physicians and Surgeons of Ontario.

PubMed Central

McAuley, R G; Henderson, H W

1984-01-01

This paper describes the experience of the College of Physicians and Surgeons of Ontario in developing and conducting a program for the peer assessment of physicians' office practices that would allow the standards of medical practice to be reviewed and assessed. Following two pilot projects in 1978 and 1979 that demonstrated the need, the feasibility and the acceptance of a peer assessment program the office practices of 391 randomly selected physicians were reviewed in 1981 and 1982. Included in the sample were 255 general/family practitioners and 136 specialists in seven fields. Serious deficiencies were found in the medical records of or in the care provided by 30 of the general/family practitioners and 3 of the specialists, accounting for 8% of the practices studied. The difference between the two groups of physicians was statistically significant (p less than 0.01). No predictors of significance were demonstrated in the general/family practitioner group. When follow-up assessments were done most of the physicians were found to have made the improvements that had been recommended. PMID:6478338

Career Development Trends and Issues in the United States.

ERIC Educational Resources Information Center

Hansen, L. Sunny

1993-01-01

Discusses global economic, political, and social trends affecting the workplace, families, education, and gender roles. Depicts current career development programs and practices with children and young, midlife, and older adults. Presents current issues in schools, adult education, and business/industry for career development. (SK)

Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

ERIC Educational Resources Information Center

Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

2015-01-01

This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

Parenting Practices in Preschool Leading to Later Cognitive Competence: A Family Stress Model

ERIC Educational Resources Information Center

Nievar, M. Angela; Moske, Amanda Kay; Johnson, Deborah Jean; Chen, Qi

2014-01-01

Research Findings: This study investigates the effect of the early home environment on self-regulation in preschoolers, and how self-regulation relates to later school achievement, while taking into account family resources. Participants were part of the National Institute of Child Health and Human Development's Study of Early Child Care and Youth…

Navigating Racialized Contexts: The Influence of School and Family Socialization on African American Students' Racial and Educational Identity Development

ERIC Educational Resources Information Center

McCoy, Shuntay Z.

2013-01-01

Within the United States, African American students experience school socialization that exposes them to racial segregation, economic stratification, and route learning masked as education. Consequently African American families are compelled to engage in socialization practices that buffer against the adverse influences of racism, oppression, and…

Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

ERIC Educational Resources Information Center

Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

2015-01-01

This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary First Step was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

The Safe Environment for Every Kid (SEEK) Model: Helping Promote Children's Health, Development, and Safety

ERIC Educational Resources Information Center

Dubowitz, Howard

2013-01-01

Child maltreatment affects millions of children each year. health care providers are increasingly called upon to address such psychosocial problems facing many families. In this article, the authors describe a practical approach to further enhance pediatric primary care and make it more responsive to the needs of children and families. The Safe…

Rearing the Sad or Mad: Differentiating the Family Environments of Depressed versus Conduct Disordered Youth

ERIC Educational Resources Information Center

Jewell, Jeremy D.; Beyers, Sarah

2008-01-01

The following review examines the current literature on parental depression and its characteristic family environment and parenting styles that may be related to the development of Conduct Disorder (CD) or depression in children. A description of the depressed parent and the general effects of depression on parenting and discipline practices are…

Working with Adolescents: A Guide for Practitioners. Social Work Practice with Children and Families Series

ERIC Educational Resources Information Center

Laser, Julie Anne; Nicotera, Nicole

2010-01-01

This state-of-the-art practitioner resource and course text provides a comprehensive view of adolescent development and spells out effective ways to help teens who are having difficulties. The book illuminates protective and risk factors in the many contexts of adolescents' lives, from individual attributes to family, school, neighborhood, and…

Parental Bookreading Practices among Families in the Netherlands

ERIC Educational Resources Information Center

Duursma, Elisabeth

2014-01-01

Bookreading has proven to be beneficial for children's language and literacy development (e.g. Bus, Van Ijzendoorn and Pellegrini, 1995; Fletcher and Reese, 2005; Mol and Bus, 2011a). Families in Western countries are often advised to read to their young children, and many parents appear to be aware of the positive effects of bookreading. However,…

Three Principles to Improve Outcomes for Children and Families. Science to Policy and Practice

ERIC Educational Resources Information Center

Cohen, Steven D.

2017-01-01

The science of child development and the core capabilities of adults point to a set of "design principles" that policymakers and practitioners in many different sectors can use to improve outcomes for children and families. That is, to be maximally effective, policies and services should: (1) support responsive relationships for children…

Teacher Educators' and Student Teachers' Beliefs about Preparation for Working with Families Including Those from Diverse Socioeconomic and Cultural Backgrounds

ERIC Educational Resources Information Center

D'Haem, Jeanne; Griswold, Peter

2017-01-01

This mixed-methods study examined teacher preparation for developing family partnerships. The attitudes and practices of teacher educators and the attitudes and experiences of student teachers were explored in focus groups, documents, and a survey instrument. Results indicated that although partnerships were considered important by faculty and…

Families' Roles in Children's Literacy in the UK throughout the 20th Century

ERIC Educational Resources Information Center

Nutbrown, Cathy; Clough, Peter; Levy, Rachael; Little, Sabine; Bishop, Julia; Lamb, Terry; Yamada-Rice, Dylan

2017-01-01

This paper explores the changing roles of families in children's developing literacy in the UK in the last century. It discusses how, during this time, understandings of reading and writing have evolved into the more nuanced notion of "literacy." Further, in acknowledging changes in written communication practices, and shifting attitudes…

Focused development of advanced practice nurse roles for specific patient groups in a Swiss university hospital

PubMed

Spichiger, Elisabeth; Zumstein-Shaha, Maya; Schubert, Maria; Herrmann, Luzia

2018-02-01

Background: To cover future health care needs of the population, new care models are necessary. The development of advanced nursing practice (ANP) offers the opportunity to meet these challenges with novel services. At the Inselspital, Bern University Hospital, ANP services and corresponding advanced practice nurse (APN) roles have been developed since 2011. Purpose: The aim is to develop innovative and evidence based ANP services to supplement health care for specific patient groups and their family members with the goal to improve safety and achieve better outcomes. Methods: Project-based ANP services are developed in close collaboration of clinical departments and the Nursing Development Unit (NDU) of the Directorate of Nursing. Structure, process and outcome data are collected for evaluation. Findings: Currently, five ANP services are established and running, eight more are in the developmental phase. Most services address the long term care of patients with chronic illnesses and their family members. Ten APNs work between 10 % and 80 %, three are leading an ANP-team. APNs work over 50 % in direct clinical practice, primarily in counselling. An ANP network connects APNs and NDU, promoting synergy and exchange. Conclusions: The available resources often constitute a challenge for the development of ANP services. Vital for the long-term success are an adequate extent of the position, the support by department directorate, the conceptual framework that is implemented across the whole hospital, and the development within project structures.

Integrating self-help materials into mental health practice.

PubMed

Church, Elizabeth; Cornish, Peter; Callanan, Terrence; Bethune, Cheri

2008-10-01

Patients' mental health issues have become an increasing focus of Canadian family physicians' practices. A self-help approach can help meet this demand, but there are few guidelines for professionals about how to use mental health self-help resources effectively. To aid health professionals in integrating self-help materials into their mental health practices. A resource library of print, audiotape, and videotape self-help materials about common mental health issues was developed for a rural community. The materials were prescreened in order to ensure high quality, and health professionals were given training on how to integrate self-help into their practices. The library was actively used by both health professionals and community members, and most resources were borrowed, particularly the nonprint materials. Health professionals viewed the resources as a way to supplement their mental health practice and reduce demands on their time, as patients generally worked through the resources independently. Some improvements are planned for future implementations of the program, such as providing health professionals with a "prescription pad" of resources and implementing Stages of Change and stepped-care models to maximize the program's effectiveness. Although more evidence is needed regarding the effectiveness of self-help within a family practice context, this program offers a promising way for family physicians to address mild to moderate mental health problems.

Family, employment, and individual resource-based antecedents of maternal work-family enrichment from infancy through middle childhood.

PubMed

Zhou, Nan; Buehler, Cheryl

2016-07-01

This study used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N = 1,019) to examine family, employment, and individual antecedents of maternal work-family enrichment from infancy through middle childhood. Work-family conflict and important confounding factors were controlled. From the family domain, higher income-to-needs ratio and social support were associated with higher work-family enrichment. From the employment domain, greater job rewards, benefits of employment for children, and work commitment were associated with higher work-family enrichment. From the individual domain, higher maternal education and extroversion were associated with higher work-family enrichment. No family, employment, and individual characteristics were associated with work-family conflict across time except for partner intimacy. In general, the results supported antecedents of work-family enrichment that supply needed resources. The present study contributed to the literature by identifying antecedents of maternal work-family enrichment across early child developmental stages, which goes beyond examinations of particular life stages and a work-family conflict perspective. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Compassion fatigue and compassion satisfaction among family physicians in the Republic of Srpska, Bosnia and Herzegovina.

PubMed

Račić, Maja; Virijević, Aleksandra; Ivković, Nedeljka; Joksimović, Bojan N; Joksimović, Vedrana R; Mijovic, Biljana

2018-03-19

The aim of this study was to examine self-perceived compassion fatigue and compassion satisfaction among family physicians in Bosnia and Herzegovina and describe potential contributing factors. The cross-sectional study enrolled 120 family physicians. Professional quality of life compassion satisfaction and fatigue version 5 (ProQOL5) was used to assess compassion satisfaction and two components of compassion fatigue, secondary traumatic stress and burnout. The symptoms of chronic fatigue were evaluated using the Chalder fatigue scale. The majority of family physicians had moderate levels of compassion satisfaction (70%), burnout (75%) and secondary traumatic stress (55.8%). Family physicians with higher levels of secondary traumatic stress reported chronic fatigue (p = 0.001), longer length of service (p = 0.024) and residency training (p = 0.041). Chronic fatigue (p = 0.001), living in a rural environment (p = 0.033), larger size of practice (p = 0.006) and high number of patients with chronic disease (p = 0.001) were associated with a higher risk of burnout. Family physicians with large practices, long years of experience, a high number of chronically ill patients and experiencing chronic fatigue are at risk of developing compassion fatigue. A systematic exploration of compassion fatigue in relation to working conditions might provide an appropriate starting point for the development of preventive interventions.

Reflective education for professional practice: discovering knowledge from experience.

PubMed

Lyons, J

1999-01-01

To continually develop as a discipline, a profession needs to generate a knowledge base that can evolve from education and practice. Midwifery reflective practitioners have the potential to develop clinical expertise directed towards achieving desirable, safe and effective practice. Midwives are 'with woman', providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice. Midwife educators and practitioners can assist students and enhance their learning by expanding the scope of practice, encouraging self-assessment and the development of reflective and professional skills. This paper explores journal writing as a learning strategy for the development of reflective skills within midwifery and explores its value for midwifery education. It also examines, through the use of critical social theory and adult learning principles, how midwives can assist and thus enhance students learning through the development of professional and reflective skills for midwifery practice.

Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.

PubMed

Smoliak, Olga; Le Couteur, Amanda; Quinn-Nilas, Christopher

2018-03-08

Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis-and of conversation analytic inquiry more generally-for the practice of family therapy. © 2018 American Association for Marriage and Family Therapy.

Meeting report: ‘How do I incorporate research into my family practice?’: Reflections on experiences of and solutions for young family doctors

PubMed Central

2018-01-01

Background Family doctors (FDs) focus on biopsychosocial components of health during consultations. However, much of the evidence employed by these doctors is produced by researchers who are not routinely involved in family practice. Family doctors competent in both clinical practice and research are essential to addressing this gap. With the growing recognition of family medicine as the specialty of choice for many young doctors, there is a scarcity of literature that describes their experiences in combining research and daily family practice. Aim Members from Young Doctor Movements (YDMs) under the auspices of the World Organisation of Family Doctors (WONCA) sought to address this knowledge gap by reflecting on their experiences towards becoming researchers. With the assistance of senior doctors, they explored solutions that can help young FDs incorporate research into their family practice. Methods Following an online YDM meeting, a summary of the experiences of young FDs as well as strategies useful for incorporating research into their everyday practice as FDs was prepared. Result Nine thematic areas were derived, including experiences and motivation towards regular research, culture and environment of practice, relevance and gains of research, teamwork and mentorship. Conclusion Family practices can incorporate research by promoting a personal and organisational research culture, highlighting gains and relevance of making it part of the profession and fostering teamwork, supportive networks and mentorship while making it enjoyable. PMID:29781695

Technology and the evolution of clinical methods for stuttering.

PubMed

Packman, Ann; Meredith, Grant

2011-06-01

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter. The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families. Copyright © 2011. Published by Elsevier Inc.

Reprint of: technology and the evolution of clinical methods for stuttering.

PubMed

Packman, Ann; Meredith, Grant

2011-09-01

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter. The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families. Copyright © 2011. Published by Elsevier Inc.

Cultural and Family Challenges to Managing Type 2 Diabetes in Immigrant Chinese Americans

PubMed Central

Chesla, Catherine A.; Chun, Kevin M.; Kwan, Christine M.L.

2009-01-01

OBJECTIVE Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. RESEARCH DESIGN AND METHODS This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. RESULTS Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. CONCLUSIONS Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted. PMID:19628812

Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.

PubMed

Chesla, Catherine A; Chun, Kevin M; Kwan, Christine M L

2009-10-01

Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.

Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward.

PubMed

Birtwhistle, Richard; Keshavjee, Karim; Lambert-Lanning, Anita; Godwin, Marshall; Greiver, Michelle; Manca, Donna; Lagacé, Claudia

2009-01-01

The development of a pan-Canadian network of primary care research networks for studying issues in primary care has been the vision of Canadian primary care researchers for many years. With the opportunity for funding from the Public Health Agency of Canada and the support of the College of Family Physicians of Canada, we have planned and developed a project to assess the feasibility of a network of networks of family medicine practices that exclusively use electronic medical records. The Canadian Primary Care Sentinel Surveillance Network will collect longitudinal data from practices across Canada to assess the primary care epidemiology and management of 5 chronic diseases: hypertension, diabetes, depression, chronic obstructive lung disease, and osteoarthritis. This article reports on the 7-month first phase of the feasibility project of 7 regional networks in Canada to develop a business plan, including governance, mission, and vision; develop memorandum of agreements with the regional networks and their respective universities; develop and obtain approval of research ethics board applications; develop methods for data extraction, a Canadian Primary Care Sentinel Surveillance Network database, and initial assessment of the types of data that can be extracted; and recruitment of 10 practices at each network that use electronic medical records. The project will continue in phase 2 of the feasibility testing until April 2010.

Early childhood development: impact of national human development, family poverty, parenting practices and access to early childhood education.

PubMed

Tran, T D; Luchters, S; Fisher, J

2017-05-01

This study was to describe and quantify the relationships among family poverty, parents' caregiving practices, access to education and the development of children living in low- and middle-income countries (LAMIC). We conducted a secondary analysis of data collected in UNICEF's Multiple Indicator Cluster Surveys (MICS). Early childhood development was assessed in four domains: language-cognitive, physical, socio-emotional and approaches to learning. Countries were classified into three groups on the basis of the Human Development Index (HDI). Overall, data from 97 731 children aged 36 to 59 months from 35 LAMIC were included in the after analyses. The mean child development scale score was 4.93 out of a maximum score of 10 (95%CI 4.90 to 4.97) in low-HDI countries and 7.08 (95%CI 7.05 to 7.12) in high-HDI countries. Family poverty was associated with lower child development scores in all countries. The total indirect effect of family poverty on child development score via attending early childhood education, care for the child at home and use of harsh punishments at home was -0.13 SD (77.8% of the total effect) in low-HDI countries, -0.09 SD (23.8% of the total effect) in medium-HDI countries and -0.02 SD (6.9% of the total effect) in high-HDI countries. Children in the most disadvantaged position in their societies and children living in low-HDI countries are at the greatest risk of failing to reach their developmental potential. Optimizing care for child development at home is essential to reduce the adverse effects of poverty on children's early development and subsequent life. © 2016 John Wiley & Sons Ltd.

The Relationship Between School Health Curriculum and Family Practices.

ERIC Educational Resources Information Center

Hearne, Jill; Andrews, Richard L.

A study investigated the differential relationship between children's involvement in an experiential health curriculum and past-reported health practices and changes in family health practices. The research is based on the assumption that established patterns of health practices in families are not immutable patterns, but are susceptible to change…

Cognitive and Socioemotional Caregiving in Developing Countries

ERIC Educational Resources Information Center

Bornstein, Marc H.; Putnick, Diane L.

2012-01-01

Enriching caregiving practices foster the course and outcome of child development. This study examined 2 developmentally significant domains of positive caregiving--cognitive and socioemotional--in more than 127,000 families with under-5 year children from 28 developing countries. Mothers varied widely in cognitive and socioemotional caregiving…

Integrating improvement learning into a family medicine residency curriculum.

PubMed

Pensa, Mellisa; Frew, Patty; Gelmon, Sherril B

2013-06-01

Knowledge of improvement practices is a critical skill for family medicine residents who will lead patient-centered medical homes. The Accreditation Council for Graduate Medical Education includes systems-based practice and improvement knowledge as a core competency for residency education. The objective of this report is to describe the 6-year implementation and development of our practice-based improvement curriculum in a family medicine residency. In 2006, Oregon Health and Science University Family Medicine Residency implemented an improvement curriculum that focused on clinic-based improvement and involved longitudinal didactics. Over the course of 6 years, the curriculum has been refined to include longitudinal instruction of improvement principles according to the levels of training and clinic-based didactics and experientials that are team oriented. Residents complete ambulatory improvement projects over the cycle of 12 months and present outcomes each year. Residents evaluated their knowledge, experience, confidence, and satisfaction at the end of the academic year. Ninety percent of residents designed and lead improvement projects upon graduation from residency in 2011. Resident confidence to make a change in local health care settings at the end of the curriculum was high and improved from 2009/2010 to 2010/2011. Upon graduation from the program, 100% of residents reported competence or proficiency in their ability to apply knowledge to an improvement project and present results. We describe a longitudinal, practical, developmental, and clinically based experiential improvement curriculum that has been successfully integrated into a family medicine residency program.

Chapter 11: Civic Youth Work

ERIC Educational Resources Information Center

Roholt, Ross VeLure; Hildreth, R. W.; Baizerman, Michael

2007-01-01

We propose civic youth work as a new craft orientation in the family of child and youth care, education, social work, recreation and other relevant semi-to-full professions. We envision this practice as based in the philosophies and practical sciences of pedagogy, politics, and human development. The ideal-type civic youth worker will have a…

Low-Income Mothers' Food Practices with Young Children: A Qualitative Longitudinal Study

ERIC Educational Resources Information Center

Harden, Jeni; Dickson, Adele

2015-01-01

Objective: Young children living in socioeconomically deprived areas of Scotland have an increased risk of becoming overweight or obese. To enhance understanding of the wider contexts within which family food practices are developed, this study examined the experiences of low-income mothers with young children. Design: Qualitative longitudinal…

Children, Child Abuse and Child Protection: Placing Children Centrally.

ERIC Educational Resources Information Center

1999

This book provides an overview of the political, moral, and social context within which British child welfare practitioners and managers attempt to work with children, families, and others. The book reviews the development of improved policy and practices in child protection. Placing children at the center of policy, practice, and discourse, it…

Reflective Practice: Using Focus Groups to Determine Family Priorities and Guide Social Pragmatic Program Development

ERIC Educational Resources Information Center

Theadore, Geraldine; Laurent, Amy; Kovarsky, Dana; Weiss, Amy L.

2011-01-01

Reflective practice requires that professionals carefully examine and integrate multiple sources of information when designing intervention and evaluating its effectiveness. This article describes the use of focus group discussion as a form of qualitative research for understanding parents' perspectives of a university-based intervention program…

FERPA Training Practices: Results of the AACRAO January 2016 60 Second Survey

ERIC Educational Resources Information Center

American Association of Collegiate Registrars and Admissions Officers (AACRAO), 2016

2016-01-01

The January 2016 American Association of Collegiate Registrars and Admissions Officers (AACRAO) "60 Second Survey" focused on institutional Family Educational Rights and Privacy Act (FERPA) training practices and measuring the level of interest in an AACRAO-developed online FERPA training module. The survey received 878 usable responses.…

Parental Values and Practices Relevant to Young Children's Social Development in Taiwan and the United States.

ERIC Educational Resources Information Center

Jose, Paul E.; Huntsinger, Carol S.; Huntsinger, Phillip R.; Liaw, Fong-Ruey

2000-01-01

Compared self-reported parental values and child-rearing practices and teacher-reported and observed children's social skills among families of young children who were first-generation Chinese Americans, European Americans, or Taiwanese Chinese. All Chinese parents more strongly endorsed traditional Chinese values and exerted more parental control…

The family as a protective asset in adolescent development.

PubMed

Kingon, Y S; O'Sullivan, A L

2001-06-01

Adolescents are considered at high risk for engaging in such negative health behaviors as drug and alcohol use, unprotected sexual intercourse, and violence. Conventional wisdom has long upheld the belief that the peer group exerts the strongest influence on adolescent behavior. However, recent research has shown that in fact the family remains a strong factor in moderating teen risk behavior. Holistic nursing acknowledges the crucial relationship between environment and health; the environment is composed of everything that surrounds the individual, which by definition includes the family. The purpose of this article is to examine the evidence supporting the concept of the family as a protective external asset in adolescent development, to explore the way the family helps defend young people from risk, and to review briefly the implications for nursing research, practice, advocacy, and education.

Comparison of female and male graduates of southern Appalachian family practice residencies.

PubMed

Rosenfeld, J A; Zaborlik, P M

1996-11-01

One aim of Southern Appalachian family practice residencies is to produce graduates for surrounding physician-needy areas. Some evidence suggests that women are less likely to go to rural areas and that they practice differently than men. This study investigated the practice patterns and location of Appalachian family practice residency female and male graduates. Surveys were sent to graduates of seven family practice residencies from 1984 to 1994 in the Southern Appalachian area to determine practice patterns, locations, and reasons for choosing practices. Women were more likely than men to be single and not to have children. More women worked part-time. Women's and men's practice patterns and characteristics were similar except that women were more likely to provide prenatal care and do vaginal deliveries. Women in similar percentages practiced in small towns, and a greater percentage of women practiced in rural areas with populations of less than 2,500. Female family practice residency graduates from Appalachian residencies are fulfilling the purposes of their residencies as well as male graduates, although more of them are working part-time.

Research and organizational issues for the implementation of family work in community psychiatric services.

PubMed

Jones, Adrian; Scannell, Tony

2002-04-01

The need for evidence-based practice (EBP) to guide and develop mental health services remains fundamental for modern services. Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors. The current drive to increase EBP requires a bi-directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.

Five Weekend National Family Medicine Fellowship. Program for faculty development.

PubMed

Talbot, Y; Batty, H; Rosser, W W

1997-12-01

PROBLEM ADDRESSEDMany faculty development programs are thought time-consuming and inaccessible to academic family physicians or physicians wanting to move into academic positions. This is largely due to difficulty in leaving their practices for extended periods. Canadian family medicine needs trained leaders who can work in teams and are well grounded in the principles of their discipline as they relate to education, management, research, and policy making.OBJECTIVE OF PROGRAMTo develop a team of leaders in family medicine.MAIN COMPONENTS OF PROGRAMThe Five Weekend National Family Medicine Fellowship Program focuses on the essentials of education, management, communication, critical appraisal skills, and the principles of family medicine to develop leadership and team-building skills for faculty and community-based family physicians entering academic careers. This unique 1-year program combines intensive weekend seminars with small-group projects between weekends. It emphasizes a broader set of skills than just teaching, has regional representation, and focuses on leadership and teamwork using a time-efficient format.CONCLUSIONThe program has graduated 34 Fellows over the last 3 years. More than 90% of the 35 projects developed through course work have been presented in national or provincial peer-reviewed settings. Quantitative ratings of program structure, course content, and course outcomes have been positive.

Bridging the divide between families and health professionals’ perspectives on family‐centred care

PubMed Central

MacKean, Gail L.; Thurston, Wilfreda E.; Scott, Catherine M.

2005-01-01

Abstract Objectives  To describe and discuss key findings from a recent research project that challenge an increasingly prevalent theme, apparent in both family‐centred care research and practice, of conceptualizing family‐centred care as shifting care, care management, and advocacy responsibilities to families. The purpose of the research, from which these findings emerged, was to develop a conceptualization of family‐centred care grounded in the experiences of families and direct health‐care providers. Design  Qualitative research methods, following the grounded theory tradition, were used to develop a conceptual framework that described the dimensions of the concept of family‐centred care and their interrelationships, in the substantive area of children's developmental services. This article reports on and extends key findings from this grounded theory study, in light of current trends in the literature. Setting and participants  The substantive area that served as the setting for the research was developmental services at a children's hospital in Alberta, Canada. Data was collected through focus groups and individual interviews with 37 parents of children diagnosed with a developmental problem and 16 frontline health‐care providers. Findings  Key findings from this research project do not support the current emphasis in family‐centred care research and practice on conceptualizing family‐centred care as the shifting of care, care management, and advocacy responsibilities to families. Rather, what emerged was that parents want to work truly collaboratively with health‐care providers in making treatment decisions and on implementing a dynamic care plan that will work best for child and family. Discussion and conclusions  A definition of collaboration is provided, and the nature of collaborative relationships described. Contributing factors to the difficulty in establishing true collaborative relationships between families and health‐care professionals, where the respective roles to be played by health‐care professionals and families are jointly determined, are discussed. In light of these findings we strongly advocate for the re‐examination of current family‐centred care policy and practice. PMID:15713173

Exploring Community Stakeholders' Perceptions of the Enhancing Family Well-being Project in Hong Kong: A Qualitative Study.

PubMed

Chu, Joanna T W; Chan, Sophia S; Stewart, Sunita M; Zhou, Qianling; Leung, Charles Sai-Cheong; Wan, Alice; Lam, Tai Hing

2017-01-01

Community engagement is a powerful tool in bringing about positive social and community change. Community stakeholders possess critical experience and knowledge that are needed to inform the development of community-based projects. However, limited literature is available on the practical experience involved with planning and implementing community-based family programs. Even less has been published documenting efforts in Chinese communities. This paper explores community stakeholders' experiences with the enhancing family well-being project-part of a citywide project entitled the "FAMILY Project," aimed at promoting family health, happiness, and harmony in Hong Kong. This qualitative evaluation examined the perspectives of community stakeholders. Four focus groups with social workers ( n  = 24) and six in-depth interviews with steering committee members were conducted from December 2012 to May 2013 in Hong Kong. Focus groups and in-depths interview were audiotaped, transcribed, and analyzed using thematic analysis techniques. Rich accounts were given by our respondents on various aspects of the project. Main themes and subthemes were identified and grouped into four categories (project conception, project implementation, project consolidation, and the overall impact of the project). Respondents described the practical challenges associated with the project (e.g., recruitment, balancing scientific research, and lack of resources) and identified the elements that are important to the success of the project. These included the commitment to a shared goal, multi-agency collaboration, and a platform for knowledge exchange. Finally, respondents perceived benefits of the project at both the individual and community level. Our project sheds light on many of the practical considerations and challenges associated with a designing and implementing a community-based family intervention project. Community stakeholders input provided important information on their perceived benefits and barriers and can inform and improve future development of community-based family intervention programs.

Seeking harmony in the provision of care to the stroke-impaired: views of Chinese family caregivers.

PubMed

Lee, Regina L T; Mok, Esther S B

2011-05-01

To explore the coping strategies of Chinese family caregivers of stroke-impaired older relatives. Many stroke-impaired patients rely heavily on support from their families, and the daily lives of such family caregivers are severely impacted. However, services and support for family caregivers of stroke-impaired relatives in the home setting have received little attention. Appropriate and relevant information and support to family caregivers are important in facilitating the care-giving task. It is, therefore, necessary to understand the nature and demands of care-giving before planning specific educational and support programmes. Grounded theory. Fifteen Chinese family caregivers of stroke-impaired older relatives were recruited and interviewed in 2003 and 2004. Theoretical sampling and constant comparative analysis were used to recruit the sample and perform data analysis. Seeking harmony to provide care for the stroke-impaired was the core category for describing and guiding the family care-giving process, with five main stages: (1) living with ambiguity, (2) monitoring the recovery progress, (3) accepting the downfalls, (4) meeting family obligations and (5) reconciling with harmony. These issues were seldom discussed openly with health professionals. The findings indicated that Chinese family caregivers determine their own needs by seeking harmony to continue to provide care without thinking about getting help from others or their own health problems. These findings help to define some of the complex dynamics that have an impact on the development of partnership care and might challenge nurses practising in the community. Community nurses should assess and understand the coping strategies of family caregivers and assist them to engage in stress-reducing practices. This is an important partnership to be formed in stroke care for family caregivers in the community. The study findings will guide further development of family care-giving aspects in nursing practice. © 2010 Blackwell Publishing Ltd.

Family-centered Care in the Outpatient General Psychiatry Clinic.

PubMed

Heru, Alison M

2015-09-01

Although family research supports family-centered care for all medical specialties, the benefit of family-centered care has not been fully realized in outpatient practice. Physicians, including psychiatrists, are not routinely taught how to work with families and may not be aware of the evidence-base for family interventions. However, some medical specialties, such as family medicine and palliative care, have a clinical practice that routinely includes the family. Clinicians working in medical clinics, such as diabetes clinics, know that successful management of chronic illness requires family involvement. Psychiatric clinics, such as The Family Center for Bipolar Disorder at Beth Israel Medical Center in New York City, also have a family-centered practice and show improved patient outcomes. This article provides guidelines, including clinical interview questions, to help psychiatrists practice family-centered care, either in a private office or in a general psychiatric outpatient clinic. The guidelines include questions that identify when to seek an in-depth family assessment or consultation. Family-centered care will become more useful when health care reimbursement focuses on patient outcome.

Teachers as researchers: a narrative pedagogical approach to transforming a graduate family and health promotion course.

PubMed

Brykczynski, Karen A

2012-01-01

Scholarship of teaching in nursing is illustrated by describing the development, implementation, evaluation, and revision of a family and health promotion course for graduate family nurse practitioner students. A narrative pedagogical approach that combines conventional pedagogy with action research is used. The work, an example of curriculum as dialogue, illustrates how teachers can incorporate research, evaluation, and reflection into their daily teaching practice. Given adequate support, these evaluation and research activities could constitute part of the scholarship of teaching, and, as such, would warrant allocation of time in faculty workloads and formal acknowledgment in annual performance evaluations and promotion and tenure decisions. The importance of increasing the clinical relevance of the scholarship of teaching in a practice discipline such as nursing is also emphasized.

Surgeon-family perioperative communication: surgeons' self-reported approaches to the "surgeon-family relationship".

PubMed

Jordan, Aubrey L; Rojnica, Marko; Siegler, Mark; Angelos, Peter; Langerman, Alexander

2014-11-01

Family members are important in the perioperative care of surgical patients. During the perioperative period, communication about the patient occurs between surgeons and family members. To date, however, surgeon-family perioperative communication remains unexplored in the literature. Surgeons were recruited from the surgical faculty of an academic hospital to participate in an interview regarding their approach to speaking with family members during and immediately after an operative procedure. An iterative process of transcription and theme development among 3 researchers was used to compile a well-defined set of qualitative themes. Thirteen surgeons were interviewed and described what informs their communication, how they practice surgeon-family perioperative communication, and how the skills integral to perioperative communication are taught. Surgeons saw perioperative communication with family members as having a special role of providing support and anxiety alleviation that is distinct from the role of communication during clinic or postoperative visits. Wide variability exists in how interviewed surgeons practice perioperative communication, including who communicates with the family, and the frequency and content of the communication. Surgeons universally reported that residents' instruction in perioperative communication with families was lacking. Surgeons recognize perioperative communication with family members to be a part of their role and responsibility to the patient. However, during the perioperative period, they also acknowledge an independent responsibility to alleviate family members' anxieties. This independent responsibility supports the existence of a distinct "surgeon-family relationship." Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

PubMed

Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

2017-08-01

The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

A Systemic Approach to the Development of a Sexual Abuse Protocol in a Rural Community: An Examination of Social Work Leadership Theory and Practice. Issues in Clinical Practice.

ERIC Educational Resources Information Center

Catalano, Stephen

The paper presents the multi-factorial problem of sexual abuse of children within their families, provides definitions of relevant terms (incest, sexual abuse, sexual misuse, molestation, sexual assault, rape), reviews the epidemiology of sexual abuse and its effects, and traces development of a Sexual Abuse Resource Team in a rural/resort New…

Multi-family update to the passive solar construction handbook

NASA Astrophysics Data System (ADS)

Howard, B. D.; Callahan, K. D.

1983-11-01

Builders and developers will accept passive solar construction and designs for integration with their existing practice if accurate and detailed plans of actual, proven passive solar subsystems and assemblies are made available to them. A Passive Solar Construction Handbook was developed. It focuses primarily upon single family homes. The multifamily update of the Handbook, is described and examples of the valuable builder information are shown. It represents a new breakthrough in DOE sponsored projects, performing a Technology Transfer on a most useful level.

Helping the Most Vulnerable Infants, Toddlers, and Their Families. Pathways to Early School Success. Issue Brief No. 1

ERIC Educational Resources Information Center

Knitzer, Jane; Lefkowitz, Jill

2006-01-01

Compelling evidence from neuroscience about how early relationships and experience influence the architecture of the brain, and in turn early school success, has led to increasing policy and practice attention to implementing child development and family support programs like Early Head Start for infants and toddlers. But, there is also a group of…

Developing Cross-Cultural Competence: A Guide for Working with Children and Their Families. Fourth Edition

ERIC Educational Resources Information Center

Lynch, Eleanor W., Ed.; Hanson, Marci J., Ed.

2011-01-01

As the U.S. population grows more and more diverse, how can professionals who work with young children and families deliver the best services while honoring different customs, beliefs, and values? The answers are in the fourth edition of this bestselling textbook, fully revised to reflect nearly a decade of population changes and best practices in…

A Cultural-Historical Reading of How Play Is Used in Families as a Tool for Supporting Children's Emotional Development in Everyday Life

ERIC Educational Resources Information Center

Chen, Feiyan; Fleer, Marilyn

2016-01-01

Many studies have identified the positive "link" between imaginary play and emotion regulation in laboratory settings. However, little is known about "how" play and emotion regulation are related in everyday practice. This article examines how families use play as a tool to support young children's emotion regulation in…

Measuring the Values and Preferences for Everyday Care of Persons with Cognitive Impairment and Their Family Caregivers

ERIC Educational Resources Information Center

Whitlatch, Carol J.; Feinberg, Lynn Friss; Tucke, Shandra S.

2005-01-01

Purpose: This study describes the development and psychometric properties of a 24-item scale to be used in both research and practice settings that assesses the everyday care values and preferences of individuals with cognitive impairment and the perceptions of family caregivers about their relative's values and preferences for care. Design and…

Real Life Calls for Real Books: Literature to Help Children Cope with Family Stressors

ERIC Educational Resources Information Center

Roberts, Sherron Killingsworth; Crawford, Patricia A.

2008-01-01

This article provides a rationale and related practical suggestions for using literature as a support system for social-emotional development as children cope with the stresses, anxieties, and feelings of loss that can occur in family life. The authors discusses types of books, how to choose them, and how teachers can use authentic literature to…

From Reminiscing to Reading: Home Contributions to Children's Developing Language and Literacy in Low-Income Families

ERIC Educational Resources Information Center

Sparks, Alison; Reese, Elaine

2013-01-01

In this study, the relations among a range of literacy-related home practices and children's acquisition of language and literacy at the outset of preschool are examined in a sample of linguistically diverse children from low-income families in the United States. Specifically, the study focuses on sources of variation found in mother-child…

Opportunities in Public Policy to Support Infant and Early Childhood Mental Health: The Role of Psychologists and Policymakers

ERIC Educational Resources Information Center

Nelson, Florence; Mann, Tammy

2011-01-01

Infant and early childhood mental health practices can be supported by policies and professional standards of care that foster the healthy development of young children. Policies that support infants and toddlers include those that strengthen their families to provide a family environment that promotes mental wellness. Policy issues for infants,…

Two Daddy Tigers and a Baby Tiger: Promoting Understandings about Same Gender Parented Families Using Picture Books

ERIC Educational Resources Information Center

Kelly, Janette

2012-01-01

There is a small body of work examining how picture books can be used with young children and their families to develop understandings of contemporary issues including diversity and practices towards inclusion. This article describes a study in one New Zealand kindergarten that explored teachers' interpretations of children's responses to a…

Key informants’ perspectives on development of family medicine training programs in Ethiopia

PubMed Central

Gossa, Weyinshet; Wondimagegn, Dawit; Mekonnen, Demeke; Eshetu, Wondwossen; Abebe, Zerihun; Fetters, Michael D

2016-01-01

As a very low-income country, Ethiopia faces significant development challenges, though there is great aspiration to dramatically improve health care in the country. Family medicine has recently been recognized through national policy as one potential contributor in addressing Ethiopia’s health care challenges. Family medicine is a new specialty in Ethiopia emerging in the context of family medicine development in Sub-Saharan Africa. The Addis Ababa University family medicine residency program started in 2013 and is the first and the only family medicine program in the country as of March 2016. Stakeholders on the ground feel that family medicine is off to a good start and have great enthusiasm and optimism for its success. While the Ministry of Health has a vision for the development of family medicine and a plan for rapid upscaling of family medicine across the country, significant challenges remain. Continuing discussion about the potential roles of family medicine specialists in Ethiopia and policy-level strategic planning to place family medicine at the core of primary health care delivery in the country is needed. In addition, the health care-tier system needs to be restructured to include the family medicine specialists along with appropriately equipped health care facilities for training and practice. Key stakeholders are optimistic that family medicine expansion can be successful in Ethiopia through a coordinated effort by the Ministry of Health and collaboration between institutions within the country, other Sub-Saharan African countries, and international partners supportive of establishing family medicine in Ethiopia. PMID:27175100

The Impact of Desired Family Size Upon Family Planning Practices in Rural East Pakistan

ERIC Educational Resources Information Center

Mosena, Patricia Wimberley

1971-01-01

Results indicated that women whose desired family size is equal to or less than their actual family size have significantly greater frequencies practicing family planning than women whose desired size exceeds their actual size. (Author)

Staff-family relationships in nursing home care: a typology of challenging behaviours.

PubMed

Bauer, Michael

2007-09-01

Aim.  This paper draws on data from a study which investigated how Australian nursing home staff constructed staff-family relationships. Background.  Working with the family in aged care to provide the best care possible is consistent with modern nursing philosophy which espouses holistic care. The quality and enjoyment of the experience however, is frequently fraught with problems and challenges for both the staff and the family involved. Design.  A qualitative constructivist design as described by Guba and Lincoln [Fourth Generation Evaluation. Sage Publications, London.] was used. Method.  Thirty paid caregivers drawn from eight nursing homes were interviewed about their experiences of working with residents' families. A constant comparative method of data analysis was used to arrive at the findings. Results.  This paper reports on seven themes under the category of 'unacceptable behaviours'. These themes describe a range of attitudes and behaviours exhibited by families which staff members found undesirable. Conclusions.  Staff members found a number of family behaviours challenging. Nursing home staff perceives the family as subordinate to their needs and want to retain control of the work environment. Relevance to clinical practice.  Nursing home staff need to move away from custodial models of care focused on 'getting the work done' and develop more family friendly work practices that are inclusive of the needs of the family and view them as equal partners in care.

24 CFR 103.1 - Purpose and applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Purpose and applicability. 103.1 Section 103.1 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE... practices on account of handicap or familial status occurring on or after March 12, 1989. (c) Part 180 of...

Annual Research Review: Parenting and Children's Brain Development--The End of the Beginning

ERIC Educational Resources Information Center

Belsky, Jay; de Haan, Michelle

2011-01-01

After questioning the practical significance of evidence that parenting influences brain development--while highlighting the scientific importance of such work for understanding "how" family experience shapes human development--this paper reviews evidence suggesting that brain structure and function are "chiselled" by parenting. Although the…

Working appreciatively to improve services for children and families.

PubMed

Onyett, Steve

2009-10-01

Service improvement approaches are described that specifically focus on appreciating the positive that individuals bring to contexts related to children and family services. This includes application of Solution-Focused approaches, Appreciative Inquiry and other approaches that promote a positive emotional climate and focus on what works. Their conceptual foundations are explored and particularly their value in supporting working well with complex adaptive systems. Specific applications described include leadership and management practice, work in school settings, engaging clinicians in healthcare improvement, establishing clinical networks, work with homeless youth, child protection and approaches to drawing out best practice and community development. The theme that unites is a focus on developing effective relationships at all levels and a pragmatic focus on what works so that we can find opportunities to do more of it.

A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers.

PubMed

Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela

2016-01-01

The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.

Longitudinal research and data collection in primary care.

PubMed

van Weel, Chris

2005-01-01

This article reviews examples of and experience with longitudinal research in family medicine. The objective is to use this empirical information to formulate recommendations for improving longitudinal research. The article discusses 3 longitudinal studies from the Nijmegen academic family practice research network: 1 on the prognosis of depression and 1 each on the prognosis of and outcomes of care for type 2 diabetes mellitus. The Nijmegen network has recorded all episodes of morbidity encountered in Dutch family medicine since 1971 in a stable practice population. This network's experience is evaluated to identify lessons that may help other practice-based research networks (PBRNs) in pursuing longitudinal research. In terms of external conditions (conditions related to the general setting), the stability of a population and a high level of continuity of care substantially enhance the ability to perform longitudinal research. In terms of internal conditions (conditions related to the PBRN), motivation of family physicians and their staff to conduct ongoing data collection, and their ownership of the data are key for success. Other critical internal conditions include standardization of data; collection of data by clinician-friendly means; training of family physicians and their staff in data collection, as well as meetings for discussion of this task; provision of feedback to practices on the research findings; use of standard procedures to promote adherence to data collection; availability of facilities for regular measurement of patients' health status or chart review; and use of mechanisms for tracking patients who leave the practice area. Insight from existing experience suggests that longitudinal research can be enhanced in PBRNs. The best way forward is to build longitudinal data collection by drawing on lessons from successful studies. Primary care research policy should advocate for a role of longitudinal research and stimulate its development in PBRNs under favorable population circumstances.

Family meals then and now: A qualitative investigation of intergenerational transmission of family meal practices in a racially/ethnically diverse and immigrant population.

PubMed

Trofholz, Amanda C; Thao, Mai See; Donley, Mia; Smith, Mireya; Isaac, Hassan; Berge, Jerica M

2018-02-01

Having frequent family meals has consistently been associated with better health outcomes in children/adolescents. It is important to identify how intergenerational transmission of family meal practices occurs to help families benefit from the protective nature of family meals. Limited studies exist that explore the intergenerational transmission of family meal practices, particularly among racially/ethnically diverse and immigrant populations. This study explores how parents describe differences and similarities between meals "then" and "now", lessons they learned as children about family meals, lessons they passed onto their children, the challenges of carrying out family meals, and how families handle the barriers/challenges to intergenerational transmission of family meal practices. The study was conducted with a sample of African American, Native American, Latino, Hmong, Somali, and White families (25/category). Qualitative themes were explored with the overall sample, by race/ethnicity, immigrant status, and by time in the United States (US) as an immigrant. Parents overwhelmingly reported learning as children that family meals were important and conveying this message to their own children. Differences existed among racial/ethnic groups and time in the US as an immigrant. For example, Somali parents frequently endorsed having no challenges with intergenerational transmission of family meal practices. Immigrant parents in the US for a longer period of time were more likely to endorse learning/teaching about family meal importance, that the food eaten now is different than growing up, that a chaotic environment is a challenge to having family meals, and that they accommodate family member's schedules when planning family meals. Results demonstrate that exploring a parent's early family meal experiences may be important when intervening with parents from diverse racial/ethnic and immigrant populations when trying to improve or increase family meal practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Designing Work, Family & Health Organizational Change Initiatives.

PubMed

Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

2014-01-01

For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.

Designing Work, Family & Health Organizational Change Initiatives

PubMed Central

Hammer, Leslie B.; Kelly, Erin L.; Moen, Phyllis

2014-01-01

Executive Summary For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win–win for productivity and employees’ well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today’s U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor. PMID:24683279

Lessons from Marrano Beach: Attachment and Culture

ERIC Educational Resources Information Center

Ledesma, Rita

2007-01-01

Clinical experiences, research within the American Indian/Alaska Native and Latino/a Los Angeles community, consultation with colleagues, and reflections on professional development indicate that cultural material exerts profound influence on individual, family, and community development. Reflections on practice are discussed that emphasize the…

Children without Permanent Parents: Research, Practice, and Policy

ERIC Educational Resources Information Center

Bakermans-Kranenburg, Marian J.; Bos, Karen; Bunkers, Kelley McCreery; Dobrova-Krol, Natasha A.; Engle, Patrice L.; Fox, Nathan A.; Gamer, Gary N.; Goldman, Philip; Groark, Christina J.; Greenberg, Aaron; Grotevant, Harold D.; Groza, Victor K.; Gunnar, Megan R.; Johnson, Dana E.; Juffer, Femmie; Kreppner, Jana M.; Le Mare, Lucy; McCall, Robert B.; Muhamedrahimov, Rifkat J.; Nelson, Charles A., III; Palacios, Jesus; Sonuga-Barke, Edmund J. S.; Steele, Howard; Steele, Miriam; Tieman, Wendy; van IJzendoorn, Marinus H.; Verhulst, Frank C.; Vorria, Panayiota; Zeanah, Charles H.

2011-01-01

This monograph reviews literature pertaining to children without permanent parents. Chapters review (1) the development of children while institutional residents; (2) the development of postinstitutionalized children transitioned to family environments (i.e., adoption); the effects of institutionalization on (3) attachment behaviors, (4) physical…

Family Life Goes On: Disability in Contemporary Families

PubMed Central

Farrell, Anne F.; Krahn, Gloria L.

2015-01-01

Disability is part of life for most contemporary families, but to date the literature on disability in families is fragmented and narrow. This editorial commentary introduces the content and findings of peer-reviewed articles appearing in a special issue of Family Relations. The editors outline unanswered but core research questions and preview the themes present in the issue: families with disabilities are diverse; economic hardship disproportionately characterizes their lives; family life with disabilities is a journey that includes stress and resilience, with support contributing significantly to the latter; and that work benefits and taxes family life. Articles extrapolate beyond findings to explore implications for family policy and practice. The editors assert that developing understanding of how disability influences families requires a more diverse and rigorous research portfolio. They further cite the need to embed disability as a variable in a range of family studies and advocate more outlets for publication. PMID:26185356

Providing end-of-life care in general practice: findings of a national GP questionnaire survey.

PubMed

Mitchell, Sarah; Loew, Joelle; Millington-Sanders, Catherine; Dale, Jeremy

2016-09-01

With increasing numbers of people living with complex life-limiting multimorbidity in the community, consideration must be given to improving the organisation and delivery of high-quality palliative and end-of-life care (EOLC). To provide insight into the experience of GPs providing EOLC in the community, particularly the facilitators and barriers to good-quality care. A web-based national UK questionnaire survey circulated via the Royal College of General Practitioners, NHS, Marie Curie, and Macmillan networks to GPs. Responses were analysed using descriptive statistics and an inductive thematic analysis. Responses were received from 516 GPs, who were widely distributed in terms of practice location. Of these, 97% felt that general practice plays a key role in the delivery of care to people approaching the end of life and their families. Four interdependent themes emerged from the data: continuity of care - which can be difficult to achieve because of resource concerns including time, staff numbers, increasing primary care workload, and lack of funding; patient and family factors - with challenges including early identification of palliative care needs and recognition of the end of life, opportunity for care planning discussions, and provision of support for families; medical management - including effective symptom-control and access to specialist palliative care services; and expertise and training - the need for training and professional development was recognised to enhance knowledge, skills, and attitudes towards EOLC. The findings reveal enduring priorities for policy, commissioning, practice development, and research in future primary palliative care. © British Journal of General Practice 2016.

Quality Primary Care and Family Planning Services for LGBT Clients: A Comprehensive Review of Clinical Guidelines.

PubMed

Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N

2018-04-01

LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.

A survey of marketing practices by family practice residency programs.

PubMed

Buckley, R L; Presley, R; Barrigar, R

1995-06-01

The purpose of the study reported in this article was to identify marketing practices that are being utilized by family practice residencies in the United States and to differentiate which strategies were felt to be most useful. A survey questionnaire on marketing strategies was mailed to 361 civilian family practice residencies listed in the 1992 Director of Family Practice Residency Programs. A total of 151 questionnaires were returned for a total response rate of 42.1 percent. The results were summarized using descriptive statistics and Chi-square analysis. Family practice residency programs use a number of different strategies to attract patients. The effectiveness of a given program is dependent on local factors, program strengths and the target population desired. The three most useful marketing strategies reported in the survey were HMO listings, emergency department referrals, and patient referrals. The three least effective strategies were health fairs, sports physicals, and school presentations.

Occupation-based practices and homelessness: A scoping review.

PubMed

Roy, Laurence; Vallée, Catherine; Kirsh, Bonnie H; Marshall, Carrie Anne; Marval, Rebecca; Low, Alissa

2017-04-01

Persons experiencing or at risk of homelessness have occupational needs that are seldom addressed in the Canadian system of care. The lack of documented evidence on occupational therapy practices in this field hinders the development of the profession. This article identifies current and potential practices that aim to enable or support the occupations of persons experiencing or at risk of homelessness. A scoping review was conducted, including evidence from both occupational therapy and non-occupational therapy sources. One hundred and seventy-eight papers were selected in the areas of occupational performance skills training, enrichment of occupational repertoire, employment/education, physical rehabilitation services, child/family services, community building, occupational transition from homeless to housed, literacy, and disaster relief. Occupational therapists can build environments and create opportunities that facilitate occupational engagement of individuals experiencing homelessness. Gaps in knowledge include the evaluation of occupational therapy practices, the Canadian context of family homelessness, and the cultural safety of occupational therapy interventions.

Family Medicine Department Chairs' Opinions Regarding Scope of Practice.

PubMed

Peterson, Lars E; Blackburn, Brenna; Phillips, Robert L; Mainous, Arch G

2015-12-01

Family physicians are trained broadly to provide the majority of health care across multiple settings; however, their scope of practice has narrowed. Department chairs' role modeling of a broad scope of practice may set the tone for faculty and trainees. In 2013, the authors surveyed family medicine department chairs about their scope of practice, personal and department characteristics, and attitudes and beliefs about scope of practice and role modeling. They used descriptive statistics and bivariate analyses to test for associations between scope of practice, personal and department characteristics, and attitudes and beliefs. They created a Scope of Practice Index by summing the number of services each respondent provided to compare scope of practice across chairs. Of 146 chairs, 88 responded (60.3% response rate); 85 were included in the final analysis. Sixty-five (77.4%) respondents were male; 73 (86.9%) were 51 years or older. Respondents spent a mean of 19.7% of their time in direct patient care and had a mean Scope of Practice Index of 11.9. Fifty-three (62.4%) disagreed that the scope of practice of family medicine was too broad for practicing physicians to keep up in all areas, and 56 (65.9%) believed that faculty should role model the full scope of practice to learners. Responses generally did not vary by respondents' personal scope of practice. Family medicine department chairs believe that role modeling a broad scope of practice increases students' interest in family medicine and encourages residency graduates to provide a wide range of services.

Partnerships at Work: Lessons Learned from Programs and Practices of Families, Professionals and Communities.

ERIC Educational Resources Information Center

Bishop, Kathleen Kirk, Ed.; Taylor, Mary Skidmore, Ed.; Arango, Polly, Ed.

Designed to celebrate family/interprofessional collaborative partnerships, this publication describes high-quality examples of how families and professionals at the family, community, state, and national levels have worked together to create programs and practices that are family-friendly and responsive to what families have said they want and…

Similarities and differences between families who have frequent and infrequent family meals: A qualitative investigation of low-income and minority households.

PubMed

Berge, Jerica M; Draxten, Michelle; Trofholz, Amanda; Hanson-Bradley, Carrie; Justesen, Kathryn; Slattengren, Andrew

2018-04-01

Numerous quantitative studies have examined the association between family meal frequency and child/adolescent weight and weight-related behaviors. However, limited qualitative research has been conducted to identify mealtime characteristics (e.g., child behavior during meals, rules/expectations, family dynamics) that occur during family meals that may explain why some families engage in frequent family meals and others do not. This is particularly important within racially/ethnically diverse households, as these demographic groups are at higher risk for weight-related problems. The current study aimed to identify similarities and differences in mealtime characteristics between households that have frequent and infrequent family meals within a low-income and minority population. This qualitative study included 118 parents who participated in Family Meals, LIVE!, a mixed-methods, cross-sectional study. Parents (90% female; mean age = 35) were racially/ethnically diverse (62% African American, 19% White, 4% Native American, 4% Asian, 11% Mixed/Other) and from low-income (73% < $35,000/yr.) households. Data were analyzed using inductive content analysis. Results indicated some similar mealtime characteristics (i.e., picky eating, involving family members in meal preparation) between households having frequent and infrequent family meals. Additionally, several differences in mealtime characteristics were identified between households having frequent (i.e., importance of family meals, flexibility in the definition of family meals, family meal rules, no pressure-to-eat feeding practices) versus infrequent family meals (i.e., pressure-to-eat parent feeding practices, family meals are dinner meals only, and difficult meal time behaviors). Study findings may be useful for developing intervention targets for low-income and racially/ethnically diverse households so more families can benefit from the protective nature of family meals. Copyright © 2018 Elsevier Ltd. All rights reserved.

Augmentative and Alternative Communication Practice in the Pursuit of Family Quality of Life: A Review of the Literature

ERIC Educational Resources Information Center

Saito, Yumiko; Turnbull, Ann

2007-01-01

Augmentative and Alternative Communication (AAC) practice may have both positive and negative impacts on quality of life (QOL) of children with AAC as well as their entire family. Thirteen studies were reviewed to analyze family outcomes and perspectives on AAC practice by using a family quality of life (FQOL) framework comprised of five…

"The Refer Less Resolve More" Initiative: A Five-year Experience from CMC Vellore, India.

PubMed

Velavan, Jachin

2012-01-01

India's one billion plus strong population presents huge health care needs. Presently, approximately 250,000 general practitioners and 30,000 Government doctors are a part of the Indian healthcare workforce, but 80% of them are based in urban India. Problems which plague healthcare delivery and attributed to physician practice may be enumerated as - physicians (1) lack competencies, (2) lack updating, (3) prescribe irrationally (pressures from pharmaceutical companies and patients), (4) practice unethically, (5) refer excessively to specialists and other clinical professionals, and (6) investigate for diseases without justification. A multi-competent Family Physician who could provide a single-window, ethical, and holistic healthcare to patients and families is the need of the hour. Therefore, training, equipping, and empowering these 250,000 doctors to become such physicians will reduce health costs considerably. Distance medical education using all the andragogic methods can be used to train large number of individuals without displacing them from their work-places. Distance learning provides a useful interface for rapidly developing a specialized pool of doctors practicing and advocating family medicine as most-needed discipline. This motivated CMC Vellore, a premier institution for medical education in India, to start a the "refer less resolve more initiative" by offering "two year family medicine diploma course" by distance mode. This is an innovatively-written program consisting of problem-based self-learning modules, video-lectures, video-conferencing, and face-to-face contact programs. Ten secondary level hospitals, across the country, under the supervision of national and international family medicine faculty form the pillars of this program. This distance learning program offered by CMC Vellore has become the platform for change as there is special focus is on ethics, rational prescribing, consultation skills, application of family medicine principles; and practical demonstration of compassionate, cost-effective and high-quality care. The change in attitude has resulted in transformation in three major aspects of practice: professional, ethical, and patient care. So far, 942 private practitioners and 177 government doctors have been enrolled.

Family planning choice behaviour in urban slums of Bangladesh: an econometric approach.

PubMed

Barkat, A; Rahman, M U; Bose, M L

1997-03-01

Bangladesh's urban population is projected to account for 26% of the country's total population by the year 2000 and 37% by 2015. A 1991 Bangladesh census report found that about 21 million of the total 111.5 million population were living in urban areas. 1551 currently-married women of reproductive age in 1551 households sampled from a representative sample of 91 slums in the metropolitan areas of Dhaka, Chittagong, and Khulna participated in a study of family planning behavior choice. 673 of the women were practicing family planning. The authors describe the construction of the econometric model used for analysis. Economic status as indicated by household income was found to considerably influence people's decisions concerning family planning practices. Higher women's educational status is also positively correlated with family planning practice. Husband's educational status has a less significant effect upon family planning practice. The change of a person from non-Muslim to Muslim has an insignificant, though positive, impact upon family planning practice. The more a woman feels empowered, being over age 19 years, the greater the number of living children, and the lower the level of preference for sons, the more likely a woman is to practice family planning.

Perspectives--Talking with Practitioners: How to Integrate Best Practices with Evidence-Based Treatment

ERIC Educational Resources Information Center

Cohen, Richard

2012-01-01

Evidence-based treatments are increasingly important and necessary parts of many disciplines when working with very young children and their families. In using them, it is advantageous to be grounded in the principles and practices that research has shown are critical to children's healthy development, particularly the importance of supporting the…

Online Training for Working with Student Veterans: A Social Work Elective Course

ERIC Educational Resources Information Center

Selber, Katherine; Biggs, Mary Jo Garcia; Chavkin, Nancy Feyl; Wright, Micah C.

2015-01-01

This article describes one school of social work's innovative online elective course to prepare Masters of Social Work (MSW) students for practice with the military, veterans and their families. Developed as part of a university-wide Veterans Initiative, this online course keeps the focus on the student veteran and uses the best practices of…

Recommended Best Practices for Mold Investigations in Minnesota Schools.

ERIC Educational Resources Information Center

Minnesota State Dept. of Health, St. Paul.

The Minnesota Department of Health developed this guidance at the request of the Minnesota Department of Children, Families and Learning. The goal of the document is to assist school district staff of Minnesota public schools in responding to problems related to indoor mold. Its focus is on practical, cost-effective methods to identify indoor mold…

Parenting with Positive Behavior Support: A Practical Guide to Resolving Your Child's Difficult Behavior

ERIC Educational Resources Information Center

Hieneman, Meme; Childs, Karen; Sergay, Jane

2006-01-01

Now the theory and research behind the positive behavior support (PBS) process--an approach already proven effective in schools and community programs--has been transformed into a practical, easy-to-use guide that's perfect for sharing with parents. Developed by educators and families, this user-friendly handbook offers parents easy-to-follow…

Parental Practices and Developmental Challenges of Boys of Color: Opportunities for Early Intervention

ERIC Educational Resources Information Center

Barbarin, Oscar A.

2015-01-01

The "My Brother's Keeper" Initiative (Obama, 2014) has helped to attract public attention to the vulnerabilities faced by many boys of color (BOC). In this article, I review what is known about the developmental status of BOC, identify key family practices that are critical to their development, and consider the implications of both for…

Delivery of Clinical Preventive Services in Family Medicine Offices

PubMed Central

Crabtree, Benjamin F.; Miller, William L.; Tallia, Alfred F.; Cohen, Deborah J.; DiCicco-Bloom, Barbara; McIlvain, Helen E.; Aita, Virginia A.; Scott, John G.; Gregory, Patrice B.; Stange, Kurt C.; McDaniel, Reuben R.

2005-01-01

BACKGROUND This study aimed to elucidate how clinical preventive services are delivered in family practices and how this information might inform improvement efforts. METHODS We used a comparative case study design to observe clinical preventive service delivery in 18 purposefully selected Midwestern family medicine offices from 1997 to 1999. Medical records, observation of outpatient encounters, and patient exit cards were used to calculate practice-level rates of delivery of clinical preventive services. Field notes from direct observation of clinical encounters and prolonged observation of the practice and transcripts from in-depth interviews of practice staff and physicians were systematically examined to identify approaches to delivering clinical preventive services recommended by the US Preventive Services Task Force. RESULTS Practices developed individualized approaches for delivering clinical preventive services, with no one approach being successful across practices. Clinicians acknowledged a 3-fold mission of providing acute care, managing chronic problems, and prevention, but only some made prevention a priority. The clinical encounter was a central focus for preventive service delivery in all practices. Preventive services delivery rates often appeared to be influenced by competing demands within the clinical encounter (including between different preventive services), having a physician champion who prioritized prevention, and economic concerns. CONCLUSIONS Practice quality improvement efforts that assume there is an optimal approach for delivering clinical preventive services fail to account for practices’ propensity to optimize care processes to meet local contexts. Interventions to enhance clinical preventive service delivery should be tailored to meet the local needs of practices and their patient populations. PMID:16189059

In defense of genuine ignorance: supporting vitality and relevance in graduate curricula.

PubMed

Goren, S; Peter, L; Fischer, S

1992-01-01

Genuine ignorance, defined by John Dewey as curiosity and openmindedness in opposition to repetition of catch phrases and familiar propositions, is nurtured in graduate nursing curricula in which the educational process is congruent with course content. Preparation for advanced practice in the mental health environment of the foreseeable future required abandonment of the familiar medical model in favor of conceptual models consistent with current thinking in psychiatric nursing and exposure to current problems (homelessness, family violence, AIDS) and current problem solving strategies (brief treatment, family preservation). Involvement in practice-based research and operationalizing new perspectives on familiar clinical problems, are suggested as strategies for developing the advanced practitioner. Two of the authors, former graduate students, describe the impact of changed perspectives and research activity on their own practice.

Pathways to Housing Policy: Translating Research to Policy to Achieve Impact on Well Being.

PubMed

Samuels, Bryan

2017-09-01

Policy emerges from the legislative, agency, and practice levels and from several pathways, including litigation; high profile or tragic events; community-based service provision and practice innovations; and research evidence. This commentary places an emphasis throughout on discussions of the articles included in this issue. It explores pathways that influenced the development of housing policy targeting child and family well being and provides examples to illustrate each pathway. The article further highlights how research on housing and child well being has influenced policy and practice and notes gaps for further research. It concludes with suggestions for structuring research to more effectively assist policymakers to make informed decisions that achieve positive change for children, youth, and families. © Society for Community Research and Action 2017.

Identifying the need for curriculum change. When a rural training program needs reform.

PubMed

Whiteside, C; Pope, A; Mathias, R

1997-08-01

To identify what changes should be made in the University of British Columbia's rural family practice training program curriculum to help graduates be better prepared to practice. Two cross-sectional surveys via mailed questionnaires: one designed to measure physicians' self-reported preparedness for practice and the other to measure the importance of various rural family medicine components. Rural training program graduates and preceptors representing rural communities in British Columbia. Thirty-nine graduates of the rural training program between 1982 and 1991 and 14 community-based rural training program preceptors representing eight communities throughout the province participated in this study. Percentage of graduates of the rural program who reported themselves to be underprepared on each family practice item and preceptors' mean scores for the attributed importance to rural practice of each item on this questionnaire. A list of curriculum areas most in need of reform was created. This list included trauma, counseling skills, radiology, vacuum extraction, fracture care, exercising community leadership, cost-effective use of diagnostic tests, using community health resources, obtaining hospital privileges, ophthalmology, dermatology, otolaryngology, personal and professional growth, relationships with other physicians, and personnel issues. Using both the level of graduates' self-reported underpreparedness and the attributed importance of elements of rural practice, as indicated by the preceptor survey, we developed a list of the areas of the rural training program curriculum most in need of reform.

Management of patients with coronary heart disease in family medicine: correlates of quality of care.

PubMed

Tušek-Bunc, Ksenija; Petek, Davorina

2018-04-10

Family medicine plays an important role in quality of care (QoC) of coronary heart disease (CHD) patients. This study's aim was to determine the quality of secondary cardiovascular disease prevention in the everyday practice of family physicians. This study was observational cross-sectional. About 36 randomly selected family medicine practices stratified by size and location in Slovenia. CHD patients randomly selected from a patient register available in family medicine practices. The instrument for assessment of quality included a form for collecting data from medical records, a general practice assessment questionnaire and a patient questionnaire. QoC was defined by two composite variables, namely risk factor registration and CHD patient process of care, as the two care outcomes. In multivariate analysis, we performed multilevel regression analysis to identify the associations between QoC, the patient and the practice characteristics. The final sample included 423 CHD patients from 36 family medicine practices. Risk factor registration was associated with the practice organisation score (P = 0.004), practice size (P = 0.042), presence of comorbid atherosclerotic diseases (P = 0.043) and a lower age of CHD patients (P = 0.001). CHD patient process of care was associated with the practice organisation score (0.045) and a lower age of CHD patients (P = 0.035). The most important factors affecting the quality of CHD patient care were linked to the organisational characteristics of the family medicine practices.

Social attitudes of Filipinos towards family planning interest groups.

PubMed

1992-08-01

Some results are provided from the 1991 Social Weather Survey conducted in 1991 for the Legislators' Committee on Population and Development. The sample included both males and females (84% Roman Catholic, 7% other indigenous Christians, 7% Protestants, 1.2% Muslims, 0.2% without a religion, and 0.1% Buddhists). Surprising findings are that the public does not feel restricted from using family planning methods due to religious rules, schooling teachings, or a physician's advice. Most people hold that politicians generally support family planning. Only 19% are reported to believe that governors are against family planning, and 16% report that their mayors are against family planning. According to stated voting intentions, incumbent government officials perceived to be anti-family planning risk not being reelected. 96% of the survey respondents believe that it is important to have control over one's fertility. Awareness of family planning methods is directly related to socioeconomic class, education, and urban location. 21% say that their religion forbids tubal ligation and 26% say that ligation should never be practiced. 22% say that their religion allows ligation. Among people who believe that religion bans ligation, 10% approve of ligation at any time and 44% stipulate that there are times when it may be practiced. Another interesting finding was that school teaching had more influence on beliefs than religion. When schools said that rhythm was not allowed, 40% agreed. When religion taught that rhythm was not allowed, only 21% agreed. 9% of persons who were sectarian educated and 5% among non-sectarian educated persons believed that ligation should not be practiced.

Women, microcredit and family planning practices: a case study from rural Ghana.

PubMed

Norwood, Carolette

2011-01-01

This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

Development and validation of a questionnaire for evaluation of students' attitudes towards family medicine.

PubMed

Šter, Marija Petek; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko

2015-03-01

The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students' attitudes towards family medicine and to evaluate the impact of the clerkship on students' attitudes regarding the competences of family doctor. In the pilot study, experienced family doctors were asked to describe their attitudes towards family medicine by using the Educational Agenda as a template for brainstorming. The statements were paraphrased and developed into a 164-items questionnaire, which was administered to 176 final-year students in academic year 2007/08. The third phase consisted of development of a final tool using statistical analysis, which resulted in the 60-items questionnaire in six domains which was used for the evaluation of students' attitudes. At the beginning of the clerkship, person-centred care and holistic approach scored lower than the other competences. Students' attitudes regarding the competences at the end of 7 weeks clerkship in family medicine were more positive, with exception of the competence regarding primary care management. The students who named family medicine as his or her future career choice, found holistic approach as more important than the students who did not name it as their future career. With the decision tree, which included students' attitudes to the competences of family medicine, we can successfully predict the future career choice in family medicine in 93.5% of the students. This study reports on the first attempt to develop a valid and reliable tool for measuring attitudes towards family medicine based on EURACT Educational Agenda. The questionnaire could be used for evaluating changes of students' attitudes in undergraduate curricula and for prediction of students' preferences regarding their future professional career in family medicine.

A practical Israeli strategy for appealing for organ donation.

PubMed

Ashkenazi, Tamar; Klein, Moti

2013-06-01

CONTEXT-Most reports on organ donation have been related to the importance of support for families, explanations of brain death, and the appeal for organ donation. In contrast, no reports have addressed organ donation from the perspective of intervention in cases of "sudden mourning" and the practical aspects of how to facilitate donation in such cases. OBJECTIVE-To develop a specific strategy for professional intervention in cases of imminent death to bring the family to a state of cognitive and emotional preparedness that will enable them to accept the tragic news, donate organs, and then take leave of the deceased. METHOD-The strategy presented here was developed on the basis of the records of donor coordinators who documented their interaction with families; consultations with professionals in the fields of marketing, persuasion, and negotiating; research conducted on families who did or did not donate organs; and statements made by family members of donors in focus and support groups in more than 10 years. RESULTS-The strategic approach includes early-stage rules such as staff self-awareness, and then later, critical stages of the process that take place before and at the time of determination of brain death: preparation for and the notification of death itself and the request for organ donation, including persuasion skills, coping with resistance and expressions of anger, and physical leave-taking from the deceased. CONCLUSIONS-The flexible, strategic approach set out here is designed to maximize the chances of procuring organ donation while protecting the family's rights and welfare.

Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

PubMed

Bengough, Theresa; Bovet, Emilie; Bécherraz, Camille; Schlegel, Susanne; Burnand, Bernard; Pidoux, Vincent

2015-12-11

Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.

Development of a Health Education Program to Promote the Self-Management of Cystic Fibrosis.

ERIC Educational Resources Information Center

Bartholomew, L. Kay; And Others

1991-01-01

Social learning theory formed the basis of a program to develop self-management skills in cystic fibrosis patients. Strategies for practical learning activities for patients and their families included goal setting, reinforcement, modeling, skill training, and self-monitoring. (SK)

Determinants of choosing a career in family medicine

PubMed Central

Scott, Ian; Gowans, Margot; Wright, Bruce; Brenneis, Fraser; Banner, Sandra; Boone, Jim

2011-01-01

Background Student choice is an important determinant of the distribution of specialties of practising physicians in many countries. Understanding characteristics at entry into medical school that are associated with the choice of residency in family medicine can assist medical schools in admitting an appropriate mix of students to serve the health care needs of their regions. Methods From 2002 to 2004, we collected data from students in 15 classes at 8 of 16 Canadian medical schools at entry. Surveys included questions on career choice, attitudes to practice and socio-demographic characteristics. We followed students prospectively with these data linked to their residency choice. We used multiple logistic regression analysis to identify entry characteristics that predicted a student’s ultimate career choice in family medicine. Results Of 1941 eligible students in the participating classes, 1542 (79.4%) contributed data to the final analyses. The following 11 entry variables predicted whether a student named family medicine as his or her top residency choice: being older, being engaged or in a long-term relationship, not having parents with postgraduate university education nor having family or close friends practicing medicine, having undertaken voluntary work in a developing nation, not volunteering with elderly people, desire for varied scope of practice, a societal orientation, a lower interest in research, desire for short postgraduate training, and lower preference for medical versus social problems. Interpretation Demographic and attitudinal characteristics at entry into medical school predicted whether students chose a career in family medicine. PMID:20974721

Like Father, like Child: Early Life Family Adversity and Children's Bullying Behaviors in Elementary School.

PubMed

de Vries, Else E; Verlinden, Marina; Rijlaarsdam, Jolien; Jaddoe, Vincent W V; Verhulst, Frank C; Arseneault, Louise; Tiemeier, Henning

2017-12-19

Family adversity has been associated with children's bullying behaviors. The evidence is, however, dominated by mothers' perceptions of the family environment and a focus on mothers' behaviors. This prospective population-based study examined whether children's bullying behaviors were associated with mother- and father-reported family adversity, assessed before and after child birth. Peer-nominations were used to assess bullying behaviors of 1298 children in elementary school (mean age 7.5 years). The following paternal risk factors were prospectively associated with children's bullying behaviors: (1) father-reported prenatal family distress, (2) fathers' hostility at preschool age, and (3) fathers' harsh disciplinary practices at preschool age, but effect sizes were relatively small. The effect of maternal risk factors was less consistent, only mother-reported family distress in childhood was associated with children's bullying behaviors. The associations were independent of background family risk factors (i.e., life stress, contextual factors, and other background factors such as parental education and risk taking record) and early childhood externalizing problems. Moreover, our results indicated that father-reported family adversity predicted children's bullying behaviors over and above the background family risk factors, early childhood externalizing problems and mother-reported family adversity. We also demonstrated that the association of fathers' prenatal hostility and family distress with subsequent bullying behavior of their child at school was partly mediated by fathers' harsh disciplinary practices at preschool age. Our findings highlight the importance of fathers' behaviors in the development of children's bullying behaviors.

Residential Instability Among Low-Income Families: A Concept Analysis.

PubMed

Cotton, Brandi Parker; Schwartz-Barcott, Donna

2016-04-01

Residential instability is relatively common among low-income families and is associated with a host of negative outcomes, especially for children and adolescents. Psychiatric nurses, especially those in the advanced practice role, observe the consequences of residential instability within the clinical setting. Yet, to-date, the concept is somewhat vague and its essential meaning and definition remain unclear. The aim of this paper is to develop a definition of residential instability using Wilson's method of concept analysis. An overview of historical perspectives is included. The paper concludes with recommendations for future research and application within clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Securing your family's future: the value of estate planning.

PubMed

Rinaldi, Ellen; Shin, Alisa M

2006-08-01

The authors provide an overview of general estate planning considerations, including minimization of federal estate taxes, estate planning techniques to be used to meet specific goals, and guidelines to ensure a well-drafted and well-organized plan. They also stress the importance of planning for incapacity. A well-thought-out and sound estate plan protects assets, minimizes estate taxes, ensures appropriate distribution to designated beneficiaries and prepares family members and business partners. In developing an estate plan, dentists should seek professional advice from a qualified attorney and a certified financial planner. Practice Implications. A sound estate plan should address business continuation or disposition with respect to the dental practice.

Administrators' Understanding and Use of Family-Centered Practices

ERIC Educational Resources Information Center

Mandell, Colleen J.; Murray, Mary M.

2009-01-01

Employing qualitative methods, administrators' understanding and use of family-centered practices were examined. Results indicate differences in role perceptions and service delivery based on their level of understanding. Administrators with a comprehensive understanding of family-centered practices, in comparison to administrators with limited or…

A qualitative study protocol of ageing carers' caregiving experiences and their planning for continuation of care for their immediate family members with intellectual disability.

PubMed

Low, Lisa Pau Le; Chien, Wai Tong; Lam, Lai Wah; Wong, Kayla Ka Yin

2017-04-07

Understanding the difficulties and needs of the family carers in taking care of a person with ID can facilitate the development of appropriate intervention programmes and services to strengthen their caring capacity and empower them to continue with their caring roles. This study aims to explore ageing family carers' caregiving experiences and the plans they have to provide care for themselves and their ageing children with mild or moderate intellectual disability (ID). A constructivist grounded theory will be used to interview around 60 carers who have a family member with mild or moderate ID and attending sheltered workshops in Hong Kong. Constant comparative analysis methods will be used for data analysis. The theory will capture family caregiving experiences and the processes of carers in addressing caregiving needs, support received and plans to continue to provide care for themselves and their relatives with ID in their later life. New insights into the emerging issues, needs and plights of family caregivers will be provided to inform the policies and practices of improving the preparation for the ageing process of the persons with ID, and to better support the ageing carers. The theoretical framework that will be generated will be highly practical and useful in generating knowledge about factors that influence the caregiving processes; and, tracking the caregiving journey at different time-points to clearly delineate areas to implement practice changes. In this way, the theoretical framework will be highly useful in guiding timely and appropriate interventions to target at the actual needs of family carers as they themselves are ageing and will need to continue to take care of their family members with ID in the community.

Interprofessional education in academic family medicine teaching units: a functional program and culture.

PubMed

Price, David; Howard, Michelle; Hilts, Linda; Dolovich, Lisa; McCarthy, Lisa; Walsh, Allyn E; Dykeman, Lynn

2009-09-01

The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration.

Gestational Diabetes Mellitus Risk score: A practical tool to predict Gestational Diabetes Mellitus risk in Tanzania.

PubMed

Patrick Nombo, Anna; Wendelin Mwanri, Akwilina; Brouwer-Brolsma, Elske M; Ramaiya, Kaushik L; Feskens, Edith

2018-05-28

Universal screening for hyperglycemia during pregnancy may be in-practical in resource constrained countries. Therefore, the aim of this study was to develop a simple, non-invasive practical tool to predict undiagnosed Gestational diabetes mellitus (GDM) in Tanzania. We used cross-sectional data of 609 pregnant women, without known diabetes, collected in six health facilities from Dar es Salaam city (urban). Women underwent screening for GDM during ante-natal clinics visit. Smoking habit, alcohol consumption, pre-existing hypertension, birth weight of the previous child, high parity, gravida, previous caesarean section, age, MUAC ≥28 cm, previous stillbirth, haemoglobin level, gestational age (weeks), family history of type 2 diabetes, intake of sweetened drinks (soda), physical activity, vegetables and fruits consumption were considered as important predictors for GDM. Multivariate logistic regression modelling was used to create the prediction model, using a cut-off value of 2.5 to minimise the number of undiagnosed GDM (false negatives). Mid-upper arm circumference (MUAC) ≥28 cm, previous stillbirth, and family history of type 2 diabetes were identified as significant risk factors of GDM with a sensitivity, specificity, positive predictive value, and negative predictive value of 69%, 53%, 12% and 95%, respectively. Moreover, the inclusion of these three predictors resulted in an area under the curve (AUC) of 0.64 (0.56-0.72), indicating that the current tool correctly classifies 64% of high risk individuals. The findings of this study indicate that MUAC, previous stillbirth, and family history of type 2 diabetes significantly predict GDM development in this Tanzanian population. However, the developed non-invasive practical tool to predict undiagnosed GDM only identified 6 out of 10 individuals at risk of developing GDM. Thus, further development of the tool is warranted, for instance by testing the impact of other known risk factors such as maternal age, pre-pregnancy BMI, hypertension during or before pregnancy and pregnancy weight gain. Copyright © 2018. Published by Elsevier B.V.