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Sample records for family practice system

  1. 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have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems.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.

  2. A dynamic family practice information system for enhanced financial management.

    PubMed

    Hofman, M N; Hughes, R L

    1982-08-01

    The definition of the fiscal unit/family structure has enabled users of the FMIS, or family practices in Colorado and Wyoming, to maintain accurate, ongoing financial information on their patients. In turn, this structure has been a major incentive for maintaining accurate family information, and a distinct benefit to FMIS users. This article has presented the rationale, design, and method of implementation of the fiscal unit structure, with the intention of presenting this concept to others for use in other information systems used in maintaining family-oriented financial and medical information for medical practices.

  3. System of telemedicine services designed for family doctors' practices.

    PubMed

    Bujnowska-Fedak, M M; Staniszewski, A; Steciwko, A; Puchala, E

    2000-01-01

    The main goal of the most European telemedicine programs is to increase access to emergency and primary care; however, telemedicine presents both profound opportunities and challenges to general practice/family medicine. The aim of this project is to develop and demonstrate a regional primary care teleconsulting system in Poland linking an academic family medicine center and 10 family doctors' practices (both urban and rural) within a range of 100-200 km, serving a local population of 25,000 individuals. It is designed to support real-time consultations among health care providers via a computer network, provide secure access to multimedia patient records, and facilitate an innovative home monitoring and remote care from doctors to their patients. The entire process (planned for 3 years) includes: selecting the best technology (i.e., teletransmission system, communication protocols, etc.) and equipment; preparing the assumptions and conditions for formats and transmission rates; analysis of the existing techniques of compression and preparing own specific solution; finding an optimal infrastructure (i.e., equipment and communication configuration); implementing the system; evaluation of the medical, economic, organizational, and sociological aspects of the system (i.e., accessibility to primary health care, cost feasibility and cost-effectiveness of telemedicine services, quality of care assessment, etc.). The project offers the potential to improve: access to high-quality primary health care; the patient-physician bond and the attending physician's level of confidence; education of family doctors; use of expensive resources; and a convenient mode of delivering medical services to the patient.

  4. Applying a family systems lens to proxy decision making in clinical practice and research.

    PubMed

    Rolland, John S; Emanuel, Linda L; Torke, Alexia M

    2017-03-01

    When patients are incapacitated and face serious illness, family members must make medical decisions for the patient. Medical decision sciences give only modest attention to the relationships among patients and their family members, including impact that these relationships have on the decision-making process. A review of the literature reveals little effort to systematically apply a theoretical framework to the role of family interactions in proxy decision making. A family systems perspective can provide a useful lens through which to understand the dynamics of proxy decision making. This article considers the mutual impact of family systems on the processes and outcomes of proxy decision making. The article first reviews medical decision science's evolution and focus on proxy decision making and then reviews a family systems approach, giving particular attention to Rolland's Family Systems Illness Model. A case illustrates how clinical practice and how research would benefit from bringing family systems thinking to proxy decisions. We recommend including a family systems approach in medical decision science research and clinical practices around proxy decisions making. We propose that clinical decisions could be less conflicted and less emotionally troubling for families and clinicians if family systems approaches were included. This perspective opens new directions for research and novel approaches to clinical care. (PsycINFO Database Record

  5. Adapting systems of care for child welfare practice with immigrant Latino children and families.

    PubMed

    Dettlaff, Alan J; Rycraft, Joan R

    2010-08-01

    Recent reform efforts in the child welfare system have called for child welfare agencies to provide community-based services and to increase the involvement of external stakeholders in identifying and developing services within the community. At the same time, child welfare agencies are faced with the challenge of providing services to an increasingly diverse population of children and families. As a result, there is a need for evidence-based practice models that respond to these challenges and promote positive outcomes for children and families. This paper describes the development of a program designed to train child welfare staff on the application of an existing evidence-based framework, systems of care, to practice with immigrant Latino children and families as a means of responding to these multiple calls for systems change and practice improvement. Immigrant Latino children and families represent the largest and fastest-growing population in the United States, and thus require the attention of child welfare systems and the development of evidence-based practices designed to respond to the unique needs of this population. Recommendations for program planners and evaluators on the application of systems of care to child welfare practice with immigrant Latino children and families are provided. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  6. A computerized system for tracking practice and prescriptive patterns of family nurse practitioner students.

    PubMed

    Fontana, S A; Kelber, S T; Devine, E C

    2001-03-01

    Decisions about the fit between advanced practice nursing curricula and the real world of primary care practice should be based on data and not on intuition. The purpose of this article is to describe a computerized database system that can be used to: 1) track practice (including prescribing) patterns of nurse practitioner (NP) students; 2) address data issues that commonly arise; and 3) describe NP students' practice during their education to prospective employers. The database system uses both the Family Nurse Practitioners Log (FNPLOG), a faculty-developed software program, and Epi Info, a companion public domain software program. Variables are categorized as being related to sociodemographic, diagnostic, or prescriptive components of primary care. The system provides a simple, efficient, and feasible way of computerizing, analyzing, and evaluating students' clinical experience and practice patterns. The implications for advanced practice nursing education will be illustrated along with other potential uses of the database system.

  7. 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…

  8. Hildegard Peplau meets family systems nursing: innovation in theory-based practice.

    PubMed

    Forchuk, C; Dorsay, J P

    1995-01-01

    Nursing theories which have evolved from mental health--psychiatric nursing have focused on the individual nurse-client relationship. Other nursing theories generally focus on the individual as client. Therefore, nurses working with families may have difficulty in applying these frameworks to their practice. Nursing theories need to be expanded to include families, groups and communities more explicitly. The well established theory of Hildegard Peplau, which previous studies have found to be the theory most frequently used by psychiatric nurses, and the family systems nursing theory of Wright and Leahey share a complementary focus. Both theories form part of the interpersonal paradigm of nursing; both view nursing from an interactional perspective, rather than focusing on individuals. Use of a combined theoretical approach offers several advantages. The approach explicitly considers both the individual and the family. The combination provides grounding for family work in an articulated nursing theory.

  9. Discretionary use of family practice information systems: an empirical examination in Turkey.

    PubMed

    Ada, Serkan; Bal, Canan Gamze; Çelik, Adnan; Akgemci, Tahir

    2013-01-01

    This study examined the antecedents and consequences of the discretionary use of the family practice information systems (FPIS) by family physicians in Turkey. A structured survey was conducted among family physicians located in Kahramanmaras, a southern province in Turkey. The partial least squares (PLS) method was used to analyse the survey data. Findings showed that (1) physicians' discretionary use of FPIS is positively related to their perceived value of patient care; (2) physicians' computer self-efficacy is positively related to their discretionary use of FPIS; (3) physicians' innovativeness in information technology (IT) is positively related to their computer self-efficacy; and (4) physicians' innovativeness in IT does not significantly impact on their discretionary use of FPIS. The present study's findings revealed that physicians should be adequately informed about the discretionary use of FPIS, and policies should be established to improve family physicians' understanding and competence of information systems, including computer self-efficacy.

  10. Frequent attendance in family practice and common mental disorders in an open access health care system.

    PubMed

    Norton, Joanna; David, Michel; de Roquefeuil, Guilhem; Boulenger, Jean-Philippe; Car, Josip; Ritchie, Karen; Mann, Anthony

    2012-06-01

    Frequent attenders in family practice are known to have higher rates of mental disorder. However little is known about specific psychiatric disorders and whether this behavior extends to specialist services, in an open access fee-for-service health care system. 1060 patients from 46 family practices completed the Patient Health Questionnaire and the Client Service Receipt Inventory. During the consultation, family practitioners blind to the questionnaire responses rated the severity of mental health and physical disorders. The 10% of patients with the highest number of 6-month consultations in six age and sex stratified groups were defined as frequent attenders. After adjustments for sociodemographic variables, physical health and other psychiatric diagnoses, patients with a somatoform disorder were more likely to be frequent attenders, with an odds ratio of 2.3 (95% CI: 1.3-3.8, p=.002). When adjusting for confounders, among the four psychiatric diagnoses investigated only somatoform disorders remain significantly associated with frequent attendance. Physical health and chronic disease were no longer associated with frequent attendance which does not support the hypothesis that in an open access fee-for-service system, patients will consult for a wider range of health problems. Greater investigation into unexplained somatic symptoms could help reduce the frequency of attendance in both primary and secondary care, as this behaviour appears to be a general health-seeking drive than extends beyond family practice. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Integrating the Illness Beliefs Model in clinical practice: a Family Systems Nursing knowledge utilization model.

    PubMed

    Duhamel, Fabie; Dupuis, France; Turcotte, Annie; Martinez, Anne-Marie; Goudreau, Johanne

    2015-05-01

    To promote the integration of Family Systems Nursing (FSN) in clinical practice, we need to better understand how nurses overcome the challenges of FSN knowledge utilization. A qualitative exploratory study was conducted with 32 practicing female nurses from hospital and community settings who had received FSN intervention training and skill development based on the Illness Beliefs Model and the Calgary Family Assessment and Intervention Models. The participants were interviewed about how they utilized FSN knowledge in their nursing practice. From the data analysis, a FSN Knowledge Utilization Model emerged that involves three major components: (a) nurses' beliefs in FSN and in their FSN skills, (b) nurses' knowledge utilization strategies to address the challenges of FSN practice, and (c) FSN positive outcomes. The FSN Knowledge Utilization Model describes a circular, incremental, and iterative process used by nurses to integrate FSN in daily nursing practice. Findings point to a need for re-evaluation of educational and management strategies in clinical settings for advancing the practice of FSN.

  12. Family practice in Turkey.

    PubMed

    Ozsahin, Akatli Kursad

    2014-03-01

    The national project 'Transformation in Health' was started in 2005 to provide expert primary care by family physicians, and decrease expenses in Turkey. The number of family physicians was far below the need, so public physicians were promoted to family physician status after a 10-day intensive course. The government declared some satisfactory results, but privately paid family physicians were not accepted into the system. Furthermore, the government stopped paying for their services from private settings. Some family physicians became unemployed as the major payer for all forms of medical care in Turkey denied their services. The process showed it's value in time. Nevertheless, family physicians should be the core of this transformation as family medicine is an academic and a scientific discipline and a primary care-oriented specialty with its own specific educational content, research and base of evidence, which cannot be achieved through standard medical education.

  13. Profession differences in family focused practice in the adult mental health system.

    PubMed

    Maybery, Darryl; Goodyear, Melinda; O'Hanlon, Brendan; Cuff, Rose; Reupert, Andrea

    2014-12-01

    There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.

  14. Strengthening Family Practices for Latino Families

    PubMed Central

    Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.

    2010-01-01

    The study examined the effectiveness of a culturally-adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9–12 year old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto Rican families. PMID:20871785

  15. Family practice clinics. Survey of family practice residents' attitudes.

    PubMed Central

    Rubenstein, H.; Levitt, C.

    1993-01-01

    All residents of McGill University's Department of Family Medicine were surveyed by mail about their family practice clinic experience. Residents were generally satisfied with their training site and their supervision, but noted problems with volume and diversity of patients, learning certain procedures, and knowledge of community resources. They did not want more family medicine clinic time. PMID:8219838

  16. Effects of In-Service Training on Early Intervention Practitioners' Use of Family-Systems Intervention Practices in the USA

    ERIC Educational Resources Information Center

    Dunst, Carl J.; Trivette, Carol M.; Deal, Angela G.

    2011-01-01

    The effectiveness of three types of in-service training designed to improve early intervention practitioners' abilities to use family-systems intervention practices was evaluated in the study of 473 participants. Participants attended either conference presentations or one of two types of workshops (half day/full day or multi-day), or received one…

  17. [Family grasping establishment of service net, making family planning work become a regular practice and a system].

    PubMed

    1987-07-01

    In accordance with Central Committee Document no. 7 which calls for family planning work reform, China's Yuncheng Prefecture established changes in its family planning System. Yuncheng Prefecture contains 13 counties, 211 townships, 3292 administrative villages, and a population of 3,850,000. Propaganda technique leadership stations were implemented in 70% of the prefectures and counties, propaganda technique service stations in 90% of the townships, 1829 service rooms and 475 services in the villages. The Central Committee has frequently stated that controlling population growth entails strategic responsibility; the establishment of service nets is the primary step for fulfilling that responsibility. Methods in its establishment include: 1) Comprehensive planning: determining which districts have leadership and are receptive; 2) Proper selection of enthusiastic and educated personnel; 3) Adequate equipment at service sites; 4) Coordination of service net efforts with public health departments; 5) Accomplishing the following 5 services through administrative and professional management: propaganda, technology, policy, eugenics, and social welfare. The social advantage of the service nets is the creation in 2 years of a specialized group form the agrarian community who will become a systematic force which will guarantee continuous family planning work. As a consequence of the establishment service nets, more couples now desire only 1 child; unplanned 2nd births in 1984 decreased 12% from 1983. The multiple child rate fell 4.83% for those years. Family planning work has become more economical and efficient.

  18. The Joy of Family Practice

    PubMed Central

    Ventres, William

    2012-01-01

    Many family physicians have written about how they influence, nurture, and empower people in their communities of practice. In this essay, the author writes of the personal joys that family medicine has brought him. An expression of his appreciation for his work as a family doctor, it touches on 6 themes that continue to rejuvenate his practice: love, faith, mystery, place, dance, and medicine. By examining the emotional and psychological dimensions of these themes, he offers a path by which other family physicians may be able to find sustenance and joy in their daily work. PMID:22585892

  19. The Canadian Family Practice Accoucheur

    PubMed Central

    Klein, Michael

    1986-01-01

    Family practice obstetrics is strongly influenced by demography and marketing. The falling birth rate is leading to a surplus of caregivers who may inappropriately apply their technical skills to a population of low-risk pregnant women. This in turn may lead to a ‘cascade’ of negative consequences for the normal, child-bearing public. The family practice accoucheur has a key role to play as an advocate of high quality, humanistic maternity care. Training programs must address the academic base of family practice obstetrics through direct teaching, role modelling, research, and quality assurance. PMID:21267147

  20. 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)

  1. Familial research reveals new practice model.

    PubMed

    Denham, Sharon A

    2003-01-01

    Three ethnographic studies investigated how families define and practice family health within their household and community settings. Synthesis of these findings prompted the Family Health Model. It suggests ways to dialogue about the complex variables associated with family health and approaches to family-focused practice.

  2. Changing policy and practice in the child welfare system through collaborative efforts to identify and respond effectively to family violence.

    PubMed

    Banks, Duren; Landsverk, John; Wang, Kathleen

    2008-07-01

    The Greenbook provides a roadmap for child welfare agencies to collaborate and provide effective responses to families who are experiencing co-occurring child maltreatment and domestic violence. A multisite developmental evaluation was conducted of six demonstration sites that received federal funding to implement Greenbook recommendations for child welfare agencies. Surveys of child welfare caseworkers show significant changes in several areas of agency policy and practice, including regular domestic violence training, written guidelines for reporting domestic violence, and working closely and sharing resources with local domestic violence service providers. Case file reviews show significant increases in the level of active screening for domestic violence, although this increase peaks at the midpoint of the initiative. These findings, coupled with on-site interview data, point to the importance of coordinating system change activities in child welfare agencies with a number of other collaborative activities.

  3. From Dyads to Family Systems: A Bold New Direction for Infant Mental Health Practice

    ERIC Educational Resources Information Center

    McHale, James P.; Phares, Vicky

    2015-01-01

    This issue on fathers was conceived as a rallying cry for all professionals to examine their practices of including fathers in their services. For too long, infant mental health professionals have either ignored fathers' important influences on infants and toddlers or have given lip-service to their importance while allowing the status quo of not…

  4. From Dyads to Family Systems: A Bold New Direction for Infant Mental Health Practice

    ERIC Educational Resources Information Center

    McHale, James P.; Phares, Vicky

    2015-01-01

    This issue on fathers was conceived as a rallying cry for all professionals to examine their practices of including fathers in their services. For too long, infant mental health professionals have either ignored fathers' important influences on infants and toddlers or have given lip-service to their importance while allowing the status quo of not…

  5. The Neurological Examination in Family Practice

    PubMed Central

    Siemens, Peter

    1974-01-01

    The family practitioner has the first opportunity and responsibility of making a diagnosis. Since a large portion of his work is concerned with neurological problems, he should be able to do a complete neurological examination. This examination should include evaluation of the gait, mental function, cranial nerves, motor system and sensory system. With practice, a routine neurological examination can be done rapidly and accurately. PMID:20469138

  6. Strengthening Family Practices for Latino Families

    ERIC Educational Resources Information Center

    Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.

    2010-01-01

    This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted…

  7. Strengthening Family Practices for Latino Families

    ERIC Educational Resources Information Center

    Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.

    2010-01-01

    This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted…

  8. Adapting Systems of Care for Child Welfare Practice with Immigrant Latino Children and Families

    ERIC Educational Resources Information Center

    Dettlaff, Alan J.; Rycraft, Joan R.

    2010-01-01

    Recent reform efforts in the child welfare system have called for child welfare agencies to provide community-based services and to increase the involvement of external stakeholders in identifying and developing services within the community. At the same time, child welfare agencies are faced with the challenge of providing services to an…

  9. A Research Framework for Understanding the Practical Impact of Family Involvement in the Juvenile Justice System: The Juvenile Justice Family Involvement Model.

    PubMed

    Walker, Sarah Cusworth; Bishop, Asia S; Pullmann, Michael D; Bauer, Grace

    2015-12-01

    Family involvement is recognized as a critical element of service planning for children's mental health, welfare and education. For the juvenile justice system, however, parents' roles in this system are complex due to youths' legal rights, public safety, a process which can legally position parents as plaintiffs, and a historical legacy of blaming parents for youth indiscretions. Three recent national surveys of juvenile justice-involved parents reveal that the current paradigm elicits feelings of stress, shame and distrust among parents and is likely leading to worse outcomes for youth, families and communities. While research on the impact of family involvement in the justice system is starting to emerge, the field currently has no organizing framework to guide a research agenda, interpret outcomes or translate findings for practitioners. We propose a research framework for family involvement that is informed by a comprehensive review and content analysis of current, published arguments for family involvement in juvenile justice along with a synthesis of family involvement efforts in other child-serving systems. In this model, family involvement is presented as an ascending, ordinal concept beginning with (1) exclusion, and moving toward climates characterized by (2) information-giving, (3) information-eliciting and (4) full, decision-making partnerships. Specific examples of how courts and facilities might align with these levels are described. Further, the model makes predictions for how involvement will impact outcomes at multiple levels with applications for other child-serving systems.

  10. 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.

  11. The Psychiatric Family Nurse Practitioner: A Collaborator in Family Practice

    PubMed Central

    Cunningham, Patricia D.

    1999-01-01

    The potential of the psychiatric family nurse practitioner (Psych.F.N.P.) to contribute to family practice through physical care and mental health care exists in the here and now. This role is a synthesis of 2 advanced practice roles, the psychiatric clinical nurse specialist (Psych.C.N.S.) and family nurse practitioner (F.N.P.), both of which continue to have great utility independently. This synthesis is a practical application of concepts that have evolved to meet the changing patterns of health care delivery. At this time, dual certification as a Psych.C.N.S. and F.N.P. best reflects the broad practice expertise of the psychiatric family nurse practitioner. The experienced psychiatric family nurse practitioner provides direct care for both physical and psychological needs of patients in a family practice setting. PMID:15014701

  12. Rural Idaho Family Physicians' Scope of Practice

    ERIC Educational Resources Information Center

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

    2010-01-01

    Context: Scope of practice is an important factor in both training and recruiting rural family physicians. Purpose: 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. Methods: A survey instrument was developed based on a literature…

  13. Rural Idaho Family Physicians' Scope of Practice

    ERIC Educational Resources Information Center

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

    2010-01-01

    Context: Scope of practice is an important factor in both training and recruiting rural family physicians. Purpose: 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. Methods: A survey instrument was developed based on a literature…

  14. Healthy Family 2009: Practicing Healthy Adult Living

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Healthy Family 2009 Practicing Healthy Adult Living Past Issues / Winter ... diabetes, or if heart disease runs in your family, begin checking cholesterol at age 20. Colorectal Cancer : ...

  15. Building Family/General Practice Research Capacity

    PubMed Central

    Del Mar, Chris; Askew, Deborah

    2004-01-01

    To promote the range of interventions for building family/general practice (family medicine) research capacity, we describe successful international examples. Such examples of interventions that build research capacity focus on diseases and illness research, as well as process research; monitor the output of research in family/general practice (family medicine); increase the number of family medicine research journals; encourage and enable research skills acquisition (including making it part of professional training); strengthen the academic base; and promote research networks and collaborations. The responsibility for these interventions lies with the government, colleges and academies, and universities. There are exciting and varied methods of building research capacity in family medicine. PMID:15655086

  16. Family Therapy, Family Practice, and Child and Family Poverty: Historical Perspectives and Recent Developments

    ERIC Educational Resources Information Center

    Frankel, Harvy; Frankel, Sid

    2006-01-01

    This paper assesses the engagement of family therapy and family practice with families with children, who are living in poverty. It analyzes four promising models from two perspectives. The first perspective relates to critiques, which have been made of the practice of family therapy with families living in poverty; and the second relates to the…

  17. Therapy for Family Systems.

    ERIC Educational Resources Information Center

    Rosmann, Michael R.

    A family therapy model, based on a conceptualization of the family as a behavioral system whose members interact adaptively so that an optimal level of functioning is maintained within the system, is described. The divergent roots of this conceptualization are discussed briefly, as are the treatment approaches based on it. The author's model,…

  18. Managing chronic pain in family practice.

    PubMed Central

    Librach, S. L.

    1993-01-01

    Pain is common in family practice. In dealing with chronic pain, both the family physician and the patient often have problems in defining and in understanding the origin of chronic pain and in providing effective pain relief. This article explores a practical, holistic approach to understanding and managing chronic pain. PMID:8471902

  19. Nutrition Education for Family Practice Residents.

    ERIC Educational Resources Information Center

    Dappen, Alan; And Others

    1986-01-01

    The American Academy of Family Practice requires that nutrition be taught to residents throughout their three-year residencies, although it does not specify a block of nutrition instruction. The nutrition knowledge of residents in eight family practice residencies in California were examined. (MLW)

  20. Alternative models for academic family practices.

    PubMed

    Michener, J Lloyd; Østbye, Truls; Kaprielian, Victoria S; Krause, Katrina M; Yarnall, Kimberly S H; Yaggy, Susan D; Gradison, Margaret

    2006-03-20

    The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-supporting practices, but seek support from specialty colleagues or hospital practice plans. Alternative models for academic family practices that are economically viable and consistent with the principles of family medicine are needed. This article presents several "experiments" to address these challenges. The basis of comparison is a traditional academic family medicine center. Apart of the faculty practice plan, our center consistently operated at a deficit despite high productivity. A number of different practice types and alternative models of service delivery were therefore developed and tested. They ranged from a multi-specialty office arrangement, to a community clinic operated as part of a federally-qualified health center, to a team of providers based in and providing care for residents of an elderly public housing project. Financial comparisons using consistent accounting across models are provided. Academic family practices can, at least in some settings, operate without subsidy while providing continuity of care to a broad segment of the community. The prerequisites are that the clinicians must see patients efficiently, and be able to bill appropriately for their payer mix. Experimenting within academic practice structure and organization is worthwhile, and can result in economically viable alternatives to traditional models.

  1. Practice with Transgendered Youth and Their Families.

    ERIC Educational Resources Information Center

    Cooper, Ken

    1999-01-01

    Explores various issues confronting social work practice with transgendered youth and their families in order to help families understand and grow along with their transgendered members. Focuses on: sex, gender attributes, and roles; intersexuality in infants; gender variation in children; transsexuality; new gender options; family transitions…

  2. Scaling up evidence-based practices for children and families in New York State: toward evidence-based policies on implementation for state mental health systems.

    PubMed

    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, policymakers, 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 more than 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.

  3. The Practicality and Significance of Microbiological Culturing in Family Practice

    PubMed Central

    Smith, John A.

    1976-01-01

    Many recommendations from microbiologists and infectious diseases physicians are suitable for hospital infectious diseases practice but are very difficult to employ in family practice. This paper bears that situation in mind when outlining worthwhile cultures for diseases commonly seen by family physicians. PMID:21308047

  4. Brief Psychotherapy in Family Practice

    PubMed Central

    MacDonald, Peter J.; Brown, Alan

    1986-01-01

    A large number of patients with psychosocial or psychiatric disorders present to family physicians, and the family physician needs a model of psychotherapy with which to cope with their problems. A model of brief psychotherapy is presented which is time limited, goal directed and easy to learn. It consists of four facets drawn from established areas of psychotherapy: characteristics of the therapist; characteristics of the patient; Eriksonian developmental stages; and the process of therapy as described by Carkhuff. These facets fit together in a way which is useful to the family physician in managing those patient problems for which brief psychotherapy is indicated. PMID:21267176

  5. Old wine in new bottles: decanting systemic family process research in the era of evidence-based practice.

    PubMed

    Rohrbaugh, Michael J

    2014-09-01

    Social cybernetic (systemic) ideas from the early Family Process era, though emanating from qualitative clinical observation, have underappreciated heuristic potential for guiding quantitative empirical research on problem maintenance and change. The old conceptual wines we have attempted to repackage in new, science-friendly bottles include ironic processes (when "solutions" maintain problems), symptom-system fit (when problems stabilize relationships), and communal coping (when we-ness helps people change). Both self-report and observational quantitative methods have been useful in tracking these phenomena, and together the three constructs inform a team-based family consultation approach to working with difficult health and behavior problems. In addition, a large-scale, quantitatively focused effectiveness trial of family therapy for adolescent drug abuse highlights the importance of treatment fidelity and qualitative approaches to examining it. In this sense, echoing the history of family therapy research, our experience with juxtaposing quantitative and qualitative methods has gone full circle-from qualitative to quantitative observation and back again. © 2014 FPI, Inc.

  6. Promising Practices in Wraparound for Children with Serious Emotional Disturbance and Their Families. Systems of Care: Promising Practices in Children's Mental Health 1998 Series. Volume IV.

    ERIC Educational Resources Information Center

    Burns, Barbara J., Ed.; Goldman, Sybil K., Ed.

    This is the fourth volume in a series of monographs from the Comprehensive Community Mental Health Service for Children and Their Families Program, which currently supports 41 comprehensive system of care sites to meet the needs of children with serious emotional disturbances (SED). This volume identifies the essential elements of wraparound…

  7. Practice Opportunities for Family Medicine Graduates

    PubMed Central

    Walters, David J.

    1980-01-01

    This paper documents the career choices of a graduating class of family medicine residents at Queen's University. In the first post-graduation year, residents were evenly divided between those who undertook a third year of training and those who began practice. For those who began practice, a profile of their first year of experience demonstrates the excellent variety of opportunities awaiting family medicine graduates. PMID:21293605

  8. Meta-analysis of family-centered helpgiving practices research.

    PubMed

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

    2007-01-01

    A meta-analysis of 47 studies investigating the relationship between family-centered helpgiving practices and parent, family, and child behavior and functioning is reported. The studies included more than 11,000 participants from seven different countries. Data analysis was guided by a practice-based theory of family-centered helpgiving that hypothesized direct effects of relational and participatory helpgiving practices on self-efficacy beliefs and parent, family, and child outcomes. Results showed that the largest majority of outcomes were related to helpgiving practices with the strongest influences on outcomes most proximal and contextual to help giver/help receiver exchanges. Findings are placed in the context of a broader-based social systems framework of early childhood intervention and family support.

  9. Dermoscopy for melanoma detection in family practice

    PubMed Central

    Herschorn, Andrea

    2012-01-01

    Abstract Objective To assess the diagnostic accuracy and clinical utility of dermoscopy for melanoma detection in family practice. Quality of evidence Ovid MEDLINE (1946 to June 2011), EMBASE, PubMed, and Cochrane databases were searched using the following terms: dermoscopy, dermatoscopy, epiluminescence microscopy, family practice, general practice, primary health care, melanoma, skin neoplasms, and pigmented nevus. To be included, studies had to be primary research articles with family physicians as the subjects and dermoscopy training and use as the intervention. Four papers met all inclusion criteria and provided level I evidence according to the Canadian Task Force on Preventive Health Care definition. Main message Among family physicians, dermoscopy has higher sensitivity for melanoma detection than naked-eye examination with generally no decrease in specificity. Dermoscopy also helps to increase family physicians’ confidence in their preliminary diagnosis of lesions. When using dermoscopy, compared with naked-eye examination, there is a higher likelihood that a lesion assessed as being malignant is in fact malignant and that a lesion assessed as being benign is in fact benign. Conclusion Dermoscopy has been shown to be a useful and fairly inexpensive tool for melanoma detection in family practice. This technique can increase family physicians’ confidence in their referral accuracy to dermatologists and can assist in decreasing unnecessary biopsies. Dermoscopy might be especially useful in examining patients at high risk of melanoma, as the current Canadian clinical practice guideline recommends yearly screening in these individuals. PMID:22859635

  10. Changing Trends In Family Practice Obstetrics

    PubMed Central

    Ranson, Peter J.

    1978-01-01

    Since trends in some countries show less involvement of the family doctor in obstetrics, and even more reliance on the obstetrician/gynecologist as the primary care physician for women, this study was designed to find out if obstetrics could be adequately practiced in a small rural hospital by family physicians with occasional surgical help. Also, a questionnaire was sent to 200 family physicians, 100 in Ottawa and 100 in Vancouver, to ascertain their involvement in obstetrics.

  11. Fewer family physicians are in solo practices.

    PubMed

    Peterson, Lars E; Baxley, Elizabeth; Jaén, Carlos Roberto; Phillips, Robert L

    2015-01-01

    Over the past 20 years there has been a statistically significant trend toward fewer family physicians identifying as being in solo practice. Further study to determine the reasons for this decline and its impact on access to care will be critical because rural areas are more dependent on solo practitioners. © Copyright 2015 by the American Board of Family Medicine.

  12. 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…

  13. 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.

  14. A Family Resilience Framework: Innovative Practice Applications.

    ERIC Educational Resources Information Center

    Walsh, Froma

    2002-01-01

    Presents an overview of a research-informed family resilience framework, developed as a conceptual map to guide clinical intervention and prevention efforts with vulnerable families. Outlines key processes that foster resilience and innovative family systems training and service applications. (JDM)

  15. A Family Resilience Framework: Innovative Practice Applications.

    ERIC Educational Resources Information Center

    Walsh, Froma

    2002-01-01

    Presents an overview of a research-informed family resilience framework, developed as a conceptual map to guide clinical intervention and prevention efforts with vulnerable families. Outlines key processes that foster resilience and innovative family systems training and service applications. (JDM)

  16. From Programs to Systems: Deploying Implementation Science and Practice for Sustained Real World Effectiveness in Services for Children and Families.

    PubMed

    Ghate, Deborah

    2016-01-01

    The transfer of knowledge of effective practice, especially into "usual care" settings, remains challenging. This article argues that to close this gap we need to recognize the particular challenges of whole-system improvement. We need to move beyond a limited focus on individual programs and experimental research on their effectiveness. The rapidly developing field of implementation science and practice (ISP) provides a particular lens and a set of important constructs that can helpfully accelerate progress. A review of selected key constructs and distinctive features of ISP, including recognizing invisible system infrastructure, co-construction involving active collaboration between stakeholders, and attention to active implementation, supports for providers beyond education and training. Key aspects of an implementation lens likely to be most helpful in sustaining effectiveness include assisting innovators to identify and accommodate the architecture of existing systems, understand the implementation process as a series of distinct but nonlinear stages, identify implementation outcomes as prerequisites for treatment outcomes, and analyse implementation challenges using frameworks of implementation drivers. In complex adaptive systems, how services are implemented may matter more than their specific content, and how services align and adapt to local context may determine their sustained usefulness. To improve implementation-relevant research, we need better process evaluation and cannot rely on experimental methods that do not capture complex systemic contexts. Deployment of an implementation lens may perhaps help to avoid future "rigor mortis," enabling more productively flexible and integrative approaches to both program design and evaluation.

  17. 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

  18. Being a family systems thinker: a psychiatrist's personal odyssey.

    PubMed

    Combrinck-Graham, Lee

    2014-09-01

    This account traces the development of family systems thinking from early pioneering thinking and practices, through the development of institutions and professional definitions, and through challenges to family systems thinking and practice from the biomedical points of view. Throughout there is a strong conviction that "thinking family" is an essential core of effective mental health treatment, because families can heal. © 2014 FPI, Inc.

  19. Rapid HIV test in family practice.

    PubMed

    Poirier, C; Aymeric, S; Grammatico-Guillon, L; Lebeau, J P; Bernard, L; Le Bret, P; Le Moal, G; Gras, G

    2015-06-01

    The 2010-2014 HIV/AIDS French program recommends using HIV rapid diagnostic tests in family practice. Our aim was to assess the acceptability and feasibility of the RDT in family practice in France. The first part of this study was to determine the opinions of family practitioners (FPs) concerning the news guidelines for screening and the possible use of rapid HIV tests in their practice. The second part was a feasibility study of the actual use of rapid HIV tests given to FPs during six months. The third part was a qualitative analysis of experience feedback to determine the impediments to using rapid HIV tests. Seventy-seven percent of the 352 FPs interviewed were favorable to rapid HIV tests use. The three main impediments were: misinterpretation of test result, complexity of quality control, and lack of training: 23 of the 112 FPs having volunteered to evaluate the rapid HIV tests followed the required training session. Sixty-nine tests were handed out, and three rapid HIV tests were used; the qualitative study involved 12 FPs. The participants all agreed on the difficult use of rapid HIV tests in daily practice. The main reasons were: too few opportunities or requests for use, complex handling, difficulties in proposing the test, fear of having to announce seropositivity, significantly longer consultation. Although FPs are generally favorable to rapid HIV tests use in daily practice, the feasibility and contribution of rapid HIV tests are limited in family practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Parents and family matter: strategies for developing family-centered adolescent care within primary care practices.

    PubMed

    Svetaz, María Verónica; Garcia-Huidobro, Diego; Allen, Michele

    2014-09-01

    Healthy adolescent development and successful transition to adulthood begins in the family. Supporting families in their communities and cultures ultimately makes this support system stronger. Parenting adolescents is described as the most challenging life stage for parents. Primary care providers are in an ideal position to support families with teens. This article reviews stressors, recommends strength-based strategies, describes how health care delivery systems can be organized to address the needs of adolescents and their families, shares a case study of a family-oriented, youth-friendly primary care clinic, and provides practical strategies for developing family-centered adolescent care within primary care practices. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Family planning practices in families with children affected by β-thalassemia major in Southern Iran.

    PubMed

    Haghpanah, Sezaneh; Johari, Sheyda; Parand, Shirin; Bordbar, Mohammad Reza; Karimi, Mehran

    2013-01-01

    Preventing the birth of children with β-thalassemia major (β-TM) is an important health issue. We investigated family planning practices and related factors among families with affected children. We selected a total of 569 parents from the parents of patients with β-TM who were registered at thalassemia referral clinics in southern Iran. Information was recorded regarding demographic variables, socioeconomic status and family planning practices. The correlations between family planning practice and related factors were evaluated. Approximately 96.0% of the parents (546) were practicing contraception at the time of the study. Only 12.8% of the families whose first child had β-TM decided to have no more children. The most frequent contraceptive method was tubal ligation (TL) (37.5%) followed by oral contraceptive pills (OCP) (31.5%). Higher education level of the mothers and higher economic status of the families were found to be related with the lower numbers of children with β-TM (p = 0.001). We found a high percentage of safe contraception being used by at-risk couples. It seems that educational programs have been effective in influencing family planning practices. Further attention should be devoted to increasing the knowledge of at-risk couples with a greater focus on parents of low socioeconomic status. Because of cultural factors in Iran, many of these at-risk couples opted to achieve the desired family size, so implementation of a well-organized prenatal diagnostic system seems necessary.

  2. Sibling Family Practices: Guidelines for Healthy Boundaries

    ERIC Educational Resources Information Center

    Johnson, Toni Cavanagh; Huang, Bevan Emma; Simpson, Pippa M.

    2009-01-01

    A questionnaire was given to 500 mental health and child welfare professionals asking for maximum acceptable ages for siblings to engage jointly in certain family practices related to hygiene, affection, and privacy. A large proportion of respondents felt it was never acceptable for siblings to take showers together (40%), kiss on the mouth (37%),…

  3. Family Literacy: From Theory to Practice.

    ERIC Educational Resources Information Center

    DeBruin-Parecki, Andrea, Ed.; Krol-Sinclair, Barbara, Ed.

    This book addresses family literacy as a theoretically sound field of research and practice that can be used to improve literacy worldwide. The book's 14 chapters are divided into four sections. Following the "Introduction" (Andrea DeBruin-Parecki and Barbara Krol-Sinclair), under Section I--Theoretical Perspectives Related to Family…

  4. Parenting Practices, Child Adjustment, and Family Diversity.

    ERIC Educational Resources Information Center

    Amato, Paul R.; Fowler, Frieda

    2002-01-01

    Uses data from the National Survey of Families and Households to test the generality of the links between parenting practices and child outcomes. Parents' reports of support, monitoring, and harsh punishment were associated in the expected direction with parents' reports of children's adjustment, school grades, and behavior problems, and with…

  5. Otolaryngology Training for Family Practice Residents.

    ERIC Educational Resources Information Center

    And Others; Rood, Stewart R.

    1980-01-01

    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  6. Otolaryngology Training for Family Practice Residents.

    ERIC Educational Resources Information Center

    And Others; Rood, Stewart R.

    1980-01-01

    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  7. Parenting Practices, Child Adjustment, and Family Diversity.

    ERIC Educational Resources Information Center

    Amato, Paul R.; Fowler, Frieda

    2002-01-01

    Uses data from the National Survey of Families and Households to test the generality of the links between parenting practices and child outcomes. Parents' reports of support, monitoring, and harsh punishment were associated in the expected direction with parents' reports of children's adjustment, school grades, and behavior problems, and with…

  8. Family Literacy: From Theory to Practice.

    ERIC Educational Resources Information Center

    DeBruin-Parecki, Andrea, Ed.; Krol-Sinclair, Barbara, Ed.

    This book addresses family literacy as a theoretically sound field of research and practice that can be used to improve literacy worldwide. The book's 14 chapters are divided into four sections. Following the "Introduction" (Andrea DeBruin-Parecki and Barbara Krol-Sinclair), under Section I--Theoretical Perspectives Related to Family…

  9. Allocation of Allowances and Associated Family Practices.

    ERIC Educational Resources Information Center

    Kerr, M. Kaye; Cheadle, Tannis

    This study gathered information on general family practices concerning allowances given to children, parental reasons for the provision of allowances, the bases for their administration, and the frequency of conflicts generated around them. The subjects were 81 parents of elementary school children in a midwest Canadian city. Subjects completed…

  10. Changing Policy and Practice in the Child Welfare System through Collaborative Efforts to Identify and Respond Effectively to Family Violence

    ERIC Educational Resources Information Center

    Banks, Duren; Landsverk, John; Wang, Kathleen

    2008-01-01

    The "Greenbook" provides a roadmap for child welfare agencies to collaborate and provide effective responses to families who are experiencing co-occurring child maltreatment and domestic violence. A multisite developmental evaluation was conducted of six demonstration sites that received federal funding to implement "Greenbook" recommendations for…

  11. Changing Policy and Practice in the Child Welfare System through Collaborative Efforts to Identify and Respond Effectively to Family Violence

    ERIC Educational Resources Information Center

    Banks, Duren; Landsverk, John; Wang, Kathleen

    2008-01-01

    The "Greenbook" provides a roadmap for child welfare agencies to collaborate and provide effective responses to families who are experiencing co-occurring child maltreatment and domestic violence. A multisite developmental evaluation was conducted of six demonstration sites that received federal funding to implement "Greenbook" recommendations for…

  12. The disorganized family: institutions, practices and normativity.

    PubMed

    Smyth, Lisa

    2016-12-01

    This paper considers the value of a normative account of the relationship between agents and institutions for contemporary efforts to explain ever more complex and disorganized forms of social life. The character of social institutions, as they relate to practices, agents and norms, is explored through an engagement with the common claim that family life has been de-institutionalized. The paper argues that a normative rather than empirical definition of institutions avoids a false distinction between institutions and practices. Drawing on ideas of social freedom and creative action from critical theory, the changes in family life are explained not as an effect of de-institutionalization, but as a shift from an organized to a disorganized institutional type. This is understood as a response to changes in the wider normative structure, as a norm of individual freedom has undermined the legitimacy of the organized patriarchal nuclear family, with gender ascribed roles and associated duties. Contemporary motherhood is drawn on to illustrate the value of analysing the dynamic interactions between institutions, roles and practices for capturing both the complexity and the patterned quality of social experience. © London School of Economics and Political Science 2016.

  13. Family practice physicians' beliefs, attitudes, and practices regarding obesity.

    PubMed

    Price, J H; Desmond, S M; Krol, R A; Snyder, F F; O'Connell, J K

    1987-01-01

    This study examined 318 family practice physicians' beliefs, attitudes, and practices regarding obese patients. Most physicians surveyed were aware of the health effects of obesity and that normal weight is important to the health of their patients. Beliefs, attitudes, and practices differed significantly based on the physicians' sex, weight, years in practice, and belief that counseling patients on weight loss is professionally gratifying and that most obese patients can lose significant amounts of weight. A notable number of respondents held negative or stereotypical attitudes toward obese patients (i.e., obese patients lack self-control, are lazy and sad). The most commonly recommended weight loss techniques were decreasing caloric consumption (92 percent), participating in Weight Watchers (84 percent), consulting a dietitian/nutritionist (76 percent), and aerobic exercise (75 percent). The two sources of weight control information most frequently cited were past experience (73 percent) and medical journals (71 percent). The results of this survey indicate that there is considerable room for improvement in the beliefs, attitudes, and practices of family physicians regarding obese patients.

  14. The family theory-practice gap: a matter of clarity?

    PubMed

    Segaric, Cheryl A; Hall, Wendy A

    2005-09-01

    Despite recognition of the importance of family in health-care and progress in family theory development, there has been limited transfer of family theory to acute care nursing practice. We argue that this family theory-practice gap results from a persistent lack of conceptual clarity in family nursing and other barriers. Lack of conceptual clarity takes the form of conceptual overlap and semantic inconsistency, as well as the complexity of language found in the family nursing literature. Barriers include practice contexts, relational problems, and knowledge types. Our exploration begins with a brief discussion of the intimate link between nursing theory and practice followed by an overview of some issues associated with the family nursing theory-practice gap. Based on a synthesis of family nursing literature, problems associated with conceptual clarity in family nursing theory are explored. We conclude with recommendations for family nursing research to develop concepts grounded in nursing practice.

  15. Practical systems thinking

    NASA Astrophysics Data System (ADS)

    Konkarikoski, K.; Ritala, R.; Ihalainen, H.

    2010-07-01

    System is a dynamic and complex whole, interacting as a structured functional unit. Systems thinking provides tools for understanding a such system structure and its dynamic behavior. Practical systems thinking course teaches first year bachelor students basics about systems and how open problem can be formulated to system task.

  16. Family Medicine's Waltz with Systems

    ERIC Educational Resources Information Center

    Downing, Raymond

    2012-01-01

    Family Medicine first formally confronted systems thinking with the adoption of the biopsychosocial model for understanding disease in a holistic manner; this is a description of a natural system. More recently, Family Medicine has been consciously engaged in developing itself as a system for delivering health care, an artificial system. We make…

  17. Family Medicine's Waltz with Systems

    ERIC Educational Resources Information Center

    Downing, Raymond

    2012-01-01

    Family Medicine first formally confronted systems thinking with the adoption of the biopsychosocial model for understanding disease in a holistic manner; this is a description of a natural system. More recently, Family Medicine has been consciously engaged in developing itself as a system for delivering health care, an artificial system. We make…

  18. Value of a regional family practice residency training program site

    PubMed Central

    Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

    2014-01-01

    Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693

  19. Family-Centred Practice: Collaboration, Competency and Evidence

    ERIC Educational Resources Information Center

    Espe-Sherwindt, Marilyn

    2008-01-01

    In the 1990s, the developing field of early intervention with young children with disabilities and their families adopted family-centred practice as its philosophical foundation. Family-centred practice includes three key elements: (1) an emphasis on strengths, not deficits; (2) promoting family choice and control over desired resources; and (3)…

  20. Patient and family engagement: a survey of US hospital practices

    PubMed Central

    Herrin, Jeph; Harris, Kathleen G; Kenward, Kevin; Hines, Stephen; Joshi, Maulik S; Frosch, Dominick L

    2016-01-01

    Background Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known. Objective We report on a survey of hospitals in the USA regarding their PFE practices during 2013–2014. Results The response rate was 42%, with 1457 acute care hospitals completing the survey. We constructed 25 items to summarise the responses regarding key practices, which fell into three broad categories: (1) organisational practices, (2) bedside practices and (3) access to information and shared decision-making. We found a wide range of scores across hospitals. Selected findings include: 86% of hospitals had a policy for unrestricted visitor access in at least some units; 68% encouraged patients/families to participate in shift-change reports; 67% had formal policies for disclosing and apologising for errors; and 38% had a patient and family advisory council. The most commonly reported barrier to increased PFE was ‘competing organisational priorities’. Summary Our findings indicate that there is a large variation in hospital implementation of PFE practices, with competing organisational priorities being the most commonly identified barrier to adoption. PMID:26082560

  1. Patient and family engagement: a survey of US hospital practices.

    PubMed

    Herrin, Jeph; Harris, Kathleen G; Kenward, Kevin; Hines, Stephen; Joshi, Maulik S; Frosch, Dominick L

    2016-03-01

    Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known. We report on a survey of hospitals in the USA regarding their PFE practices during 2013-2014. The response rate was 42%, with 1457 acute care hospitals completing the survey. We constructed 25 items to summarise the responses regarding key practices, which fell into three broad categories: (1) organisational practices, (2) bedside practices and (3) access to information and shared decision-making. We found a wide range of scores across hospitals. Selected findings include: 86% of hospitals had a policy for unrestricted visitor access in at least some units; 68% encouraged patients/families to participate in shift-change reports; 67% had formal policies for disclosing and apologising for errors; and 38% had a patient and family advisory council. The most commonly reported barrier to increased PFE was 'competing organisational priorities'. Our findings indicate that there is a large variation in hospital implementation of PFE practices, with competing organisational priorities being the most commonly identified barrier to adoption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Compensation and Production in Family Medicine by Practice Ownership.

    PubMed

    Essary, Alison C; Green, Ellen P; Gans, David N

    2016-01-01

    The increasing focus on high performance, patient-centered, team-based care calls for a strategy to evaluate cost-effective primary care. The trend toward physician practice consolidation further challenges the primary care health care system. Productivity measures establish provider value and help inform decision making regarding resource allocation in this evolving health care system. In this national survey of family medicine practices, physician assistant (PA) productivity, as defined by mean annual patient encounters, exceeds that of both nurse practitioners (NPs) and physicians in physician-owned practices and of NPs in hospital or integrated delivery system-owned practices. Total compensation, defined as salary, bonus, incentives, and honoraria for physicians, is significantly more compared to both PAs and NPs, regardless of practice ownership or productivity. Physician assistants and NPs earn equivalent compensation, regardless of practice ownership or productivity. Not only do these data support the value and role of PAs and NPs on the primary care team but also highlight differences in patient encounters between practice settings. Rural and underserved community practices, where physician-owned practices persist, also merit further consideration. Further research is needed to inform both organizational and policy decisions for the provision of high-quality, cost-effective, and accessible primary health care.

  3. Participatory Design Research as a Practice for Systemic Repair: Doing Hand-in-Hand Math Research with Families

    ERIC Educational Resources Information Center

    Booker, Angela; Goldman, Shelley

    2016-01-01

    Success and failure in formal mathematics education has been used to legitimize stratification. We describe participatory design research as a methodology for systemic repair. The analysis describes epistemic authority--exercising the right or the power to know--as a form of agency in processes of mathematical problem solving and learning. We…

  4. Participatory Design Research as a Practice for Systemic Repair: Doing Hand-in-Hand Math Research with Families

    ERIC Educational Resources Information Center

    Booker, Angela; Goldman, Shelley

    2016-01-01

    Success and failure in formal mathematics education has been used to legitimize stratification. We describe participatory design research as a methodology for systemic repair. The analysis describes epistemic authority--exercising the right or the power to know--as a form of agency in processes of mathematical problem solving and learning. We…

  5. Patients' willingness to utilize a SMS-based appointment scheduling system at a family practice unit in a developing country.

    PubMed

    Adedokun, Ayoade; Idris, Oladipo; Odujoko, Tolulope

    2016-03-01

    Aim The investigators aimed to assess the willingness of patients to utilize and pay for a proposed short message service- (SMS) based appointment scheduling service. Telecommunication applications have been introduced to improve the delivery of healthcare services in developed countries; however, public-funded healthcare systems in developing countries like Nigeria are mostly unfamiliar with the use of such technologies for improving healthcare access. We proposed a SMS-based (text message) appointment scheduling system to consenting subjects at an outpatients' clinic and explored their willingness to utilize and pay for the service. Using semi-structured interview schedules, we collected information on: estimated arrival time, most important worry when seeking for healthcare services at public hospitals in the study setting, ownership of a mobile phone, willingness to utilize a SMS-based appointment for clinic visits and willingness to pay for the service. In addition, respondents were asked to suggest a tariff for the proposed system. Findings A total of 500 consecutively recruited patients aged 16-86 (42.1±15.4) years participated; 54% (n=270) were females. Waiting time ranged from 1-7.5 h (3.9±1.1). Two overlapping themes emerged as most important worries: crowded waiting rooms and long waiting time. Ownership of mobile phones was reported by 96.4% (n=482) of subjects. Nearly all favoured the proposed appointment scheduling system (n=486, 97.2%). Majority of patients who favoured the system were willing to pay for the service (n=484, 99.6%). Suggested tariff ranged from 0.03 to 20.83 (1.53±2.11) US dollars; 89.8% (n=349) of the subjects suggested tariffs that were greater than the prevailing retail cost of the proposed service. In sum, our findings indicate that patients in this study were willing to utilize and pay for a proposed SMS-based appointment scheduling system. The findings have implications for policies aimed at improving healthcare access and

  6. Dimensions of patient safety culture in family practice.

    PubMed

    Palacios-Derflingher, Luz; O'Beirne, Maeve; Sterling, Pam; Zwicker, Karen; Harding, Brianne K; Casebeer, Ann

    2010-01-01

    Safety culture has been shown to affect patient safety in healthcare. While the United States and United Kingdom have studied the dimensions that reflect patient safety culture in family practice settings, to date, this has not been done in Canada. Differences in the healthcare systems between these countries and Canada may affect the dimensions found to be relevant here. Thus, it is important to identify and compare the dimensions from the United States and the United Kingdom in a Canadian context. The objectives of this study were to explore the dimensions of patient safety culture that relate to family practice in Canada and to determine if differences and similarities exist between dimensions found in Canada and those found in previous studies undertaken in the United States and the United Kingdom. A qualitative study was undertaken applying thematic analysis using focus groups with family practice offices and supplementary key stakeholders. Analysis of the data indicated that most of the dimensions from the United States and United Kingdom are appropriate in our Canadian context. Exceptions included owner/managing partner/leadership support for patient safety, job satisfaction and overall perceptions of patient safety and quality. Two unique dimensions were identified in the Canadian context: disclosure and accepting responsibility for errors. Based on this early work, it is important to consider differences in care settings when understanding dimensions of patient safety culture. We suggest that additional research in family practice settings is critical to further understand the influence of context on patient safety culture.

  7. Indian family systems, collectivistic society and psychotherapy

    PubMed Central

    Chadda, Rakesh K.; Deb, Koushik Sinha

    2013-01-01

    Indian society is collectivistic and promotes social cohesion and interdependence. The traditional Indian joint family, which follows the same principles of collectivism, has proved itself to be an excellent resource for the care of the mentally ill. However, the society is changing with one of the most significant alterations being the disintegration of the joint family and the rise of nuclear and extended family system. Although even in today's changed scenario, the family forms a resource for mental health that the country cannot neglect, yet utilization of family in management of mental disorders is minimal. Family focused psychotherapeutic interventions might be the right tool for greater involvement of families in management of their mentally ill and it may pave the path for a deeper community focused treatment in mental disorders. This paper elaborates the features of Indian family systems in the light of the Asian collectivistic culture that are pertinent in psychotherapy. Authors evaluate the scope and effectiveness of family focused psychotherapy for mental disorders in India, and debate the issues and concerns faced in the practice of family therapy in India. PMID:23858272

  8. The mentoring needs of trainees in family practice.

    PubMed

    Brown, Judith Belle; Thorpe, Cathy; Paquette-Warren, Jann; Stewart, Moira; Kasperski, Jan

    2012-05-01

    This qualitative study examined medical students' and family practice residents' ideas, perceptions, and experiences of being mentored and their expectations of the mentoring experience. Eight focus groups and 16 individual interviews were used to collect data from 49 medical students and 29 family practice residents. Interviews and focus groups were audiotaped and transcribed verbatim. The analysis was iterative and interpretive, using both individual and team analyses. The analysis of the data revealed two central but related themes. The first theme reflected participants' overall experiences with mentors composed of three distinct elements: mentor roles (e.g. coach, advisor) and attributes (e.g. openness and approachability), interactions with mentors, and early exposure to family practice mentors (e.g. observing patient encounters). The second theme explicated the trainees' specific learning needs to be addressed by mentors that were categorised into three distinct yet overlapping levels: 1 practice level (i.e. guidance regarding the logistics of practice management) 2 system level (i.e. knowledge about the medical community as well as community resources) 3 personal level (i.e. guidance in balancing personal and professional responsibilities). Having the option of selecting multiple mentors to address unique aspects of the mentees' personal and professional development is critical in respecting the evolutionary nature and fluidity of the mentoring experience.

  9. Bridging the gap from values to actions: a family systems framework for family-centered AAC services.

    PubMed

    Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M

    2017-03-01

    Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.

  10. Introducing the Computer to Family Practice

    PubMed Central

    Petreman, Mel

    1984-01-01

    The medical profession has been far more reluctant than the general business community to adopt the computer as a useful business tool. The experience of a group of five family physicians who have been using a computer since 1979 demonstrates that it is possible to achieve significant financial benefits, and to reduce the stress and workload of both physicians and office staff. The computerization of medical records, scheduling, and patient billing is discussed in detail. Physicians have controlled the paper load of the modern medical office by pioneering their own medical software system. PMID:21279036

  11. A Survey of Adverse Drug Reactions in Family Practice

    PubMed Central

    Reynolds, J. L.

    1984-01-01

    In this study, 232 Canadian family physicians recorded suspected adverse drug reactions (SADRs) in their practices for five months. Patients' age and sex, the drug(s) implicated, type of reaction and any disability were recorded on a card and sent to a central coordinating office each week. The number of SADRs in clinical practice seems to be small. An estimated 300,000 patients were involved in the study, and a total of 314 suspected adverse drug reactions in 314 patients were reported. A proposal is made for a surveillance system for new drugs. Family physicians would monitor all patients taking a drug or group of drugs and matched controls. The status of patients and controls would be recorded regularly and any SADRs reported to a central coordinating centre. PMID:21283495

  12. Using family paradigms to improve evidence-based practice.

    PubMed

    Hidecker, Mary Jo Cooley; Jones, Rebecca S; Imig, David R; Villarruel, Francisco A

    2009-08-01

    Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP. This article describes the family paradigms framework: 4 classic paradigms of "closed," "random," "open," and "synchronous." Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples. A family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions. Family and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.

  13. Role of the family in suicide prevention: an attachment and family systems perspective.

    PubMed

    Lobo Prabhu, Sheila; Molinari, Victor; Bowers, Theron; Lomax, James

    2010-01-01

    Suicide can be an act of despair, anger, or escape from intolerable pain associated with prior bonding disturbances within the family system, interpersonal loss, and current perceived lack of social support. Using a variety of online databases, the authors examined the research on the family's role in preventing suicide from an attachment and family systems perspective. They found relevant articles describing how to make use of family support in suicide prevention. From a study of the literature, the authors outline three new family concepts in suicide prevention: family cohesion, family adhesion, and formation of a new family. Therapists should use every familial resource to avoid premature closure and to expand perception of support options. The authors suggest specific practice recommendations to successfully involve families in suicide prevention based on the outlined family conceptual framework, and they recommend research investigation to determine empirical validation of these tentative formulations.

  14. Social workers as "experts" in the family court system: is evidence-based practice a missing link or host-created knowledge?

    PubMed

    Prescott, Dana E

    2013-10-01

    The graduate school curriculum for social workers requires that students learn to critically distinguish between opinion-based knowledge and evidence-based practices, or empirically-supported interventions. Once graduated, licensed social workers are often called upon to offer diagnostic and predictive opinions as experts in a variety of macro-environments. When the family courts are that "host" environment, social workers proffer expert opinions that may categorize and label parents or children for purposes of a judge's allocation of physical or legal custody. In this article, it is suggested that the social work profession, within all three domains of education, practice, and research, should more precisely link the design and fidelity of an evidence-based practice (EBP) with its potential misapplication or warping when proffered as science in "host" environments like family courts. As Foucault and other scholars warn, the failure to verify that an intervention is applied correctly may actually enhance the risk of social injustice by interpreting and translating EBP knowledge in the non-empirical form of authority-by-license. This article, therefore, proposes that the social work profession, from the classroom to the field, has an obligation to thoroughly understand and engage interdisciplinary practices that assure respect for the strengths and limits of social work knowledge.

  15. 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.

  16. Collaborative Counselor and Medical Training at a Family Practice Residency Program: A Sharing of the Experience.

    ERIC Educational Resources Information Center

    McBride, LeBron; Pilkington, Lloyd; Murray, Paige Johnson; Whitfield, Donna

    2000-01-01

    The reactions of a Ph.D.-level, counselor-in-training, a medical student, and a family practice resident to collaborative systems clinical training at a family practice residency program are given in this article. Addresses the initial impressions of the content and process of the teaching model and how the experience changed their views of…

  17. Integrating School and Family Counseling: Practical Solutions. The Family Psychology and Counseling Series.

    ERIC Educational Resources Information Center

    Miller, Lynn D., Ed.

    This book offers practical suggestions for school counselors to begin integrating family counseling methods into their practice, while providing a rationale and the research support for working with families from a school base. It also provides specific techniques for using solution-focused tools, conducting family therapy with children, working…

  18. Family Therapist as Consultant in Foster Care: Expanding the Parameters of Practice.

    ERIC Educational Resources Information Center

    Morrissette, Patrick J.

    1996-01-01

    Traditionally, the role of the family therapist working in foster care has been limited to the areas of evaluation and treatment. This paper proposes that the family therapist can extend conventional boundaries to include the practice of systemic consultation. Case studies are included to exemplify family therapist microlevel consultation with…

  19. Integrating Social Justice into the Practice of CBFT: A Critical Look at Family Schemas.

    PubMed

    Parker, Elizabeth O; McDowell, Teresa

    2017-07-01

    Many families come to therapy struggling with the negative consequence of social inequity. Family therapy modalities have been developed to address these negative consequences and attend to power and social equity (Transformative family therapy: Just families in a just society. Boston, MA: Pearson Education; Socio-emotional relationship therapy. New York, NY: Springer). We argue that many family therapy modalities can be adapted to include social equity (Applying critical social theory in family therapy practice. AFTA Springer Series. New York, NY: Springer Publishing). Specifically, cognitive behavioral family therapy can be used to address the inequality in social systems that negatively affect the family system. We focus on schema formation and suggest an emphasis on societal schemas within the therapy milieu as a tool to help families see how societal inequality can affect the problems faced in family life. © 2016 American Association for Marriage and Family Therapy.

  20. Intimate partner violence: patients' experiences and perceptions in family practice.

    PubMed

    Narula, Archna; Agarwal, Gina; McCarthy, Lisa

    2012-10-01

    To understand how women affected by intimate partner violence (IPV), felt their family physicians cared for them and to identify where gaps in care exist. Interviews were conducted with ten women (mean age 50 years and minimum to maximum ages of 40-73 years). Content analysis was used to identify common themes. Women acknowledged a lack of insight into their abusive relationships given a lack of physical violence, preconceptions about IPV or presumed reasons their abusers had for violence. After identifying abuse, most shared feelings of fear, preventing them from disclosure. They feared being judged, not believed and consequences from their abuser. Perceptions' about their family physician's role prevented disclosure particularly misconceptions regarding physician's interest and time to discuss non-medical issues. After disclosure, women valued their family physicians listening, following up, providing validation and advocacy. All women experienced isolation secondary to the abuser, the family practice clinic, the physician and/or the 'system' itself. Women were not aware of family doctors' interest in issues aside from physical health. They appreciated a confidential and non-threatening environment and valued follow-up and advocacy on their behalf. They expressed frustration with open access scheduling and multiple providers. To improve care, family physicians should educate patients about their role, provide safe environments for disclosure and offer follow-up and support. Recommended system changes include measures to ensure continuity of care and easy booking of appointments. Finally, family physicians should recognize that there is a need to follow these patients long term as the effects of IPV are long lasting.

  1. Guiding the Family: Practical Counseling Techniques.

    ERIC Educational Resources Information Center

    Grunwald, Bernice Bronia; McAbee, Harold V.

    This book, intended as a text for therapists and counselors in family counseling, is based on principles of Adlerian psychology. The first chapter examines Adlerian theory and family counseling. Basic principles of individual psychology are applied to family counseling, and the goals of children with disturbing behavior are discussed. Reasons why…

  2. Strengthening Adoption Practice, Listening to Adoptive Families

    ERIC Educational Resources Information Center

    Atkinson, Anne; Gonet, Patricia

    2007-01-01

    In-depth interviews with 500 adoptive families who received postadoption services through Virginia's Adoptive Family Preservation (AFP) program paint a richly detailed picture of the challenges adoptive families face and what they need to sustain adoption for many years after finalization. Findings document the need for support in a variety of…

  3. Marriage & Family Counseling in Mental Health Practice.

    ERIC Educational Resources Information Center

    Feist, Stanley C.

    Marriage and Family Therapy is an increasingly popular treatment that was almost unknown 50 years ago. Family Therapy has been multidisciplinary from the beginning, drawing practitioners from social work, psychology, psychiatry, nursing, and pastoral and mental health counseling. It is often difficult to get a whole family to arrange schedules so…

  4. Strengthening Adoption Practice, Listening to Adoptive Families

    ERIC Educational Resources Information Center

    Atkinson, Anne; Gonet, Patricia

    2007-01-01

    In-depth interviews with 500 adoptive families who received postadoption services through Virginia's Adoptive Family Preservation (AFP) program paint a richly detailed picture of the challenges adoptive families face and what they need to sustain adoption for many years after finalization. Findings document the need for support in a variety of…

  5. Applying Research on Family Violence to Clinical Practice.

    ERIC Educational Resources Information Center

    Gelles, Richard J.

    1982-01-01

    Considers whether research on family violence can be applied to clinical practice. Suggests limitations of the knowledge base constrain the application of research on family violence to clinical work, and certain aspects of the research paradigm also limit the transfer of research knowledge to clinical practice. (Author)

  6. 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…

  7. Experience with a Family-Practice-Resident-Directed Obstetrical Clinic.

    ERIC Educational Resources Information Center

    Hunter, Jerry L.; Snyder, Frank

    1980-01-01

    At Toledo Hospital, family practice residents have assumed responsibility for the normal obstetrics clinic. Specialty consultations are provided by the hospital's obstetrics residency program. A medical audit of the clinic indicates that the family practice residents obtained consultations and made referrals at the appropriate times. (JMD)

  8. Family Counseling in Malaysia: Current Issues and Practices

    ERIC Educational Resources Information Center

    Noor, Norhayati Mohd.

    2014-01-01

    The study is carried out to explore the issues and practices in family counselling among the family counsellors at few counseling centres in Malaysia. Qualitative approach of single case embedded units was used for the study. Data collection was done using in-depth interview, observation and document analysis with 12 family counsellors. The data…

  9. Preparing Early Interventionists to Implement Family-Centered Practices

    ERIC Educational Resources Information Center

    Hile, Kimberly A.; Milagros Santos, Rosa; Hughes, Mary-alayne

    2016-01-01

    The reauthorization of IDEA in 1997 placed greater emphasis on providing early intervention services to the family unit versus solely focusing on children with disabilities or children who are at risk for disabilities. Due to the shift from child-focused services to family-focused services, the need to implement family-centered practices became…

  10. Preparing Early Interventionists to Implement Family-Centered Practices

    ERIC Educational Resources Information Center

    Hile, Kimberly A.; Milagros Santos, Rosa; Hughes, Mary-alayne

    2016-01-01

    The reauthorization of IDEA in 1997 placed greater emphasis on providing early intervention services to the family unit versus solely focusing on children with disabilities or children who are at risk for disabilities. Due to the shift from child-focused services to family-focused services, the need to implement family-centered practices became…

  11. The Practice of Marriage and Family Counseling in Cyberspace.

    ERIC Educational Resources Information Center

    Jencius, Marty; Sager, Denise E.

    2001-01-01

    Reviews the current practice of using the Internet to provide marriage and family counseling services. Discusses how the Internet has developed into a medium that can be used for the provision of marriage and family counseling services. Ethical guidelines developed by other associations have direct implication in how marriage and family therapists…

  12. Preparing School Counseling Students to Aid Families: Integrating a Family Systems Perspective

    ERIC Educational Resources Information Center

    Paylo, Matthew John

    2011-01-01

    In this article, the value of integrating family systems theory into a school counseling curriculum is explored. Some programs have historically placed school counselors in a difficult position by not adequately preparing them for the demands of incorporating family systems and community collaboration into clinical practice. The rationale for…

  13. [Family medicine and practice in the Mexican Social Security Institute].

    PubMed

    Casas Patiño, Donovan; Jarillo Soto, Edgar; Rodríguez Torres, Alejandra

    2014-06-26

    The central ideas of this research paper are related to the practice of family medicine as a specialty. It focuses in its origins, problems, unique characteristics, limitations, scope, management, and processes within the context of primary care of the Mexican Social Security System. This approach was based on a qualitative, hermeneutical study closely related to the Structural Functionalism Theory. Within this framework, medical practice is seen as an equation: Meaning = action + function/structure. This offers an approach to the understanding of reality through surveys and observations in five categories: identity, activity, purpose, values/norms, and power/relationship. The practice of family medicine is defined as a medical act in the Mexican Social Security Institute. This act is limited to a brief encounter and a prescription, which makes it a short, fleeting, medicalized interaction. The result is a negative social imaginary of the physician, the patient and the whole of society. Thus, individuals and society host a negative social imaginary bestowed on doctors and users of the health system.

  14. The role of family institutes in promoting the practice of family therapy.

    PubMed

    Rampage, Cheryl

    2014-09-01

    Much of the development of family therapy as a discipline was an outcome of the clinical, training, and theory-building activities conducted at family institutes around the United States. Beginning in the 1960s, these institutes were the crucibles in which the concepts and practices of family therapy flourished. The author, a leader at one of the largest family institutes in the United States, discusses the role of family institutes in promoting the practice of family therapy, as well as the challenges of doing so.

  15. Family nursing research for practice: the Swedish perspective.

    PubMed

    Saveman, Britt-Inger

    2010-02-01

    This article offers a synthesis of the significant developments and progress of family nursing in Sweden. A review was conducted to locate Swedish family nursing research produced over the past 10 years. CINAHL, Medline, and PubMed were the primary databases used to locate approximately 75 family nursing studies conducted in Sweden. The majority of the studies used descriptive methods with data collected from surveys and interviews involving nurses and family members either together or individually. Only a few of the studies examined family nursing interventions. This article also reports the results of a recent survey of Swedish nurses that examined how family nursing is used in practice. After 10 years of creating a strong foundation for family-focused nursing in Sweden, there is still a need for nurse researchers, educators, and administrators to collaborate in the implementation of family nursing to practice.

  16. Family physicians' approach to psychotherapy and counseling. Perceptions and practices.

    PubMed Central

    Swanson, J. G.

    1994-01-01

    To determine how family physicians perceive the support they get for psychotherapy and counseling, we surveyed a random sample of Ontario College of Family Physicians members. Of 100 physicians who had family medicine residency training with psychotherapy experience, 43% indicated that such training was inadequate for their current needs. Because family physicians often provide psychotherapy and counseling, their training should reflect the needs found in practice. PMID:8080505

  17. Strengthening Fragile Families through Research and Practice

    ERIC Educational Resources Information Center

    Bembry, James X.

    2011-01-01

    Almost one third of all children in the United States are born to unmarried parents. This figure is even higher among poor and minority populations. Because of their heightened risk for economic and social problems and family dissolution, disadvantaged, unmarried parents have been called "fragile families." In 2002 the Bush administration…

  18. Why Incorporate Family Counseling into Your Practice?

    ERIC Educational Resources Information Center

    Kaplan, David M.

    This chapter addresses questions about the utility of family work as a separate discipline distinct from other helping professions. Empirical evidence is presented that supports the effectiveness of family involvement in treating childhood and school problems, psychotic disorders, mood disorders, anxiety disorders, physical health problems,…

  19. Strengthening Fragile Families through Research and Practice

    ERIC Educational Resources Information Center

    Bembry, James X.

    2011-01-01

    Almost one third of all children in the United States are born to unmarried parents. This figure is even higher among poor and minority populations. Because of their heightened risk for economic and social problems and family dissolution, disadvantaged, unmarried parents have been called "fragile families." In 2002 the Bush administration…

  20. Practical Suggestions for Family Planning Education.

    ERIC Educational Resources Information Center

    Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

    This manual is designed to address some of the basic problems of those who work in family planning education, and is based on the recurring questions and concerns of participants in a nationwide series of DHEW-sponsored family planning education and communication workshops. The manual proceeds chronologically, dealing first with the planning of a…

  1. 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

  2. The care of children in family practice

    PubMed Central

    Carne, Stuart

    1980-01-01

    The role of the general practitioner in the care of children is described and compared with that of the paediatrician. Several practical problems arising in child care in general practice are described with emphasis on the respiratory tract. A quarter of a century ago, maternity care was the foundation on which general practice was built. Today the care of children is the new base of general practice. PMID:7420320

  3. Factors influencing palliative care. Qualitative study of family physicians' practices.

    PubMed Central

    Brown, J. B.; Sangster, M.; Swift, J.

    1998-01-01

    OBJECTIVE: To examine factors that influence family physicians' decisions to practise palliative care. DESIGN: Qualitative method of in-depth interviews. SETTING: Southwestern Ontario. PARTICIPANTS: Family physicians who practise palliative care on a full-time basis, who practise on a part-time basis, or who have retired from active involvement in palliative care. METHOD: Eleven in-depth interviews were conducted to explore factors that influence family physicians' decisions to practise palliative care and factors that sustain their interest in palliative care. All interviews were audiotaped and transcribed verbatim. The analysis strategy used a phenomenological approach and occurred concurrently rather than sequentially. All interview transcriptions were read independently by the researchers, who then compared and combined their analyses. Final analysis involved examining all interviews collectively, thus permitting relationships between and among central themes to emerge. MAIN OUTCOME FINDINGS: The overriding theme was a common philosophy of palliative care focusing on acceptance of death, whole person care, compassion, communication, and teamwork. Participants' philosophies were shaped by their education and by professional and personal experiences. In addition, participants articulated personal and systemic factors currently affecting their practice of palliative care. CONCLUSIONS: Participants observed that primary care physicians should be responsible for their patients' palliative care within the context of interdisciplinary teams. For medical students to be knowledgeable and sensitive to the needs of dying patients, palliative care should be given higher priority in the curriculum. Finally, participants argued compellingly for transferring the philosophy of palliative care to the overall practice of medicine. PMID:9612588

  4. Innovative Family-Centered Practices in Personnel Preparation

    ERIC Educational Resources Information Center

    Murray, Mary M.; Mandell, Colleen J.

    2005-01-01

    Although early childhood special education recommended practices and professional standards support the use of family-centered practices in intervention service delivery, empirical investigations have concluded that providers either do not value such practices or lack the skills necessary to build and maintain parent-professional partnerships.…

  5. Pod people. Response of family physicians and family practice nurses to Kosovar refugees in Greenwood, NS.

    PubMed Central

    Twohig, P. L.; Burge, F.; MacLachlan, R.

    2000-01-01

    OBJECTIVE: To explore roles of family physicians and family practice nurses who provided care to Kosovar refugees at Greenwood, NS. DESIGN: Qualitative study based on individual interviews with family physicians and family practice nurses. SETTING: Family practices in Halifax, NS. PARTICIPANTS: Six family practice nurses, four physician faculty members, four community-based family physicians, and two family medicine residents were interviewed. Participants were purposefully chosen from the roster of service providers. METHOD: All interviews were conducted by one of the researchers and were semistructured. Interviews lasted approximately 30 minutes and were immediately transcribed. Key words and phrases were identified and compared with subsequent interviews until saturation was achieved. MAIN FINDINGS: Data yielded four analytical categories: the clinical encounter, expectation and experience, role and team functioning, and response. Participants reported how providing care in the context of a refugee camp was both similar to and different from their daily activities in family practice, as were their working relationships with other health care professionals. CONCLUSION: Primary care for refugees during complex health emergencies is often underreported in the literature. Yet family practice physicians and nurses recounted that they had the requisite skills to provide care in such a context. Images Figure 1 Figure 2 PMID:11143581

  6. Defining The Other Solitude: Urban family practice training.

    PubMed

    Gruson, V; Bates, J

    1990-11-01

    The changing content of urban-based family practice needs to be redefined so that appropriate family medicine training programs can be planned to meet the primary care health needs of Canada's urban-based population. Although the core content of family practice is common to both rural and urban areas, each requires specific skills and attitudes dictated by differences in patient characteristics, disease incidence, physician expectations, and professional contexts. A challenge for the future is the development of both rural-based and urban-based streams of family medicine training that will unite rather than divide the profesiion.

  7. Supporting families of parents with mental illness in general practice.

    PubMed

    Baulderstone, Michaela J; Morgan, Bradley S; Fudge, Elizabeth A

    2013-08-05

    The general-practice setting provides a unique opportunity to positively influence the impact of mental illness on individuals and families. Intervention can begin from the moment an individual seeks professional help. Using a family-focused approach, and supporting parents to develop practical strategies to promote resilience in their children, can aid parents' recovery and promote the optimal emotional wellbeing of their children. We suggest a family-orientated therapeutic approach relevant to the general-practice setting, with particular consideration of the value of communicating with children according to the child's stage of emotional development.

  8. Constructing the "Ideal" Family for Family-Centred Practice: Challenges for Delivery

    ERIC Educational Resources Information Center

    Dodd, Jenny; Saggers, Sherry; Wildy, Helen

    2009-01-01

    Family-centred practice positions families as the key decision-makers, central to and experts in the wants and needs of their child. This paper discusses how families interviewed for a Western Australian study describe their relationships with a range of allied health professionals in the paediatric disability sector. The allied health…

  9. Constructing the "Ideal" Family for Family-Centred Practice: Challenges for Delivery

    ERIC Educational Resources Information Center

    Dodd, Jenny; Saggers, Sherry; Wildy, Helen

    2009-01-01

    Family-centred practice positions families as the key decision-makers, central to and experts in the wants and needs of their child. This paper discusses how families interviewed for a Western Australian study describe their relationships with a range of allied health professionals in the paediatric disability sector. The allied health…

  10. The Challenge of Teaching Obstetrics to Family Practice Residents

    PubMed Central

    Carroll, June C.

    1986-01-01

    Physicians who incorporate maternity care into family practice experience an increase in job satisfaction and enjoy a more favourable practice profile. Yet many family physicians are opting out of the obstetrical care of their patients. This development presents a major challenge to the teachers of family medicine. In many teaching programs the response of staff has been to move significant portions of residency training in obstetrics to smaller community hospitals. At Mount Sinai Hospital in Toronto, we believe that an integrated program in the tertiary care centre offers definite advantages. Our obstetrical training program integrates four elements: the community, the hospital, the Department of Family and Community Medicine, and the training program offered by that Department. We expect that family practice residents, by participating in this multifaceted, integrated program, will make a better-informed choice about practising obstetrics. PMID:21267328

  11. [Environmental Hazards Assessment Program annual report, June 1992--June 1993]. Results of the environmental health activities and needs assessment of the South Carolina statewide family practice system for the Environmental Hazards Assessment Program: EHAP Volume 1, No. 1

    SciTech Connect

    Musham, C.; Hainer, B.

    1993-05-01

    An activities and needs assessment was conducted to determine what each of the seven family practice residency programs in South Carolina is providing in environmental health education. In addition, this study was designed to determine: what are the barriers to greater emphasis on environmental health in family practice residency programs and, what the basic environmental health educational goals for family practice residency programs should be.

  12. Family Counseling Interventions: Understanding Family Systems and the Referral Process.

    ERIC Educational Resources Information Center

    McWhirter, Ellen Hawley; And Others

    1993-01-01

    This article describes concepts underlying the idea of the "family as a system"; compares and contrasts four approaches to family therapy (those of Virginia Satir, Jay Haley, Murray Bowen, and Salvador Minuchin); and offers suggestions to teachers referring parents for family counseling. (DB)

  13. Family Counseling Interventions: Understanding Family Systems and the Referral Process.

    ERIC Educational Resources Information Center

    McWhirter, Ellen Hawley; And Others

    1993-01-01

    This article describes concepts underlying the idea of the "family as a system"; compares and contrasts four approaches to family therapy (those of Virginia Satir, Jay Haley, Murray Bowen, and Salvador Minuchin); and offers suggestions to teachers referring parents for family counseling. (DB)

  14. Building on Strengths: Intergenerational Practice with African American Families

    ERIC Educational Resources Information Center

    Waites, Cheryl

    2009-01-01

    Intergenerational kinship and multigenerational families (three or more generations) have been a source of strength for African Americans. This article presents a culturally responsive intergenerational practice model for working with African American families that draws on this legacy. The model looks at intergenerational kinship and…

  15. Family Religious Involvement, Parenting Practices and Academic Performance in Adolescents

    ERIC Educational Resources Information Center

    Park, Hae Seong; Bonner, Patricia

    2008-01-01

    This project investigated the impacts of family religious involvement and family religious affiliations on parenting practices and academic performance. This study utilized data from the base-year and first follow-up of the Education Longitudinal Study: 2002/2004 (ELS). A series of statistical techniques were incorporated to examine the nature of…

  16. Trajectories of Family Management Practices and Early Adolescent Behavioral Outcomes

    ERIC Educational Resources Information Center

    Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.

    2011-01-01

    Stage-environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth…

  17. Trajectories of Family Management Practices and Early Adolescent Behavioral Outcomes

    ERIC Educational Resources Information Center

    Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.

    2011-01-01

    Stage-environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth…

  18. The Management of Schizophrenia in Family Practice

    PubMed Central

    Pell, Bryan A.

    1984-01-01

    While the pattern of treatment for schizophrenia varies from province to province, in the past 20 years there has been a general shift away from treatment in psychiatric hospitals to general hospital psychiatric units. The emphasis is on a shorter hospital stay, and greater use of community resources on discharge. Family physicians are therefore more likely to see their schizophrenic patients soon after an admission or readmission to hospital and will be more directly involved in their on going care. It is important for FPs to be aware of community resources which may help their schizophrenic patients. Resources include outpatient medical clinics where injections of long-acting neuroleptics can be regularly administered; public health nurses and community health workers; patients' families; alternative housing programs; social organizations' volunteer programs and community colleges and retraining programs. PMID:21279019

  19. Reinvigorating pediatric care in an academic family medicine practice.

    PubMed

    Page, Cristen; Carlough, Martha C; Lam, Yee; Steiner, Julea

    2014-02-01

    Primary care access is critical for all populations, and family physicians remain a vital link to pediatric care, especially for rural/underserved areas and adolescents. Pediatric visits to family physicians have declined nationally, a trend also noted at the University of North Carolina (UNC) Family Medicine Center (FMC). Academic FMCs are challenged with maintaining their pediatric population in a competitive environment and providing excellent pediatric training to prepare residents to care for children. We investigated potential factors impacting pediatric visits with a goal of reversing this trend. We developed a 360-degree approach to examine and reinvigorate pediatric care and training in our practice. To determine which aspects of our practice made pediatric care challenging, we conducted focus groups with parents of former and current FMC pediatric practices. We used billing data to assess pediatric patient volume and performed chart audits to examine preventive health visits, immunizations, and developmental screening. We anonymously contacted local family medicine and pediatric practices to compare services offered in their practice versus ours. Resident in-training exam scores and graduate surveys were reviewed to assess our pediatric training. Based on our evaluation, we identified and implemented improvements in the areas of clinical quality interventions, provider/education competency, and community marketing/relationships. A longitudinal evaluation and quality improvement initiative positively impacted our pediatric practice and training. The 360-degree approach of quality improvement may be useful for other academic family practices that are challenged with pediatric volume.

  20. 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.

  1. 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.

  2. FamilyLog: A Mobile System for Monitoring Family Mealtime Activities.

    PubMed

    Bi, Chongguang; Xing, Guoliang; Hao, Tian; Huh, Jina; Peng, Wei; Ma, Mengyan

    2017-03-01

    Research has shown that family mealtime plays a critical role in establishing good relationships among family members and maintaining their physical and mental health. In particular, regularly eating dinner as a family significantly reduces prevalence of obesity. However, American families with children spend only 1 hour on family meals while three hours watching TV on an average work day. Fine-grained activity-logging is proven effective for increasing self-awareness and motivating people to modify their life styles for improved wellness. This paper presents FamilyLog - a practical system to log family mealtime activities using smartphones and smartwatches. FamilyLog automatically detects and logs details of activities during the mealtime, including occurrence and duration of meal, conversations, participants, TV viewing etc., in an unobtrusive manner. Based on the sensor data collected from real families, we carefully design robust yet lightweight signal features from a set of complex activities during the meal, including clattering sound, arm gestures of eating, human voice, TV sound, etc. Moreover, FamilyLog opportunistically fuses data from built-in sensors of multiple mobile devices available in a family through an HMM-based classifier. To evaluate the real-world performance of FamilyLog, we perform extensive experiments that consist of 77 days of sensor data from 37 subjects in 8 families with children. Our results show that FamilyLog can detect those events with high accuracy across different families and home environments.

  3. Using Movies to Teach Family Systems Concepts.

    ERIC Educational Resources Information Center

    Hudock, Anthony M., Jr.; Warden, Sherry A. Gallagher

    2001-01-01

    This article reflects a review of research relevant to family systems training and the use of films in the teaching of family systems theory. Advantages and disadvantages of using movies in an introductory-level graduate family therapy course are discussed. An outline of family therapy training objectives, as well as examples of a movie-based…

  4. How does a changing country change family practice?

    PubMed

    South-Paul, J E; Grumbach, K

    2001-04-01

    The US population is changing. Ethnic minorities are now the fastest growing segment of the US population, and they have higher mortality rates than the remainder of Americans. Members of minority groups also earn less and are twice as likely as other residents to lack medical insurance. Minority communities have poorer health and access to care than the remainder of the population. Women constitute more than half the total population of the United States and are half of the labor force. Family structure has changed such that 53% of African-American, 32% of Hispanic, and 27% of all families were headed by a single parent in 1992. The elderly population has also increased and has a greater prevalence of chronic disease. The physician workforce has more female and younger physicians than in the past but a still-inadequate number of minority physicians. In contrast to the low proportion of minorities in the US physician workforce, women now comprise approximately half of medical students. A major economic trend affecting health care access in the United States is the lack of secure insurance coverage for 44 million people in 1998. Rates of no insurance are higher among minorities, households with no full-time worker, the near poor, and among persons with less education. Private charitable services, as well as the formal safety net systems, are experiencing financial pressure in the United States, further jeopardizing access to care for the uninsured. The average family in the United States is now working harder--but earning less money. The changing population mix, shifting gender balance, increasing proportion of elderly, and major socioeconomic trends and income disparities occurring in the United States today have shaped a practice environment that differs from whatfacedfamily physicians 30 years ago. Thus, a change in approach to training and practice is needed, while preserving the critical relationship we have with our patients and continuing to meet their needs.

  5. Clinical Practice Patterns of Canadian Couple/Marital/Family Therapists

    ERIC Educational Resources Information Center

    Beaton, John; Dienhart, Anna; Schmidt, Jonathan; Turner, Jean

    2009-01-01

    This clinical practice pattern survey had two unique aspects. It was a national survey of American Association for Marriage and Family Therapy (AAMFT) members in Canada that included all AAMFT membership categories, including student, affiliate, associate, clinical, and supervisor. It compared practice pattern data for clinical members from Canada…

  6. Characteristics and Clinical Practices of Rural Marriage and Family Therapists

    ERIC Educational Resources Information Center

    Morris, James

    2007-01-01

    This report presents a subset of data collected from the American Association for Marriage and Family Therapy (AAMFT) Practice Research Network project conducted in 2002. A sample of 47 clinical members of AAMFT who indicated they practiced in a rural community provided descriptive information on demographic characteristics, training, clinical…

  7. Practising family history: 'identity' as a category of social practice.

    PubMed

    Bottero, Wendy

    2015-09-01

    Research on family history argues it performs the task of anchoring a sense of 'self' through tracing ancestral connection and cultural belonging, seeing it as a form of storied 'identity-work'. This paper draws on a small-scale qualitative study to think further on the identity-work of family history. Using practice theory, and a disaggregated notion of 'identity', it explores how the storying of family histories relates to genealogy as a leisure hobby, a form of historical research, and an information-processing activity; and examines the social organization of that narrativity, where various practical engagements render certain kinds of genealogical information more, or less, 'storyable'. Key features of 'identity-work' in family history, such as the construction of genealogy as a personal journey of discovery and identification with particular ancestors, emerge as a consequence of the procedures of family history, organized as a set of practical tasks. The paper explores 'identity-work' as a consequence of people's engagement in specific social practices which provide an internal logic to their actions, with various components of 'identity' emerging as categories of practice shaped within, and for, use. Focusing on 'identity' as something produced when we are engaged in doing other things, the paper examines how the practical organization of 'doing other things' helps produce 'identity' in particular ways.

  8. Genital Herpetic Infection: A Family Practice Perspective

    PubMed Central

    Lawee, David

    1982-01-01

    Several major breakthroughs have occurred in our understanding of the epidemiology, immunology and biological behavior of the human herpes virus I and II. The family physician, however, is still confronted with four basic clinical situations: patients who present with a genital erosion or ulcer, affected patients in the reproductive age group, patients who ask if herpes causes cervical cancer, and patients who are very troubled by endless recurrences. As syphilitic chancre is becoming rare, the family physician has to recognize the increasing importance of herpes viruses in the etiology of the genital erosion-ulcer syndrome to acquire the clinical and laboratory skills to make that distinction. The prevention of neonatal disease is now possible in the majority of cases provided that pregnancies at risk are identified. Adequate virological surveillance should make it possible to virtually eliminate the disease. The evidence for the oncogenecity is circumstantial. Potential intra- and interpersonal effects of the disease are outlined. ImagesFig. 1Fig. 3 PMID:21286567

  9. Transition to Family Practice in Turkey

    ERIC Educational Resources Information Center

    Gunes, Evrim Didem; Yaman, Hakan

    2008-01-01

    Introduction: Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary…

  10. Transition to Family Practice in Turkey

    ERIC Educational Resources Information Center

    Gunes, Evrim Didem; Yaman, Hakan

    2008-01-01

    Introduction: Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary…

  11. Can naloxone prescription and overdose training for opioid users work in family practice?

    PubMed Central

    Leece, Pamela; Orkin, Aaron; Shahin, Rita; Steele, Leah S.

    2015-01-01

    Abstract Objective To explore family physicians’ attitudes toward prescribing naloxone to at-risk opioid users, as well as to determine the opportunities and challenges for expanding naloxone access to patients in family practice settings. Design One-hour focus group session and SWOT (strengths, weaknesses, opportunities, and threats) analysis. Setting Workshop held at the 2012 Family Medicine Forum in Toronto, Ont. Participants Seventeen conference attendees from 3 Canadian cities who practised in various family practice settings and who agreed to participate in the workshop. Methods The workshop included an overview of information about naloxone distribution and overdose education programs, followed by group discussion in smaller focus groups. Participants were instructed to focus their discussion on the question, “Could this [overdose education and naloxone prescription] work in your practice?” and to record notes using a standardized discussion guide based on a SWOT analysis. Two investigators reviewed the forms, extracting themes using an open coding process. Main findings Some participants believed that naloxone could be used safely among family practice patients, that the intervention fit well with their clinical practice settings, and that its use in family practice could enhance engagement with at-risk individuals and create an opportunity to educate patients, providers, and the public about overdose. Participants also indicated that the current guidelines and support systems for prescribing or administering naloxone were inadequate, that medicolegal uncertainties existed for those who prescribed or administered naloxone, and that high-quality evidence about the intervention’s effectiveness in family practice was lacking. Conclusion Family physicians believe that overdose education and naloxone prescription might provide patients at risk of opioid overdose in their practices with broad access to a potentially lifesaving intervention. However, they

  12. Kidney organ donation: developing family practice initiatives to reverse inertia

    PubMed Central

    2010-01-01

    Background Kidney transplantation is associated with greater long term survival rates and improved quality of life compared with dialysis. Continuous growth in the number of patients with kidney failure has not been matched by an increase in the availability of kidneys for transplantation. This leads to long waiting lists, higher treatment costs and negative health outcomes. Discussion Misunderstandings, public uncertainty and issues of trust in the medical system, that limit willingness to be registered as a potential donor, could be addressed by community dissemination of information and new family practice initiatives that respond to individuals' personal beliefs and concerns regarding organ donation and transplantation. Summary Tackling both personal and public inertia on organ donation is important for any community oriented kidney donation campaign. PMID:20478042

  13. The Child's Eye Examination in Family Practice

    PubMed Central

    Brierley, L.

    1986-01-01

    In view of the tragic results of undiagnosed and untreated visual problems in childhood, it is important for the family physician to have at her or his disposal a number of simple tests to detect problems at their earliest stages. Visual problems must be sought in the routine childhood physical examination because, unlike adults, children will not draw our attention to them. This article attempts to present several such tests as well as to discuss the mechanism of loss of sight through deprivation of clear visual stimuli, known as amblyopia. Other common childhood ophthalmic problems will also be discussed in the context of the child's eye examination. ImagesFigures 1a and 1bFigure 2Figures 3a and 3bFigure 4Figure 5Figures 6a and 6b PMID:21267232

  14. Trajectories of Family Management Practices and Early Adolescent Behavioral Outcomes

    PubMed Central

    Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.

    2013-01-01

    Stage– environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth in family management practices and adolescents’ behavioral outcomes and to detect predictors of interindividual differences in initial status and rate of change. The sample comprised approximately 1,000 adolescents between ages 11 years and 15 years. The results indicated that adolescents’ antisocial behaviors and substance use increased and their positive behavioral engagement decreased over time. As adolescent age increased, parental knowledge of their adolescent’s activities decreased, as did parental rule making and support. The level and rate of change in family management and adolescent behavioral outcomes varied by family structure and by gender. Reciprocal longitudinal associations between parenting practices and adolescent problem behavior were found. Specifically, parenting practices predicted subsequent adolescent behavior, and adolescent behavior predicted subsequent parenting practices. In addition, parental warmth moderated the effects of parental knowledge and rule making on adolescent antisocial behavior and substance use over time. PMID:21688899

  15. Family Systems Theory: Background and Implications.

    ERIC Educational Resources Information Center

    Bavelas, Janet Beavin; Segal, Lynn

    1982-01-01

    Describes the historical context of a systems approach to the family; defines basic systems concepts with emphasis on their application to the family; and describes some axioms of human communication theory and the role they play in understanding family communication from a systems viewpoint. (PD)

  16. Magnetic resonance imaging. Application to family practice.

    PubMed Central

    Goh, R. H.; Somers, S.; Jurriaans, E.; Yu, J.

    1999-01-01

    OBJECTIVE: To review indications, contraindications, and risks of using magnetic resonance imaging (MRI) in order to help primary care physicians refer patients appropriately for MRI, screen for contraindications to using MRI, and educate patients about MRI. QUALITY OF EVIDENCE: Recommendations are based on classic textbooks, the policies of our MRI group, and a literature search using MEDLINE with the MeSH headings magnetic resonance imaging, brain, musculoskeletal, and spine. The search was limited to human, English-language, and review articles. Evidence in favour of using MRI for imaging the head, spine, and joints is well established. For cardiac, abdominal, and pelvic conditions, MRI has been shown useful for certain indications, usually to complement other modalities. MAIN MESSAGE: For demonstrating soft tissue conditions, MRI is better than computed tomography (CT), but CT shows bone and acute bleeding better. Therefore, patients with trauma or suspected intracranial bleeding should have CT. Tumours, congenital abnormalities, vascular structures, and the cervical or thoracic spine show better on MRI. Either modality can be used for lower back pain. Cardiac, abdominal, and pelvic abnormalities should be imaged with ultrasound or CT before MRI. Contraindications for MRI are mainly metallic implants or shrapnel, severe claustrophobia, or obesity. CONCLUSIONS: With the increasing availability of MRI scanners in Canada, better understanding of the indications, contraindications, and risks will be helpful for family physicians and their patients. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 PMID:10509224

  17. Children of Divorce: A Family Systems Perspective.

    ERIC Educational Resources Information Center

    Beal, Edward W.

    1979-01-01

    Utilizes concepts of family systems theory to describe the way emotional attachments and child focus operate in families undergoing separation or divorce. Compares and contrasts the management of emotional attachment in families with either a mild or severe degree of child focus. Considers family therapy in relation to these issues. (Author/GC)

  18. Perceived Family Functioning and Family Resources of Hong Kong Families: Implications for Social Work Practice

    ERIC Educational Resources Information Center

    Ma, Joyce L. C.; Wong, Timothy K. Y.; Lau, Luk King; Pun, Shuk Han

    2009-01-01

    This article reports the results of a telephone survey (n = 1,015 respondents) that aims to identify the perceived general family functioning and family resources of Hong Kong Chinese families and their linkage to each other in a rapidly transforming society. The perceived general family functioning of the respondents was average, and the five…

  19. [Family planning. Regional differences in contraceptive practice].

    PubMed

    Palma Cabrera, Y; Suarez Morales, J

    1994-01-01

    Great efforts have been made to measure contraceptive prevalence in Mexico and to assess various aspects of differential usage. At present, 63.1% of fertile aged women in union are estimated to use a method. State prevalence rates ranged from 77.2% of couples in Baja California Sub to 46.3% in Oaxaca. In general, northern states and Mexico City had the highest prevalence rates and states in the center and south had the lowest. Results of the 1988 Survey of Determinants of Contraceptive Prevalence permit identification of sociocultural variables related to contraceptive usage. The data show that residents of the northwestern states have a considerably higher educational level and proportion urban than do those of the center or southeast. The southeast lagged the center in indicators of household characteristics and services, income, and infant mortality, and also had a higher rate of female labor force participation. The states of the center had a lower rate of contraceptive usage at 54.8% than did those of the southeast at 56.4%. The rate for the northwest states was 71.8%. Knowledge of contraceptive methods in the northwest and center was nearly universal, but almost one-fourth of rural women in the southeast reported not knowing a method. Reasons for not using a method varied in the three regions. Problems of access, lack of knowledge, and fear of side effects were the principal factors in the southeast. Opposition of the woman or spouse or religious beliefs were the main factors in the center. No significant barriers of culture or access were identified in the northwest. The average ideal family size was around 3.5 children in all three regions. The survey results demonstrate that having children was highly valued in all three regions. Children were more highly valued in the southeast for companionship, aid, and economic contribution; in the center as sources of affective relations; and in the northwest for satisfaction or personal fulfillment of the woman.

  20. Behavioral Medicine and University Departments of Family Practice

    PubMed Central

    Grantham, Peter

    1983-01-01

    Behavioral medicine brings knowledge and skills from the social sciences to the practice of medicine. Modifying behavior which causes a health problem, disease prevention and health promotion, improving the relationship between patients and health professionals, understanding cultural and ethical issues, and the effect of illness on behavior are all aspects of behavioral medicine. Such `whole person' medicine fits well into family practice. However, careful consideration of the risks, challenges, opportunities and responsibilities of behavioral medicine is necessary. Academic family physicians must conduct research and help develop educational programs that will prepare graduates to deal with frustrating health problems which are affected by behavior. A division of behavioral medicine eventually may be established in the University of British Columbia's Department of Family Practice. PMID:20469407

  1. Are family practice trainers and their host practices any better? comparing practice trainers and non-trainers and their practices

    PubMed Central

    2013-01-01

    Background Family Physician (FP) trainees are expected to be provided with high quality training in well organized practice settings. This study examines differences between FP trainers and non-trainers and their practices to see whether there are differences in trainers and non-trainers and in how their practices are organized and their services are delivered. Method 203 practices (88 non-training and 115 training) with 512 FPs (335 non-trainers and 177 trainers) were assessed using the “Visit Instrument Practice organization (VIP)” on 369 items (142 FP-level; 227 Practice level). Analyses (ANOVA, ANCOVA) were conducted for each level by calculating differences between FP trainees and non-trainees and their host practices. Results Trainers scored higher on all but one of the items, and significantly higher on 47 items, of which 13 remained significant after correcting for covariates. Training practices scored higher on all items and significantly higher on 61 items, of which 23 remained significant after correcting for covariates. Trainers (and training practices) provided more diagnostic and therapeutic services, made better use of team skills and scored higher on practice organization, chronic care services and quality management than non-training practices. Trainers reported more job satisfaction and commitment and less job stress than non-trainers. Discussion There are positive differences between FP trainers and non-trainers in both the level and the quality of services provided by their host practices. Training institutions can use this information to promote the advantages of becoming a FP trainer and training practice as well as to improve the quality of training settings for FPs. PMID:23433175

  2. Diabetes Mellitus Coding Training for Family Practice Residents.

    PubMed

    Urse, Geraldine N

    2015-07-01

    Although physicians regularly use numeric coding systems such as the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to describe patient encounters, coding errors are common. One of the most complicated diagnoses to code is diabetes mellitus. The ICD-9-CM currently has 39 separate codes for diabetes mellitus; this number will be expanded to more than 50 with the introduction of ICD-10-CM in October 2015. To assess the effect of a 1-hour focused presentation on ICD-9-CM codes on diabetes mellitus coding. A 1-hour focused lecture on the correct use of diabetes mellitus codes for patient visits was presented to family practice residents at Doctors Hospital Family Practice in Columbus, Ohio. To assess resident knowledge of the topic, a pretest and posttest were given to residents before and after the lecture, respectively. Medical records of all patients with diabetes mellitus who were cared for at the hospital 6 weeks before and 6 weeks after the lecture were reviewed and compared for the use of diabetes mellitus ICD-9 codes. Eighteen residents attended the lecture and completed the pretest and posttest. The mean (SD) percentage of correct answers was 72.8% (17.1%) for the pretest and 84.4% (14.6%) for the posttest, for an improvement of 11.6 percentage points (P≤.035). The percentage of total available codes used did not substantially change from before to after the lecture, but the use of the generic ICD-9-CM code for diabetes mellitus type II controlled (250.00) declined (58 of 176 [33%] to 102 of 393 [26%]) and the use of other codes increased, indicating a greater variety in codes used after the focused lecture. After a focused lecture on diabetes mellitus coding, resident coding knowledge improved. Review of medical record data did not reveal an overall change in the number of diabetic codes used after the lecture but did reveal a greater variety in the codes used.

  3. Procedural skills training. Canadian family practice residency programs.

    PubMed Central

    van der Goes, T.; Grzybowski, S. C.; Thommasen, H.

    1999-01-01

    OBJECTIVE: To survey Canadian family practice residency programs to discover which procedural skills residents are expected to learn. DESIGN: Cross-sectional eight-item questionnaire. SETTING AND PARTICIPANTS: The survey was sent to all 92 program directors and site or unit directors of family practice residency programs across Canada. MAIN OUTCOME MEASURES: Information on procedural skills lists was solicited. We sought date of creation, date of most recent revision, and who was involved in creating the list. A copy of the most recent list available was requested. RESULTS: We received 65 responses, for a 71% return rate. Surveys were received from all provinces and from all Canadian universities offering family practice residency programs. We received 24 unique lists of procedural skills: the shortest listed only 10 procedural skills; the longest, 75 skills; and the average, 36 skills. Only five procedural skills were found on more than 80% of the lists; 30 skills were listed on half or more of the lists. CONCLUSIONS: Canadian family practice residency programs have widely varying expectations of procedural skills for their residents. This survey is a first step in examining the whole issue of procedural skills training in Canadian family medicine programs. PMID:10889860

  4. A feminist model of family care: practice and policy directions.

    PubMed

    Hooyman, N R; Gonyea, J G

    1999-01-01

    Using a feminist perspective, this article examines women's experiences in caring for older family members with chronic illnesses or disabilities. Central to this analysis are the concepts of the social construction of gender-based inequities in caring, the interconnections between generations of women as givers and receivers of care, and variations in family care by gender, race, ethnicity, social class and sexual orientation. The authors critique current practice interventions and policies and purpose models for the elimination of gender-based inequities in caregiving and the provision of caregiver choice and empowerment for women and men, including feminist models of practice with women caregivers and economic and long-term care supports.

  5. Family medicine residents' practice intentions: Theory of planned behaviour evaluation.

    PubMed

    Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W

    2015-11-01

    To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

  6. Keeping family physicians in rural practice. Solutions favoured by rural physicians and family medicine residents.

    PubMed Central

    Rourke, James T. B.; Incitti, Filomena; Rourke, Leslie L.; Kennard, MaryAnn

    2003-01-01

    OBJECTIVE: To determine how family medicine residents and practising rural physicians rate possible solutions for recruiting and sustaining physicians in rural practice. DESIGN: Cross-sectional mailed survey. SETTING: Rural family practices and family medicine residency programs in Ontario. PARTICIPANTS: Two hundred seventy-six physicians and 210 residents. MAIN OUTCOME MEASURES Ratings of proposed solutions on a 4-point scale from "very unimportant" to "very important". RESULTS: Rural family physicians rated funding for learner-driven continuing medical education (CME) and limiting on-call duty to 1 night in 5 as the most important education and practice solutions, respectively. Residents rated an alternate payment plan to include time off for attending and teaching CME and comprehensive payment plans with a guaranteed income for locums as the most important education and practice solutions, respectively. CONCLUSION: Residents and physicians rated solutions very similarly. A comprehensive package of the highest-rated solutions could help recruit and sustain physicians in rural practice because the solutions were developed by experts on rural practice and rated by family medicine residents and practising rural physicians. PMID:14526866

  7. Best Practices in Working with Linguistically Diverse Families

    ERIC Educational Resources Information Center

    Araujo, Blanca E.

    2009-01-01

    Many schools face the challenge of forging partnerships with families from linguistically diverse backgrounds. Effective communication, funds of knowledge, culturally relevant teaching, and extending and accepting assistance are best practices that have been used successfully by school personnel when working with students who are identified as…

  8. The costs of a family practice residency ambulatory care program.

    PubMed

    Pawlson, L G; Watkins, R

    1979-12-01

    The cost of patient care service and education occurring in a family practice residency unit of a community based prepaid health program was determined from accounting records. The cost of producing the same number of patient visits in comparable family practice units which did not have residents on-site was determined in a similar manner. The cost per visit in the residency unit was $15.53 while that in the nonresidency unit was $13.92. There was an excess cost of $1.61 per visit in the residency, or, based on the number of residents present, a net cost of $7 per resident per day. None of the costs of central residency program administration or of ambulatory based subspecialty rotations were included. While a small increase (ten percent) in productivity or efficiency would result in the residency patient care unit itself being self-sustaining, this study casts considerable doubt on the ability of the model family practice residency unit to offset the full costs of the ambulatory care portion of family practice residency training.

  9. Marital and Family Therapy Research: Outcomes and Implications for Practice.

    ERIC Educational Resources Information Center

    Baldwin, Cynthia; Huggins, Don

    1998-01-01

    A review of marriage-and-family therapy-outcome studies from the past 10 years is discussed. Results indicate success over a broad scope of practices, including problems traditionally treated with individual psychotherapy, and when used in collaboration with other treatment modalities. Implications for the field are presented. (Author/EMK)

  10. Reducing Teachers' Work-Family Conflict: From Theory to Practice

    ERIC Educational Resources Information Center

    Cinamon, Rachel Gali; Rich, Yisrael

    2005-01-01

    Work-family conflict is a vocational psychology variable whose antecedents and outcomes have been extensively investigated. In contrast, less effort has been invested in creating practical programs to prevent and reduce it. This article provides the rationale and describes the framework for a comprehensive organizational program designed to ease…

  11. Beliefs Guiding Practice: Developing Professionals in Family and Consumer Sciences.

    ERIC Educational Resources Information Center

    Montgomery, Bette

    1999-01-01

    Examines questions related to family and consumer sciences internships: What should be the purpose--work or learning? How should knowledge and practice be connected? and What is the role of the onsite professional--knowledge delivery or knowledge construction? (SK)

  12. Social Work Practice with Native American Families: A Handbook.

    ERIC Educational Resources Information Center

    Wintemute, Ginger, Ed.; Messer, Bonnie, Ed.

    A handbook on social work practice with Native American families, developed for use by students in undergraduate social work programs and by social service practitioners who work with Native American people, is divided into four sections. The first section contains four articles, written by Joseph A. Dudley (Methodist minister and Yankton Sioux)…

  13. Sexual medicine in family practice. Part 2: Treating sexual dysfunction.

    PubMed Central

    Holzapfel, S.

    1993-01-01

    Sexual problems can be caused by organic or psychological factors, or a combination of the two. Deciding which leads to an appropriate management plan. This paper describes the current status of treatments for common sexual dysfunctions seen in family practice. PMID:8471907

  14. Guiding the Family: Practical Counseling Techniques. Second Edition.

    ERIC Educational Resources Information Center

    Grunwald, Bernice Bronia; McAbee, Harold V.

    This text on principles of Adlerian Psychology is designed for use in family counseling. It begins with an overview of Alfred Adler and his basic philosophy on human relationships. Throughout the book, as the Adlerian theory is discussed, practical application of theory is explained for counselors. Counselors must have a firm theoretical basis for…

  15. Observed Parenting Practices of First-Generation Latino Families

    ERIC Educational Resources Information Center

    Domenech Rodriguez, Melanie; Davis, Melissa R.; Rodriguez, Jesus; Bates, Scott C.

    2006-01-01

    This study used an established behavioral observation methodology to examine the parenting practices of first-generation Latino parents of children 4 to 9 years of age. The study had three central aims, to examine: (1) the feasibility of using a behavioral observation methodology with Spanish-speaking immigrant families, (2) the utility of the…

  16. Guiding the Family: Practical Counseling Techniques. Second Edition.

    ERIC Educational Resources Information Center

    Grunwald, Bernice Bronia; McAbee, Harold V.

    This text on principles of Adlerian Psychology is designed for use in family counseling. It begins with an overview of Alfred Adler and his basic philosophy on human relationships. Throughout the book, as the Adlerian theory is discussed, practical application of theory is explained for counselors. Counselors must have a firm theoretical basis for…

  17. Families, Infants and the Justice System.

    ERIC Educational Resources Information Center

    Fenichel, Emily, Ed.

    1993-01-01

    This periodical issue focuses on infants and toddlers and the justice system. The main article is entitled: "Families, Infants and the Justice System," written by Robert Horowitz. It looks at the role of the justice system in family dissolution and creation, the use of courts to resolve disputes, the role of the justice system in family…

  18. Human-animal bonds II: the role of pets in family systems and family therapy.

    PubMed

    Walsh, Froma

    2009-12-01

    The vast majority of pet owners regard their companion animals as family members, yet the role of pets in family systems and family therapy has received little attention in research, training, and practice. This article first notes the benefits of family pets and their importance for resilience. It then examines their role in couple and family processes and their involvement in relational dynamics and tensions. Next, it addresses bereavement in the loss of a cherished pet, influences complicating grief, and facilitation of mourning and adaptation. Finally, it explores the ways that clients' pets and the use of therapists' companion animals in animal-assisted therapy can inform and enrich couple and family therapy as valuable resources in healing.

  19. Moving from principles to practice: recommended policy changes to promote family-centered care.

    PubMed

    Kilmer, Ryan P; Cook, James R; Palamaro Munsell, Eylin

    2010-12-01

    This paper emphasizes the value of family-centered care. Discussion highlights family-centered philosophies (e.g., Systems of Care [SOCs]) and practice models (i.e., wraparound) and identifies discrepancies between conceptualizations and actual practice. Data from multiple sources detail issues in fidelity to family-centered values and needs and risks experienced by siblings of children with severe emotional disturbance and their caregivers. This discussion provides a springboard for policy recommendations to strengthen family support programming and enhance family-centered care, from modifying funding streams such that systems extend their reach beyond children with full-blown, diagnosable problems (those meeting standards of "medical necessity), to supporting prevention and early intervention initiatives that address families as targets for intervention. Recommendations include ensuring that communities with SOC funding address the needs of families; broadening Medicaid rules and definitions; expanding the range of reimbursable activities and services; and increasing funding for evaluating family-centered care models and family support programming.

  20. Impact of individual and team features of patient safety climate: a survey in family practices.

    PubMed

    Hoffmann, Barbara; Miessner, Carolin; Albay, Zeycan; Schröber, Jakob; Weppler, Katrin; Gerlach, Ferdinand M; Güthlin, Corina

    2013-01-01

    Knowledge about safety climate is fundamental to improving patient safety in health care organizations. Because individual and organizational factors influence the safety climate, we conducted a health care survey of German family practices so we could analyze the impact of the professional group, the professional experience of practice staff, and practice characteristics on perceptions of the safety climate. We wrote to health care assistants and doctors in 1,800 randomly selected family practices in Germany and asked them to complete a newly developed and validated Frankfurt Patient Safety Climate Questionnaire. We conducted a descriptive analyses of items and climate factors, as well as regression analysis, to identify potential predictors of the safety climate in family practice. The response rate from the participating practices was 36.1%. Safety climate was perceived to be generally positive with the exception of the factors of error management and perception of the causes of errors. We discovered that whether or not the entire team had taken part in the survey had a positive influence on most factors. Doctors had more positive perceptions of 4 of 7 factors addressed to both professions. Male participants and doctors showed the most willingness to admit they had made an error. Though the safety climate in German family practices was positive overall, health care professionals' use of incident reporting and a system's approach to errors was fairly rare. When evaluating the safety climate in primary health care practices, respondents' individual characteristics, as well as organizational features, should be taken into account.

  1. Family meetings in palliative care: Multidisciplinary clinical practice guidelines

    PubMed Central

    Hudson, Peter; Quinn, Karen; O'Hanlon, Brendan; Aranda, Sanchia

    2008-01-01

    Background Support for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers. Yet it seems there is insufficient research to demonstrate the utlility of family meetings or the best way to conduct them. This study sought to develop multidisciplinary clinical practice guidelines for conducting family meetings in the specialist palliative care setting based on available evidence and consensus based expert opinion. Methods The guidelines were developed via the following methods: (1) A literature review; (2) Conceptual framework; (3) Refinement of the guidelines based on feedback from an expert panel and focus groups with multidisciplinary specialists from three palliative care units and three major teaching hospitals in Melbourne, Australia. Results The literature review revealed that no comprehensive exploration of the conduct and utility of family meetings in the specialist palliative care setting has occurred. Preliminary clinical guidelines were developed by the research team, based on relevant literature and a conceptual framework informed by: single session therapy, principles of therapeutic communication and models of coping and family consultation. A multidisciplinary expert panel refined the content of the guidelines and the applicability of the guidelines was then assessed via two focus groups of multidisciplinary palliative care specialists. The complete version of the guidelines is presented. Conclusion Family meetings provide an opportunity to enhance the quality of care provided to palliative care patients and their family carers. The clinical guidelines developed from this study offer a framework for preparing, conducting and evaluating family meetings. Future research and clinical implications are outlined. PMID:18710576

  2. Family violence assessment practices of pediatric ED nurses and physicians.

    PubMed

    O'Malley, Donna M; Kelly, Patricia J; Cheng, An-Lin

    2013-05-01

    Recommendations by the ENA and other professional organizations have not resulted in widespread adoption of routine assessment for family violence such as child abuse and intimate partner violence. The aim of this qualitative study was to use a theory-driven approach to explore the salient beliefs and attitudes of nurses and physicians related to routine assessment of child abuse and intimate partner violence in the pediatric emergency department. Nurse and physician participants from a large Midwestern pediatric trauma center responded to a series of open-ended questions designed to identify positive or negative attitudes toward family violence assessment, approving or disapproving beliefs about family violence assessment, and the perception of ease or difficulty in performing family violence assessment. Respondents valued early identification and the associated health benefits of keeping pediatric patients safe, as well as linking at-risk families to community resources. They believe that victims, health care organizations, and some providers approve of routine family violence assessment but also believe that some providers and families who value privacy disapprove. Previously identified barriers and facilitators to family violence assessment were confirmed by participants. A finding unique to this study was that participants expressed the belief that routine family violence assessment offers more complete health care to children. Participants viewed child abuse and intimate partner violence as an event in a child's life that affects the child's health. Participants valued the benefits of routine family violence assessment; however, translating these value beliefs into practice remains elusive. A theoretical framework may provide insight into yet unidentified aspects of known barriers and facilitators. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  3. Adolescent Career Development and the Family System.

    ERIC Educational Resources Information Center

    Hesser, Al

    Trends in recent literature advocate a family systems approach to career development. To examine associations between process aspects of adolescent career development and family adaptability-family cohesion, 262 Virginia high school students (157 females, 105 males) completed the Career Development Inventory, the Assessment of Career Decision…

  4. Environmental health concerns in urban and rural family practice.

    PubMed Central

    Sanborn, M. D.; Scott, E. A.

    1998-01-01

    OBJECTIVE: To describe environmental health problems encountered in some Ontario family practices and to describe differences between the environmental concerns of urban (small and large) and rural physicians. DESIGN: A self-completed questionnaire was mailed to 536 family physicians with hospital affiliations in three areas of Ontario. SETTING: Family practices (rural, small urban, and large urban) in Ontario. PARTICIPANTS: Of 521 eligible community family physicians with hospital affiliations, 214 returned usable questionnaires for a 41% response rate. MAIN OUTCOME MEASURES: Environmental health problems encountered in practice were measured using questions about physician concerns, reported patient questions, physician-identified high-risk groups, problems related to environmental exposure, self-rated knowledge, and current and preferred sources of information on environmental health effects. RESULTS: Physicians were highly concerned and reported many patient questions about the health effects of environmental exposures. Pregnant women, agricultural workers, and children were considered important at-risk groups. Self-ratings of knowledge were generally very low. Rural physicians were concerned about agricultural pesticide exposure and their patients about moldy hay. Urban physicians had different concerns about lead and reported patient concerns about exposure to Great Lakes fish. All groups used similar sources of current environmental health information. CONCLUSIONS: Family physicians who participated in this study identified important patient and professional concerns about environmental health issues and reported a lack of resources to meet those concerns. This study provides information to family medicine residency programs and continuing medical education providers to help them enhance their focus on environmental health. PMID:9678275

  5. Urinary tract symptoms: microbiologic evaluation in rural family practice.

    PubMed

    Pinkerton, R E; Garibaldi, R A; Conrad, C; Bush, F; Brown, D H; Testa, M A; Gallo, S J; Lerer, T J; Ryan, R; Aukerman, G

    1988-01-01

    In order to define the etiology of urinary symptoms in rural family practice, this study examines 106 patients (88 women, 18 men) who went to their family physicians in private practice or a resident-faculty practice with genitourinary symptoms. Evaluation of each patient included history, physical examination, urinalysis, and urine or cervical cultures for bacteria, Mycoplasma, and Chlamydia. Using agar plate culturing techniques, 37 patients (35 percent) were identified as having significant urine bacteria. Chlamydia was rarely associated with urinary tract symptoms. Mycoplasma hominis, however, was isolated and felt to be etiologic in 19 (22 percent) of the 88 symptomatic women (P = 0.0026). Older women (mean age 42 years, P less than 0.001) with greater than 5 white blood cells per high-power field (WBC/hpf) on microscopic urinalysis (P less than 0.001) were likely to have cystitis and significant bacteria on urine culture. Younger women (mean age 31 years, P less than 0.001) with less than 5 WBC/hpf (P less than 0.001) had negative urine cultures and were likely to have M. hominis as a pathogen. These results demonstrate that the etiology of genitourinary symptoms seen in rural family practice may vary substantially from those seen in other patient care settings.

  6. Translating Family-Focused Prevention Science Into Effective Practice

    PubMed Central

    Spoth, Richard

    2010-01-01

    Family-focused preventive intervention research could serve as an exemplar for the translation of science into practice on a scale that achieves public health impact. This article outlines advances in the field and translational research that still is needed, presenting these within a heuristic framework. The framework is designed to guide a broad translational research agenda fostering a shift toward a paradigm of public health impact—called a translational impact paradigm. Current advances and needed research in the subfield are mapped onto a set of four translational impact factors: effectiveness of interventions; extensiveness of their population coverage; efficiency of interventions; and engagement of eligible populations or organizations, including widespread adoption and sustained, quality implementation (the “4 Es” of intervention impact). The article then highlights key tasks required to progress in this area: improving practitioner–scientist partnership networks embedded in systems for delivery of evidence-based interventions; application of research guidelines and standards that facilitate translational impact; and policy change that supports needed research. PMID:20523761

  7. Applying a Family Resilience Framework in Training, Practice, and Research: Mastering the Art of the Possible.

    PubMed

    Walsh, Froma

    2016-12-01

    With growing interest in systemic views of human resilience, this article updates and clarifies our understanding of the concept of resilience as involving multilevel dynamic processes over time. Family resilience refers to the functioning of the family system in dealing with adversity: Assessment and intervention focus on the family impact of stressful life challenges and the family processes that foster positive adaptation for the family unit and all members. The application of a family resilience framework is discussed and illustrated in clinical and community-based training and practice. Use of the author's research-informed map of core processes in family resilience is briefly noted, highlighting the recursive and synergistic influences of transactional processes within families and with their social environment. Given the inherently contextual nature of the construct of resilience, varied process elements may be more or less useful, depending on different adverse situations over time, with a major crisis; disruptive transitions; or chronic multistress conditions. This perspective is attuned to the diversity of family cultures and structures, their resources and constraints, socio-cultural and developmental influences, and the viability of varied pathways in resilience. © 2016 Family Process Institute.

  8. Coparenting within the family system: review of literature.

    PubMed

    Marsanić, Vlatka Boricević; Kusmić, Enes

    2013-12-01

    Family systems theory which postulates that family-level processes affect children's development over and above any individual subsystem, has changed the emphasis in research on children and families. Previous research of child development in families focused on associations with individual parent-child relationships or on connections between the marital relationships and child adjustment. In contrast, researchers have recently articulated distinctive family group dynamic, coparenting, which uniquely predicts children's social and emotional adaptation, over and above the effects of parenting and marital processes. This article reviews the literature on recent coparenting research and studies linking this family relationship to important indicators of children's development and adjustment. The implications for clinical practice and directions for future research are discussed.

  9. Familial mental retardation: a review and practical classification.

    PubMed

    Maris, Angelica Francesca; Barbato, Ingrid Tremel; Trott, Alexis; Montano, Marco Aurélio Echart

    2013-06-01

    Mental retardation (MR) is a definition which comprises a series of conditions whose common feature is an intellectual handicap that develops before the age of 18, afflicting 2-3% of the world's population. The classification of MR into different categories is determined by the extent of the handicap instead of its cause, which often remains unrecognized. Sometimes, MR runs in a family, characterizing familial MR, and those cases permit an in-depth look into the genetic causes and consequences of the problem. However, almost no work is available on the prevalence of familial MR among the registered MR cases, possibly because familial MR is a term with no clear definition. The scope of this work is to review the topic and discuss the implications of different genetic and environmental factors, which characterize particular categories of familial cases, suggesting a practical classification of familial MR, which is important for epidemiologic studies and also for counseling in the clinic. Some of the aspects are discussed under the perspective of a newly-developed country like Brazil.

  10. The family meetings in oncology: some practical guidelines

    PubMed Central

    Gritti, Paolo

    2015-01-01

    Somatic illness is not only an individual experience of physical and psychological suffering, but also a psychosocial status that modulates the patient’s interpersonal relationships. Receiving a diagnosis of cancer causes severe distress. The patient’s family, too, feels the emotional ups and downs of the patient. Like the patient, they feel distressed during the onset, course and outcome of the disease. Minimizing the interpersonal impact of the illness contributes to an improved quality of life for both patients and caregivers. Thus, it is widely assumed that cancer treatments should include some kind of psychological support for the patient and family members. All of these treatments are aimed at improving collaboration and illness perception among family, patients and healthcare professionals, and support the family during the course of the disease and cancer therapies. The family system theory is a valuable framework to explain how the disease of the patient and the family’s daily life are interconnected. The therapeutic alliance with the family is a powerful tool to improve the quality of life for the patient, as well as to relieve the psychological distress of the family members who are involved. The following pages describe the objectives and conversational techniques that can be a tool for psychosocial work with the family of a cancer patient. The goal of this intervention is to help the patient’s family to understand their problems and acknowledge the anxiety and fear of mourning that can impede their capacity to face the everyday problems they must cope with. To achieve this goal, it is recommended that a meeting (or a series of meetings) be scheduled, and conducted both in hospital and in the home. The steps to set up and conduct a family meeting are described in the paper, with special emphasis on communication skills required to meet family expectations and discuss the crucial issues of their everyday life. PMID:25653629

  11. Do procedural skills workshops during family practice residency work?

    PubMed Central

    MacKenzie, Mark S.; Berkowitz, Jonathan

    2010-01-01

    ABSTRACT OBJECTIVE To determine if participation in a procedural skills workshop during family practice residency affects future use of these skills in postgraduate clinical practice. DESIGN Survey involving self-assessment of procedural skills experience and competence. SETTING British Columbia. PARTICIPANTS Former University of British Columbia family practice residents who trained in Vancouver, BC, including residents who participated in a procedural skills workshop in 2001 or 2003 and residents graduating in 2000 and 2002 who did not participate in the procedural skills workshop. MAIN OUTCOME MEASURES Self-assessed experience and competence in the 6 office-based procedural skills that were taught during the procedural skills workshops in 2001 and 2003. RESULTS Participation in a procedural skills workshop had no positive effect on future use of these skills in clinical practice. Participation in the workshop was associated with less reported experience (P = .091) in injection of lateral epicondylitis. As with previous Canadian studies, more women than men reported experience and competence in gynecologic procedures. More women than men reported experience (P = .001) and competence (P = .004) in intrauterine device insertion and experience (P = .091) in endometrial aspiration biopsy. More men than women reported competence (P = .052) in injection of trochanteric bursae. A third year of emergency training was correlated with an increase in reported experience (P = .021) in shoulder injection. CONCLUSION Participation in a procedural skills workshop during family practice residency did not produce a significant increase in the performance of these skills on the part of participants once they were in clinical practice. The benefit of a skills workshop might be lost when there is no opportunity to practise and perfect these skills. Sex bias in the case of some procedures might represent a needs-based acquisition of skills on the part of practising physicians. Short

  12. A Third-Year Family Medicine Clerkship Based in an Academic Family Practice Center.

    ERIC Educational Resources Information Center

    Taylor, Robert B; And Others

    1984-01-01

    A 5-week family medicine clerkship is described that uses several innovative techniques: problem-based learning focusing on patient management tutorials; consultation with specialists; supervised patient care and a nursing home inpatient teaching service; and workshops on topics such as office-surgical techniques, practice management, and…

  13. A Third-Year Family Medicine Clerkship Based in an Academic Family Practice Center.

    ERIC Educational Resources Information Center

    Taylor, Robert B; And Others

    1984-01-01

    A 5-week family medicine clerkship is described that uses several innovative techniques: problem-based learning focusing on patient management tutorials; consultation with specialists; supervised patient care and a nursing home inpatient teaching service; and workshops on topics such as office-surgical techniques, practice management, and…

  14. Value of a regional family practice residency training program site: perceptions of residents, nurses, and physicians.

    PubMed

    Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

    2014-09-01

    To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Interviews and focus groups were conducted. Nanaimo, BC. A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients' perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. Copyright© the College of Family Physicians of Canada.

  15. The framework of family therapy in clinical practice and research in Serbia.

    PubMed

    Pantovic, Maja; Dunjic-Kostic, Bojana; Ivkovic, Maja; Damjanovic, Aleksandar; Jovanovic, Aleksandar A

    2012-04-01

    In the last two decades, Serbia has had to deal with multiple social and economic problems reflecting on society's demographics and seemed to weaken its core cell - the family. The paper describes the framework of family therapy in clinical practice and research, within the recent transition of the Serbian family. Family therapy treatment in Serbia uses the systemic family therapy (SFT) approach, applied according to the standards of the European Association for Psychotherapy. A large number of professionals who practise in Serbia hold European qualifications, setting high standards in education, clinical practice, and research. Although SFT is also available in the private sector, the majority of patients are still treated in state institutions. Family therapy is often used for adults and adolescents with psychosis and addictions in psychiatric hospital settings. However, in counselling centres it is used for marital and relationship problems. Interestingly, family therapy has recently started to emerge as a more frequent tool in consultation-liaison, particularly psycho-oncology but also in correctional institutions. The clinical practice and research interests are interlinked with changes in social settings.

  16. Changing Families in a Changing Military System.

    ERIC Educational Resources Information Center

    Hunter, Edna J., Ed.

    Recently, the military system has begun to feel the impact of the military family. Whenever sudden dramatic changes or transitions occur, crises may result either for the individual or for the institution. At present both the military system and the military family are in a period of rapid transition. Perhaps one of the most important changes that…

  17. Are family practice residents able to interpret electrocardiograms?

    PubMed

    Boltri, John M; Hash, Robert B; Vogel, Robert L

    2003-01-01

    Teaching electrocardiogram (ECG) interpretation is a recommended component of the family practice residency curriculum. Published information concerning the ECG interpretation ability of residents is sparse. This study sought to ascertain the baseline knowledge of family practice residents' ECG interpretation skills and extent of improvement after one year of training. A 15 ECG examination was administered to 38 PG-1 and 14 upper level residents at 5 residency programs at the beginning of the academic year and to residents at the authors' program at the end of the academic year. Pre-test scores among the five programs were compared using an analysis of variance (ANOVA). Pre-test and post-test scores were compared using a paired randomization test. No difference was found between average scores from each site, or between the beginning and end of the academic year. Residents were more likely to misinterpret items such as myocardial infarction, myocardial ischemia, and atrial fibrillation. Residents in family practice have considerable deficiencies in ECG interpretation skills. Further studies are needed to determine effective ECG teaching curricula.

  18. Type 2 diabetes in family practice. Room for improvement.

    PubMed Central

    Harris, Stewart B.; Stewart, Moira; Brown, Judith Belle; Wetmore, Stephen; Faulds, Catherine; Webster-Bogaert, Susan; Porter, Sheila

    2003-01-01

    OBJECTIVE: To further knowledge of diabetes management in family practice. DESIGN Retrospective, observational chart audit study. SETTNG: Southwestern Ontario. PARTICIPANT: A random sample of non-academic family physicians and a random selection of their patients with type 2 diabetes mellitus. MAIN OUTCOME MEASURES: Glycemic control as measured by HbA1c and adherence to recommendations in clinical practice guidelines (CPGs). RESULTS: Eighty-four percent of patients had at least one HbA1c test ordered in the previous year. Overall mean HbA1c was 0.079 and half-the patients had levels deemed acceptable by 1992 CPGs. Screening for microvascular complications was disappointing; only 28% were tested for microalbuminuria, and 15% were examined for diabetes-related foot conditions. Screening for macrovascular complications was more comprehensive; blood pressure was measured in 88%, and lipid profiles documented in 48%, of patient charts. CONCLUSION: Management of glycemic control and screening for microvascular and macrovascular disease in family practice can be improved. PMID:12836867

  19. Integrating family medicine residents into a rural practice.

    PubMed Central

    Kelly, L.

    1997-01-01

    PROBLEM: Integrating residents into community family practices can be challenging for busy doctors, especially when new preceptors have no formal preparation or teaching experience. OBJECTIVE OF PROGRAM: To develop an organized and practical approach to teaching residents in our busy rural group practice. Our seven northern Ontario family doctors have been training elective residents and clerks for 15 years. Recently, we have gone from hosting elective residents and students to teaching core family medicine residents. Our precepting plan allows us to dedicate a reasonable time to teaching while fulfilling our primary care duties. MAIN COMPONENTS: The program involves contracting, teaching, monitoring, feedback, and evaluation. CONCLUSION: We think we have developed a sustainable, workable set of teaching parameters that is applicable by various preceptors in different settings. It has simplified our teaching role and lessened our anxieties. Residents have benefited from the consistent protocol, which can be flexible enough to adapt to individual residents and preceptors, and have valued this teaching approach. Images p278-a p280-a PMID:9040915

  20. 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.

  1. 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…

  2. We Are Family: Applying Family Systems Theory to Classrooms.

    ERIC Educational Resources Information Center

    Braun, Joseph A., Jr.; Garrett, Joyce Lynn

    1988-01-01

    Describes how counselors can apply the family systems model to classrooms in helping teachers create a more open and effective climate. Discusses these strategies for implementation: basic communication and interpersonal skills, fairness conferences, classroom meetings, magic circle and circle of warmth, and role playing. (Author/ABL)

  3. We Are Family: Applying Family Systems Theory to Classrooms.

    ERIC Educational Resources Information Center

    Braun, Joseph A., Jr.; Garrett, Joyce Lynn

    1988-01-01

    Describes how counselors can apply the family systems model to classrooms in helping teachers create a more open and effective climate. Discusses these strategies for implementation: basic communication and interpersonal skills, fairness conferences, classroom meetings, magic circle and circle of warmth, and role playing. (Author/ABL)

  4. Training family medicine residents to practice collaboratively with psychology trainees.

    PubMed

    Porcerelli, John H; Fowler, Shannon L; Murdoch, William; Markova, Tsveti; Kimbrough, Christina

    2013-01-01

    This article will describe a training curriculum for family medicine residents to practice collaboratively with psychology (doctoral) trainees at the Wayne State University/Crittenton Family Medicine Residency program. The collaborative care curriculum involves a series of patient care and educational activities that require collaboration between family medicine residents and psychology trainees. Activities include: (1) clinic huddle, (2) shadowing, (3) pull-ins and warm handoffs, (4) co-counseling, (5) shared precepting, (6) feedback from psychology trainees to family medicine residents regarding consults, brief interventions, and psychological testing, (7) lectures, (8) video-observation and feedback, (9) home visits, and (10) research. The activities were designed to teach the participants to work together as a team and to provide a reciprocal learning experience. In a brief three-item survey of residents at the end of their academic year, 83% indicated that they had learned new information or techniques from working with the psychology trainees for assessment and intervention purposes; 89% indicated that collaborating with psychology trainees enhanced their patient care; and 89% indicated that collaborating with psychology trainees enhanced their ability to work as part of a team. Informal interviews with the psychology trainees indicated that reciprocal learning had taken place. Family medicine residents can learn to work collaboratively with psychology trainees through a series of shared patient care and educational activities within a primary care clinic where an integrated approach to care is valued.

  5. Detailed Requirements Analysis for a Management Information System for the Department of Family Practice and Community Medicine at Silas B. Hays Army Community Hospital, Fort Ord, California

    DTIC Science & Technology

    1989-03-01

    development and can be used to design. construct . and implement an ilnbrmation s\\ stem for the targe ted department. The requirements analysis can also...methodologies for information systems development and can be used to design, construct , and implement an information system for the targeted department. The...hardware or software configurations from the selection phase, the analyst can now design and construct the information system. Computer outputs are

  6. Parents' and professionals' perceptions of the implementation of family-centered practices in child assessments.

    PubMed

    Crais, Elizabeth R; Roy, Vicky Poston; Free, Karen

    2006-11-01

    To determine the degree to which early intervention professionals and families agreed on whether specific family-centered practices were implemented in specific child assessments and which practices were viewed as important to include in future child assessments. A self-rating instrument was used to survey 134 early intervention professionals (across a variety of disciplines) and 58 family members in triads (2 professionals and 1 family member for each assessment) after they had participated together in a child assessment. Participants were asked to identify across 41 family-centered practices whether the practice was implemented (actual practice) and would be important to include in future assessments (ideal practice). Agreement between families and professionals and between professionals was high for both actual practices (69% and 78%, respectively) and ideal practices (82% and 84%, respectively). Some practices were frequently implemented, whereas others were seldom implemented. Both professionals and families viewed most of the practices as ideal. However, an implementation gap was seen on almost half of the practices between what families and professionals viewed as actually implemented and what was ideal implementation. Although a number of family-centered practices were implemented in the child assessments studied, the results pinpointed specific practices that professionals and families agreed should be changed. The results can serve as a guide for enhancing the implementation of, and continued investigation into, family-centered practices in child assessment and can add key information toward the identification of evidence-based practices.

  7. Practical aspects of systems hardening

    SciTech Connect

    Shepherd, W.J.

    1989-01-01

    Applications of hardening technology in a practical system require a balance between the factors governing affordability, producibility, and survivability of the finished design. Without careful consideration of the top-level system operating constraints, a design engineer may find himself with a survivable but overweight, unproductive, expensive design. This paper explores some lessons learned in applying hardening techniques to several laser communications programs and is intended as an introductory guide to novice designers faced with the task of hardening a space system.

  8. Diagnosis and management of dementia in family practice.

    PubMed

    Wilcock, Jane; Jain, Priya; Griffin, Mark; Thuné-Boyle, Ingela; Lefford, Frances; Rapp, David; Iliffe, Steve

    2016-01-01

    Improving quality of care for people with dementia is a high priority. Considerable resources have been invested in financial incentives, guideline development, public awareness and educational programmes to promote earlier diagnosis and better management. Evaluating family physicians' concordance with guidelines on diagnosis and management of people with dementia, from first documentation of symptoms to formal diagnosis. Analysis of medical records of 136 people with dementia recruited by 19 family practices in NW London and surrounding counties. Practices invited 763 people with dementia to participate, 167 (22%) agreed. Complete records were available for 136 (18%). The majority of records included reference to recommended blood tests, informant history and caregiver concerns. Presence or absence of symptoms of depression, psychosis, other behavioural and psychological symptoms of dementia, and cognitive function tests were documented in 30%-40% of records. Documentation of discussions about signs and symptoms of dementia, treatment options, care, support, financial, legal and advocacy advice were uncommon. Comparison of these findings from a similar study in 2000-2002 suggests improvements in concordance with blood tests, recording informant history, presence or absence of depression or psychosis symptoms. There was no difference in documenting cognitive function tests. Immediate referral to specialists was more common in the recent study. Five years after UK dementia guidelines and immediately after the launch of the dementia strategy, family physicians appeared concordant with clinical guidelines for dementia diagnosis (other than cognitive function tests), and referred most patients immediately. However, records did not suggest systematic dementia management.

  9. Assessing Idaho Rural Family Physician Scope of Practice Over Time.

    PubMed

    Schmitz, David; Baker, Ed; MacKenzie, Lisa; Kinney, Logan; Epperly, Ted

    2015-01-01

    An important consideration determining health outcomes is to have an adequate supply of physicians to address the health needs of the community. The purpose of this investigation was to assess scope of practice factors for Idaho rural family physicians in 2012 and to compare these results to findings from a 2007 study. The target population in this study was rural family physicians in Idaho counties with populations of fewer than 50,000. Identical surveys and methods were utilized in both 2007 and 2012. The physician survey was mailed to 252 rural physicians and was returned by 89 for a response rate of 35.3%. Parametric and nonparametric statistical analyses were conducted to analyze the 2012 results and to assess changes in scope of practice across the time periods. The percentage of rural family physicians in Idaho in 2012 who provided prenatal care, vaginal deliveries, and nursing home care was significantly lower than the results from the 2007 survey. Female physicians were more likely to provide prenatal care and vaginal deliveries than males in 2012. Male physicians were more likely to provide emergency room coverage and esophagogastroduodenoscopy or colonoscopy services than females in 2012. Younger physicians were found to be more likely to provide inpatient admissions and mental health services in 2012 than older physicians. Employed physicians were more likely to provide cesarean delivery, other operating room services and emergency room coverage in 2012 than nonemployed physicians. Further research is needed to assess the root causes of these changes. © 2015 National Rural Health Association.

  10. Salvador Minuchin's structural family therapy and its application to multicultural family systems.

    PubMed

    Navarre, S E

    1998-01-01

    The structural approach to family therapy offers a useful perspective to the nurse therapist working with families with various cultural backgrounds. Asian and Hispanic families are examined to illustrate using Minuchin's approach to family counseling. The rationale for the structural approach is explored, and specific therapeutic techniques for practice are described. Nurses who work with culturally diverse families might profit by using this approach.

  11. Family Systems and Catechetics: An Alternative Approach.

    ERIC Educational Resources Information Center

    Ilg, Peter

    2000-01-01

    Describes the incorporation of family-systems theory into the catechetical process by Blessed Sacrament/St. Charles Borromeo Church. This approach recognizes the role of the family in this area. Faith formation is holistic and simultaneously addresses the main areas of faith development and the context of an individual's life. Thus, family…

  12. Women, Family Systems & the TC. Chapter 8.

    ERIC Educational Resources Information Center

    Acampora, Alfonso P., Ed.; Nebelkopf, Ethan, Ed.

    This document contains 11 papers from the ninth World Conference of Therapeutic Communities (TCs) that deal with women's issues, family systems, and the TC. Papers include: (1) "Families in the Eighties" (Cecil Williams); (2) "Women, Work & Substance Abuse" (Lois Morris); (3) "The National Federation of Parents"…

  13. Literacy and Illiteracy in the Family System.

    ERIC Educational Resources Information Center

    Bryant, Lizbeth A.

    Scholars from various disciplines who examine the role an individual plays in the family as a major influence on his/her literacy are currently considering a factor often overlooked by researchers. Mikhail Bakhtin, Basil Bernstein, David Bleich and others find a cause-and-effect relationship between literacy and family systems. This suggests the…

  14. Affirmative Action Implications for Worldwide Family Systems.

    ERIC Educational Resources Information Center

    Liss, Lora

    This paper views the interrelatedness of political, economic, and family systems as they are being affected by the growing awareness of sex discrimination. The reduction in sex inequalities throughout the world, regardless of political or economic orientation, will necessitate a new perception of the woman's role in the family unit. The hypothesis…

  15. Career Indecision: A Family Systems Perspective.

    ERIC Educational Resources Information Center

    Lopez, Frederick G.; Andrews, Scott

    1987-01-01

    Presents a family systems perspective on career indecision as an alternative to existing theories of vocational development which generally contribute career indecision to character deficits in young adults. Speculates on family patterns that contribute to career indecisiveness and on the functions that this problem may serve within the larger…

  16. Family Systems-Oriented School Counseling.

    ERIC Educational Resources Information Center

    Widerman, James L.; Widerman, Eileen

    1995-01-01

    Emphasizes the importance of positive family influence in successful school education. Describes and applies family systems counseling, using the interactional game metaphor, to many of the problems common in school settings. Stresses that negative responses or physical punishment are not only ineffective but result in perpetuating unintended…

  17. How family practice physicians, nurse practitioners, and physician assistants incorporate spiritual care in practice.

    PubMed

    Tanyi, Ruth A; McKenzie, Monica; Chapek, Cynthia

    2009-12-01

    To investigate how primary care family practice providers incorporate spirituality into their practices in spite of documented barriers. A phenomenological qualitative design was used. Semi-structured interviews were conducted with three physicians, five nurse practitioners, and two physician assistants. Five major theme clusters emerged: (1) discerning instances for overt spiritual assessment; (2) displaying a genuine and caring attitude; (3) encouraging the use of existing spiritual practices; (4) documenting spiritual care for continuity of care; (5) managing perceived barriers to spiritual care. Findings support that patients' spiritual needs can be addressed in spite of documented barriers. Techniques to assist providers in providing spiritual care are discussed and directions for future research are suggested.

  18. Indiana family physician attitudes and practices concerning smoking cessation.

    PubMed

    Saywell, R M; Jay, S J; Lukas, P J; Casebeer, L L; Mybeck, K C; Parchman, M L; Haley, A J

    1996-01-01

    Most physicians are aware of the health benefits of smoking cessation and agree they have a responsibility to help smokers quit. Many physicians, however, do not regularly address smoking cessation with their patients. Questionnaires were sent to 2,095 family practice physicians in Indiana. Information obtained included: demographic data; office-based smoking cessation practices; counseling; and physicians' perceptions of intervention outcomes. Most physicians (86%) asked new patients if they smoked, and 23% questioned patients about their exposure to passive smoke. Younger physicians, female physicians and urban physicians were more likely to ask new patients if they smoked. A formal smoking cessation program was used by 28% of the responding physicians. Among those not using a program, 7% reported plans to implement one in the coming year, 40% were not planning to implement one, and 53% were unsure. Physician and practice characteristics were not correlated with the use of smoking cessation programs. Only 11% of physicians considered their smoking cessation counseling skills to be excellent; 27% indicated the need for improvement in skills. One-half (52%) believed their counseling efforts were effective; almost half (45%) believed that current reimbursement policies limited their involvement in smoking cessation interventions. Most respondents have not instituted smoking cessation programs in their practices. It is likely that a combination of strategies, including both undergraduate, graduate and continuing medical education programs and reform in reimbursement practices for cessation programs, will be required to achieve significant increases in long-term smoking abstinence rates.

  19. The Accuracy of Recording Patient Problems in Family Practice

    ERIC Educational Resources Information Center

    Bentsen, Bent Gutterm

    1976-01-01

    Reports studies of the validity of medical data recorded and computerized at University of Western Ontario family medical centers. In the 59 encounters observed residents recorded an average of 1.51 problems and observers 2.45. Implications for medical education, audit, research, computer systems, and quality of care are discussed. (JT)

  20. Reported practice patterns among family physicians with a geriatrics certificate of added qualifications.

    PubMed

    Peterson, Lars E; Cochrane, Anneli; Bazemore, Andrew W; Petterson, Stephen

    2015-01-01

    Practice patterns of family physicians with additional certification are unknown but are important to workforce planners and policymakers, who may presume that all family physicians provide primary care to patients of all ages. We found that a majority of family medicine geriatricians self-report practicing primarily geriatric medicine. © Copyright 2015 by the American Board of Family Medicine.

  1. Preventive adolescent health care in family practice: a program summary.

    PubMed

    Knishkowy, Barry; Schein, Moshe; Kiderman, Alexander; Velber, Aliza; Edman, Richard; Yaphe, John

    2006-06-07

    The AMA Guidelines for Adolescent Preventive Services (GAPS) has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice-based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC) program targeted all adolescent patients aged 12-18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57%) of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.

  2. 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,…

  3. 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,…

  4. Practical Applications of Space Systems.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Assembly of Engineering.

    This report gives an overview of a study conducted by the Space Applications Board (SAB) on the practical applications of space systems. In this study, the SAB considered how the nation's space capability might be used to solve problems such as the shortage of food and energy; the improvement of the physical environment; inventorying and…

  5. Health visiting and refugee families: issues in professional practice.

    PubMed

    Drennan, Vari M; Joseph, Judy

    2005-01-01

    This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London. Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees. Despite successive waves of refugees to the United Kingdom in the 20th century, there are no empirical studies of health visiting practice with this vulnerable group. There is also no body of evidence to inform the practice of health visitors new to working with asylum seekers and refugees. An exploratory study was undertaken in Inner London in 2001. Semi-structured interviews were conducted with a purposive sample of 13 health visitors experienced in working with women and families who are refugees. A range of structural challenges was identified that mediated against the development of a health-promoting relationship between health visitors and refugee women. With refugee families, who were living in temporary accommodation, health visitors were prioritizing basic needs that had to be addressed: in addition, they prioritized the needs of children before those of women. Health visitors were aware of the emotional needs of women and had strategies for addressing these with women in more settled circumstances. Health visitors considered themselves ill-prepared to deal with the complexities of working with women in these situations. This study identifies issues for further exploration, not least from the perspective of refugee women receiving health visiting services. Health visitors in countries receiving refugee women are framing their work with these women in ways that reflect Maslow's theory of a hierarchy of needs. This study suggests ways that public health

  6. Intervention fidelity: ensuring application to practice for youth and families.

    PubMed

    Faulkner, Melissa Spezia

    2012-01-01

    Limited information on intervention fidelity is available in published studies with youth and families. The components of intervention fidelity, the complexity of measurement in these studies, and strategies for measuring intervention fidelity are described. Strategies for ensuring intervention fidelity according to the Treatment Fidelity Workgroup of the Behavior Change Consortium in the areas of study design, provider training, treatment delivery, treatment receipt, and treatment enactment provide guidance for evaluating or developing intervention fidelity plans. Ensuring the quality of intervention fidelity in evidence-based reviews or when developing new interventions is essential for translating findings into practice. © 2011, Wiley Periodicals, Inc.

  7. Biofeedback, Humanistic Psychology and Psychosomatics in Family Practice

    PubMed Central

    James, R. T.; Burrows, Terry

    1976-01-01

    An innovative educational approach to psychosomatic illness in family practice has been developed. It is a synthesis of experiential methods of non-verbal communication and creativity training developed from psychotronic applications of biofeedback, humanistic psychology and eidetics. The methodology, called eidetic biofeedback, operates on non-traditional models of human potential and involves a holistic approach to the mind-body/environment relationship. The methods work by transferring the responsibility for health back to the awareness of the individual. Of 200 office practice patients, 60 percent achieved major changes in personality integration and vitality. This was reflected in cessation of the presenting complaint, without symptom substitution and diminished demand for clinical services. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:21304760

  8. 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…

  9. Accounting for graduate medical education funding in family practice training.

    PubMed

    Chen, Frederick M; Phillips, Robert L; Schneeweiss, Ronald; Andrilla, C Holly A; Hart, L Gary; Fryer, George E; Casey, Susan; Rosenblatt, Roger A

    2002-10-01

    Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding. Using a national survey of 453 family practice residency programs and Medicare hospital cost reports, we assessed residency programs' knowledge of their federal GME funding and compared their responses with the actual amounts paid to the sponsoring hospitals by Medicare. A total of 328 (72%) programs responded; 168 programs (51%) reported that they did not know how much federal GME funding they received. Programs that were the only residency in the hospital (61% versus 36%) and those that were community hospital-based programs (53% versus 22%) were more likely to know their GME allocation. Programs in hospitals with other residencies received less of their designated direct medical education payment than programs that were the only residency in the sponsoring hospital (-45% versus +19%). More than half of family practice training programs do not know how much GME they receive. These findings call for improved accountability in the use of Medicare payments that are designated for medical education.

  10. Mini-immersion in medical Spanish for family practice residents.

    PubMed

    York Frasier, Pamela; Dávalos, Diane; Nusbaum, Margaret R H; Skinner, Bron

    2005-01-01

    Residency programs vary widely in types of training to increase cultural competency and sensitivity. Moreover, few empirical studies exist regarding effectiveness of these experiences. The purpose of our study was to offer and evaluate a linguistic mini-immersion, !Español Rápido!, required of 8 new family practice interns during their orientation month at the University of North Carolina. The curriculum was based on accelerative learning, a pedagogy that considers all parts of the brain, the paraconscious, and the role of the emotions. Pretests and posttests and a postimmersion and 6-month follow-up evaluation indicated that the mini-immersion was successful. A simple t test for paired samples showed a significant improvement in interns' comprehension after the 6-day immersion, t(7)=11.399, p<.000. This brief experience should be viewed only as a first step in a long-term plan for a comprehensive curriculum to prepare family practice residents as culturally competent practitioners.

  11. Improving consistency in student evaluation at affiliated family practice centers.

    PubMed

    Rabinowitz, H K

    1986-01-01

    The Department of Family Medicine at Jefferson Medical College has since 1974 been successful in administering a required third-year family medicine clerkship, providing students with a structured, didactic, and experiential curriculum in six affiliated family practice centers. Prior analysis (1976-1981) had indicated, however, that variation existed in evaluating similar students, depending on the clerkship training site, i.e., three sites graded students in a significantly different fashion than the three other sites. Utilizing these data to focus on the evaluation process, a comprehensive and specific six-point plan was developed to improve consistency in evaluations at the different training sites. This plan consisted of a yearly meeting of affiliate faculty, assigning predoctoral training administrative responsibility to one faculty member at each training site, increased telephone communication, affiliate-faculty attendance at the university site evaluation session, faculty rotation to spend time at other training sites, and financial reimbursement to the affiliate training sites. After intervention, analysis (1981-1983) indicated that five of the six clerkship sites now grade students in a consistent fashion, with only one affiliate using different grading standards. The intervention was therefore judged to be successful for five of the six training sites, allowing for better communication and more critical and consistent evaluation of medical students.

  12. The cost and funding of family practice graduate education in the United States.

    PubMed

    Ciriacy, E W; Liang, F Z; Godes, J R; Dunn, L D

    1985-03-01

    This paper reports the findings of a national cost survey of 369 nonmilitary family practice graduate education programs in the United States, 1981-82. The purpose of the study was to develop a reliable revenue and cost information data base to enable an understanding of current family practice education costs and funding. The availability of this information will be of assistance in the development of future budgetary plans for family practice graduate education. The results presented are based on 147 programs associated with hospitals using a non-cost center accounting protocol. These programs provided 100 percent complete revenue and cost data (40 percent of the targeted programs). Major sources of income were hospital support (35 percent), patient income (31 percent), and public dollars (28 percent). The mean cost per accredited position was $57,471. Expenses, each at approximately one third of the total, were resident stipends, faculty salaries, and clinic expenses. Statistically significant differences were found only for source of income when program structure, program size, and geographic location were examined. Recommendations for future family practice funding include modification of present reimbursement formulas and other third-party payment mechanisms, increasing hospital support, maintenance of public subsidies, and development of a uniform system of monitoring and evaluating costs of residency programs operated under both cost center and non-cost center accounting protocols.

  13. Parenting, family life, and well-being among sexual minorities: nursing policy and practice implications.

    PubMed

    Weber, Scott

    2008-06-01

    Parenting and family life are fundamental social constructs in human society and in law and public policy. Family structures and support systems provide important economic and psychological advantages for parents as well as for their children. Stigma toward lesbian and gay parents often marginalize individuals in these families and restrict family members' full expression of social citizenship, humanity, and personhood. Stigma directly contributes to increased risk for substance abuse, anxiety, and depressive illness among both parents and children. This article reviews the relevant policy literature to deconstruct the impacts of stigma on the psychological health and well-being of sexual minority parents so that psychiatric/mental health nurses and other health care providers can identify and counter these effects in their practices and advocate for policy improvements.

  14. Contributions of medical family therapy to the changing health care system.

    PubMed

    Doherty, William J; McDaniel, Susan H; Hepworth, Jeri

    2014-09-01

    Medical family therapy is a form of professional practice that uses a biopsychosocial approach and systemic family therapy principles in the collaborative treatment of individuals and families dealing with medical problems. It emerged out of the experience of family therapists working in primary medical care settings in the 1980s and 1990s. This article describes how contemporary medical family therapy can contribute to a transformed health care system in four areas: the patient experience of health care, the health of the population, the containment of health care costs, and enhanced practice environments.

  15. Patient care staffing patterns and roles in community-based family practices.

    PubMed

    Aita, V; Dodendorf, D M; Lebsack, J A; Tallia, A F; Crabtree, B F

    2001-10-01

    Our study describes patient care staff patterns and roles in community-based family practices. We used a multimethod comparative case study design that included detailed descriptive field notes of the office environment of 18 family practices and of 1637 clinical encounters, as well as in-depth interviews of practice staff and physicians. Systematic analysis of these data provided detailed descriptions of patient care staff patterns and functions. We included physicians and staff in 18 community-based Nebraska family practices. Practices are staffed with a range of clinical personnel, including registered nurses, licensed practical nurses, certified medical assistants, radiology technicians, and trained and untrained medical assistants. Each of these has specific educational preparation that potentially qualifies them for different patient care roles; however, staff roles were determined primarily by local needs and physician expectations rather than by education, training, or licensure. Staffing patterns varied greatly; the majority of practices employed at least one registered nurse (10 of 18), one licensed practical nurse (5), or both (4). Still, the overall majority of practices used non-nursing personnel as the predominate patient care staff. Patient care staff-to-clinician ratios ranged from a low of 0.5 to a high of 3.3. Many recent recommendations about collaborative models of clinical care seem problematic when put into a context of the findings of current staffing patterns and use of personnel in family practices. Staff members often fulfill roles independent of training. Staff leadership is also potentially important for designing effective collaborative care models; however, we found leadership only occurred with the approval of clinic authorities. These practical issues are rarely addressed in normative recommendations about system change and intervention. Our findings indicate that there are considerable opportunities for better use of the nursing and

  16. 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.

  17. Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study.

    PubMed

    Donald, Maoliosa; King-Shier, Kathryn; Tsuyuki, Ross T; Al Hamarneh, Yazid N; Jones, Charlotte A; Manns, Braden; Tonelli, Marcello; Tink, Wendy; Scott-Douglas, Nairne; Hemmelgarn, Brenda R

    2017-01-01

    The RxEACH trial was a randomized trial to evaluate the efficacy of community pharmacy-based case finding and intervention in patients at high risk for cardiovascular (CV) events. Community-dwelling patients with poorly controlled risk factors were identified and their CV risk reduced through patient education, prescribing and follow-up by their pharmacist. Perspectives of patients, family physicians and community pharmacists were obtained regarding pharmacists' identification and management of patients at high risk for CV events, to identify strategies to facilitate implementation of the pharmacist's expanded role in routine patient care. We used a qualitative methodology (individual semistructured interviews) with conventional qualitative content analysis to describe perceptions about community pharmacists' care of patients at high risk for CV events. Perceptions were categorized into macro (structure), meso (institution) and micro (practice) health system levels, based on a conceptual framework of care for optimizing scopes of practice. We interviewed 48 participants (14 patients, 13 family physicians and 21 community pharmacists). Patients were supportive of the expanded scope of practice of pharmacists. All participant groups emphasized the importance of communication, ability to share patient information, trust and better understanding of the roles, responsibilities, accountabilities and liabilities of the pharmacist within their expanded role. Despite support from patients and changes to delivery of care in primary care settings, ongoing efforts are needed to understand how to best harmonize family physician and community pharmacist roles across the health system. This will require collaboration and input from professional associations, regulatory bodies, pharmacists, family physicians and patients.

  18. Meeting the Challenge of Practice Quality Improvement: A Study of Seven Family Medicine Residency Training Practices

    PubMed Central

    Chase, Sabrina M.; Miller, William L.; Shaw, Eric; Looney, Anna; Crabtree, Benjamin F.

    2011-01-01

    Purpose Incorporating quality improvement (QI) into resident education and clinical care is challenging. This report explores key characteristics shaping the relative success or failure of QI efforts in seven primary care practices serving as family medicine residency training sites. Method The authors used data from the 2002–2008 Using Learning Teams for Reflective Adaptation (ULTRA) study to conduct a comparative case analysis. This secondary data analysis focused on seven residency training practices' experiences with RAP (reflective adaptive process), a 12-week intensive QI process. Field notes, meeting notes, and audiotapes of RAP meetings were used to construct case summaries. A matrix comparing key themes across practices was used to rate practices' QI progress during RAP on a scale of 0 to 3. Results Three practices emerged as unsuccessful (scores of 0–1) and four as successful (scores of 2–3). Larger practices with previous QI experience, faculty with extensive exposure to QI literature, and an office manager, residency director, or medical director who advocated for the process made substantial progress during RAP, succeeding at QI. Smaller practices without these characteristics were unable to do so. Successful practices also engaged residents in the QI process and identified serious problems as potential crises; unsuccessful practices did not. Conclusions Larger residency training practices are more likely to have the resources and characteristics that permit them to create a QI-supportive culture leading to QI success. The authors suggest, however, that smaller practices may increase their chances of success by adopting a developmental approach to QI. PMID:22030767

  19. Efficacy of Bowen Theory on Marital Conflict in the Family Nursing Practice: A Randomized Controlled Trial.

    PubMed

    Yektatalab, Shahrzad; Seddigh Oskouee, Fatemeh; Sodani, Mansour

    2017-03-01

    Family plays an important role in health and illness, and preparing the nurses to assess and improve the family functioning and relationship based on a theoretical framework is of critical importance. This randomized controlled trial was performed to evaluate the effectiveness of Bowen system theory on marital conflict in the family nursing practice. A total of 42 couples referring to the family court of Shiraz, Iran were randomly assigned to either the intervention (receiving eight 90-minute sessions of Bowen systemic family therapy) or the control group (receiving no interventions). Outcomes were measured before, after and after one month of the follow up by marital conflict questionnaire and analyzed using repeated measure ANOVAs and t-test. The study results revealed no statistically significant differences between the study groups regarding the total marital conflict scores (t = 2.8, p = .935) or any of the seven subscales of conflict before the intervention (p > .05). However, a significant difference was observed between the two groups in this regard immediately and one month after the intervention (p < .05). The results demonstrated a significant difference between the intervention and control groups regarding the conflict scores and its subscales during the three study periods and groups (F = 79.43, p < .001). This study highlighted the importance of applying Bowen systemic family therapy by nurses in decreasing marital conflicts. Similar studies with larger sample sizes and longer follow-ups are recommended to be conducted on the issue.

  20. 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.

  1. The Therapist's Role in Effective Marriage and Family Therapy Practice: The Case for Evidence Based Therapists.

    PubMed

    Blow, Adrian J; Karam, Eli A

    2016-09-30

    In this paper we argue that the therapist is a crucial change variable in psychotherapy as a whole and in couple, marital, and family therapy specifically. Therapists who work with complex systems require more skills to negotiate demanding therapy contexts. Yet, little is known about what differentiates effective couple, marital, and family therapists from those who are less effective, what innate therapy skills they possess, how they learn, and how they operationalize their knowledge in the therapy room. We discuss the need to emphasize evidence based therapists (as opposed to therapies), and implications of the importance of the role therapists for training, practice, research priorities, and policy.

  2. Food Insecurity and Compensatory Feeding Practices among Urban Black Families

    PubMed Central

    Feinberg, Emily; Kavanagh, Patricia L.; Young, Robin L.; Prudent, Nicole

    2009-01-01

    OBJECTIVE This study explored the relationship between food insecurity and compensatory maternal feeding practices that may be perceived as buffers against periodic food shortages among urban Black families. PATIENTS AND METHODS We interviewed a convenience sample of Black mothers of children ages 2–13 years. Food security status (predictor) was assessed at the household level. Five maternal feeding practices (outcomes) were assessed. Two were based on Birch’s Child Feeding Questionnaire (CFQ): restricting access to certain desired foods and pressuring a child to eat; and 3 were derived from investigators’ clinical experience: the use of high calorie supplements, added sugar in beverages, and perceived appetite stimulants. Anthropometric data were collected from mothers and children. RESULTS 278 mother-child dyads were analyzed, and 28% of these mothers reported being food insecure. Use of CFQ feeding practices was defined as the top quartile of responses. Use of nutritional supplements, defined as “at least 1–2 times monthly”, was common, ranging from 13%–25%. In logistic regression models adjusted for child age, BMI, and ethnicity and maternal BMI, mothers from food insecure households were significantly more likely to use high calorie supplements (OR, 2.1; 95% CI, 1.1–4.0) and appetite stimulants (OR, 3.2; 95% CI, 1.5–7.1). The odds of using the remaining compensatory feeding practices were elevated among food insecure households, but not reach statistical significance: adding sugars to beverages (OR, 2.1; 95% CI, 0.99–4.4), pressuring a child to eat (OR, 1.8; 95% CI, 0.98–3.2), and restricting access to certain foods (OR, 1.5; 95% CI 0.8–2.7). CONCLUSIONS Household food insecurity was independently associated with two of the five maternal compensatory feeding practices studied. Such practices may alter the feeding environment and increase the risk of overweight in children. Longitudinal research is necessary to determine how the

  3. Using the Neuman systems model for best practices.

    PubMed

    Ume-Nwagbo, Pearl N; DeWan, Sharon A; Lowry, Lois W

    2006-01-01

    Human beings with unmet needs related to their health and illnesses are the central focus of the domain of nursing. It is proposed in this column that nurses who conduct their practice from a nursing theory base, while assisting individuals and families to meet their health needs, are more likely to provide comprehensive, individualized care that exemplifies best practices. The Neuman systems model has been widely acclaimed to guide practice, yet specific examples are few in the published literature. The purpose of this column is to present two case studies based upon Neuman systems model; one case is directed toward family care, and the other demonstrates care with an individual. Theory-based exemplars serve as teaching tools for students and practicing nurses. These case studies illustrate how nurses' actions, directed by Neuman's wholistic principles, integrate evidence-based practice and generate high quality care.

  4. Epilogue: Systems Approaches and Systems Practice

    NASA Astrophysics Data System (ADS)

    Reynolds, Martin; Holwell, Sue

    Each of the five systems approaches discussed in this volume: system dynamics (SD), the viable systems model (VSM), strategic options development and analysis (SODA), soft systems methodology (SSM) and critical systems heuristics (CSH) has a pedigree. Not in the sense of the sometimes absurd spectacle of animals paraded at dog shows. Rather, their pedigree derives from their systems foundations, their capacity to evolve and their flexibility in use. None of the five approaches has developed out of use in restricted and controlled contexts of either low or high levels of complicatedness. Neither has any one of them evolved as a consequence of being applied only to situations with either presumed stakeholder agreement on purpose, or courteous disagreement amongst stakeholders, or stakeholder coercion. The compilation is not a celebration of abstract ‘methodologies', but of theoretically robust approaches that have a genuine pedigree in practice.

  5. School Access and Participation: Family Engagement Practices in the New Latino Diaspora

    ERIC Educational Resources Information Center

    Lowenhaupt, Rebecca

    2014-01-01

    This article describes how schools shape family engagement practices in the context of the New Latino Diaspora. Building on critical scholarship that has called for more culturally appropriate definitions of family engagement, this study seeks to develop a theoretical understanding of how school practices influence immigrant families' access to…

  6. School Access and Participation: Family Engagement Practices in the New Latino Diaspora

    ERIC Educational Resources Information Center

    Lowenhaupt, Rebecca

    2014-01-01

    This article describes how schools shape family engagement practices in the context of the New Latino Diaspora. Building on critical scholarship that has called for more culturally appropriate definitions of family engagement, this study seeks to develop a theoretical understanding of how school practices influence immigrant families' access to…

  7. Culture and Power in Practice: Cultural Democracy and the Family Support Movement. Best Practices Project Commissioned Paper III.

    ERIC Educational Resources Information Center

    Akinyela, Makungu M.

    The Best Practices Project of the Family Resource Coalition of American (FRCA) began in 1991 with the aim of meeting the need for better definition and articulation of what constitutes best practice in family support programs. This monograph, the third in a series of four, reports on some of the ideas about cultural democracy which have generated…

  8. Premenstrual syndrome. Evidence-based treatment in family practice.

    PubMed Central

    Douglas, Sue

    2002-01-01

    OBJECTIVE: To evaluate the strength of evidence for treatments for premenstrual syndrome (PMS) and to derive a set of practical guidelines for managing PMS in family practice. QUALITY OF EVIDENCE: An advanced MEDLINE search was conducted from January 1990 to December 2001. The Cochrane Library and personal contacts were also used. Quality of evidence in studies ranged from level I to level III, depending on the intervention. MAIN MESSAGE: Good scientific evidence shows that calcium carbonate (1200 mg/d) and selective serotonin reuptake inhibitors are effective treatments for PMS. The most commonly used therapies (including vitamin B6, evening primrose oil, and oral contraceptives) are based on inconclusive evidence. Other treatments for which there is inconclusive evidence include aerobic exercise, stress reduction, cognitive therapy, spironolactone, magnesium, nonsteroidal anti-inflammatory drugs, various hormonal regimens, and a complex carbohydrate-rich diet. Although evidence for them is inconclusive, it is reasonable to recommend healthy lifestyle changes given their overall health benefits. Progesterone and bromocriptine, which are still widely used, are ineffective. CONCLUSION: Calcium carbonate should be recommended as first-line therapy for women with mild-to-moderate PMS. Selective serotonin reuptake inhibitors can be considered as first-line therapy for women with severe affective symptoms and for women with milder symptoms who have failed to respond to other therapies. Other therapies may be tried if these measures fail to provide adequate relief. PMID:12489244

  9. Language and Literacy Practices in Dominican Families in New York City

    ERIC Educational Resources Information Center

    Rodriguez, M. Victoria

    2006-01-01

    This article presents the results of two ethnographic studies that explored the language and literacy practices present in the everyday lives of seven Dominican families living in the New York City metropolitan area. The families engaged in literacy practices that were embedded in their daily lives and often depended on the practical problems that…

  10. Narrative and Collaborative Practices in Work with Families that Are Homeless

    ERIC Educational Resources Information Center

    Fraenkel, Peter; Hameline, Thomas; Shannon, Michele

    2009-01-01

    This article reports on the use of narrative therapy ideas and practices in working with families that are homeless in a shelter-based, multiple-family discussion group program called Fresh Start for Families. It begins with a review of the challenges facing homeless families. It then briefly describes the collaborative methods used to develop the…

  11. Cultural transition of international medical graduate residents into family practice in Canada

    PubMed Central

    Triscott, Jean A.C.; Waugh, Earle H.; Torti, Jacqueline M.I.; Barton, Martina

    2016-01-01

    Objectives To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. Methods This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Results Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths.  At the same time, IMG residents appeared to experience challenges in the areas of:  (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada’s health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning,  unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles.   Conclusions Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum.  IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning. PMID:27149322

  12. Family planning studies the teachers' survey. Part 2: fertility differentials and practice of family planning.

    PubMed

    Kamel, W H; Hanna, A T; Kamel, N A; Wahdan, M H

    1970-06-01

    This study deals with biologic and socioeconomic fertility differentials of married female teachers in the Alexandria Governorate who were surveyed via questionnaire from October 1966 to February 1967. It also shows fertility patterns of educated working women, their opinions about family planning, their use of contraceptives, and their knowledge and use of family planning services. Of the 3893 teachers who responded, 65%, or 2626, were married and 92.5% were of childbearing age. The average age was 32.70 years; the average duration of marriage was 7.18 years. Half had just 1 or 2 children, with an inverse relationship between educational attainment and number of children. The number of children increased with the age of the teacher, but there was an inverse relationship between age at marriage and number of children. Just over 25% of the pregnancies ended in abortion, with an average of .64 abortions per teacher. There was a direct relationship between age of teacher and frequency of abortion. Teachers who married when they were under 20 were the most likely to abort. 13% of the teachers were pregnant at the time of the study. An inverse relationship existed between the desire to be pregnant and the number of surviving children. Statistics for married teachers over 45 who had completed their fertility indicate that the average teacher is likely to have 1.02 abortions, 3.1 deliveries, and 2.6 living children. All teachers favored family planning. 77.3% were currently practicing it, most in the 30-44 age group. 42% had consulted private doctors; 44.3% were prac ticing without medical advice; and only 14.8% went to a family planning center. The pill and the IUD were the most popular method, being used by 59.7%. Among those with children, those with no boys were the least likely to use contraceptives. Teachers, with their frequent contact with young people and parents, are seen as a good conduit for information about family planning. However, most teachers themselves

  13. Elder abuse and neglect in African American families: informing practice based on ecological and cultural frameworks.

    PubMed

    Horsford, Sheena R; Parra-Cardona, José Rubén; Schiamberg, Larry; Post, Lori A

    2011-01-01

    Despite the rapid growth of the elderly African American population in the U.S., elder abuse and neglect in African American families continue to be underdeveloped areas of study. This article presents an ecological and culturally informed framework for the study of elder abuse in African American populations. The model was developed based on Bronfenbrenner's Human Ecological Theory. The model identifies risk factors associated with different systems that have an influence on the lives of African American families. Cultural protective factors also are identified in the model. The model is intended to provide an understanding of elder abuse and neglect in African American families by considering the influence of contextual factors such as the legacy of slavery, social exclusion, and structural segregation and racism. Specific suggestions for practice are proposed according to cultural strengths of African American communities as well as the ecological premises of the model.

  14. Changing Systems for Children and Families.

    ERIC Educational Resources Information Center

    McCart, Linda

    This document summarizes the results of research on reform of state and national policy affecting families and children. The document begins with a rationale for change, and follows with four chapters that identify barriers stemming from attitudes, system organization, resource limitations, and technical problems. Each chapter suggests strategies…

  15. Family Resource System Preventing Unnecessary Foster Care.

    ERIC Educational Resources Information Center

    Reid, Dolores B.

    Montgomery County Children's Services, which provides public child welfare services in Dayton, Ohio, has instituted a family resource system to better serve and reduce the number of black children placed in foster care. The agency is mandated to receive and investigate child abuse and neglect complaints and to provide support services. The system…

  16. Social Constructionist Family Systems Research: Conceptual Considerations

    ERIC Educational Resources Information Center

    Puig, Ana; Koro-Ljungberg, Mirka; Echevarria-Doan, Silvia

    2008-01-01

    The purpose of this article is to illustrate how theory and particularly the theoretical perspective of social constructionism can influence the ways in which scholars conduct qualitative research studies in the area of family systems. The authors argue for the importance of theory in qualitative research projects and promote researchers' clear…

  17. Changing Systems for Children and Families.

    ERIC Educational Resources Information Center

    McCart, Linda

    This document summarizes the results of research on reform of state and national policy affecting families and children. The document begins with a rationale for change, and follows with four chapters that identify barriers stemming from attitudes, system organization, resource limitations, and technical problems. Each chapter suggests strategies…

  18. 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.

  19. Computer multitasking with Desqview 386 in a family practice.

    PubMed Central

    Davis, A E

    1990-01-01

    Computers are now widely used in medical practice for accounting and secretarial tasks. However, it has been much more difficult to use computers in more physician-related activities of daily practice. I investigated the Desqview multitasking system on a 386 computer as a solution to this problem. Physician-directed tasks of management of patient charts, retrieval of reference information, word processing, appointment scheduling and office organization were each managed by separate programs. Desqview allowed instantaneous switching back and forth between the various programs. I compared the time and cost savings and the need for physician input between Desqview 386, a 386 computer alone and an older, XT computer. Desqview significantly simplified the use of computer programs for medical information management and minimized the necessity for physician intervention. The time saved was 15 minutes per day; the costs saved were estimated to be $5000 annually. PMID:2383848

  20. 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…

  1. 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…

  2. Factors influencing family planning practice among reproductive age married women in Hlaing Township, Myanmar.

    PubMed

    Lwin, Myo Min; Munsawaengsub, Chokchai; Nanthamongkokchai, Sutham

    2013-12-01

    To study the factors that influence the family planning practice among married, reproductive age women in Hlaing Township, Myanmar. Cross-sectional survey research was conducted among 284 married, reproductive age women using stratified random sampling. The data were collected through questionnaire interviews during February and March 2012 and analyzed by frequency, percentage, Chi-square test, and multiple logistic regression. The proportion of families practicing family planning was 74.7%, contraceptive injection being the most commonly used method. The factors influencing family planning practice were attitude towards family planning, 24-hour availability of family planning services, health worker support, and partner and friends support. The women with a positive attitude toward family planning practiced family planning 3.7 times more than women who had a negative attitude. If family planning services were available for 24 hours, then women would practice 3.4 times more than if they were not available for 24 hours. When women got fair to good support from health workers, they practiced 15.0 times more on family planning and 4.3 times more who got fair to good support from partners and friends than women who got low support. The factors influencing family planning practice of married, reproductive age women were attitude toward family planning, 24-hour availability of family planning services, health worker support, and partner and friends support. The findings suggest that empowerment of health workers, training of volunteers, pharmacists and contraceptive drug providers, encouraging inter-spousal communication, and peer support, as well as an integrated approach to primary health care in order to target different populations to change women's attitudes on family planning, could increase family planning practice among Myanmar women.

  3. [Systemic-psychodynamic model for family evaluation].

    PubMed

    Salinas, J L; Pérez, M P; Viniegra, L; Armando Barriguete, J; Casillas, J; Valencia, A

    1992-01-01

    In this paper a family evaluation instrument called systemic-psychodynamic family evaluation model is described. Also, the second stage of the validation study of this instrument is presented (which deals with the inter-observers variation). Twenty families were studied. They were assessed always by the same interviewers designated as experts. They are all family therapy specialists and their assessment was used as the evaluation reference standard or "gold standard". The observers were psychiatrists without previous training in family therapy. For the purpose of the interview, both experts and observers were blind to the medical diagnosis of the patients. During the first stage of the validation study the observers did not have a reference guide which resulted in a low concordance rating. For the second stage, a 177 item guide was used and a considerable increase in the concordance rating was observed. Validation studies like the one used here are of considerable value to increase the reliability and further utilisation of evaluation instruments of this type.

  4. Child feeding practices and overweight status among Mexican immigrant families.

    PubMed

    Vera-Becerra, Luz Elvia; Lopez, Martha L; Kaiser, Lucia L

    2015-04-01

    The purpose was to compare maternal perceptions, feeding practices, and overweight status of children in immigrant households in California (US) with a cohort in Guanajuato, Mexico (MX). In 2006, staff interviewed mothers and weighed and measured their children, 1-6 years (US: n = 95 and MX: n = 200). Prevalence of overweight [body mass index z-score (BMIZ) >1.0 and <1.65] and obesity (BMIZ > 1.65) was 21.1 and 28.4% in the US respectively, compared to 11.5 and 12.9% in MX (p < 0.001). No differences were observed in maternal ability to identify correctly the child's weight status or ever being told the child was overweight. US children ate away from home more often (p < 0.0001), had fewer family meals (p < 0.0001), and played outdoors less often than MX children (p < 0.0002). Further analyses should examine how differences in eating and activity patterns explain the disparity in childhood obesity across the countries.

  5. Nursing Practices and Policies Related to Family Presence During Resuscitation.

    PubMed

    Powers, Kelly A; Candela, Lori

    Despite its shown benefits, family presence during resuscitation (FPDR) is a controversial topic among critical care nurses and is not routinely implemented. The objective of this study was to describe FPDR practices among critical care nurses, as well as the prevalence of FPDR policies and education. The study used a descriptive survey design. Data were collected from a convenience sample of critical care nurses obtained at a national level. A 25-item demographic and professional attribute survey was administered to all participants. There were 124 critical care nurses who participated. Results indicated critical care nurses have vast resuscitative care experience; however, FPDR is not a routine component. In the past year, 23% (n = 29) had never experienced FPDR, and only 17% (n = 21) had experienced it more than 5 times. Furthermore, 48% (n = 59) had never invited FPDR, and 45% (n = 56) had invited it only 1 to 5 times. A lack of FPDR policy was noted, with 73% (n = 91) indicating their facility or unit did not have a policy or they were unsure if one existed. Only 38% (n = 47) had ever received education on FPDR. Despite the shown benefits of FPDR, it is not a routine component of resuscitation in critical care settings. Nurse managers and educators should focus on policy creation and education to help guide nurses at the bedside. The impact of policy and education on critical care nurses' support for and implementation of FPDR requires further study.

  6. [Patient safety culture in Family practice residents of Galicia].

    PubMed

    Portela Romero, Manuel; Bugarín González, Rosendo; Rodríguez Calvo, María Sol

    To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. A cross-sectional study. Seven FP of Galicia teaching units. 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. The "Organisational learning" and "Teamwork" items were considered strong areas. However, the "Patient safety and quality issues", "Information exchange with other settings", and "Work pressure and pace" items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. 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.

  8. 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.

  9. Fusion within a classification system family

    NASA Astrophysics Data System (ADS)

    Oxley, Mark E.; Schubert Kabban, Christine M.

    2017-05-01

    A detection system outputs two distinct labels, thus, there are two errors it can make. The Receiver Operating Characteristic (ROC) function quantifies both of these errors as parameters vary within the system. Combining two detection systems typically yields better performance when a combining rule is chosen appropriately. When detection systems are combined the assumption of independence is usually made in order to simplify the math- ematics, so that we need only combine the individual ROC curve from each system into one ROC curve. This paper investigates label fusion of two detection systems drawn from a single Detection System Family (DSF). Given that one knows the ROC function for the DSF, we seek a formula with the resultant ROC function of the fused detection systems as a function (specifically, a transformation) of the ROC function. In this paper, we derive this transformation for the disjunction and conjunction label rules. Examples are given that demonstrates this transformation. Furthermore, another transformation is given to account for the dependencies between the two systems within the family. Examples will be given that demonstrates these ideas and the corresponding transformation acting on the ROC curve.

  10. 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

  11. 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

  12. Associations between family characteristics and parental empowerment in the family, family service situations and the family service system.

    PubMed

    Vuorenmaa, M; Perälä, M-L; Halme, N; Kaunonen, M; Åstedt-Kurki, P

    2016-01-01

    Parental empowerment signifies parents' sense of confidence in managing their children, interacting with services that their children use and improving child care services. High empowerment is associated with parents' resilience to demands and their confidence to make decisions and take actions that positively affect their families. Most families with children access various healthcare and education services. Professionals working in these services are therefore ideally placed to reinforce parental empowerment. However, little is known about the characteristics associated with parental empowerment within a generic sample of parents or in the context of basic child care services. The aim of this study was to assess how family characteristics are associated with maternal and paternal empowerment in the family, in service situations and in the service system. Parental empowerment was measured among 955 parents (mothers = 571; fathers = 384) of children aged 0-9 years using the Generic Family Empowerment Scale. Family characteristics were assessed through questions on children, parents and the life situation. Associations between empowerment and family characteristics were evaluated using one-way analysis of variance and t-test. Parental empowerment was predicted by multiple linear regression analysis. Parents' concerns related to their parenting, such as whether they possessed sufficient skills as a parent or losing their temper with children, as well as experiences of stress in everyday life, were negatively associated with all dimensions of maternal and paternal empowerment. Both determinants were more common and more significant in empowerment than child-related problems. Promoting parental self-confidence and providing appropriate emotional and concrete support for everyday functioning may reinforce parental empowerment, thereby enhancing families' well-being and coping, as well as improving their access to required services and timely support. Finally

  13. Adherence to antihypertensive medications among family practice patients with diabetes mellitus and hypertension

    PubMed Central

    Natarajan, Nandini; Putnam, Wayne; Van Aarsen, Kristine; Beverley Lawson, Kristine; Burge, Fred

    2013-01-01

    Objective To measure adherence and to identify factors associated with adherence to antihypertensive medications in family practice patients with diabetes mellitus (DM) and hypertension. Design A cross-sectional study using a mailed patient self-report survey and clinical data. Setting Twenty-seven family physician and nurse practitioner clinics from Nova Scotia, New Brunswick, and Prince Edward Island (the Maritime Family Practice Research Network). Participants A total of 527 patients with type 2 DM and hypertension who had had their blood pressure measured with the BpTRU (an automated oscillometric instrument) at family practice clinic visits within the previous 6 months. Main outcome measures Level of adherence to antihypertension medications as measured by patients' self-report on the Morisky scale; association between high adherence on the Morisky scale and 22 patient factors related to demographic characteristics, clinical variables, knowledge, beliefs, behaviour, health care provider relationships, and health system influences. Results The survey response rate was 89.6%. The average age of patients was 66 years, and 51.6% of participants were men. Forty-three percent of patients had had a diagnosis of DM for more than 10 years, and 49.7% had had a diagnosis of hypertension for more than 10 years. Eighty-nine percent of patients had some form of medical insurance. All patients had seen their family physician providers at least once within the past year. Seventy-seven percent of patients reported high adherence as measured by the Morisky scale. On multiple logistic regression, being older than 55, taking more than 7 prescribed medications, and having a lifestyle that included regular exercise or a healthy diet with low salt intake or both were significant independent predictors of high adherence scores on the Morisky scale (P ≤ .05). Conclusion More than three-quarters of patients with type 2 DM and hypertension from community family practice clinics in

  14. How to rationally use information diagnostic technologies in family and general medicine practice.

    PubMed

    Sivić, Suad; Masic, Izet; Petkovic, Darko; Huseinagic, Senad; Tandir, Salih; Zunic, Lejla

    2009-01-01

    NONE DECLARED New discoveries in technology indeed enabled significant improvement of health care in the last three decades. Only during the last few years a significant breakthrough is achieved in the field of antiviral drugs, biotechnology, digital diagnostic technology, molecular diagnosis, tissues and organs transplantation as well as surgical and information technologies, which all contributed to the improvement of health care. Rapid growth of medical technology has led to the increase in costs of health care, increased access to these technologies and improvement of health care that is permanently encouraging the further development of technology. Technology encompasses the skills, knowledge and ability to understand, use and create useful things. It is the practical application of knowledge. Evaluation of health technology is the systematic evaluation of characteristics, results or impact of health technologies. The primary purpose of evaluation is to provide information to responsible parties for the technology in the health care system, which will be used in decision-making and introduction of these technologies. Information technology in medicine and health care represents all medical and health technology in the process of work, monitoring and evaluation done using computer technology. Progress of medical science in recent years especially needs to thank to the development of information technologies. The health care system of Bosnia and Herzegovina is currently operating in the two sub-systems of primary health care. One is inherited from the past system, in which the primary health care is provided by general practitioners, specialists in general practice, as well as gynecologists, pediatricians and pulmologists, and the second subsystem occurs when in PHC is introduced the system of family medicine doctors and family medicine specialists. Family medicine, based on the concept of orientation towards the methods which are more effective, rational and

  15. Preparing Educators to Involve Families: From Theory to Practice

    ERIC Educational Resources Information Center

    Weiss, Heather Bastow, Ed.; Kreider, Holly Marie, Ed.; Lopez, M. Elena, Ed.; Chatman, Celina M., Ed.

    2005-01-01

    Family involvement in children's education is widely considered critical to student achievement. Yet teachers and other education professionals often feel unprepared to engage families in children's learning. The goal of Preparing Educators to Involve Families is to help prepare teachers and other professionals to partner effectively with the…

  16. Resources for Advancing Family Gerontology Education and Practice

    ERIC Educational Resources Information Center

    Price, Christine A.; Brosi, Whitney A.

    2006-01-01

    The unprecedented growth in the older adult population combined with increased scholarly interest in family dynamics has resulted in the gradual expansion of family gerontology as its own area of study. Consisting of both university faculty and practitioners, family gerontology educators integrate multiple disciplines in order to teach about later…

  17. 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…

  18. Preparing Educators to Involve Families: From Theory to Practice

    ERIC Educational Resources Information Center

    Weiss, Heather Bastow, Ed.; Kreider, Holly Marie, Ed.; Lopez, M. Elena, Ed.; Chatman, Celina M., Ed.

    2005-01-01

    Family involvement in children's education is widely considered critical to student achievement. Yet teachers and other education professionals often feel unprepared to engage families in children's learning. The goal of Preparing Educators to Involve Families is to help prepare teachers and other professionals to partner effectively with the…

  19. Effective Family Intervention after Traumatic Brain Injury: Theory and Practice.

    ERIC Educational Resources Information Center

    Rosenthal, Mitchell; Young, Terry

    1988-01-01

    A framework is presented for intervention with families of traumatic brain injured patients. Described are family assessment strategies; levels of intervention (permission, limited information, specific suggestions, and intensive therapy); and intervention techniques in the areas of family education, counseling, marital/sexual counseling, family…

  20. Resources for Advancing Family Gerontology Education and Practice

    ERIC Educational Resources Information Center

    Price, Christine A.; Brosi, Whitney A.

    2006-01-01

    The unprecedented growth in the older adult population combined with increased scholarly interest in family dynamics has resulted in the gradual expansion of family gerontology as its own area of study. Consisting of both university faculty and practitioners, family gerontology educators integrate multiple disciplines in order to teach about later…

  1. Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study

    PubMed Central

    Donald, Maoliosa; King-Shier, Kathryn; Tsuyuki, Ross T.; Al Hamarneh, Yazid N.; Jones, Charlotte A.; Manns, Braden; Tonelli, Marcello; Tink, Wendy; Scott-Douglas, Nairne; Hemmelgarn, Brenda R.

    2017-01-01

    Background: The RxEACH trial was a randomized trial to evaluate the efficacy of community pharmacy-based case finding and intervention in patients at high risk for cardiovascular (CV) events. Community-dwelling patients with poorly controlled risk factors were identified and their CV risk reduced through patient education, prescribing and follow-up by their pharmacist. Perspectives of patients, family physicians and community pharmacists were obtained regarding pharmacists' identification and management of patients at high risk for CV events, to identify strategies to facilitate implementation of the pharmacist's expanded role in routine patient care. Methods: We used a qualitative methodology (individual semistructured interviews) with conventional qualitative content analysis to describe perceptions about community pharmacists' care of patients at high risk for CV events. Perceptions were categorized into macro (structure), meso (institution) and micro (practice) health system levels, based on a conceptual framework of care for optimizing scopes of practice. Results: We interviewed 48 participants (14 patients, 13 family physicians and 21 community pharmacists). Patients were supportive of the expanded scope of practice of pharmacists. All participant groups emphasized the importance of communication, ability to share patient information, trust and better understanding of the roles, responsibilities, accountabilities and liabilities of the pharmacist within their expanded role. Interpretation: Despite support from patients and changes to delivery of care in primary care settings, ongoing efforts are needed to understand how to best harmonize family physician and community pharmacist roles across the health system. This will require collaboration and input from professional associations, regulatory bodies, pharmacists, family physicians and patients. PMID:28401136

  2. Sacred Practices and Family Processes in a Jewish Context: Shabbat as the Weekly Family Ritual Par Excellence.

    PubMed

    Marks, Loren D; Hatch, Trevan G; Dollahite, David C

    2017-03-19

    The present article provides a deep and more focused look at the utility, meaning, processes, and power involved in a specific, family-level, sacred practice or ritual from Judaism: Shabbat (Sabbath). Content analysis of in-depth interviews with 30 diverse, marriage-based Jewish families living in the United States (N = 77 individuals) yielded three emergent themes: (a) "Shabbat brings us closer together"; (b) How Shabbat brings the family together; and (c) The Power of Blessing the Children. These themes will be discussed respectively, along with related verbatim data from participants' in-depth qualitative interviews. © 2017 Family Process Institute.

  3. Family systems theory, attachment theory, and culture.

    PubMed

    Rothbaum, Fred; Rosen, Karen; Ujiie, Tatsuo; Uchida, Nobuko

    2002-01-01

    Family systems theory and attachment theory have important similarities and complementarities. Here we consider two areas in which the theories converge: (a) in family system theorists' description of an overly close, or "enmeshed," mother-child dyad, which attachment theorists conceptualize as the interaction of children's ambivalent attachment and mothers' preoccupied attachment; (b) in family system theorists' description of the "pursuer-distance cycle" of marital conflict, which attachment theorists conceptualize as the interaction of preoccupied and dismissive partners. We briefly review family systems theory evidence, and more extensively review attachment theory evidence, pertaining to these points of convergence. We also review cross-cultural research, which leads us to conclude that the dynamics described in both theories reflect, in part, Western ways of thinking and Western patterns of relatedness. Evidence from Japan suggests that extremely close ties between mother and child are perceived as adaptive, and are more common, and that children experience less adverse effects from such relationships than do children in the West. Moreover, in Japan there is less emphasis on the importance of the exclusive spousal relationship, and less need for the mother and father to find time alone to rekindle romantic, intimate feelings and to resolve conflicts by openly communicating their differences. Thus, the "maladaptive" pattern frequently cited by Western theorists of an extremely close mother-child relationship, an unromantic, conflictual marriage characterized by little verbal communication and a peripheral, distant father, may function very differently in other cultures. While we believe that both theories will be greatly enriched by their integration, we caution against the application of either theory outside the cultures in which they were developed.

  4. Shared Knowledge and Mutual Respect: Enhancing Culturally Competent Practice through Collaboration with Families and Communities

    ERIC Educational Resources Information Center

    Verdon, Sarah; Wong, Sandie; McLeod, Sharynne

    2016-01-01

    Collaboration with families and communities has been identified as one of six overarching principles to speech and language therapists' (SLTs') engagement in culturally competent practice (Verdon et al., 2015a). The aim of this study was to describe SLTs' collaboration with families and communities when engaging in practice to support the speech,…

  5. The Arts and Family Social Work: A Call for Advancing Practice, Research, and Education

    ERIC Educational Resources Information Center

    Mazza, Nicholas

    2009-01-01

    This brief report serves as a call for creative and artistic works relative to family social work. Recognizing the "art" of family social work, Mazza's (2003) multidimensional poetry therapy practice model is used as a framework for addressing all arts-based approaches to practice and research.

  6. Programs That Work, from the Promising Practices Network on Children, Families and Communities. RAND Tool

    ERIC Educational Resources Information Center

    Kilburn, M. Rebecca, Ed.

    2014-01-01

    The Promising Practices Network (PPN) on Children, Families and Communities (www.promisingpractices.net) began as a partnership between four state-level organizations that help public and private organizations improve the well-being of children and families. The PPN website, archived in June 2014, featured summaries of programs and practices that…

  7. Funerals, Family, and Forefathers: A View of Italian-American Funeral Practices.

    ERIC Educational Resources Information Center

    Cowell, Daniel David

    1986-01-01

    Traces the evolution of Italian-American funeral practices from the preimmigrant culture of southern Italy to contemporary funeral practices of Italian-Americans. The author describes his family experience of death as rooted in Old World traditions, modified by American social patterns, and shaped by psychosocial family dynamics. (NRB)

  8. Shared Knowledge and Mutual Respect: Enhancing Culturally Competent Practice through Collaboration with Families and Communities

    ERIC Educational Resources Information Center

    Verdon, Sarah; Wong, Sandie; McLeod, Sharynne

    2016-01-01

    Collaboration with families and communities has been identified as one of six overarching principles to speech and language therapists' (SLTs') engagement in culturally competent practice (Verdon et al., 2015a). The aim of this study was to describe SLTs' collaboration with families and communities when engaging in practice to support the speech,…

  9. Programs That Work, from the Promising Practices Network on Children, Families and Communities. RAND Tool

    ERIC Educational Resources Information Center

    Kilburn, M. Rebecca, Ed.

    2014-01-01

    The Promising Practices Network (PPN) on Children, Families and Communities (www.promisingpractices.net) began as a partnership between four state-level organizations that help public and private organizations improve the well-being of children and families. The PPN website, archived in June 2014, featured summaries of programs and practices that…

  10. Systems effects on family planning innovativeness.

    PubMed

    Lee, S B

    1983-12-01

    Data from Korea were used to explore the importance of community level variables in explaining family planning adoption at the individual level. An open system concept was applied, assuming that individual family planning behavior is influenced by both environmental and individual factors. The environmental factors were measured at the village level and designated as community characteristics. The dimension of communication network variables was introduced. Each individual was characterized in terms of the degree of her involvement in family planning communication with others in her village. It was assumed that the nature of the communication network linking individuals with each other effects family planning adoption at the individual level. Specific objectives were to determine 1) the relative importance of the specific independent variables in explaining family planning adoption and 2) the relative importance of the community level variables in comparison with the individual level variables in explaining family planning adoption at the individual level. The data were originally gathered in a 1973 research project on Korea's mothers' clubs. 1047 respondents were interviewed, comprising all married women in 25 sample villages having mothers' clubs. The dependent variable was family planning adoption behavior, defined as current use of any of the modern methods of family planning. The independent variables were defined at 3 levels: individual, community, and at a level intermediate between them involving communication links between individuals. More of the individual level independent variables were significantly correlated with the dependent variables than the community level variables. Among those variables with statistically significant correlations, the correlation coefficients were consistently higher for the individual level than for the community level variables. More of the variance in the dependent variable was explained by individual level than by

  11. 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…

  12. 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…

  13. Home Literacy Beliefs and Practices among Low-Income Latino Families

    ERIC Educational Resources Information Center

    Davis, Heather S.; Gonzalez, Jorge E.; Pollard-Durodola, Sharolyn; Saenz, Laura M.; Soares, Denise A.; Resendez, Nora; Zhu, Leina; Hagan-Burke, Shanna

    2016-01-01

    The aim of this study was to explore within-group patterns of variability in the home literacy environments (HLEs) of low-income Latino families using latent profile analysis. Participants were (N = 193) families of Latino preschoolers enrolled in a larger study. In the fall of 2012, mothers filled out a family literacy practices inventory, a…

  14. Child Abuse and Neglect in Cambodian Refugee Families: Characteristics and Implications for Practice

    ERIC Educational Resources Information Center

    Chang, Janet; Rhee, Siyon; Berthold, S. Megan

    2008-01-01

    This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services…

  15. Relationship-Centered Practices in Early Childhood: Working with Families, Infants, and Young Children at Risk

    ERIC Educational Resources Information Center

    Ensher, Gail L.; Clark, David A.

    2011-01-01

    Strong working relationships with diverse families and children are the foundation of successful early intervention. Discover fresh, practical ways to build these relationships in this essential guidebook, every professional's blueprint for working with children and families within the specific context of their culture, family structure, and risk…

  16. Home Literacy Beliefs and Practices among Low-Income Latino Families

    ERIC Educational Resources Information Center

    Davis, Heather S.; Gonzalez, Jorge E.; Pollard-Durodola, Sharolyn; Saenz, Laura M.; Soares, Denise A.; Resendez, Nora; Zhu, Leina; Hagan-Burke, Shanna

    2016-01-01

    The aim of this study was to explore within-group patterns of variability in the home literacy environments (HLEs) of low-income Latino families using latent profile analysis. Participants were (N = 193) families of Latino preschoolers enrolled in a larger study. In the fall of 2012, mothers filled out a family literacy practices inventory, a…

  17. Family Management Practice, School Achievement, and Problem Behavior in African American Adolescents: Mediating Processes

    ERIC Educational Resources Information Center

    Taylor, R.D.; Lopez, E.I.

    2005-01-01

    The association of mothers' report of family management practices (e.g., family routine and parental achievement expectations) with school achievement, school engagement, and problem behavior was assessed among African American mothers and adolescents. Findings revealed that family routine was positively associated with school achievement and…

  18. Medical Student Clinics: The Basis for a Clerkship in Family Practice.

    ERIC Educational Resources Information Center

    Dervin, John V.; Rodnick, Jonathan E.

    1979-01-01

    The key element in a clerkship in family practice at Community Hospital, Santa Rosa, California, is the student's General Medical Clinic. Under the supervision of a family physician teacher, senior medical students work as a team with family nurse practitioners caring for patients. (Author/JMD)

  19. Relationship-Centered Practices in Early Childhood: Working with Families, Infants, and Young Children at Risk

    ERIC Educational Resources Information Center

    Ensher, Gail L.; Clark, David A.

    2011-01-01

    Strong working relationships with diverse families and children are the foundation of successful early intervention. Discover fresh, practical ways to build these relationships in this essential guidebook, every professional's blueprint for working with children and families within the specific context of their culture, family structure, and risk…

  20. On-the-Job Practices of Early Childhood Special Education Providers Trained in Family-Centered Practices

    ERIC Educational Resources Information Center

    Murray, Mary M.; Mandell, Colleen J.

    2006-01-01

    This qualitative study investigated the use of family-centered practices by graduates of two early childhood special education personnel preparation programs that embedded family-centered pedagogy and involvement in all coursework. Three cohorts, involving 19 graduates employed in 19 different programs located in six states, participated in…

  1. A discussion of HIV/AIDS family interventions: implications for family-focused nursing practice.

    PubMed

    Eustace, Rosemary W

    2013-07-01

    This article presents a discussion on the role of family interventions in HIV/AIDS disease prevention and care. Although HIV/AIDS epidemic and its impact on the society traditionally has been measured in terms of individual risk behaviours and individual-level HIV prevention, HIV/AIDS family-focused prevention and management strategies are increasingly becoming a priority. However, little is known as to what constitutes a HIV/AIDS family intervention. The search was limited to English and published literature starting in the year 1983 to date. CINAHL and PubMed were emphasized using a combination of text words and subject headings. Cochrane Library, PsycInfo, Scopus, and the ISI Web of Science databases were also searched using keywords and in the case of PsycInfo, subject headings were used. The main keywords were 'nurse', or 'nursing', 'HIV/AIDS', 'family interventions', 'family support' and 'family education', and/or 'family subsystems'. The process of theorizing about 'family interventions' and 'HIV/AIDS-family interventions' is critical for putting forth essential components unique for designing culturally specific HIV/AIDS family interventions. In addition, any proposed design of HIV/AIDS family intervention should consider the impact of HIV/AIDS on the family across the family life span, disease trajectory, and from an interdisciplinary perspective. Training needs of family nurses should be met when designing multidisciplinary HIV/AIDS-FIs. Furthermore, nurses should be proactive in advocating for HIV/AIDS family intervention and HIV/AIDS family policies to improve outcomes in family functioning, processes, and relationships. More needs to be done in regard to research on families, family interventions, effectiveness, and cost of family-focused approaches. © 2012 Blackwell Publishing Ltd.

  2. Practice-Generated Questions: A Method of Formulating True Learning Needs of Family Physicians

    PubMed Central

    Jennett, Penny A.; Lockyer, Jocelyn M.; Parboosingh, I. John P.; Maes, William R.

    1989-01-01

    The importance of identifying true learning needs prior to planning and conducting educational programs is well documented. In this study a collection of 579 clinical questions forwarded by 87 family physicians in southern Alberta was reviewed and analysed to determine if the questions would cluster and, therefore, be useful as sources for planning continuing medical education (CME) conferences and newsletters. The nature of submitted questions was also examined to determine if particular groups of physicians, as identified by socio-demographic characteristics, significanly differed by type of questions submitted. The study findings indicate that the questions generated by the clinical practices of family practitioners did cluster into meaningful categories, and did vary significantly by identified physician groups. Questions relating to the genito-urinary system; adverse drug effects, interactions and contraindications; and nervous system and sense organs were most frequently submitted. The nature of questions generated differed significantly by gender, size of practice setting, and year and place of medical graduation. When highly relevant and specific clinical questions, as contrasted with broadly expressed needs, serve as sources of identified learning needs for CME planners, the daily clinical problems faced by practitioners are better addressed. The learning needs identified by this approach provide an optimum framework for planned CME to influence physician behaviour or practice patterns. PMID:21248985

  3. Cultural Competency Training in a New-Start Rural/Frontier Family Practice Residency Program: A Cultural Immersion Integrative Model.

    ERIC Educational Resources Information Center

    Doty, Barbara J.; Pastorino, Ray

    The Alaska Family Practice Residency (AFPR) is a graduate medical education training program for family physicians headed for rural and remote practice sites. Located in Anchorage and affiliated with the University of Washington family practice residency network, the program has an integrated curriculum aimed at preparing family physicians to…

  4. Leveraging Social Media in #FamilyNursing Practice.

    PubMed

    Schroeder, Wilma K

    2017-02-01

    The use of social media to find and disseminate health information is rapidly increasing worldwide. It is essential for family nurses to participate in this trend, and to meet our clients where they are, on social media. Nurses can use social media to promote family health, reduce illness suffering, and meet family needs for information and support. As well, social media provides a way to build relationships with families outside of the physical health care setting or clinic. It is important to understand the types and potential uses of social media, as well as the risks and pitfalls. Standards for e-professionalism must be maintained. Through using social media, family nurses can increase their reach and effectiveness for family health promotion.

  5. Family-Focused Autism Spectrum Disorder Research: A Review of the Utility of Family Systems Approaches

    ERIC Educational Resources Information Center

    Cridland, Elizabeth K.; Jones, Sandra C.; Magee, Christopher A.; Caputi, Peter

    2014-01-01

    A family member with an autism spectrum disorder presents pervasive and bidirectional influences on the entire family system, suggesting a need for family-focused autism spectrum disorder research. While there has been increasing interest in this research area, family-focused autism spectrum disorder research can still be considered relatively…

  6. Family-Focused Autism Spectrum Disorder Research: A Review of the Utility of Family Systems Approaches

    ERIC Educational Resources Information Center

    Cridland, Elizabeth K.; Jones, Sandra C.; Magee, Christopher A.; Caputi, Peter

    2014-01-01

    A family member with an autism spectrum disorder presents pervasive and bidirectional influences on the entire family system, suggesting a need for family-focused autism spectrum disorder research. While there has been increasing interest in this research area, family-focused autism spectrum disorder research can still be considered relatively…

  7. Can the Quality of Care in Family Practice Be Measured Using Administrative Data?

    PubMed Central

    Katz, Alan; Soodeen, Ruth-Ann; Bogdanovic, Bogdan; De Coster, Carolyn; Chateau, Dan

    2006-01-01

    Objective To explore the feasibility of using administrative data to develop process indicators for measuring quality in primary care. Data Sources/Study Setting The Population Health Research Data Repository (Repository) housed at the Manitoba Centre for Health Policy which includes physician claims, hospital discharge abstracts, pharmaceutical use (Drug Program Information Network (DPIN)), and the Manitoba Immunization Monitoring Program (MIMS) for all residents of Manitoba, Canada who used the health care system during the 2001/02 fiscal year. Family physicians were identified from the Physician Resource Database. Indicators were developed based on a literature review and focus group validation. Data Collection/Extraction Methods Data files were extracted from administrative data available in the Repository. We extracted data based on the ICD-9-CM codes and ATC-class drugs prescribed and then linked them to the Physician Resource Database. Physician practices were defined by allocating patients to their most responsible physician. Every family physician in Manitoba that met the inclusion criteria (having either 5 or 10 eligible patients depending on the indicator) was ‘scored’ on each indicator. Physicians were then grouped according to the proportion of the patients allocated to their practice who received the recommended care for the specific indicator. Principal Findings Using administrative health data we were able to develop and measure eight indicators of quality of care covering both preventive care services and chronic disease management. The number of eligible physicians and patients varied for each indicator as did the percent of patients with recommended care, per physician. For example, the childhood immunization indicator included 544 physicians who, on average, provided immunization for 65 percent of their patients. Conclusions Quality of care provided by family physicians can be measured using administrative data. Despite the limitations

  8. [Exhaustion of family caregivers: a masked domestic crisis? A psychodynamic and systemic approach].

    PubMed

    Bouati, Noureddine; Sagne, Alain; Hunsicker, Morgane; Gavazzi, Gaëtan; Couturier, Pascal

    2016-03-01

    We try, from our clinical practice in a geriatric medicine department, to identify the processes involved in family crisis, especially in the relationship carer/cared. Psychodynamic and systemic determinants are highlighted to understand how family caregivers may suffer burn out, and suggest preventive measures.

  9. Handheld Computer Use in U.S. Family Practice Residency Programs

    PubMed Central

    Criswell, Dan F.; Parchman, Michael L.

    2002-01-01

    Objective: The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States. Study Design: In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States. Measurements: Data and patterns of the use and non-use of handheld computers were identified. Results: Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was $461.58. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs. Conclusions: Handheld computers are widely used in family practice residency programs in the United States

  10. Family Sense-Making Practices in Science Center Conversations

    ERIC Educational Resources Information Center

    Zimmerman, Heather Toomey; Reeve, Suzanne; Bell, Philip

    2010-01-01

    In this paper, we examine the interactional ways that families make meaning from biological exhibits during a visit to an interactive science center. To understand the museum visits from the perspectives of the families, we use ethnographic and discourse analytic methods, including pre- and postvisit interviews, videotaped observations of the…

  11. A Short Course in Family Therapy: Translating Research Into Practice

    ERIC Educational Resources Information Center

    Williams, Robert

    2005-01-01

    This article outlines a graduate-level, one-time-only family therapy course that prepares counseling trainees to be competent at entry-level family therapy in the United States. The approach outlined addresses the training concerns of programs that significantly emphasize individual-focused paradigms and that have limited time to train counseling…

  12. Family, School, and Community Partnerships: Practical Strategies for Afterschool Programs

    ERIC Educational Resources Information Center

    Finn-Stevenson, Matia

    2014-01-01

    Much attention is given today to the importance of forging family, school, and community partnerships. Growing numbers of schools, many of them with afterschool programs, are dedicating resources to support and sustain relationships with families and community-based organizations. And, among government agencies and the philanthropic sector, there…

  13. Factors Influencing Satisfaction for Family Practice Residency Faculty.

    ERIC Educational Resources Information Center

    Kay, Lawrence E.; D'Amico, Frank

    1999-01-01

    A survey of 383 faculty in family medical-residency programs explored perceptions of 60 professional, scheduling, compensation, and regional factors as they related to overall job satisfaction and career plans, and 59 factors related to the initial decision to enter academic family medicine. Results indicate high levels of satisfaction, feeling…

  14. Family-School Partnerships: Towards Sustainable Pedagogical Practice

    ERIC Educational Resources Information Center

    Daniel, Graham

    2011-01-01

    The role of family-school partnerships in facilitating children's educational engagement and achievement is now widely recognised. However, the theoretical foundations of family-school partnerships remain under-developed and research in many aspects of this field is incomplete. The need for the development of a rigorously informed and theorised…

  15. Fostering Family-Teacher Partnerships: Principles in Practice

    ERIC Educational Resources Information Center

    Knight-McKenna, Mary; Hollingsworth, Heidi L.

    2016-01-01

    Twenty-first century educators of young children need skills and dispositions for building partnerships with the families of all their students. Educators worldwide frequently teach children from families whose backgrounds, including socioeconomic status and home language, are different from their own. This article introduces 12 principles for…

  16. Needs of Kinship Care Families and Pediatric Practice.

    PubMed

    Rubin, David; Springer, Sarah H; Zlotnik, Sarah; Kang-Yi, Christina D

    2017-03-27

    As many as 3% of children in the United States live in kinship care arrangements with caregivers who are relatives but not the biological parents of the child. A growing body of evidence suggests that children who cannot live with their biological parents fare better, overall, when living with extended family than with nonrelated foster parents. Acknowledging this, federal laws and public policies increasingly favor kinship care over nonrelative foster care when children are unable to live with their biological parents. Despite overall better outcomes, families providing kinship care experience many hardships, and the children experience many of the same adversities of children in traditional foster care. This policy statement reviews both the strengths and vulnerabilities of kinship families and suggests strategies for pediatricians to use to address the needs of individual patients and families. Strategies are also outlined for community, state, and federal advocacy on behalf of these children and their families.

  17. Family Astronomy: Improving Practices and Developing New Approaches

    NASA Astrophysics Data System (ADS)

    Noel-Storr, J.; Drobnes, E.; Mitchell, S. E.

    2008-06-01

    We present effective strategies for family astronomy programs based on the experiences in recent years developing programs around four key elements: child and parent engagement in the process of science; family cohesiveness and cooperation; parent ``professional development''; and continuity of learning beyond the programs we create. We present strategies developed by workshop attendees to implement or improve family programs that can be facilitated in a variety of settings, with an emphasis on creativity and innovation to push the field forwards. We discuss the design of evaluation tools and education research questions centered on family learning that will ensure the value that family astronomy programs add to Science, Technology, Engineering and Mathematics (STEM) education in a range of communities is increased and better understood.

  18. Rapid changes in American family life: consequences for child health and pediatric practice.

    PubMed

    Fiese, Barbara H; Rhodes, Holly G; Beardslee, William R

    2013-09-01

    Pediatricians are in the unique position of being on the front line of care for children and having access to their families. This article presents both a rationale and the evidence base for identifying the family characteristics and processes that affect child health and suggests approaches that pediatricians can implement to improve the care of children, using data from 3 recent reports of the Institute of Medicine and National Research Council, as well as other recent family research. Evidence regarding the impact on child health of 3 family factors in particular (family composition and living arrangements, family routines, and parental depression) is highlighted, and implications for pediatric practice are described.

  19. Rapid Changes in American Family Life: Consequences for Child Health and Pediatric Practice

    PubMed Central

    Fiese, Barbara H.; Beardslee, William R.

    2013-01-01

    Pediatricians are in the unique position of being on the front line of care for children and having access to their families. This article presents both a rationale and the evidence base for identifying the family characteristics and processes that affect child health and suggests approaches that pediatricians can implement to improve the care of children, using data from 3 recent reports of the Institute of Medicine and National Research Council, as well as other recent family research. Evidence regarding the impact on child health of 3 family factors in particular (family composition and living arrangements, family routines, and parental depression) is highlighted, and implications for pediatric practice are described. PMID:23918891

  20. Systems and Complexity Thinking in the General Practice Literature: An Integrative, Historical Narrative Review

    PubMed Central

    Sturmberg, Joachim P.; Martin, Carmel M.; Katerndahl, David A.

    2014-01-01

    PURPOSE Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine. METHODS We performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010. A total of 16,242 articles were retrieved, of which 49 were published in general practice/family medicine journals. Hand searches and snowballing retrieved another 35. After a full-text review, we included 56 articles dealing specifically with systems sciences and general/family practice. RESULTS General practice/family medicine engaged with the emerging systems and complexity theories in 4 stages. Before 1995, articles tended to explore common phenomenologic general practice/family medicine experiences. Between 1995 and 2000, articles described the complex adaptive nature of this discipline. Those published between 2000 and 2005 focused on describing the system dynamics of medical practice. After 2005, articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine. CONCLUSIONS This historical review describes the development of general practice/family medicine in relation to complex adaptive systems theories, and shows how systems sciences more accurately reflect the discipline’s philosophy and identity. Analysis suggests that general practice/family medicine first embraced systems theories through conscious reorganization of its boundaries and scope, before applying empirical tools. Future research should concentrate on applying nonlinear dynamics and empirical modeling to patient care, and to organizing and developing local practices, engaging in

  1. Systems and complexity thinking in the general practice literature: an integrative, historical narrative review.

    PubMed

    Sturmberg, Joachim P; Martin, Carmel M; Katerndahl, David A

    2014-01-01

    Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine. We performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010. A total of 16,242 articles were retrieved, of which 49 were published in general practice/family medicine journals. Hand searches and snowballing retrieved another 35. After a full-text review, we included 56 articles dealing specifically with systems sciences and general/family practice. General practice/family medicine engaged with the emerging systems and complexity theories in 4 stages. Before 1995, articles tended to explore common phenomenologic general practice/family medicine experiences. Between 1995 and 2000, articles described the complex adaptive nature of this discipline. Those published between 2000 and 2005 focused on describing the system dynamics of medical practice. After 2005, articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine. This historical review describes the development of general practice/family medicine in relation to complex adaptive systems theories, and shows how systems sciences more accurately reflect the discipline's philosophy and identity. Analysis suggests that general practice/family medicine first embraced systems theories through conscious reorganization of its boundaries and scope, before applying empirical tools. Future research should concentrate on applying nonlinear dynamics and empirical modeling to patient care, and to organizing and developing local practices, engaging in community development, and influencing

  2. Child feeding practices in families of working and nonworking mothers of Indonesian middle class urban families: what are the problems?

    PubMed

    Roshita, Airin; Schubert, Elizabeth; Whittaker, Maxine

    2013-01-01

    This study aims to explore the feeding practices in families of working and nonworking mothers with children (aged 12-36 months) of different nutritional status and types of domestic caregiver in Indonesian urban middle class families. It was designed as a qualitative multiple case study. Mothers and caregivers from 26 families were interviewed in depth, and caregivers were categorized as family and domestic-paid caregivers. The result suggested that offering formula milk to young children was a common practice, and there was a high recognition and familiarity toward a range of formula milk brands. Mothers reported challenges in encouraging their children to eat, and in some cases they appeared to lack knowledge on overcoming their child's feeding problem. The findings suggested the need to address the child feeding problems experienced by mothers in order to overcome the double burden of child nutrition in Indonesia.

  3. Location of family medicine graduates' practices. What factors influence Albertans' choices?

    PubMed

    Szafran, O; Crutcher, R A; Chaytors, R G

    2001-11-01

    To examine factors that influence family medicine graduates' choice of practice location. Cross-sectional, retrospective survey employing a self-administered, mailed questionnaire. Family medicine residency programs at the University of Alberta (U of A) and the University of Calgary (U of C) in Alberta. Graduates (n = 702) who completed the family medicine residency program at U of A or U of C between 1985 and 1995. Current practice location; 23 factors influencing current practice location; physicians' sex; community lived in until 18 years of age. Response rate was 63% (442 graduates completed the questionnaire). Overall, the most influential factors in attracting graduates to their current practice locations were spousal influence, type of practice, and proximity to extended family. Type of practice, income, community effort to recruit, medical need in the area, and loan repayments had a substantial influence on family physicians' decisions to practise in rural areas. Male physicians ranked type of practice, whereas female physicians ranked spousal influence, as having the most influence on choice of practice location. Significantly more female than male physicians identified working hours, familiarity with the medical community or resources, and availability of support facilities and personnel as having a moderate or major influence on their decisions. Differences between rural and metropolitan residents and between sexes affect family medicine graduates' choices of practice location. These differences should be taken into account in recruitment strategies.

  4. Integrating personal computers into family practice: a comparison of practicing physicians and residents.

    PubMed Central

    Cook, M C; Hartman, J A; Russell, L R

    1998-01-01

    A survey was used to assess levels of experience with personal computers and interest in learning personal computer applications among Alabama family practice physicians and residents in 1994. The study compared responses of 272 physicians and 77 residents as well as responses of physicians and residents in a sample of respondents thirty-eight years old or younger, including 77 physicians and 73 residents. Almost 25% of physicians reported never having used a computer, compared to 7.9% of residents. Respondents had learned computer skills through various combinations of methods, with over half of each group claiming to be self-taught through reading and hands-on experience. More than 86% of both groups expressed interest in learning more; interest increased in the population thirty-eight years or younger. Respondents, especially physicians, reported using professional applications less often than personal applications. Overall, there was a high level of interest in learning various practice-related applications; however, a significantly larger proportion of residents reported interest in each type of application than did physicians. PMID:9681166

  5. Army Family Policies and Practices: A Summary of Regulations, Letters, Pamphlets, and Circulars That Impact on Army Families

    DTIC Science & Technology

    1990-05-01

    the work environment adversely affects health. The attitudes of family are adversely affected , influencing career motivation and the morale and...the levzorai and Social Sciences PERI-R MDA903-87-C-0540 Sc. ADDRESS (City, State, and ZIP Code) 10. SOURCE OF FUNDING NUMBERS PROGRAM PROJECT TASK WORK ...if necessary and identify by block number) .This report on Army family policies and practices lists and abstracts those Army poli- cies that affect

  6. Family-focused autism spectrum disorder research: a review of the utility of family systems approaches.

    PubMed

    Cridland, Elizabeth K; Jones, Sandra C; Magee, Christopher A; Caputi, Peter

    2014-04-01

    A family member with an autism spectrum disorder presents pervasive and bidirectional influences on the entire family system, suggesting a need for family-focused autism spectrum disorder research. While there has been increasing interest in this research area, family-focused autism spectrum disorder research can still be considered relatively recent, and there are limitations to the existing literature. The purpose of this article is to provide theoretical and methodological directions for future family-focused autism spectrum disorder research. In particular, this article proposes Family Systems approaches as a common theoretical framework for future family-focused autism spectrum disorder research by considering theoretical concepts such as Boundaries, Ambiguous Loss, Resilience and Traumatic Growth. We discuss reasons why these concepts are important to researching families living with autism spectrum disorder and provide recommendations for future research. The potential for research grounded in Family Systems approaches to influence clinical support services is also discussed.

  7. Fostering Family-Centered Practices through a Family-Created Portfolio

    ERIC Educational Resources Information Center

    Gregg, Katy; Rugg, Mary; Souto-Manning, Mariana

    2011-01-01

    When a child has disabilities, families and professionals must communicate their concerns and goals for the child. Often these concerns are expressed as weaknesses within a deficits-based framework. The use of a strengths-based, family-created portfolio is a communication strategy for reconceptualizing a child from the family's perspective in…

  8. Exploring Cumulative Risk and Family Literacy Practices in Low-Income Latino Families

    ERIC Educational Resources Information Center

    Marcella, Jennifer; Howes, Carollee; Fuligni, Allison Sidle

    2014-01-01

    Research Findings: The home literacy environment and other early learning settings such as preschool play a role in children's language and literacy outcomes, yet research suggests that Latino, Spanish-speaking families are less likely than other families to participate in family literacy activities. This study explored the relations among…

  9. Exploring Cumulative Risk and Family Literacy Practices in Low-Income Latino Families

    ERIC Educational Resources Information Center

    Marcella, Jennifer; Howes, Carollee; Fuligni, Allison Sidle

    2014-01-01

    Research Findings: The home literacy environment and other early learning settings such as preschool play a role in children's language and literacy outcomes, yet research suggests that Latino, Spanish-speaking families are less likely than other families to participate in family literacy activities. This study explored the relations among…

  10. The contribution of practice skills in a care management process for family caregivers.

    PubMed

    Rowe, Jeannine M; Rizzo, Victoria M

    2013-01-01

    Practice skills are believed to improve practice, yet, little is known about the extent to which skills affect outcomes. This exploratory study examined the extent to which 3 practice skills specific to a care management context for family caregivers, including communication skills, supportive skills, and linking skills, were associated with fidelity of a care management process. Twenty-one care managers who used a single process to serve 113 family caregivers were included in the study. Bivariate correlation analysis revealed the 3 practice skills are positively associated with process fidelity. Implications for social work practice, education, and research are discussed.

  11. Patient empowerment, an additional characteristic of the European definitions of general practice/family medicine.

    PubMed

    Mola, Ernesto

    2013-06-01

    Growing evidence supports the inclusion of patient empowerment as a key ingredient of care for patients with chronic conditions. In recent years, several studies based on patient empowerment, have been carried out in different European countries in the context of general practice and primary care to improve management of chronic diseases. These studies have shown good results of the care model, increasing patient and health professionals' satisfaction, adherence to guidelines and to treatment, and improving clinical outcomes. In 2011, the Wonca European Council included as the twelfth characteristic of the European definitions of general practice/family medicine: 'promote patient empowerment'. The aim of this paper is to clarify the meaning of 'patient empowerment' and to explain why family medicine should be considered the most suitable setting to promote it. The inclusion of patient empowerment as one of the essential characteristics of general practice fills a conceptual gap and clearly suggests to the European health care systems a tested model to face chronic diseases: involving and empowering patients in managing their own conditions to improve health and well-being.

  12. Building a framework for theory-based ethnographies for studying intergenerational family food practices.

    PubMed

    Visser, Sanne Siete; Hutter, Inge; Haisma, Hinke

    2016-02-01

    The growing rates of (childhood) obesity worldwide are a source concern for health professionals, policy-makers, and researchers. The increasing prevalence of associated diseases-such as diabetes, cardiovascular diseases, and psychological problems-shows the impact of obesity on people's health, already from a young age. In turn, these problems have obvious consequences for the health care system, including higher costs. However, the treatment of obesity has proven to be difficult, which makes prevention an important goal. In this study, we focus on food practices, one of the determinants of obesity. In recent years, it has become increasingly clear that interventions designed to encourage healthy eating of children and their families are not having the desired impact, especially among groups with a lower socioeconomic background (SEB). To understand why interventions fail to have an impact, we need to study the embedded social and cultural constructions of families. We argue that we need more than just decision-making theories to understand this cultural embeddedness, and to determine what cultural and social factors influence the decision-making process. By allowing families to explain their cultural background, their capabilities, and their opportunities, we will gain new insights into how families choose what they eat from a complex set of food choices. We have thus chosen to build a framework based on Sen's capability approach and the theory of cultural schemas. This framework, together with a holistic ethnographic research approach, can help us better understand what drives the food choices made in families. The framework is built to serve as a starting point for ethnographic research on food choice in families, and could contribute to the development of interventions that are embedded in the cultural realities of the targeted groups.

  13. The benefits of motivational interviewing and coaching for improving the practice of comprehensive family assessments in child welfare.

    PubMed

    Snyder, Elizabeth H; Lawrence, C Nicole; Weatherholt, Tara N; Nagy, Paul

    2012-01-01

    The engagement of families in child welfare services is critical for successful outcomes related to safety, permanency, and child and family well-being. Motivational interviewing (MI), an effective approach to working with individuals struggling with alcohol and drug addiction, has great appeal for use with families involved with the child welfare system. Consequently, many social service agencies are beginning to integrate MI into their training curriculum. However, research has shown that training in MI alone is not enough; ongoing coaching is crucial in order to transfer learned MI skills into practice.The current study employs qualitative interview data from case-workers in order to examine the implementation of MI and long-term coaching within the child welfare system. Findings showed that MI can be implemented successfully within the child welfare system, and that caseworkers believed MI, supported by ongoing coaching, to be a valuable tool in engaging families in the assessment process.

  14. 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…

  15. Parental Psychopathology and Child-Rearing Practices in Young Alcoholic Families.

    ERIC Educational Resources Information Center

    Davies, W. Hobart; And Others

    The relationship of parent alcohol involvement, depression, and antisocial behavior to self-reported parenting practices in a sample of 79 intact alcoholic families with male children of 3-6 years of age was studied. Child rearing practices were measured with the Block Child Rearing Practices Report. Psychopathology was measured with the…

  16. Measuring Family System Characteristics in Families Caring for Dementia Patients.

    ERIC Educational Resources Information Center

    Niederehe, George; And Others

    This paper describes an ongoing study evaluating families that provide in-home care to elderly relatives wth dementia. Characteristics of the study, which include a focus on progressive senile dementia, use of a clinical approach, longitudinal design, descriptive nature, focus on the dyad of patient and primary caregiver, and use of videotaping…

  17. 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

  18. Family violence: contemporary research findings and practice issues.

    PubMed

    Yegidis, B L

    1992-12-01

    The purpose of this paper is to describe recent empirical research findings about family violence, and to explore selected social work treatment issues in the light of these findings. The last two decades has seen a proliferation of research about family violence. Most of the early research used small clinical samples and so generalizing findings to other groups has been difficult. However, the recent research has examined a number of important psychosocial correlates of family violence using more methodologically sound methods. As a result, we now know quite a bit about how and why family violence occurs. Also, within the last decade a number of studies have explicated the kinds of treatments and approaches that are most effective in dealing with abusive people. This paper summarizes these treatment strategies.

  19. Cultural health beliefs in a rural family practice: a Malaysian perspective.

    PubMed

    Ariff, Kamil M; Beng, Khoo S

    2006-02-01

    Understanding the sociocultural dimension of a patient's health beliefs is critical to a successful clinical encounter. Malaysia with its multi-ethnic population of Malay, Chinese and Indian still uses many forms of traditional health care in spite of a remarkably modern rural health service. The objective of this paper is discuss traditional health care in the context of some of the cultural aspects of health beliefs, perceptions and practices in the different ethnic groups of the author's rural family practices. This helps to promote communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoids cultural blind spots and unnecessary medical testing and leads to better adherence to treatment by patients. Includes traditional practices of 'hot and cold', notions of Yin-Yang and Ayurveda, cultural healing, alternative medicine, cultural perception of body structures and cultural practices in the context of women's health. Modern and traditional medical systems are potentially complementary rather than antagonistic. Ethnic and cultural considerations can be integrated further into the modern health delivery system to improve care and health outcomes.

  20. Diagnosing Marital and Family Systems: A Training Model.

    ERIC Educational Resources Information Center

    Cromwell, Ronald E.; Keeney, Bradford P.

    1979-01-01

    A three-part training model in diagnosing marital and family systems is described. The first unit introduced diagnostic tools and techniques. The second focuses on family systems theory and its relation to diagnosis. The third integrates the derived theory of diagnosing marital and family systems with clinical application. (Author)

  1. Narrative and collaborative practices in work with families that are homeless.

    PubMed

    Fraenkel, Peter; Hameline, Thomas; Shannon, Michele

    2009-07-01

    This article reports on the use of narrative therapy ideas and practices in working with families that are homeless in a shelter-based, multiple-family discussion group program called Fresh Start for Families. It begins with a review of the challenges facing homeless families. It then briefly describes the collaborative methods used to develop the program. It then describes a range of practices and activities that provide opportunities for families to be witnessed in telling their stories of challenge and coping, to help and be helped by other families experiencing similar challenges, to reconnect and strengthen a positive sense of family identity while externalizing the constraining, stigmatizing descriptions associated with homelessness, and to envision and take steps towards their preferred futures.

  2. Parenting practices and adolescent depressive symptoms in Chinese American families.

    PubMed

    Kim, S Y; Ge, X

    2000-09-01

    This study examined parenting practices and adolescent depressive symptoms among Chinese Americans. First, confirmatory factor analyses revealed that self-reported parenting practices by mothers and fathers and adolescent perception of parenting practices loaded adequately on three subscales: Inductive Reasoning, Monitoring, and Harsh Discipline. Second, parents' depressive symptoms were related to disrupted parenting practices, which, in turn, were significantly related to the negative evaluation of these behaviors by the adolescents. Adolescents' perceptions of such parenting practices were significantly associated with their depressive symptoms. Third, the relationships were robust even after parental income, education, and generation status were statistically controlled. Overall, the relationships between parenting practices and adolescent depressive symptoms among Chinese Americans seemed to echo those found among European Americans.

  3. Practical Approaches to Family-friendly Medical Studies

    PubMed Central

    Liebhardt, Hubert; Niehues, Johanna; Fegert, Jörg M.

    2012-01-01

    Based on the pilot study carried out by the Office of the Dean of the Medical University of Ulm on the family-friendliness of the organisation of medical education in Ulm, this paper describes concrete measures that were designed at the university or have been partly implemented already. More flexibility and customization are essential characteristics and prerequisites of a family-friendly medical school as part of university education structures. Flexibility and customization can be achieved by designing lesson plans and study regulations so that both childcare is assured and that in emergencies, help can be quickly offered with a minimum of bureaucracy. More flexibility includes, amongst other things, adequate means for the individual to compensate for missed compulsory attendances and examination dates. The necessary shift in thinking and the willingness to cooperate on behalf of the management and teaching staff can be supported through the audit for family-friendliness “berufundfamilie” (job and family) or “familiengerechte hochschule” (family-friendly university), as well as strategic management tools of family-friendly corporate policies. Supporting mechanisms such as effectively networked advice services, course progression monitoring based on data, providing a parents’ passport with a cross-semester training contract, creating more interaction between student-parents or other students through a parent community or by study pairings and finally, reliable information on and compliance with the maternity leave rules for pregnant and breastfeeding medical students can help safeguard successful studying with children. PMID:22558029

  4. Patient and Citizen Innovation Council in family practice.

    PubMed

    Garnett, Ron T; Bowman, Jane; Ganton, Joanne

    2017-02-01

    Patient engagement is integral to the Patient's Medical Home model. Patient-centred care is more than what happens in the examination room. Decisions around clinic processes, work flow, and initiative prioritization also warrant a patient perspective. The Academic Family Medicine Clinic at the South Health Campus in Calgary, Alta, identified a need for patient and community advisory expertise regarding clinic initiatives and quality improvement. A council was proposed to engage patients and citizens in exploring meaningful ways to drive innovation and improve the care experience. The Academic Family Medicine Clinic partnered with the South Health Campus Patient and Family Centred Care staff in developing a dedicated family medicine patient and community council. The resulting committee of 6 volunteers and 3 staff members has delivered presentations to incoming family medicine residents and staff on the role of a patient advisory council; advised on methodology to collect and represent broad patient perspectives; provided patient-perspective input to operations management and quality improvement committees; developed a pilot patient satisfaction and experience survey; and brought additional perspective, based on learnings from other industries and professions with experience in "customer service," on how to enhance the quality of the patient experience. A patient advisory council has the potential to reach beyond simple patient engagement toward functional involvement in decision making about clinic operations. Copyright© the College of Family Physicians of Canada.

  5. Practical approaches to family-friendly medical studies.

    PubMed

    Liebhardt, Hubert; Niehues, Johanna; Fegert, Jörg M

    2012-01-01

    Based on the pilot study carried out by the Office of the Dean of the Medical University of Ulm on the family-friendliness of the organisation of medical education in Ulm, this paper describes concrete measures that were designed at the university or have been partly implemented already. More flexibility and customization are essential characteristics and prerequisites of a family-friendly medical school as part of university education structures. Flexibility and customization can be achieved by designing lesson plans and study regulations so that both childcare is assured and that in emergencies, help can be quickly offered with a minimum of bureaucracy. More flexibility includes, amongst other things, adequate means for the individual to compensate for missed compulsory attendances and examination dates. The necessary shift in thinking and the willingness to cooperate on behalf of the management and teaching staff can be supported through the audit for family-friendliness "berufundfamilie" (job and family) or "familiengerechte hochschule" (family-friendly university), as well as strategic management tools of family-friendly corporate policies. Supporting mechanisms such as effectively networked advice services, course progression monitoring based on data, providing a parents' passport with a cross-semester training contract, creating more interaction between student-parents or other students through a parent community or by study pairings and finally, reliable information on and compliance with the maternity leave rules for pregnant and breastfeeding medical students can help safeguard successful studying with children.

  6. A family psychosocial risk questionnaire for use in pediatric practice.

    PubMed

    Pati, Susmita; Guevara, James; Zhang, Guangxiang; Bhatt, Suraj K; Kavanagh, Jane; Gerdes, Marsha; Localio, Russell; Forrest, Christopher B

    2013-12-01

    The objective of this study is to develop new methods to better identify psychosocial risk such that children with the greatest risk of poor future outcomes receive more intensive preventive health services. Based on structured literature review and secondary data analysis, a 52-item psychosocial risk questionnaire was administered to 2,083 families of children (<36 months). To quantify the questionnaire's construct validity, developmental concern was assessed with the Ages and Stages Questionnaire version II (ASQ) [n = 1,163]. An iterative model selection process was used to produce the most parsimonious predictive model. Model fit was examined using c-statistics, the Hosmer-Lemeshow test, and a heuristic measure of model overfit based on the fitted log-likelihood values and associated number of degrees of freedom. We found 13 items easily obtained from parental report produced a regression model with a c-statistic of 0.70. Using an integer scoring system derived from the regression model, we calculated stratum specific likelihood ratios to revise a given prior probability of ASQ failure. The posterior probability of ASQ failure was 44.9 % for a child in the highest risk group (score >25) on the questionnaire, more than double our observed average failure rate of 19.5 %, while it was less than 7 % for a child with the lowest possible score on the questionnaire. Thirteen parent-reported items can be compiled into a summary psychosocial risk questionnaire that predicts failure on developmental screening among preschool children. With further validation, this questionnaire could conceivably be used by clinicians to tailor pediatric preventive care to children at varying levels of risk.

  7. Involving family systems in critical care nursing: challenges and opportunities.

    PubMed

    Leon, Ana M; Knapp, Sandra

    2008-01-01

    The literature indicates that involvement of families in critical care settings is effective in meeting the needs of families and patients during a medical crisis. This article presents basic concepts from family systems theory, including cultural considerations useful in developing nursing care plans that integrate family involvement in the care of critically ill patients.

  8. Improving Functioning of the Remarried Family System.

    ERIC Educational Resources Information Center

    Sager, Clifford J.; And Others

    1981-01-01

    Presents salient issues for therapists in understanding and treating the remarried (REM, second, blended, reconstituted or step) family. The structure of the remarried family is differentiated from that of the intact family. Specific treatment goals for REM families are elaborated and various treatment modalities advocated. (Author)

  9. Differences between family practices in the associations of patient characteristics with health care experiences.

    PubMed

    Damman, Olga C; de Boer, Dolf; Hendriks, Michelle; Meuwissen, Liesbeth E; Rademakers, Jany; Delnoij, Diana M J; Groenewegen, Peter P

    2011-12-01

    When comparing health care providers, patient experience data are usually adjusted for case-mix associations to ensure fair comparisons. Previous studies in the United States showed that case-mix associations sometimes vary across health care providers. Such variation could indicate differential provider behavior for patient subgroups, in which case current adjustment techniques might be inappropriate. To see whether this variation is also apparent in a health care system different from the U.S. system, the authors analyzed Dutch patients' experiences with family practice care. Using multilevel random slope models, the associations between age, general health status, mental health status, education, sex, and ethnicity on one hand and reported experiences on the other hand were assessed across family practices. The authors found only five significant variances between case-mix coefficients, all for outcomes related to health care professionals' conduct. These findings correspond to previous U.S. findings, suggesting that the case-mix variations reported here and previously constitute a rather robust phenomenon.

  10. The network perspective: an integration of attachment and family systems theories.

    PubMed

    Kozlowska, Kasia; Hanney, Lesley

    2002-01-01

    In this article we discuss the network paradigm as a useful base from which to integrate attachment and family systems theories. The network perspective refers to the application of general systems theory to living systems, and provides a framework that conceptualizes the dyadic and family systems as simultaneously distinct and interconnected. Network thinking requires that the clinician holds multiple perspectives in mind, considers each system level as both a part and a whole, and shifts the focus of attention between levels as required. Key epistemological issues that have hindered the integration of the theories are discussed. These include inconsistencies within attachment theory itself and confusion surrounding the theoretical conceptualizations of the relationship between attachment and family systems theories. Detailed information about attachment categories is provided using the Dynamic Maturational model. Case vignettes illustrating work with young children and their families explore the clinical implications of integrating attachment data into family therapy practice.

  11. Capacity Building for Integrated Family-Centered Practice.

    ERIC Educational Resources Information Center

    Briar-Lawson, Katharine

    1998-01-01

    Highlights social work legacies and how they will impact 21st-century practice. Provides several examples to help inform integrative social and economic foundations for practice, policy, and human well-being. Importance of these and other income-support and capacity-building strategies is featured against the challenges associated with welfare…

  12. 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.

  13. Patient and Citizen Innovation Council in family practice

    PubMed Central

    Garnett, Ron T.; Bowman, Jane; Ganton, Joanne

    2017-01-01

    Abstract Problem addressed Patient engagement is integral to the Patient’s Medical Home model. Patient-centred care is more than what happens in the examination room. Decisions around clinic processes, work flow, and initiative prioritization also warrant a patient perspective. Objective of program The Academic Family Medicine Clinic at the South Health Campus in Calgary, Alta, identified a need for patient and community advisory expertise regarding clinic initiatives and quality improvement. A council was proposed to engage patients and citizens in exploring meaningful ways to drive innovation and improve the care experience. Program description The Academic Family Medicine Clinic partnered with the South Health Campus Patient and Family Centred Care staff in developing a dedicated family medicine patient and community council. The resulting committee of 6 volunteers and 3 staff members has delivered presentations to incoming family medicine residents and staff on the role of a patient advisory council; advised on methodology to collect and represent broad patient perspectives; provided patient-perspective input to operations management and quality improvement committees; developed a pilot patient satisfaction and experience survey; and brought additional perspective, based on learnings from other industries and professions with experience in “customer service,” on how to enhance the quality of the patient experience. Conclusion A patient advisory council has the potential to reach beyond simple patient engagement toward functional involvement in decision making about clinic operations. PMID:28209701

  14. Family Literacy and Digital Literacies: A Redefined Approach to Examining Social Practices of an African-American Family

    ERIC Educational Resources Information Center

    Lewis, Tisha Y.

    2009-01-01

    This dissertation examines the digital literacy practices of an urban African-American family. Using an ethnographic case study approach (Stake, 2000), this qualitative study explores the multiple ways a mother (Larnee) and son (Gerard) interacted with digital literacies in the home. Situated within the framework of sociocultural traditions from…

  15. Family Literacy and Digital Literacies: A Redefined Approach to Examining Social Practices of an African-American Family

    ERIC Educational Resources Information Center

    Lewis, Tisha Y.

    2009-01-01

    This dissertation examines the digital literacy practices of an urban African-American family. Using an ethnographic case study approach (Stake, 2000), this qualitative study explores the multiple ways a mother (Larnee) and son (Gerard) interacted with digital literacies in the home. Situated within the framework of sociocultural traditions from…

  16. Family Resource Systems: The Nebraska Model. Proceedings of the Family Resource Systems Conference (January 24-25, 1980).

    ERIC Educational Resources Information Center

    Stark, Jack A., Ed.

    Proceedings are presented from a 1980 conference on community based services for families of developmentaly disabled children. The following ten papers are included: "Leading Edge Services to Families of Persons with Developmental Disabilities" (R. Perske); "Family Resource Services and Support Systems for Families with Handicapped…

  17. The correlation of family management practices and delinquency.

    PubMed

    Patterson, G R; Stouthamer-Loeber, M

    1984-08-01

    Family-management skills of parents of seventh- and tenth-grade boys were related to each of 2 criterion measures of delinquency: police contacts and self-reported delinquency. The measures of family-management skills were monitoring, discipline, problem solving, and reinforcement. The measures of parent monitoring and discipline were shown to correlate significantly with both criterion measures. The monitoring score accounted for the most variance in both criterion measures of delinquency, and the problem solving and reinforcement measures accounted for the least. The monitoring score also differentiated moderate offenders from persistent offenders.

  18. Integrating family nursing into a mental health urgent care practice framework: ladders for learning.

    PubMed

    Leahey, Maureen; Harper-Jaques, Sandy

    2010-05-01

    Integrating family nursing into a busy mental health urgent care setting is a challenge given the high acuity of patients and the demands of delivering service 7 days/week, 14 hours/day. In this article, the authors describe the development of a Mental Health Urgent Care Practice Framework that incorporates four elements: mental health/psychiatric assessment, physical health assessment, family nursing, and integrated behavioral health care. Sample family nursing skills and ladders for mental health urgent care practice are highlighted.The framework and ladders have implications for recruitment and hiring, orientation, peer mentoring, performance appraisals, and continuing education and supervision. A clinical vignette illustrates sample conceptual/ perceptual and executive skills used to apply the framework and ladders in practice. Family nursing is conceptualized as an integral component of nursing care provided to individual and families in this unique setting.

  19. Influence of family history of diabetes on health care provider practice and patient behavior among nondiabetic Oregonians.

    PubMed

    Zlot, Amy I; Bland, Mary Pat; Silvey, Kerry; Epstein, Beth; Mielke, Beverly; Leman, Richard F

    2009-01-01

    People with a family history of diabetes are at increased risk of developing diabetes; however, the effect of family history of diabetes on health care provider practice and patient behavior has not been well defined. We analyzed data from the 2005 Oregon Behavioral Risk Factor Surveillance System, a state-based, random-digit-dialed telephone survey, to evaluate, among people with diabetes, associations between family history of diabetes and 1) patients' reports of health care provider practices, 2) patients' perceived risk of developing diabetes, and 3) patients' behaviors associated with an increased risk of developing diabetes. Compared with respondents at average risk, respondents with a positive family history (strong or moderate familial risk for diabetes) were more likely to report that their health care provider collects family history information about diabetes, discusses the risk of developing diabetes or other chronic conditions, and makes recommendations to change their diet or exercise behaviors to reduce the chance of developing diabetes. Respondents with a strong family history of diabetes were 5 times more likely to be very or somewhat worried about developing diabetes than were people at average risk (odds ratio [OR], 5.0; 95% confidence interval [CI], 4.0-6.2). Compared with respondents at average risk, respondents with a strong family history were more likely to report making changes in diet and exercise (OR, 1.7; 95% CI, 1.4-2.1). Integrating family history of diabetes into clinical practice offers opportunities to improve the effectiveness of diabetes detection and to promote interventions aimed at preventing or delaying the development of diabetes in people at high risk.

  20. Ethical and practical implications of the human genome initiative for family medicine.

    PubMed

    McCrary, S V; Allen, B; Moseley, R; Crandall, L A; Ostrer, H; Curry, R W; Dewar, M A; Nye, D

    1993-11-01

    Major advances in predictive genetic testing resulting from the Human Genome Initiative could change significantly the routine practice of family medicine. Family physicians should be aware that increased genetic information may affect patients' abilities to acquire and maintain insurance and employment and that interested parties will have incentives to seek this information. The social consequences of genetic information, as well as increased health promotion efforts, may raise problems of informed consent and confidentiality. In addition to their ethical implications, these developments will also affect the practice of family physicians in practical ways such as record keeping. We discuss cases that illustrate the potential impact of these emerging technologies on the practice of family medicine.

  1. 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.

  2. Focus on Families! How to Build and Support Family-Centered Practices in After School

    ERIC Educational Resources Information Center

    Kakli, Zenub; Kreider, Holly; Little, Priscilla; Buck, Tania; Coffey, Maryellen

    2006-01-01

    Children benefit when their parents or caregivers are actively involved in their out-of-school learning. Yet a new report by the Harvard Family Research Project and United Way of Massachusetts Bay finds that only a quarter of programs surveyed had effectively incorporated families. This guide, funded by the Wallace Foundation under its Parents and…

  3. Promising Practices for Family Involvement in Schools. Family, School, Community, Partnership Issues, Volume 1.

    ERIC Educational Resources Information Center

    Hiatt-Michael, Diana B., Ed.

    Parent involvement as one of the eight National Education Goals has brought heightened awareness to the importance of connecting educational institutions and their communities. This book addresses major frameworks for understanding family involvement and government support of family involvement projects. The work also presents a theoretical base…

  4. 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,…

  5. Using Interagency Collaboration to Support Family-Centered Transition Practices

    ERIC Educational Resources Information Center

    Branson, Diane M.; Bingham, Ann

    2009-01-01

    The transition from early intervention to early childhood special education is only one of the many transitions that children with disabilities and their families will face throughout their lives (Individuals with Disabilities Education Act, 2004). This transition, however, can be particularly difficult for children and parents (Hanson et al.,…

  6. Early Intervention with Latino Families: Implications for Practice

    ERIC Educational Resources Information Center

    Withrow, Rebecca L.

    2008-01-01

    Counselors and early interventionists increasingly serve Spanish-speaking families. Yet, often, cultural accommodations merely imply use of interpreters or bilingual providers. Cultural competence requires self-awareness and understanding the client's community and specific risk and resiliency factors. Implications for serving clients of Latino…

  7. Using Interagency Collaboration to Support Family-Centered Transition Practices

    ERIC Educational Resources Information Center

    Branson, Diane M.; Bingham, Ann

    2009-01-01

    The transition from early intervention to early childhood special education is only one of the many transitions that children with disabilities and their families will face throughout their lives (Individuals with Disabilities Education Act, 2004). This transition, however, can be particularly difficult for children and parents (Hanson et al.,…

  8. Using a family systems approach to investigate cancer risk communication within melanoma families

    PubMed Central

    Harris, Julie N.; Hay, Jennifer; Kuniyuki, Alan; Asgari, Maryam M; Press, Nancy; Bowen, Deborah J.

    2009-01-01

    OBJECTIVE The family provides an important communication nexus for information and support exchange about family cancer history, and adoption of family-wide cancer risk reduction strategies. The goals of this study were to: 1) use the family systems theory to identify characteristics of this sample of families at increased risk of developing melanoma and 2) to relate familial characteristics to the frequency and style of familial risk communication. METHODS Participants were first-degree relatives (n=313) of melanoma patients, recruited into a family web-based intervention study. We used multivariable logistic regression models to analyze the association between family functioning and family communication. RESULTS Most participants were female (60%), with an average age of 51 years. Fifty percent of participants reported that they spoke to their relatives about melanoma risk and people were more likely to speak to their female family members. Familial adaptation, cohesion, coping, and health beliefs were strongly associated with an open style of risk communication within families. None were associated with a blocked style of risk communication. Only cohesion and adaptation were associated with the amount of risk communication that occurred within families. CONCLUSIONS Overall, individuals who came from families that were more highly cohesive, adaptable, and shared strong beliefs about melanoma risk were more likely to communicate openly about melanoma. The fact that this association was not consistent across blocked communication and communication frequency highlights the multifaceted nature of this process. Future research should focus on the interplay between different facets of communication. PMID:20119933

  9. Using a Systems Framework for Organizing Family Financial Planning.

    ERIC Educational Resources Information Center

    Edwards, Kay P.

    1988-01-01

    Systems concepts are applied to family financial planning using a functional interpretation of systems analyses. The framework can help professionals researching family financial behavior and its outcomes, planning programs, and offering financial services. It can also be used by families in their own financial planning. (Author/JOW)

  10. Family-centered rounds in theory and practice: an ethnographic case study.

    PubMed

    Subramony, Anupama; Hametz, Patricia A; Balmer, Dorene

    2014-01-01

    Family-centered rounds (FCR) seek to incorporate principles of family-centered care-including clear and open information sharing, respect, participation and collaboration-into inpatient settings. Although potential models designed to translate these principles into everyday clinical practice have been reported, few studies explore how FCR practices align with principles of family-centered care. We conducted an ethnographic study, observing over 200 hours of FCR on a general pediatrics inpatient service from January to August 2010 (185 distinct rounding events). To complement observation, we conducted interviews with 6 family members. Qualitative analysis entailed applying codes to data from observation and interviews and deriving themes using the principles of family-centered care as an interpretive lens. Four themes emerged that suggested incomplete alignment between FCR practices and principles of family-centered care. 1) FCR provided a forum for information sharing; nonetheless, medical jargon sometimes limited communication. 2) Medical teams approached families with practices intended to demonstrated respect, but contextual factors served to undermine this intent. 3) FCR gave family members the opportunity to participate in care but did not guarantee their involvement. 4) FCR were a starting point for collaboration around plan making, but did not guarantee that collaboration occurred. Although FCR practices may set the stage for family-centered care, they do not necessarily ensure that the principles of family-centered care are upheld. Efforts to more effectively deliver FCR should consider physical, organizational, and cultural factors that influence both patient/family and medical team behavior. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Capturing the Family Context of Emotion Regulation: A Family Systems Model Comparison Approach

    ERIC Educational Resources Information Center

    Fosco, Gregory M.; Grych, John H.

    2013-01-01

    Several dimensions of family functioning are recognized as formative influences on children's emotion regulation. Historically, they have been studied separately, limiting our ability to understand how they function within the family system. The present investigation tested models including family emotional climate, interparental conflict, and…

  12. Uniqueness of family therapists as family business systems consultants: a cross-disciplinary investigation.

    PubMed

    Lee, Jinhee; Danes, Sharon M

    2012-06-01

    The purpose of this study is to address how the consulting approaches of family therapists working with family businesses differ from those of business consultants. The logic of analytic induction was used to analyze qualitative data from family business consultants with and without training in family therapy. Consultants were asked to respond to two vignettes: one emphasized primarily family system problems, whereas the other emphasized business problems with influencing issues at the family/business intersection. Both similarities and differences were found in reference to problem assessment, consulting goal orientation, intervention strategy focus, consultant role and function, and consulting setting preference between consultants with and without family therapy training. Results indicate that consultants of each discipline provide a unique perspective and expertise that allow them to successfully address the spectrum of issues that family firms face. Further, findings highlight the unique contribution of family therapists to an interdisciplinary consulting team.

  13. Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices. Summary

    ERIC Educational Resources Information Center

    Lenz-Rashid, Sonja

    2013-01-01

    The "Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices" report describes the outcome evaluation of Cottage Housing Incorporated's Serna Village program in Sacramento, California. Serna Village is a supportive housing program serving homeless families. Outcomes from the program illustrate that it is…

  14. AAMFT Master Series Tapes: An Analysis of the Inclusion of Feminist Principles into Family Therapy Practice.

    ERIC Educational Resources Information Center

    Haddock, Shelley A.; MacPhee, David; Zimmerman, Toni Schindler

    2001-01-01

    Content analysis of 23 American Association for Marriage and Family Therapy Master Series tapes was used to determine how well feminist behaviors have been incorporated into ideal family therapy practice. Feminist behaviors were infrequent, being evident in fewer than 3% of time blocks in event sampling and 10 of 39 feminist behaviors of the…

  15. 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…

  16. Young Children's Initiation into Family Literacy Practices in the Digital Age

    ERIC Educational Resources Information Center

    Marsh, Jackie; Hannon, Peter; Lewis, Margaret; Ritchie, Louise

    2017-01-01

    This article reports a study that explored young children's digital literacy in the home. The aim of the study was to identify the range of digital literacy practices in which children are engaged in the home and to explore how these are embedded into family life and involve family members. Four children, two girls and two boys aged between 2 and…

  17. Community-Based Family-Focused Practice and Social Network Intervention. Data Trends #129

    ERIC Educational Resources Information Center

    Research and Training Center on Family Support and Children's Mental Health, 2006

    2006-01-01

    "Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" examines research on the "contribution of informal support linkages in the achievement of treatment outcomes" in three models of family-based practice: Intensive Family…

  18. Building Family Partnerships: The Journey from Preservice Preparation to Classroom Practice

    ERIC Educational Resources Information Center

    Zygmunt-Fillwalk, Eva

    2011-01-01

    This study reports the relationship of an undergraduate course in family and community relations to the teaching practices of 1st-, 2nd-, and 3rd-year elementary and early childhood education graduates of a mid-sized Midwestern university. Sixty students were surveyed using the Peabody Family Involvement Survey (Katz & Bauch, 1999), with a…

  19. Culture and Family-Centered Practice. FRC Report, 1995-1996.

    ERIC Educational Resources Information Center

    Goetz, Kathy, Ed.

    1996-01-01

    This double issue of the "Family Resource Coalition Report" contains 13 articles focusing on culture and family-centered practice, along with a resource section listing organizations, trainers, consultants, and publications. The following articles are included: (1) "Developing a Knowledge Base to Support Cultural Competence"…

  20. Residency Training and the Later Use of Marital and Family Therapy in Psychiatric Practice.

    ERIC Educational Resources Information Center

    Carter, Ross E.

    1989-01-01

    Compared marital and family therapy training during psychiatry residency to later use among psychiatrists (N=87). Results indicated that respondents reported modest to minimal amounts of training in residency but practiced marital and family therapy with variety of problems, identified spread of effect to other treatment modalities, and preferred…

  1. Do Private Religious Practices Moderate the Relation between Family Conflict and Preadolescents' Depression and Anxiety Symptoms?

    ERIC Educational Resources Information Center

    Davis, Kelly A.; Epkins, Catherine C.

    2009-01-01

    We extended past research that focused on the relation between family conflict and preadolescents' depressive and anxiety symptoms. In a sample of 160 11- to 12-year-olds, we examined whether private religious practices moderated the relations between family conflict and preadolescents' depressive and anxiety symptoms. Although preadolescents'…

  2. Do Private Religious Practices Moderate the Relation between Family Conflict and Preadolescents' Depression and Anxiety Symptoms?

    ERIC Educational Resources Information Center

    Davis, Kelly A.; Epkins, Catherine C.

    2009-01-01

    We extended past research that focused on the relation between family conflict and preadolescents' depressive and anxiety symptoms. In a sample of 160 11- to 12-year-olds, we examined whether private religious practices moderated the relations between family conflict and preadolescents' depressive and anxiety symptoms. Although preadolescents'…

  3. Minority Ethnic Adolescents' Wellbeing: Child Rearing Practices and Positive Family Influences

    ERIC Educational Resources Information Center

    Ochieng, Bertha M. N.

    2014-01-01

    Objective: This paper examines Black adolescents' experiences and views on the interrelationships between their families' parenting practices and their wellbeing. Method: The material is drawn from a community-based qualitative study on the health and wellbeing experiences of Black African families and adolescents. A total of 53 adolescents of…

  4. The Impact of Public Housing Policy on Family Social Work Theory and Practice

    ERIC Educational Resources Information Center

    McCarty, Dawn

    2008-01-01

    Social workers are the professionals most engaged with families living in low-income and subsidized housing and most familiar with the problems associated with inadequate housing. Yet the discussion of public housing policy has been left largely to economists and housing activists and the clear implications for family social work practice have not…

  5. Bilingual "Educación" in the Home: Everyday Mexican Immigrant Family Educational Practices

    ERIC Educational Resources Information Center

    Valdez, Verónica

    2015-01-01

    As we embrace the increasing numbers of young Mexican immigrant children and their families present in our schools, it is important for educators to better understand the many family educational practices present in these households. This article examines the strategies and resources utilized by two Mexican-born and two U.S.-born Mexican immigrant…

  6. The Theory and Practice of Structural and Strategic Family Therapies: A Delphi Study.

    ERIC Educational Resources Information Center

    Fish, Linda Stone; Piercy, Fred P.

    1987-01-01

    Examined the similarities and differences in the theory and practice of structural and strategic family therapy. A national panel of structural and strategic therapists identified items they thought important to a profile of either structural or strategic family therapy. Mental Research Institute, Haley/Madanes, and Milan/Ackerman approaches to…

  7. Marriage and Family Therapists and Psychotropic Medications: Practice Patterns from a National Study

    ERIC Educational Resources Information Center

    Hernandez, Barbara Couden; Doherty, William J.

    2005-01-01

    A national sample of marriage and family therapists (MFTs) was used to describe practice patterns of MFTs whose clients use psychotropics and to compare medicated and nonmedicated clients. Marriage and Family Therapists (n = 283) reported on 195 medicated and 483 nonmedicated adult clients. Clients (n = 375) rated their improvement and…

  8. The Theory and Practice of Structural and Strategic Family Therapies: A Delphi Study.

    ERIC Educational Resources Information Center

    Fish, Linda Stone; Piercy, Fred P.

    1987-01-01

    Examined the similarities and differences in the theory and practice of structural and strategic family therapy. A national panel of structural and strategic therapists identified items they thought important to a profile of either structural or strategic family therapy. Mental Research Institute, Haley/Madanes, and Milan/Ackerman approaches to…

  9. Building Family Partnerships: The Journey from Preservice Preparation to Classroom Practice

    ERIC Educational Resources Information Center

    Zygmunt-Fillwalk, Eva

    2011-01-01

    This study reports the relationship of an undergraduate course in family and community relations to the teaching practices of 1st-, 2nd-, and 3rd-year elementary and early childhood education graduates of a mid-sized Midwestern university. Sixty students were surveyed using the Peabody Family Involvement Survey (Katz & Bauch, 1999), with a…

  10. Telephone interventions for family caregivers of patients with dementia: what are best nursing practices?

    PubMed

    Mason, Bernadette J; Harrison, Barbara E

    2008-01-01

    Family caregivers of patients with dementia experience caregiver burden and need holistic nursing interventions, such as telephone support. This article reviews the literature on telephone support interventions for family caregivers of patients with dementia and describes evidence-based holistic nursing practices within Watson's theory of human caring, which focuses on transpersonal caring relationships.

  11. The Impact of Public Housing Policy on Family Social Work Theory and Practice

    ERIC Educational Resources Information Center

    McCarty, Dawn

    2008-01-01

    Social workers are the professionals most engaged with families living in low-income and subsidized housing and most familiar with the problems associated with inadequate housing. Yet the discussion of public housing policy has been left largely to economists and housing activists and the clear implications for family social work practice have not…

  12. Minority Ethnic Adolescents' Wellbeing: Child Rearing Practices and Positive Family Influences

    ERIC Educational Resources Information Center

    Ochieng, Bertha M. N.

    2014-01-01

    Objective: This paper examines Black adolescents' experiences and views on the interrelationships between their families' parenting practices and their wellbeing. Method: The material is drawn from a community-based qualitative study on the health and wellbeing experiences of Black African families and adolescents. A total of 53 adolescents of…

  13. Child Welfare Worker Perception of the Implementation of Family-Centered Practice

    ERIC Educational Resources Information Center

    Michalopoulos, Lynn; Ahn, Haksoon; Shaw, Terry V.; O'Connor, Julia

    2012-01-01

    Objectives: The purpose of this study was to explore perceptions of Family-Centered Practice (FCP) among child welfare workers who are expected to use FCP principles in their work with children and families. Method: Nine focus groups were conducted among child welfare workers across seven different regions within one state to assess caseworker's…

  14. A Comprehensive Survey of Institutional Patient/Family Educational Practices for Newly Diagnosed Pediatric Oncology Patients.

    PubMed

    Withycombe, Janice S; Andam-Mejia, Rachel; Dwyer, Annie; Slaven, Abigail; Windt, Katherine; Landier, Wendy

    Patient/family education is an important component of nursing practice and is essential to the care of children newly diagnosed with cancer. Practices regarding patient/family education in Children's Oncology Group (COG) treatment centers have not been well described. We used an Internet-based survey to determine current patient/family educational practices at COG institutions; participation rate was 90.5% (201/222). Patient/family education was delivered primarily by an individual (rather than a team) at 43% of institutions. Advanced practice nurses had primary responsibility for providing education at 32% of institutions. "Fever" was the most frequently reported topic considered mandatory for inclusion in education for newly diagnosed patients. More than half of institutions reported using checklists and/or end-of-shift reports to facilitate health care team communication regarding patient/family education, and 77% reported using the "teach-back" method of assessing readiness for discharge. Thirty-seven percent of institutions reported delays in hospital discharge secondary to the need for additional teaching. An understanding of current practices related to patient/family education is the first step in establishing effective interventions to improve and standardize educational practices in pediatric oncology.

  15. The nurse practitioner in family planning services: law and practice.

    PubMed

    Roemer, R

    1977-06-01

    Before 1971, when Idaho became the 1st state to authorize expanded scope of functions for registered nurses, nearly all states made it illegal for any nurse to perform diagnosis or prescribe treatment, creating an ambiguity as more and more nurses were equipped by education and technology to perform new tasks. Today 30 states have liberalized the scope of nursing functions, making it possible for nurses and nurse-midwives to assume, among other tasks, family planning functions. A table gives the status of legislation and regulations governing nurse practitioners and nurse-midwives in each state. The area of greatest controversy is the prescription of oral contraceptives. In some states it is allowed under doctor's supervision or in rural areas or in areas where clear need exists for a nurse to dispense such medication. Usually this dispensing is limited to a single course of treatment. Nurse-midwives are rapidly being accepted as extensions of scarce medical facilities. Generally nurse-midwives are authorized to provide prenatal and postpartum care, to handle normal deliveries, and do family planning work including fitting diaphragms and inserting and removing IUDs. An innovation is the family planning nurse practitioner. Several courses for such practitioners have been set up across the U.S. Graduates may, with medical direction, perform bimanual pelvic examinations and breast examinations, take blood pressure, prescribe contraception, fit diaphragms, insert IUDs, examine vaginal secretions microscopically, and refer patients with problems to physicians. In a California program both registered and nonregistered nurses are being trained as women's health specialists who may make routine examinations in both pregnant and nonpregnant women and give family planning advice. Non-RN family planning specialists being trained include licensed vocational nurses, baccalaureate degree holders in nonnursing fields, and qualified persons with less formal education. The 24-week

  16. The implementation of a practice management programme for family medicine residents in Qatar.

    PubMed

    Al-Mutawa, Noora; Elmahdi, Hisham; Joyce, Pauline

    2016-09-01

    The aim of this study was to measure the effectiveness of introducing a full five-day practice management (PM) training workshop based on selected Accreditation Council for Graduate Medical Education (ACGME) competencies; professionalism, interpersonal and communication skills, practice-based learning and improvement (PBLI), and system-based practice. The study used pre-post study design. A total of 39 family medicine residents in Qatar were included in this study. The outcomes of interest were the level of change in the selected ACGME competencies. Pre- vs. post-workshop scores as well as change in scores of quarterly formative assessment were analysed using paired T-test. The overall improvement in post-programme scores compared to pre-programme scores was 9.8% (p-value < 0.001). The PGY1 Group showed the most significant improvement with a score difference of 18.6% (p-value < 0.001). In self-assessment of skills, the main improvement was in writing objectives and time management skills (p-value < 0.001). The residents showed greater improvements in scores related to communication skills specifically in communicating effectively with patients (p-value = 0.032) as well as in specified skills among system-based practices; specifically in effectively using health resources (p-value < 0.001) and in co-ordinating patient care (p-value < 0.001). Implementing a full five-days PM training workshop had resulted in moderate improvements in residents' score in selected ACGME competencies. A longer study on whether the effects of the programme on residents' sustained performance and applicability in practice is required.

  17. Oncologists' and oncology nurses' attitudes and practices towards family involvement in cancer consultations.

    PubMed

    Laidsaar-Powell, R; Butow, P; Bu, S; Fisher, A; Juraskova, I

    2017-01-01

    Family members (FMs) regularly attend cancer consultations with patients, may assume an array of roles (e.g. emotional, informational) and their involvement may result in benefits and/or challenges. Little is currently known about how oncology health professionals (HPs) view FMs who accompany a patient in consultations. This study aimed to explore the attitudes and practices of Australian oncologists and oncology nurses regarding family involvement in consultations. Eleven oncologists and 10 nurses from a range of subspecialties and tumour streams participated in semi-structured interviews. Interviews were transcribed and qualitatively analysed using framework analysis methods. Five relevant themes were identified: (1) the varied and dynamic nature of family roles during consultations; (2) positivity towards FMs; (3) the benefits of family involvement to the FM themselves; (4) current HP practices to facilitate positive family involvement; and (5) the challenges of family involvement in consultations and HP practices to manage them. Overall, participants held mostly positive attitudes towards family involvement. Although they identified a number of challenges which can arise when family are involved, many noted these situations are the exception, that there are strategies which can help to overcome the challenges, and that the benefits of family involvement typically outweigh the costs. © 2016 John Wiley & Sons Ltd.

  18. A community-oriented primary care experience for medical students and family practice residents.

    PubMed

    Summerlin, H H; Landis, S E; Olson, P R

    1993-02-01

    Medical students and residents are more likely to understand the health needs of a community if they have community-based practical experience during their training. This report describes a community-oriented educational experience for medical students and family practice residents in rural North Carolina. Medical students and residents from the University of North Carolina at Chapel Hill and residents from Asheville spend one month in a small community in western North Carolina. During the month-long experience, these trainees live in the community and provide clinical care to patients. They also meet with local health officials, service agencies, and community organizations to learn about the community's health system. The trainees then prepare a written report about the community's health system, a community health problem identified by the trainee, and a proposal to solve the problem. Trainees report that the rotation provides a unique opportunity to understand the health system of a community. Some of the trainee-proposed solutions to problems have been implemented by community leaders. A community-oriented primary care rotation can provide students and residents with an important understanding of the health system and health problems of a community.

  19. Family self-tailoring: Applying a systems approach to improving family healthy living behaviors.

    PubMed

    Moore, Shirley M; Jones, Lenette; Alemi, Farrokh

    2016-01-01

    The adoption and maintenance of healthy living behaviors by individuals and families is a major challenge. We describe a new model of health behavior change, SystemCHANGE (SC), which focuses on the redesign of family daily routines using system improvement methods. In the SC intervention, families are taught a set of skills to engage in a series of small, family self-designed experiments to test ideas to change their daily routines. The family system-oriented changes brought about by these experiments build healthy living behaviors into family daily routines so that these new behaviors happen as a matter of course, despite wavering motivation, willpower, or personal effort on the part of individuals. Case stories of the use of SC to improve family healthy living behaviors are provided. Results of several pilot tests of SC indicate its potential effectiveness to change health living behaviors across numerous populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A health/patient education database for family practice.

    PubMed Central

    Gibson, P A; Ruby, C; Craig, M D

    1991-01-01

    Using pilot project funding from the W. K. Kellogg Foundation, the American Academy of Family Physicians Foundation (AAFP/F) developed a program by which health/patient education print materials were reviewed. Favorably reviewed materials were entered into a database accessible through the AAFP/F's Huffington Library. The review service and resulting database were designed to help the busy clinician identify scientifically accurate, reliable materials for use in patient education. The review process developed for the project is described, as is the database and its use by family physicians. Research findings from the pilot project are discussed, some of which assisted in planning the self-supporting second phase of the program. PMID:1958908

  1. Research in a Family Practice: An Inside View

    PubMed Central

    Stewart, Moira; Weston, Wayne

    1977-01-01

    For seven months in 1973-74 the physicians and staff of the Tavistock Family Health Centre participated in a research project conducted by a graduate student in epidemiology. The study examined the relationships between the doctors' awareness of the patients' problems and their recovery and satisfaction. In this paper the problems and rewards of getting involved in such research are presented from the points of view of the patient, the physician, the staff and the research investigator.

  2. Family Practitioners' Immunization Consent Practice Washington State, 1986

    PubMed Central

    Holt, Victoria L.; Coombs, John B.; Marcuse, Edgar K.

    1988-01-01

    Of 400 Washington State family practitioners surveyed in 1986, 46% of those who give routine immunizations reported that they require written parental consent before administering vaccine. In all, 57% of respondents said they discuss diphtheria-tetanus-pertussis, measles-mumps-rubella, and oral polio vaccine with their patients. Nearly half provide written information on these immunizations, except for inactivated polio vaccine, for which fewer than 20% of the physicians surveyed provide verbal or written information. PMID:3388860

  3. Young, vulnerable and pregnant: family support in practice.

    PubMed

    Halliday, Joyce; Wilkinson, Tina

    2009-10-01

    Intervention in the early years, including family support, can reduce inequality and disadvantage across the life course. This paper reports on an evaluation of a local project, which aims to increase resilience and avert crisis among vulnerable young mothers. It suggests that paraprofessional link workers, spanning the antenatal-postnatal period, may contribute to maternal health and wellbeing and increase use of support services and networks. However, challenges for inter-agency and interprofessional working remain.

  4. Adult-trained perioperative nurses' practice of family-centered care.

    PubMed

    Hamilton, Grainne; Corlett, Jo; Dowling, Maura

    The aim of this study was to explore adult-trained perioperative nurses' practice of family-centered care (FCC). A qualitative research design with a hermeneutic phenomenological approach was used. In-depth interviews were conducted with six adult-trained perioperative nurses. Data analysis was guided by Colaizzi's seven-step framework, resulting in a composite description of perioperative nurses' practice of FCC. While participants supported the principle of family involvement in care, they found its implementation in practice difficult and stressful. They reported that families often appeared inadequately prepared for the surgical experience, and subsequent poor experiences for families caused feelings of upset and inadequacy for nurses. While some of these findings are similar to those in previous studies of paediatric nurses' practice of FCC, this is the first known study to examine adult-trained perioperative nurses' practice of FCC. Participants articulated an awareness of what constitutes effective FCC and showed the motivation to accomplish the task of improving family-centered practice in their practice area.

  5. [Factors influencing general practitioners and specialists of general practice to declare in favor of accepting the role of family doctors].

    PubMed

    Lapcević, Mirjana; Dimitrijević, Ivan; Ristić, Jelena; Vuković, Mira; Nikolić, Radivoje; Stanojević, Petar

    2006-10-01

    Protection and promotion of health of an individual, family and society as the whole depends on the organization and efficiency of the public health service. Modern health service is focused on the health prevention and improvement of the family which is the basic unit of society. The life cycle of the family indicates crisis related to development and underdevelopment as well as some expected and unexpected life situations and this is very important when discussing about many somatic and mental diseases. The objective of our project which included 473 specialists of general practice and 355 general practitioners was to determine the factors which influence the positive attitude of the general practitioners about becoming a family doctor. A total of 828 doctors in Serbia were required to answer the set of eight questions. Statistical analysis included Pearson chi square test with contingency tables and logistic regression, while dependent variable was doctor's attitude about becoming a family doctor in a certain situation. The answer 'no' or 'I don't know' was scored 1 point and the 'yes' answer was graded 2 points. Eight questions mentioned above were independent variables. Logistic model accounting for 79.3% of dependent variable was obtained. Positive attitude of doctors was very much affected by family problems and great majority of these doctors were specialists of general practice. Other questions were not so important for our results. Specialists of general practice, regardless of their working experience and years of practice, gave significantly more positive answers, and the situation was quite opposite with general practitioners. Family medicine supported by modern information systems provides ideal model of comprehensive and complete health prevention with high level of rationalism, quality, efficiency and cost-effectiveness.

  6. Quick, simple measures of family relationships for use in clinical practice and research. A systematic review.

    PubMed

    Pritchett, Rachel; Kemp, Jeremy; Wilson, Philip; Minnis, Helen; Bryce, Graham; Gillberg, Christopher

    2011-04-01

    Family functioning has been implicated in the onset of child and adult psychopathology. Various measures exist for assessing constructs in the areas of parent-child relationships, parental practices and discipline, parental beliefs, marital quality, global family functioning and situation-specific measures. To identify systematically all questionnaire measures of family functioning appropriate for use in primary care and research. A systematic literature review was conducted, following PRISMA guidelines and searching 14 bibliographic databases using pre-determined filters, to identify family functioning measures suitable for use in families with children from 0 to 3 years old. One hundred and seven measures of family functioning were reported and tabulated and the most commonly used measures were identified. There are numerous measures available demonstrating characteristics, which make them suitable for continued use. Future research is needed to examine the more holistic measurement of family functioning using integration of multi-informant data.

  7. Family Profiles of Cohesion and Parenting Practices and Latino Youth Adjustment.

    PubMed

    Bámaca-Colbert, Mayra Y; Gonzales-Backen, Melinda; Henry, Carolyn S; Kim, Peter S Y; Roblyer, Martha Zapata; Plunkett, Scott W; Sands, Tovah

    2017-08-10

    Using a sample of 279 (52% female) Latino youth in 9th grade (M = 14.57, SD = .56), we examined profiles of family cohesion and parenting practices and their relation to youth adjustment. The results of latent profile analyses revealed four family profiles: Engaged, Supportive, Intrusive, and Disengaged. Latino youth in the Supportive family profile showed most positive adjustment (highest self-esteem and lowest depressive symptoms), followed by youth in the Engaged family profile. Youth in the Intrusive and Disengaged profiles showed the lowest levels of positive adjustment. The findings contribute to the current literature on family dynamics, family profiles, and youth psychological adjustment within specific ethnic groups. © 2017 Family Process Institute.

  8. Family Functioning and Early Learning Practices in Immigrant Homes

    ERIC Educational Resources Information Center

    Jung, Sunyoung; Fuller, Bruce; Galindo, Claudia

    2012-01-01

    Poverty-related developmental-risk theories dominate accounts of uneven levels of household functioning and effects on children. But immigrant parents may sustain norms and practices--stemming from heritage culture, selective migration, and social support--that buffer economic exigencies. "Comparable" levels of social-emotional functioning in…

  9. Family Functioning and Early Learning Practices in Immigrant Homes

    ERIC Educational Resources Information Center

    Jung, Sunyoung; Fuller, Bruce; Galindo, Claudia

    2012-01-01

    Poverty-related developmental-risk theories dominate accounts of uneven levels of household functioning and effects on children. But immigrant parents may sustain norms and practices--stemming from heritage culture, selective migration, and social support--that buffer economic exigencies. "Comparable" levels of social-emotional functioning in…

  10. Consumers and families as partners in implementing evidence-based practice.

    PubMed

    Birkel, Richard C; Hall, Laura Lee; Lane, Tom; Cohan, Kathryn; Miller, Joel

    2003-12-01

    Evidence-based practices represent an extremely important advance in the mental health system, and NAMI continues its support of efforts to develop and implement these interventions. Moving forward, the authors envision consumers and family members playing a much greater role in developing and promulgating EBP. Individually and corporately, consumers can: facilitate research that will expedite equitable implementation of existing and new EBPs; play a significant role in providing services; play a lead role in promoting policies that support EBP implementation through the development and use of advocacy toolkits; influence provider adaptation of EBP through the broad development and testing of resources that urge EBP consumerism; and, advance through the monitoring of EBP. These consumer-led activities generally have been relegated to a lower level of importance in the current research, policy, and funding environment leading to poorly developed partnerships and "buy in" from the consumer community. It is important that the level of importance of these activities and the role of consumers and families be rethought. Further advancement of EBP will require implementing a three-track program of research, including a much greater focus on action research and the involvement of consumers as research and evaluation partners. This is the fastest and most effective way to achieve breakthrough results in practices for treating people with serious mental illnesses and to address the serious and growing problem of racial and cultural disparities and the disconnect that causes between those individuals and the means to their recovery. The hope of consumers and families rest on the ability to initiate action now.

  11. Quality of Diabetes Care in Family Medicine Practices: Influence of Nurse-Practitioners and Physician’s Assistants

    PubMed Central

    Ohman-Strickland, Pamela A.; Orzano, A. John; Hudson, Shawna V.; Solberg, Leif I.; DiCiccio-Bloom, Barbara; O’Malley, Dena; Tallia, Alfred F.; Balasubramanian, Bijal A.; Crabtree, Benjamin F.

    2008-01-01

    PURPOSE The aim of this study was to assess whether the quality of diabetes care differs among practices employing nurse-practitioners (NPs), physician’s assistants (PAs), or neither, and which practice attributes contribute to any differences in care. METHODS This cross-sectional study of 46 family medicine practices from New Jersey and Pennsylvania measured adherence to American Diabetes Association diabetes guidelines via chart audits of 846 patients with diabetes. Practice characteristics were identified by staff surveys. Hierarchical models determined differences between practices with and without NPs or PAs. RESULTS Compared with practices employing PAs, practices employing NPs were more likely to measure hemoglobin A1c levels (66% vs 33%), lipid levels (80% vs 58%), and urinary microalbumin levels (32% vs 6%); to have treated for high lipid levels (77% vs 56%); and to have patients attain lipid targets (54% vs 37%) (P ≤ .005 for each). Practices with NPs were more likely than physician-only practices to assess hemoglobin A1c levels (66% vs 49%) and lipid levels (80% vs 68%) (P≤.007 for each). These effects could not be attributed to use of diabetes registries, health risk assessments, nurses for counseling, or patient reminder systems. Practices with either PAs or NPs were perceived as busier (P=.03) and had larger total staff (P <.001) than physician-only practices. CONCLUSIONS Family practices employing NPs performed better than those with physicians only and those employing PAs, especially with regard to diabetes process measures. The reasons for these differences are not clear. PMID:18195310

  12. Heritage-Language Literacy Practices: A Case Study of Three Japanese American Families

    ERIC Educational Resources Information Center

    Hashimoto, Kumi; Lee, Jin Sook

    2011-01-01

    This article documents the heritage-language (HL) literacy practices of three Japanese American families residing in a predominantly Anglo and Latino community. Through interviews and observations, this study investigates Japanese children's HL-literacy practices, parental attitudes toward HL literacy, and challenges in HL-literacy development in…

  13. In-Forming Practice through Action Research. Family and Consumer Sciences Teacher Education. Yearbook.

    ERIC Educational Resources Information Center

    Peterat, Linda, Ed.; Smith, M. Gale

    This book contains 16 papers about informing family and consumer sciences educational practice through action research. The following papers are included: "Informing Practice through Classroom Inquiry" (Linda Peterat, M. Gale Smith); "Focusing Praxis Research on Sexism in a Primary Classroom" (Emily Sutherland);…

  14. Heritage-Language Literacy Practices: A Case Study of Three Japanese American Families

    ERIC Educational Resources Information Center

    Hashimoto, Kumi; Lee, Jin Sook

    2011-01-01

    This article documents the heritage-language (HL) literacy practices of three Japanese American families residing in a predominantly Anglo and Latino community. Through interviews and observations, this study investigates Japanese children's HL-literacy practices, parental attitudes toward HL literacy, and challenges in HL-literacy development in…

  15. In-Forming Practice through Action Research. Family and Consumer Sciences Teacher Education. Yearbook.

    ERIC Educational Resources Information Center

    Peterat, Linda, Ed.; Smith, M. Gale

    This book contains 16 papers about informing family and consumer sciences educational practice through action research. The following papers are included: "Informing Practice through Classroom Inquiry" (Linda Peterat, M. Gale Smith); "Focusing Praxis Research on Sexism in a Primary Classroom" (Emily Sutherland);…

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

    USDA-ARS?s Scientific Manuscript database

    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 stu...

  17. Systemic amyloid deposits in familial British dementia.

    PubMed

    Ghiso, J A; Holton, J; Miravalle, L; Calero, M; Lashley, T; Vidal, R; Houlden, H; Wood, N; Neubert, T A; Rostagno, A; Plant, G; Revesz, T; Frangione, B

    2001-11-23

    Familial British dementia (FBD) is an early onset inherited disorder that, like familial Alzheimer's disease (FAD), is characterized by progressive dementia, amyloid deposition in the brain, and neurofibrillary degeneration of limbic neurons. The primary structure of the amyloid subunit (ABri) extracted from FBD brain tissues (Vidal, R., Frangione, B., Rostagno, A., Mead, S., Revesz, T., Plant, G., and Ghiso, J. (1999) Nature 399, 776-781) is entirely different and unrelated to any previously known amyloid protein. Patients with FBD have a single nucleotide substitution at codon 267 in the BRI2 gene, resulting in an arginine replacing the stop codon and a longer open reading frame of 277 amino acids instead of 266. The ABri peptide comprises the 34 C-terminal residues of the mutated precursor ABriPP-277 and is generated via furin-like proteolytic processing. Here we report that carriers of the Stop-to-Arg mutation have a soluble form of the amyloid peptide (sABri) in the circulation with an estimated concentration in the range of 20 ng/ml, several fold higher than that of soluble Abeta. In addition, ABri species identical to those identified in the brain were also found as fibrillar components of amyloid deposits predominantly in the blood vessels of several peripheral tissues, including pancreas and myocardium. We hypothesize that the high concentration of the soluble de novo created amyloidogenic peptide and/or the insufficient tissue clearance are the main causative factors for the formation of amyloid deposits outside the brain. Thus, FBD constitutes the first documented cerebral amyloidosis associated with neurodegeneration and dementia in which the amyloid deposition is also systemic.

  18. The role of family communication and parents' feeding practices in children's food preferences.

    PubMed

    Alm, Siril; Olsen, Svein Ottar; Honkanen, Pirjo

    2015-06-01

    This study used Family Communication Patterns Theory (FCPT) to explore how family-dinner-related communication takes place and how parents' feeding practices may be associated with children's preferences for dinner meals. The sample consisted of 12 dyads with seven- and eight-year-old Norwegian children and their parents. In-depth photo interviews were used for collecting data. Interview transcripts and photographs were examined through content analysis. Results indicated that most families were conversation oriented, and communication tended to shift from consensual during weekdays to pluralistic at weekends. On weekdays, the dinner menu was often a compromise between children's preferences and parents' intentions to provide quick, healthy dinner options for the family. To a greater extent at weekends, children were allowed to choose dinner alternatives for the entire family. Restriction of unhealthy dinner alternatives was the practice most used to control children's diets and, in fact, might explain children's high preferences for unhealthy dinner alternatives. Results underline the importance of giving children control of what they eat and being responsive to children's preferences while guiding them towards healthy dinner alternatives rather than using force and restriction. From a more theoretical perspective, this study explored how FCPT could be combined with theories about parents' feeding practices to understand meal preferences and choices among young children and their families, and how time and situation (context) influence families' communication patterns and feeding practices in their homes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Practical Steps to Integrate Family Voice in Organization, Policy, Planning, and Decision-Making for Socio-Emotional Trauma-Informed Integrated Pediatric Care.

    PubMed

    Dayton, Lauren; Buttress, Amelia; Agosti, Jen; Aceves, Javier; Kieschnick, Meredith; Popejoy, Agatha; Robbins, Robyn; Farinholt, Kate

    2016-12-01

    This article explores barriers and strategies to achieving family-driven integrated child health care. Family involvement in health system design and reform has become a guiding principle in national and local efforts to improve children's mental health services. In practice, primary care clinicians, staff, and families continue to describe common barriers to integrating family voice. Drawing from the collective knowledge of the Pediatric Integrated Care Collaborative (PICC) and the National Alliance on Mental Illness (NAMI), we present strategies to overcome these barriers to successfully recruit, sustain, and expand family influence on health systems. Family advocates and clinical leaders from two clinic sites in Albuquerque, New Mexico and Santa Rosa, California share challenges and strategies for building family involvement in system design.

  20. Systemic psychotherapy with families where someone has an autism spectrum condition

    PubMed Central

    Helps, Sarah

    2016-01-01

    BACKGROUND: Families play an important role in facilitating the development and well-being of children with autism spectrum conditions. OBJECTIVES: After setting the scene with a clinical example, and providing a brief discussion of the current thinking about the aetiology of Autism spectrum conditions, this paper provides a review of the literature regarding the practice of systemic psychotherapy with families in which a child has an autism spectrum condition (ASC). METHODS: A search of databases and journals revealed a large number of opinion papers regarding how family therapists might work with families of children with ASCs and a smaller number of papers that describe or explore actual clinical practice. RESULTS: Pilot studies using qualitative methods and practice-based evidence in the form of descriptions of clinical work offer a solid footing on which to develop systemic practice to help families where a person has an ASC. CONCLUSION: Given the multifactorial nature of the aetiology of ASCs it is suggested that systemic interventions have the potential to influence changes at multiple levels of functioning for the child and the family. PMID:27030899

  1. Discourse analysis: what is it and why is it relevant to family practice?

    PubMed

    Shaw, Sara E; Bailey, Julia

    2009-10-01

    This paper aims to illustrate what discourse analysis is and how it can contribute to our understanding of family practice. Firstly, we describe what 'discourse analysis' is, mapping the discourse analysis terrain by discussing four studies relevant to primary care to illustrate different methodological approaches and key concepts. We then address the practicalities of how to actually do discourse analysis, providing readers with a worked example using one particular approach. Thirdly, we touch on some common debates about discursive research. We conclude by advocating that researchers and practitioners take up the challenge of understanding, utilizing and extending the field of discourse studies within family practice.

  2. System of Social Services for Children and Their Families: An Overview.

    ERIC Educational Resources Information Center

    Administration for Children, Youth, and Families (DHEW), Washington, DC.

    This guide for administrators, based on the best practices found in 25 states, proposes a prototype system within which a more humane and sensitive delivery of services at the agency level can be efficiently achieved for children and their families. System goals for assisting clients are described, and the objectives which must be met to achieve…

  3. An assessment of practice support and continuing medical education needs of rural Pennsylvania family physicians.

    PubMed

    Forti, E M; Martin, K E; Jones, R L; Herman, J M

    1996-01-01

    Family physicians provide the greatest proportion of care in rural communities. Yet, the number of physicians choosing family practice and rural practice has continued to decline. Undesirable aspects of rural practice, such as professional isolation and a lack of or inadequate resources, are assumed to be associated with this decline. This article reports on the practice support and continuing medical education needs of rural family physicians. A mail survey was conducted in 1993 on a purposive sample of family physicians in 39 of 67 rural-designated or urban Pennsylvania counties with low population densities. The physicians identified needs that included patient education materials and programs, community health promotion, federal regulation updates, technical assistance with computers and business management, database software and a videotape lending library, a drug hotline, and mini-fellowships on clinical skill development. A majority of respondents were willing to participate in clinical educational experiences for students and residents. Some physicians indicated a lack of interest in access to information through telecommunications, e.g., video conference referrals and consultations. Overall, findings revealed that family physicians need and are receptive to a variety of practice support and continuing education programs. A practice support program coupled with policy coordination among public and private organizations is likely to lessen complaints by rural primary care physicians.

  4. Retesting for repeat chlamydial infection: family planning provider knowledge, attitudes, and practices.

    PubMed

    Park, Ina U; Amey, Annette; Creegan, Linda; Barandas, Aileen; Bauer, Heidi M

    2010-06-01

    Repeated genital infections with Chlamydia trachomatis are common and associated with serious adverse reproductive sequelae in women such as infertility, ectopic pregnancy, and chronic pelvic pain. Retesting for repeat chlamydial infection is recommended 3 months after treatment for an initial infection; however, retesting rates in various settings are low. In order to design interventions to increase retesting rates, understanding provider barriers and practices around retesting is crucial. Therefore, in this survey of family planning providers we sought to describe: (1) knowledge about retesting for chlamydia; (2) attitudes and barriers toward retesting; (3) practices currently utilized to ensure retesting, and predictors associated with their use. We conducted a cross-sectional, self-administered, Internet-based survey of a convenience sample of family planning providers in California inquiring about strategies utilized to ensure retesting in their practice setting. High-intensity strategies included chart flagging, tickler (reminder) systems, follow-up appointments, and phone/mail reminders. Of 268 respondents, 82% of providers reported at least 1 barrier to retesting, and only 44% utilized high-intensity interventions to ensure that patients returned. Predictors associated with use of high-intensity interventions included existence of clinic-level retesting policies (OR 3.95, 95% CI 1.98-7.88), and perception of a high/moderate level of clinic priority toward retesting (OR 3.75, 95% CI 2.12-.6.63). Emphasizing the importance of retesting to providers through adoption of clinic policies will likely be an important component of a multimodal strategy to ensure that patients are retested and that provider/clinic staff take advantage of opportunities to retest patients. Innovative approaches such as home-based retesting with self-collected vaginal swabs and use of cost-effective technologies to generate patient reminders should also be considered.

  5. Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

    PubMed Central

    Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim

    2011-01-01

    More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners (“Heilpraktiker”). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned. PMID:19293252

  6. Clinical Decision Support for Vascular Disease in Community Family Practice

    PubMed Central

    Keshavjee, K; Holbrook, AM; Lau, E; Esporlas-Jewer, I; Troyan, S

    2006-01-01

    The COMPETE III Vascular Disease Tracker (C3VT) is a personalized, Web-based, clinical decision support tool that provides patients and physicians access to a patient’s 16 individual vascular risk markers, specific advice for each marker and links to best practices in vascular disease management. It utilizes the chronic care model1 so that physicians can better manage patients with chronic diseases. Over 1100 patients have been enrolled into the COMPETE III study to date.

  7. A Study to Determine the Best Design for a Family Practice Center at Womack Army Hospital, Fort Bragg, North Carolina.

    DTIC Science & Technology

    1979-06-01

    documentation of competent treatment of patients. 1 2 Since the American Board of Family Practice approval in 1969, the number of training programs has...dency training program and to contain the operations of a growing family medicine program . The area lacked suitable conference and study space...care services at Womack Army Hospital, and in July 1974, a Family Practice residency training program was initiated. The Family Practice Activity was

  8. Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices.

    PubMed

    Tang, Woung-Ru; Hong, Ji-Hong; Rau, Kun-Ming; Wang, Cheng-Hsu; Juang, Yeong-Yuh; Lai, Chien-Hong; Fujimori, Maiko; Fang, Chun-Kai

    2017-07-01

    Despite the significant role played by cancer patients' families in medical decision-making in Asian countries, inconsistencies have hitherto not been evaluated between patients' and families' preferences and doctors' actual practices with regard to cancer truth telling. For this quantitative comparative study of cancer patients' and families' truth-telling preferences and their experiences of doctors' practices, 532 patients, 551 family members, and 127 doctors (N = 1 210) were enrolled from five hospitals across Taiwan over 2 years. Truth telling was assessed using the Taiwanese version of a modified Japanese truth-telling scale. Patients' truth-telling preferences and their experiences of doctors' truth-telling practices differed significantly in scores on the overall truth-telling scale and each subscale, including method of disclosure, emotional support, additional information, and setting (P < .001). Similar findings were obtained for families' preferences and doctors' actual practices (P < .001). Patients' and families' truth-telling preference scores were higher than doctors' actual practice scores. Multiple regression analysis revealed a dose-dependent effect of doctors' monthly truth-telling frequency on their truth-telling preferences, but this effect was only borderline significant (P = .08). This multiple regression model explained 30% of the total variance in doctors' truth-telling preferences (F = 1.38, P = .22). Taiwanese medical educational policies need to be revised to better equip doctors to practice truth telling in accordance with the preferences of cancer patients and families. Communication skills training should be prioritized for doctors who refrain from truth telling in actual practice. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Clinical Training and Practice Patterns of Medical Family Therapists: A National Survey.

    PubMed

    Zubatsky, Max; Harris, Steven M; Mendenhall, Tai J

    2017-04-01

    Medical family therapy (MedFT) has gained momentum as a framework in healthcare for individuals and families. However, little is known about what background training and clinical experiences Medical Family Therapists (MedFTs) have in everyday practice. This study investigated the clinical training of MedFTs and their practices in a variety of care settings. A survey was completed by 80 participants who use a MedFT framework in practice, with descriptive data on curriculum, clinical training, and treatment characteristics. Results reflect that many MedFTs lack formal coursework in key content areas of their graduate training and work primarily with psychological and relational concerns. Future research is needed to explore how MedFTs practice around specific mental health and chronic health conditions.

  10. An International Perspective on Regulated Family Day Care Systems

    ERIC Educational Resources Information Center

    Davis, Elise; Freeman, Ramona; Doherty, Gillian; Karlsson, Malene; Everiss, Liz; Couch, Jane; Foote, Lyn; Murray, Patricia; Modigliani, Kathy; Owen, Sue; Griffin, Sue; Friendly, Martha; McDonald, Grace; Bohanna, India; Corr, Lara; Smyth, Lisa; Morkeseth, Elisabeth Ianke; Morreaunet, Sissel; Ogi, Mari; Fukukawa, Sumi; Hinke-Rahnau, Jutta

    2012-01-01

    Despite emerging evidence of the contributors to high-quality family day care, a comprehensive comparison of international family day care systems has not been undertaken. The aim of this paper is to compare regulated family day care (FDC) in Australia, Canada, England and Wales, Germany, Ireland, Japan, Norway, New Zealand, Sweden, and the USA,…

  11. Families with Noncompliant Children: Applications of the Systemic Model.

    ERIC Educational Resources Information Center

    Neilans, Thomas H.; And Others

    This paper describes the application of a systems approach model to assessing families with a labeled noncompliant child. The first section describes and comments on the applied methodology for the model. The second section describes the classification of 61 families containing a child labeled by the family as noncompliant. An analysis of data…

  12. Families with Noncompliant Children: Applications of the Systemic Model.

    ERIC Educational Resources Information Center

    Neilans, Thomas H.; And Others

    This paper describes the application of a systems approach model to assessing families with a labeled noncompliant child. The first section describes and comments on the applied methodology for the model. The second section describes the classification of 61 families containing a child labeled by the family as noncompliant. An analysis of data…

  13. The Matricentric Family System: A Cross-Cultural Examination

    ERIC Educational Resources Information Center

    Staples, Robert

    1972-01-01

    Reports of the matricentric family system as it appears in three different societies: the Caribbean, the Nayar of India and Afro American families in the United States, to show the variations in female centered families by studying their nature and functions among different groups in diverse parts of the world. (Author)

  14. An International Perspective on Regulated Family Day Care Systems

    ERIC Educational Resources Information Center

    Davis, Elise; Freeman, Ramona; Doherty, Gillian; Karlsson, Malene; Everiss, Liz; Couch, Jane; Foote, Lyn; Murray, Patricia; Modigliani, Kathy; Owen, Sue; Griffin, Sue; Friendly, Martha; McDonald, Grace; Bohanna, India; Corr, Lara; Smyth, Lisa; Morkeseth, Elisabeth Ianke; Morreaunet, Sissel; Ogi, Mari; Fukukawa, Sumi; Hinke-Rahnau, Jutta

    2012-01-01

    Despite emerging evidence of the contributors to high-quality family day care, a comprehensive comparison of international family day care systems has not been undertaken. The aim of this paper is to compare regulated family day care (FDC) in Australia, Canada, England and Wales, Germany, Ireland, Japan, Norway, New Zealand, Sweden, and the USA,…

  15. Embedding Cognitive Systems into Systems Engineering Practice

    DTIC Science & Technology

    2008-12-01

    performing knowledge elicitation, task analyses, or workload and manpower assessments , as examples. Contrast a systems engineering simulation, a computer...aid. The product can be used to depict scripted human interactions with products. Its engine underpins the Imprint human systems integration tool...like CIOs decide what users need and their opinions, not user demand, dictate system characteristics. What should be an assessment of functional

  16. Patient Care and Paternalism: Dilemmas of Family Practice

    PubMed Central

    Wilbush, Joel

    1990-01-01

    From the clinical records of a country doctor, this vignette concerns a teenaged girl who, having refused treatment, is persuaded, under near duress, to accept a regimen that her family physician considers best for her. Although apparently arrogant paternalism, the practitioner's approach proves, on reflection, to possess considerable merit. The author discusses the ethical principles that have led to rejection of paternalism in the West. Formulated as absolute maxims, they soon require, like all absolutes, a multitude of explanations and additions. Some logical, social, and other “exceptions” are briefly mentioned, because the old doctor's intuitive actions seem to have oddly coincided with a number of them. Yet the questions remain: Should this medical practitioner have become so deeply involved? Should he have interfered with his patient's autonomy to the extent he did? Was he justified? PMID:11659246

  17. Nutrition Education Practices and Opinions of Alberta Family Physicians

    PubMed Central

    Kelly, S. Ann; Joffres, Michel R.

    1990-01-01

    A questionnaire was mailed to a random sample of 532 members of the Alberta Chapter of the College of Family Physicians in order to assess the role of physicians in providing nutrition education to their patients. Of the 255 respondents (53% response rate), over 97% agreed that “educating patients about nutrition is an important role for physicians.” Physicians most often gave nutrition information on obesity, constipation, heart disease and hypertension, alcohol, coffee, infant feeding, osteoporosis, and prenatal nutrition. Female physicians gave nutrition information significantly more often than male physicians on four maternal and child health topics. Perceived barriers to nutrition education included lack of reimbursement for physicians (86%), lack of time (48%), and limited access to patient information (42%). Most physicians often informed patients on the seven most common nutrition topics despite these concerns. PMID:21249103

  18. Analysis of Theoretical Metaphors with Illustrations from Family Systems Theory.

    ERIC Educational Resources Information Center

    Rosenblatt, Paul C.

    Metaphoric analysis of family systems theory illustrates how metaphors and alternatives to those metaphors identify what a psychological theory has highlighted and obscured about the phenomena at its focus and how it has structured that phenomena. The most commonly used metaphors in family systems theory are the metaphors of system (system…

  19. Family Values as Practiced by Feminist Parents: Bridging Third-Wave Feminism and Family Pluralism

    ERIC Educational Resources Information Center

    Mack-Canty, Colleen; Wright, Sue

    2004-01-01

    The shift from second-wave feminism, with its emphasis on gender equality, to third-wave feminism, whose concern is with oppression more generally, poses intriguing questions about theoretical and social change. We have chosen to explore these issues through the insight and perspectives of families who parent from feminist perspectives. To gain…

  20. From Public Policy to Family Practices: Researching the Everyday Realities of Families' Technology Use at Home

    ERIC Educational Resources Information Center

    Stevenson, O.

    2011-01-01

    Informed by "critical" approaches to "educational technology", this paper aims to move away from presenting a "could" and "should" explanation of children learning with technology to a more nuanced, context-rich analyses of how information and communication technologies (ICTs) are being used by technologically privileged families at home. Here, a…

  1. Family Values as Practiced by Feminist Parents: Bridging Third-Wave Feminism and Family Pluralism

    ERIC Educational Resources Information Center

    Mack-Canty, Colleen; Wright, Sue

    2004-01-01

    The shift from second-wave feminism, with its emphasis on gender equality, to third-wave feminism, whose concern is with oppression more generally, poses intriguing questions about theoretical and social change. We have chosen to explore these issues through the insight and perspectives of families who parent from feminist perspectives. To gain…

  2. Experiencing chronic widespread pain in a family context: giving and receiving practical and emotional support.

    PubMed

    Richardson, Jane C; Ong, Bie Nio; Sim, Julius

    2007-04-01

    The impact of pain and chronic illness on the family has been documented, but there is little information about living with chronic widespread pain in the context of the family. This article uses data from a qualitative study of the experience of living with chronic widespread pain to examine the experience and meaning of support for people with this condition in the context of their families. It focuses on the varying, dynamic and reciprocal nature of practical and emotional support in the family. Family members may provide support but are also receivers of support from the person with chronic widespread pain. The factors mediating the provision of this support are also explored, including the nature of the pain and the needs of the person with pain, and the roles, responsibilities and characteristics of other family members.

  3. [Dutch-Romanian cooperation in the area of family practice].

    PubMed

    van Es, J C

    2001-10-27

    During the years 1992-2000, there was a cooperative programme between the Romanian general practitioners' association (Societatea Nationala de Medicina Generala) in Romania and the Dutch Foundation for the Advancement of Quality in Healthcare in Romania. A succession of programmes were developed and carried out, which were financed by the Dutch government. The purpose of the cooperative programme was to support the development of Romanian general practice in terms of quality and structure. In the first programme, financed by the Dutch Ministry of Health, Welfare and Sport, about 200 Romanian general practitioners received continuing education. This was followed by a social transformation programme (MATRA) that had two parts: (a) the general practitioners association was supported and advised with respect to improving its organisational efficiency and (b) about 50 carefully selected Romanian general practitioners were trained, in post-academic research, management or teaching. The Romanian authorities accredited these trainees as teachers. The co-operation is being continued in 2001 with the setting up of a sentinel station programme in which 100 Romanian general practitioners collect relevant, representative data on health, illness and practice.

  4. Paediatric training for family doctors: principals and practice.

    PubMed

    Melville, C; Wall, D; Anderson, J

    2002-05-01

    There is controversy as to how best to train general practitioners for the paediatric challenges they will meet in practice, in particular what should be included in training, what should be left out and how long should it last? All 615 general practice principals referring to 6 hospitals were surveyed (40% response rate). West Midlands region of England. Postal questionnaire. Quantitative and qualitative assessment of responses. Quantitative responses were analysed by hospital, decade of qualification, and duration of paediatric training. Qualitative responses were analysed using grounded theory. Satisfaction with training was directly related to its duration, with low levels of satisfaction for less than 6 months paediatrics, moderate levels for 6-11 months, and high levels with 12 months or more. The most important item of training was recognition of the sick child. Acute and chronic paediatrics was generally well covered. Psychosocial aspects, public health and immunisation were poorly addressed. Neonatal resuscitation and first day checks were seen as relevant, but neonatal intensive care was not. At least 6 months of paediatrics is necessary for GPs in training, but longer paediatric exposure further increases their satisfaction with training. GPs have a biopsychosocial rather than biomedical approach to their child patients, suggesting potential benefits from a greater emphasis on psychosocial and public health aspects at the expense of neonatal intensive care. Recognition of the sick child is essential, and acute and chronic organic illness should be covered in breadth. Possible future models for GP training in paediatrics are discussed.

  5. 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

  6. 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.

  7. [Changes in midwifery practice. 26. Postwar legislative guideline concerning family planning].

    PubMed

    Obayashi, M

    1987-09-01

    Yoshio Furuya, who authored the 1951 legislative guidelines for family planning in Japan, designated 3 villages to model family planning upon his return from the United States in 1950. The instructors were public health nurses, midwives and regular nurses who had been trained and certified by the National Public Health Institute. They showed film strips and slides, and distributed contraceptives and medication. Population Research Group also embarked on the New Life Style Movement among Japanese industries in 1951. The new life style was said to have 3 pillars: family planning, career planning, and family morals. The idea of family planning was welcomed at the beginning by industries because it would mean less dependents of employees to provide financial aid for. The movement lasted only several years. In 1955, the International Family Planning Federation and the Japan Family Planning Federation co-sponsored the Fifth International Family Planning Conference in Tokyo. 572 participants including Margaret Sanger delivered 91 papers on techniques and practices of family planning. Soon after the conference, the Family Planning Study Committee was organized, and they met once a month to discuss socio-cultural implications of family planning, theory and practice of contraception, maternal and child health. Many of the committee members were idealistic/feminist public health officials but there were no women among them. A post-war family planning movement approved by the Japanese government resulted in the dramatic reduction in the birth rate from 34.3% in 1947 to 17.2% in 1957. Midwives played an important role in enforcing the policy but they were excluded from policy making.

  8. Assessing Children's Appraisals of Security in the Family System: The Development of the Security in the Family System (SIFS) Scales

    ERIC Educational Resources Information Center

    Forman, Evan M.; Davies, Patrick T.

    2005-01-01

    Background: Although delineating the processes by which children appraise the family as a source of security from their collective experiences in the family subsystem has assumed center stage in many conceptualizations of child development, the dearth of measures of child adaptation in the family system has hindered empirical advances. Therefore,…

  9. Exploratory Practice and Soft Systems Methodology

    ERIC Educational Resources Information Center

    Tajino, Akira; Smith, Craig

    2005-01-01

    This paper aims to demonstrate that Soft Systems Methodology (SSM), a soft systems approach developed in management studies (see Checkland, 1981), can be usefully linked with Exploratory Practice (EP), a form of practitioner research for language classrooms. Some compatible SSM and EP characteristics, in tandem, could enhance continual efforts to…

  10. Examining the Role of Social Network Intervention as an Integral Component of Community-Based, Family-Focused Practice

    ERIC Educational Resources Information Center

    Cox, Kathleen F.

    2005-01-01

    Social network intervention aimed at bolstering the informal supports of high risk families is recognized as a common element of community-based, family-focused practice models, such as intensive family preservation services (IFPS), multisystemic therapy (MST), and the wraparound process. The empirical research basis for these practice models is…

  11. 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…

  12. Family Digital Literacy Practices and Children's Mobile Phone Use.

    PubMed

    Terras, Melody M; Ramsay, Judith

    2016-01-01

    Smart phones are ubiquitous in everyday life and are having a major impact on work, education, social relationships and modes of communication. Children are the fastest growing population of smart phone users, with use often focusing around internet access, e.g., 1 in 3 internet users in the UK are under 18 years of age. Despite their widespread use, relatively little is known about the factors that underpin children's use. The home is a significant ecological context of development and recent research has highlighted the importance of the home environment in promoting and supporting the development of both safe and unsafe online behavior. Yet the importance of these influences currently remains relatively unrecognized. Therefore, in this paper we present a narrative review of evidence examining parental practices concerning digital communication technologies and applications, with a particular focus on smartphones, and how they relate to the use of technology by their children. Emerging evidence to date indicates that two important factors are at play. Firstly, parental technology use is closely related to that of their child. Secondly, that despite parents frequently voiced concerns about the nature and extent of their child's mobile phone use, parents themselves often engage in a number of unsafe internet behaviors and excessive phone use in the home environment. Our review identifies two crucial lines of enquiry that have yet to be comprehensively pursued by researchers in the field: firstly, the adoption of a psychological perspective on children's emergent behaviors with mobile devices and secondly, the influential role of context. Given parental concerns about the possible negative impact of technologies, parental awareness should be raised about the influence of their behavior in the context of internet safety along with the adoption of good digital literacy practices. It is anticipated that a comprehensive characterization of the associated contextual

  13. Systems Concepts Effectively Taught Using Systems Practices

    ERIC Educational Resources Information Center

    Ludwig, Claudia; Baliga, Nitin S.

    2008-01-01

    This article describes two lessons within the authors' education module entitled, Ecological Networks, that successfully teaches introductory systems content to middle and high school students. To catch students' attention when teaching these new concepts, they decided to use a network that was familiar and fun for students--a cell-phone…

  14. Systems Concepts Effectively Taught Using Systems Practices

    ERIC Educational Resources Information Center

    Ludwig, Claudia; Baliga, Nitin S.

    2008-01-01

    This article describes two lessons within the authors' education module entitled, Ecological Networks, that successfully teaches introductory systems content to middle and high school students. To catch students' attention when teaching these new concepts, they decided to use a network that was familiar and fun for students--a cell-phone…

  15. Delivering patient-centred care in rural family practice: using the patient's concept of health to guide treatment

    PubMed Central

    Charlesworth, Jennifer M; McManus, Evelyn

    2017-01-01

    Through an examination of the life of an 83-year-old patient diagnosed clinically with secondary progressive multiple sclerosis (MS), general practice specialists, consultants and junior doctors will see the importance of assessing their patient's concept of health and how to use this understanding to target healthcare options within their healthcare system. This article highlights, in a resource limited context of rural family practice, the utility of a strong physician–patient relationship, recalls the definition of patient-centred care, and the role of judicious inaction in certain contexts. These lessons can be extrapolated for use in more resource rich or specialised settings such as academic hospitals throughout Europe. PMID:28069782

  16. Exemplary family physicians and consultants: empirical definition of contemporary medical practice.

    PubMed Central

    Langley, G R; Till, J E

    1989-01-01

    To identify the characteristics of exemplary family physicians and consultants, we interviewed 25 family physicians and 25 consultants (5 each in the specialties of internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery) selected by their peers as being exemplary in their own practice setting. The results indicated that the participants had well-formulated concepts of exemplary practitioners, defining five main categories of performance: clinical competence, relationship with patients, availability, family physician-consultant relationship and a fifth category that included organizational ability and personality attributes. The family physicians and the consultants placed different values on these categories and indicated that these values might change under different clinical circumstances. Their concepts appear to be compatible with, but not restricted to, a model of contemporary medical practice based on an ethic specific to medicine. PMID:2766165

  17. Exemplary family physicians and consultants: empirical definition of contemporary medical practice.

    PubMed

    Langley, G R; Till, J E

    1989-08-15

    To identify the characteristics of exemplary family physicians and consultants, we interviewed 25 family physicians and 25 consultants (5 each in the specialties of internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery) selected by their peers as being exemplary in their own practice setting. The results indicated that the participants had well-formulated concepts of exemplary practitioners, defining five main categories of performance: clinical competence, relationship with patients, availability, family physician-consultant relationship and a fifth category that included organizational ability and personality attributes. The family physicians and the consultants placed different values on these categories and indicated that these values might change under different clinical circumstances. Their concepts appear to be compatible with, but not restricted to, a model of contemporary medical practice based on an ethic specific to medicine.

  18. Ontario pharmacists practicing in family health teams and the patient-centered medical home.

    PubMed

    Dolovich, Lisa

    2012-04-01

    The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The integration of pharmacists as key members of the health care team providing on-site, in-office coordinated care to FHT patients was included from the start of planning the FHT model and represents a substantial opportunity for pharmacists to realize their professional vision. Several research projects in Canada and elsewhere have contributed to providing evidence to support the integration of pharmacists into primary care practice sites. Two major research programs, the Seniors Medication Assessment Research Trial (SMART) cluster randomized controlled trial and the Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) multipronged demonstration project made substantial contributions to evidence-informed policy decisions supporting the integration of pharmacists into FHTs. These projects can provide useful information to support the integration of pharmacists into the PCMH and to encourage further research to better measure the effect of the pharmacist from the holistic patient-centered perspective.

  19. Examining family meetings at end of life: The model of practice in a hospice inpatient unit.

    PubMed

    Meeker, Mary Ann; Waldrop, Deborah P; Seo, Jin Young

    2015-10-01

    Our purpose was to rigorously examine the nature of family meetings as conducted in an inpatient hospice care unit in order to generate an inductive theoretical model. In this two-phase project, we first interviewed eight members of the interdisciplinary care team who participated in multiple family meetings each week. Interview questions explored why and how they conducted family meetings. Using an observation template created from these interview data, we subsequently conducted ethnographic observations during family meetings. Using the methods of grounded theory, our findings were synthesized into a theoretical model depicting the structure and process of formal family meetings within this setting. The core of the family meeting was characterized by cognitive and affective elements aimed at supporting the family and facilitating quality care by clarifying the past, easing the present, and protecting the future. This inductive model was subsequently found to be highly aligned with a sense of coherence, an important influence on coping, and adaptation to the stress of a life-limiting illness. Provider communication with family members is particularly critical during advanced illness and end-of-life care. The National Consensus Project clinical practice guidelines for quality palliative care list regular family meetings among the recommended practices for excellent communication during end-of-life care, but do not provide specific guidance on how and when to provide such meetings. Our findings provide a theoretical model that can inform the design of a family meeting to address family members' needs for meaningful and contextualized information, validation of their important contributions to care, and preparation for the patient's death.

  20. Preventing running injuries. Practical approach for family doctors.

    PubMed Central

    Johnston, C. A. M.; Taunton, J. E.; Lloyd-Smith, D. R.; McKenzie, D. C.

    2003-01-01

    OBJECTIVE: To present a practical approach for preventing running injuries. QUALITY OF EVIDENCE: Much of the research on running injuries is in the form of expert opinion and comparison trials. Recent systematic reviews have summarized research in orthotics, stretching before running, and interventions to prevent soft tissue injuries. MAIN MESSAGE: The most common factors implicated in running injuries are errors in training methods, inappropriate training surfaces and running shoes, malalignment of the leg, and muscle weakness and inflexibility. Runners can reduce risk of injury by using established training programs that gradually increase distance or time of running and provide appropriate rest. Orthoses and heel lifts can correct malalignments of the leg. Running shoes appropriate for runners' foot types should be selected. Lower-extremity strength and flexibility programs should be added to training. Select appropriate surfaces for training and introduce changes gradually. CONCLUSION: Prevention addresses factors proven to cause running injuries. Unfortunately, injury is often the first sign of fault in running programs, so patients should be taught to recognize early symptoms of injury. PMID:14526862

  1. Medical students’ perceptions and attitudes about family practice: a qualitative research synthesis

    PubMed Central

    2012-01-01

    Background During the last decade medical students from most Western countries have shown little interest in family practice. Understanding the factors that influence medical students to choose family medicine is crucial. Objective To systematically review and synthesize published evidence about medical students’ attitudes and perceptions towards family practice. Methods A qualitative systematic review. The literature search was undertaken in July 2010 in PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Science Citation Index (SSCI), and ProQuest Dissertations & Theses. Two authors independently selected the studies for their inclusion and assessed their quality. The selected studies were thoroughly read. Key themes and categories were identified. A matrix was created for allowing the comparison of each theme across studies. Results Ten studies were finally included. Seven broad themes were identified across them: 1) Scope and context of practice was a broad theme comprising linked sub-themes: perception of a varied specialty, broad practice, holistic perspective and flexibility that allows having a family; 2) Lower interest or intellectually less challenging: treating common disease, repetitive, quasi administrative job; 3) Influence of role models, either positive and negative, and society: negative comments from other professionals, peers and family; 4) Lower prestige; 5) Poor remuneration; 6) Medical school influences, being important both the length and quality of the exposure; 7) Post graduate training, where the shorter duration and the lower intensity were perceived as positive aspects. After identifying these seven key themes, were also looked into patterns in the distribution of these themes among studies. Conclusions Our qualitative review provides a comprehensive picture of medical students’ attitudes towards family practice in the available literature. In general, although some students find family medicine

  2. Family practice residencies in community health centers--an approach to cost and access concerns.

    PubMed Central

    Zweifler, J

    1995-01-01

    An inadequate number of trained primary care clinicians limits access to care at Community Health Centers. If family practice residents working in these centers can provide care to patients at a cost that is comparable to the center's hiring its own physicians, then expansion of Family Practice Residency Programs into community centers can address both cost and access concerns. A cost-benefit analysis of the Family Practice Residency Program at the Fresno, CA, community center was performed; the community center is affiliated with the University of California at San Francisco. Costs included (a) residents' salaries, (b) supervision of the family practice residents, (c) family practice program costs for educational activities apart from supervision at the community center, and (d) administrative costs attributable to family practice residents in the community center. Benefits were based on the number of patients that residents saw in the community center. Using this approach, a cost of $7,700 per resident per year was calculated. This cost is modest compared with the cost of training residents in inpatient settings. The added costs attributable to training residents in community health centers can be shared with agencies that are concerned with medical education, providing physicians to underserved communities, and increasing the supply of primary care physicians. Redirecting graduate medical education funding from hospitals to selected ambulatory care training centers of excellence would facilitate placing residents in community centers. This change would have the dual advantage of addressing the current imbalance between training in ambulatory care and hospital sites and increasing the capacity of community health centers to meet the health care needs of underserved populations. PMID:7610223

  3. Prolepsis, Syncretism, and Synergy in Early Language and Literacy Practices: A Case Study of Family Language Policy in Singapore

    ERIC Educational Resources Information Center

    Ren, Li; Hu, Guangwei

    2013-01-01

    This article reports a case study of two Chinese-English bilingual families in Singapore and illustrates the importance of incorporating two hitherto disconnected fields of research--family language policy and family literacy practices--to an understanding of early language and literacy acquisition in the familial milieu. Specifically, this work…

  4. Prolepsis, Syncretism, and Synergy in Early Language and Literacy Practices: A Case Study of Family Language Policy in Singapore

    ERIC Educational Resources Information Center

    Ren, Li; Hu, Guangwei

    2013-01-01

    This article reports a case study of two Chinese-English bilingual families in Singapore and illustrates the importance of incorporating two hitherto disconnected fields of research--family language policy and family literacy practices--to an understanding of early language and literacy acquisition in the familial milieu. Specifically, this work…

  5. Personality types of family practice residents as measured by the Myers-Briggs type indicator.

    PubMed

    Harris, D L; Ebbert, P

    1985-01-01

    This study was initiated to test the hypothesis that individuals currently choosing family practice as a career are likely to have different personality types than those who previously pursued general practice. Incoming residents to the University of Utah Family Practice Residency Program were compared to a group of private primary care physicians serving rural areas. Personality types were determined by administering the Myers-Briggs Type Indicator to both groups. Results showed that the current resident group differed significantly from the primary care physician group and that the residents' personality types were similar to personality types of faculty in other studies. This raises the concern that many family practice residents may not choose to practice in underserved areas. Further studies need to follow personality types through medical school and residency training and into practice to help determine which prospective physicians are likely to choose a primary care career and a rural practice. This information may be useful in health manpower planning and in examining admissions policies of medical schools and residencies.

  6. Systemic Family Assessment: Concepts and Strategies for School Psychologists.

    ERIC Educational Resources Information Center

    Paget, Kathleen D.

    1987-01-01

    This article explores concepts and strategies pertaining to systemic family assessment, enumerates the essential principles of systems theory, and discusses the purposes of family assessment in the context of children's school-related problems. An overview of assessment strategies is provided. (Author/LMO)

  7. Family Systems Theory: A Unifying Framework for Codependence.

    ERIC Educational Resources Information Center

    Prest, Layne A.; Protinsky, Howard

    1993-01-01

    Considers addictions and construct of codependence. Offers critical review and synthesis of codependency literature, along with an intergenerational family systems framework for conceptualizing the relationship of the dysfunctional family to the construct of codependence. Presents theoretical basis for systemic clinical work and research in this…

  8. Family Systems Theory: A Unifying Framework for Codependence.

    ERIC Educational Resources Information Center

    Prest, Layne A.; Protinsky, Howard

    1993-01-01

    Considers addictions and construct of codependence. Offers critical review and synthesis of codependency literature, along with an intergenerational family systems framework for conceptualizing the relationship of the dysfunctional family to the construct of codependence. Presents theoretical basis for systemic clinical work and research in this…

  9. Towards a Web-Based System for Family Health Record

    PubMed Central

    Marceglia, Sara; Bonacina, Stefano; Braidotti, Andrea; Nardelli, Marco; Pinciroli, Francesco

    2006-01-01

    Electronic health records are a fundamental support needed not only by healthcare providers, but also for individual patients. We considered the health management in the familiar environment and we developed a web-based system for family health record. The system permits an easy compilation and provides an effective visualization of the clinical data concerning family members also for friendly printing tasks. PMID:17238642

  10. Towards a web-based system for family health record.

    PubMed

    Marceglia, Sara; Bonacina, Stefano; Braidotti, Andrea; Nardelli, Marco; Pinciroli, Francesco

    2006-01-01

    Electronic health records are a fundamental support needed not only by healthcare providers, but also for individual patients. We considered the health management in the familiar environment and we developed a web-based system for family health record. The system permits an easy compilation and provides an effective visualization of the clinical data concerning family members also for friendly printing tasks.

  11. Long-term attendance at a family practice teaching unit. Qualitative study of patients' views.

    PubMed Central

    Brown, J. B.; Dickie, I.; Brown, L.; Biehn, J.

    1997-01-01

    OBJECTIVE: To identify the factors that contribute to patients' long-term attendance at a family practice teaching unit. DESIGN: Qualitative method of focus groups. SETTING: A community-based family practice teaching unit in southwestern Ontario. PARTICIPANTS: Patients who had been coming to St Joseph's Family Medical Centre for more than 15 years were purposefully selected to participate. METHOD: Five focus groups composed of patients who had been affiliated with one of the three practices at the Centre for more than 15 years explored factors contributing to long-term attendance. MAIN FINDINGS: Four key themes were identified as the primary factors contributing to long-term attendance: the relationship context, the team concept, professional responsibility and attitudes, and comprehensive and convenient care. CONCLUSION: The resource-rich era of medical care, during which participants formulated their views and opinions about the factors contributing to their long-term attendance at a family practice teaching unit, has come to a close. The findings of this study provide important information that could help maintain one of the basic tenets of family medicine-continuity of care. PMID:9154362

  12. Treating Adolescent Drug Abuse: A Comparison of Family Systems Therapy, Group Therapy, and Family Drug Education.

    ERIC Educational Resources Information Center

    Joanning, Harvey; And Others

    1992-01-01

    Assessed differential effectiveness of three models of adolescent drug abuse treatment: Family Systems Therapy (FST), Adolescent Group Therapy (AGT), and Family Drug Education (FDE). FST appeared more effective in stopping adolescent drug abuse than AGT or FDE, registering twice as many apparently drug-free clients as FDE and three times as many…

  13. Treating Adolescent Drug Abuse: A Comparison of Family Systems Therapy, Group Therapy, and Family Drug Education.

    ERIC Educational Resources Information Center

    Joanning, Harvey; And Others

    1992-01-01

    Assessed differential effectiveness of three models of adolescent drug abuse treatment: Family Systems Therapy (FST), Adolescent Group Therapy (AGT), and Family Drug Education (FDE). FST appeared more effective in stopping adolescent drug abuse than AGT or FDE, registering twice as many apparently drug-free clients as FDE and three times as many…

  14. Development of a diabetes care management curriculum in a family practice residency program.

    PubMed

    Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann

    2004-01-01

    Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites.

  15. Socio demographic determinants and knowledge, attitude, practice: survey of family planning.

    PubMed

    Sharma, Vasundhara; Mohan, Uday; Das, Vinita; Awasthi, Shally

    2012-01-01

    Understanding of family planning scenario among different societies and communities, which by and large reside in urban slum and rural areas, might prove useful in increasing family planning acceptance by them and decreasing population growth. To assess the sociodemographic determinants and KAP of family planning among urban slum and rural areas of Lucknow. Cross sectional. Bal Mahila Chikitsalaya, Aliganj, in urban and Primary Health Centre, Bakshi Ka Talaab, in rural area of Lucknow. October 2008 to April 2009. Six hundred and eightytwo postpartum women (within 42 days of delivery) who came to these health facilities for their child's vaccination were interviewed, by a preformed and pretested schedule. Maximum utilization of family methods were seen among Hindu women, women of age group 30 or more, parity four and more, educational level upto high school and above and those of higher socioeconomic class. Although overall residential area (urban or rural) of women had no influence on the practice of family planning by them and all of them were willing to adopt family planning methods in future, urban women were found to have a higher level of knowledge and attitude toward modern methods of family planning. Only 2.8% were unsure of preferred method for future use. Family planning programs which effectively promotes the use of family planning methods, so that the trend toward increase in population could be arrested is the need of hour.

  16. The practice of nurses caring for families of pediatric inpatients in light of Jean Watson.

    PubMed

    Santos, Maiara Rodrigues Dos; Bousso, Regina Szylit; Vendramim, Patrícia; Baliza, Michelle Freire; Misko, Maira Deguer; Silva, Lucía

    2014-08-01

    Objective To know the facilities and the difficulties of nurses in caring practice of hospitalized children's families in the light of Jean Watson's Theory of Human Caring. Method It was used the descriptive qualitative approach. The data collection was conducted in three stages: presentation of theoretical content; engagement with families in the light of Watson's theory; and semi-structured interview with 12 pediatric nurses. The interviews were analysed using inductive thematic analysis, being possible to form three themes: Recognizing a framework for care; Considering the institutional context; and Challenges in family's relationship. Results The theory favored reflections about self, about the institutions and about nurses' relationship with the family of the child, normalized by a consciousness toward caring attitudes. Conclusion In this process, it is imperative that nurses recognize the philosophical-theoretical foundations of care to attend the child's family in hospital.

  17. Reflective practice enhances public health nurse implementation of nurse-family partnership.

    PubMed

    Beam, Rita J; O'Brien, Ruth A; Neal, Michelle

    2010-01-01

    Reflective practice is defined as a cyclical process involving a series of phases in which an individual describes a salient event, attends to his/her positive and negative feelings about the event, and ultimately reexamines the experience in an effort to understand and to plan how he or she would act in a similar situation in the future. This paper describes how the concept of reflective practice is integrated into the evidence-based Nurse-Family Partnership (NFP) program. The pivotal role of the nursing supervisor in guiding nurses to engage in reflection on their work with families is emphasized. Exemplars drawn from the experience of 2 NFP nursing supervisors are presented to illustrate how reflection in the NFP program is operationalized. The benefits as well as the challenges to the use of reflective practice are also discussed. While anecdotal comments from NFP nurses and supervisors are cited to suggest how the regular use of reflective practice has the potential to improve implementation of the program with families, the authors further propose that research is needed to more rigorously examine the benefits that reflective practice may have on the quality of program implementation, family outcomes, and the retention of nurses working in the NFP program.

  18. Practice simulated office orals as a predictor of Certification examination performance in family medicine.

    PubMed

    Noel, Kendall; Archibald, Douglas; Brailovsky, Carlos

    2017-04-01

    To determine if performance on practice simulated office orals (SOOs) conducted during residency training could predict residents' performance on the SOO component of the College of Family Physicians of Canada's (CFPC's) final Certification examination. Prospective cohort study. University of Ottawa in Ontario. Family medicine residents enrolled in the University of Ottawa's Family Medicine Residency program between July 1, 2012, and June 30, 2014, who were eligible to write the CFPC Certification examination in the spring of 2014 and who had participated in all 4 practice SOO examination sessions; 23 residents met these criteria. Scores on practice SOO sessions during fall 2012, spring 2013, fall 2013, and spring 2014; and the SOO component score on the spring 2014 administration of the CFPC Certification examination. Weighted least squares regression analysis using the 4 practice SOO session scores significantly predicted the final Certification examination SOO score (P < .05), with an adjusted R(2) value of 0.29. Additional analysis revealed that the mean scores for the cohort generated at each time point were statistically different from each other (P < .001) and that the relationship over time could be represented by either a linear relationship or a quadratic relationship. A generalizability study generated a relative generalizability coefficient of 0.63. Our results confirm the usefulness of practice SOOs as a progress test and demonstrate the feasibility of using them to predict final scores on the SOO component of the CFPC's Certification examination. Copyright© the College of Family Physicians of Canada.

  19. Managing Diabetes Mellitus: A Survey of Attitudes and Practices Among Family Physicians.

    PubMed

    Fogelman, Yacov; Goldfracht, Margalit; Karkabi, Khaled

    2015-10-01

    Due to the increasing prevalence of diabetes and the shortage of endocrinologists, family physicians have an important role in diabetes management. The purpose of this study was to examine the sources of knowledge, attitudes and practices of family physicians regarding the management of type 2 diabetes. Attendees at continuous medical education (CME) programs in Israel were requested to respond anonymously to written questions about their sources of knowledge about diabetes, the methods of diabetes management they advise their patients, their knowledge of diabetes medication treatments, and their attitudes toward people with type 2 diabetes. Questionnaires were completed by 362 family physicians (79% response rate). Of them, 329 (91%) reported that they usually manage their patients' diabetes care, including that of patients with concomitant risk factors. Their most common recommendations for diabetes control were: to increase physical activity, decrease total calorie intake, consult with a dietitian and undergo weight loss counseling. Almost all physicians (97%) reported providing lifestyle change counseling. Sixty percent reported lacking knowledge about nutritional issues. Only 58% answered correctly regarding the effect of the anti-diabetic drug, GLP1 analog. Board certified family physicians and their residents exhibited more knowledge about diabetes practice than did non-board certified family physicians. The great majority of family physicians surveyed usually manage their patients' diabetes themselves, and do not refer them to diabetes specialists. The implementation of strategies that will enhance the competencies and confidence of family physicians in diabetes management are important for achieving successful treatment.

  20. 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

  1. Impact of Individual and Team Features of Patient Safety Climate: A Survey in Family Practices

    PubMed Central

    Hoffmann, Barbara; Miessner, Carolin; Albay, Zeycan; Schröber, Jakob; Weppler, Katrin; Gerlach, Ferdinand M.; Güthlin, Corina

    2013-01-01

    PURPOSE Knowledge about safety climate is fundamental to improving patient safety in health care organizations. Because individual and organizational factors influence the safety climate, we conducted a health care survey of German family practices so we could analyze the impact of the professional group, the professional experience of practice staff, and practice characteristics on perceptions of the safety climate. METHODS We wrote to health care assistants and doctors in 1,800 randomly selected family practices in Germany and asked them to complete a newly developed and validated Frankfurt Patient Safety Climate Questionnaire. We conducted a descriptive analyses of items and climate factors, as well as regression analysis, to identify potential predictors of the safety climate in family practice. RESULTS The response rate from the participating practices was 36.1%. Safety climate was perceived to be generally positive with the exception of the factors of error management and perception of the causes of errors. We discovered that whether or not the entire team had taken part in the survey had a positive influence on most factors. Doctors had more positive perceptions of 4 of 7 factors addressed to both professions. Male participants and doctors showed the most willingness to admit they had made an error. CONCLUSIONS Though the safety climate in German family practices was positive overall, health care professionals’ use of incident reporting and a system’s approach to errors was fairly rare. When evaluating the safety climate in primary health care practices, respondents’ individual characteristics, as well as organizational features, should be taken into account. PMID:23835822

  2. Collaborative Efforts to Improve System Response to Families Who Are Experiencing Child Maltreatment and Domestic Violence

    ERIC Educational Resources Information Center

    Banks, Duren; Dutch, Nicole; Wang, Kathleen

    2008-01-01

    The "Greenbook" demonstration initiative provided federal funding and other support to six communities to establish collaborations to plan and implement policy and practice changes in systems that serve families who are experiencing domestic violence and child maltreatment or child exposure to domestic violence. The demonstration sites established…

  3. Family functioning and the adolescent mother: a systems approach.

    PubMed

    Nathanson, M; Baird, A; Jemail, J

    1986-01-01

    This study examines unwanted adolescent pregnancy and early childbearing within the context of the family system. Fifty pregnant adolescents and their families were interviewed prenatally and again during the postpartum period. Utilizing the concepts of structural family theory and therapy as described by Minuchin, certain characteristics of family style and structure of organization were rated. These family variables were then related to aspects of the adolescent mother's adaptation postpartum. Boundaries, in terms of degree of intrusiveness and differentiation, were related to such variables as whether the adolescent is maintained in the household and to her continuing relationship with the baby's father. Similarly, the family's style of dealing with conflict was related to the relationship between the adolescent parents, among other outcome variables. Implications of the findings both for working with these families and for further research are discussed, and issues are raised about hypothesized relationships between independent and dependent variables which were not borne out.

  4. Cultural influences on the survivorship of families affected by childhood cancer: a case for using family systems theories.

    PubMed

    Yi, Jaehee

    2009-09-01

    This paper uses the family systems perspective to synthesize existing studies on the 3 components of Olson's (2000) Circumplex Model-family cohesion, flexibility, and communication-as they relate to family adaptation to cancer; and to extend the discussion to the cultural influences on these components. Family systems theory was found to be a useful framework for understanding the variance of positive and negative family adaptation in the survivorship of childhood cancer and the cultural impact on the family level variables.

  5. [As index patient into therapeutic alternatives?--Children in systemic family therapy and counseling].

    PubMed

    Vossler, A

    2000-01-01

    Since systemic therapy and counseling approaches have become established in child guidance, and children and adolescent psychiatry the understanding for children in the therapeutic context has also changed. They are part of the family system who, with their symptoms, point to restricting reality constructions and interaction patterns which create suffering (index patients). They are often treated correspondingly in the family setting. On this background this article investigates the special situation of children in the practice of systemic family therapy. The few results from studies from practice research dealing with this subject are compared with system-theoretical basic assumptions. The results indicate that the children are only insufficiently integrated into the therapy sessions and are excluded partly. They often experience the family discussions as being adult-oriented and feel that their needs and views are considered only slightly. Possible causes for this may be expecting too much emotionally and/or cognitively especially from younger children with family-oriented methods (such as circular questioning) as well as deficits in the training of family therapists. The closing thoughts on the therapeutic implications from the presented results include suggestions on methodical approaches more suitable for children and a reflected therapeutic attitude (transparency, participation, respect) towards children.

  6. Intervening in Family Systems with Observer Messages.

    ERIC Educational Resources Information Center

    Breunlin, Douglas C.; Cade, Brian

    1981-01-01

    Presents an approach to family therapy where a group of observers becomes part of a therapeutic team by introducing strategic messages into the sessions. Messages are described in terms of five components: function, target, timing, content, and delivery. Suggests guidelines for effective team functioning and discusses implications for training.…

  7. Infant Developmental Outcomes: A Family Systems Perspective

    ERIC Educational Resources Information Center

    Parfitt, Ylva; Pike, Alison; Ayers, Susan

    2014-01-01

    The aim of the current study was to examine whether parental mental health, parent-infant relationship, infant characteristics and couple's relationship factors were associated with the infant's development. Forty-two families took part at three time points. The first, at 3?months postpartum, involved a video recorded observation (CARE-index) of…

  8. Infant Developmental Outcomes: A Family Systems Perspective

    ERIC Educational Resources Information Center

    Parfitt, Ylva; Pike, Alison; Ayers, Susan

    2014-01-01

    The aim of the current study was to examine whether parental mental health, parent-infant relationship, infant characteristics and couple's relationship factors were associated with the infant's development. Forty-two families took part at three time points. The first, at 3?months postpartum, involved a video recorded observation (CARE-index) of…

  9. Thai Parenting Practices, Family Rituals and Risky Adolescent Behaviors: Alcohol Use, Cigarette Use and Delinquency

    PubMed Central

    Miller, Brenda A.; Byrnes, Hilary F.; Cupp, Pamela K.; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Fongkaew, Warunee; Rosati, Michael J.; Chookhare, Warunee; Zimmerman, Rick S.

    2011-01-01

    Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics. PMID:24511362

  10. Family Physicians' Satisfaction with Current Practice: What Is the Role of Their Interactions with Specialists?

    PubMed Central

    Thind, Amardeep; Freeman, Tom; Thorpe, Cathy; Burt, Andrea; Stewart, Moira

    2009-01-01

    Provision of high-quality care sometimes necessitates a referral to, and receipt of timely feedback from, specialist physicians. Interaction with specialists is a key role of family physicians, but it has not received significant attention with respect to its impact on family physician satisfaction. The authors conducted a cross-sectional analysis of data gathered from a decennial census of family physicians in southwestern Ontario. The conceptual framework was based on the model developed by the Society of General Internal Medicine (SGIM) Career Satisfaction Work Group. More than two-thirds of respondents were “very satisfied” with their current practice. Stepwise regression analysis based on a generalized linear model showed that greater difficulty in referring patients to specialists was associated with 23% lower odds of being “very satisfied”. Not receiving a timely response from specialists was associated with 26% higher odds of not being “very satisfied.” Marital status, teaching involvement and practice volume were also associated with satisfaction. The findings indicate that the practice of family medicine offers a fulfilling career in today's medical marketplace. However, linkages and feedback between family physicians and specialists need to be augmented. PMID:19377349

  11. Privacy and Confidentiality Practices In Adolescent Family Planning Care At Federally Qualified Health Centers.

    PubMed

    Beeson, Tishra; Mead, Katherine H; Wood, Susan; Goldberg, Debora Goetz; Shin, Peter; Rosenbaum, Sara

    2016-03-01

    The confidentiality of family planning services remains a high priority to adolescents, but barriers to implementing confidentiality and privacy practices exist in settings designed for teenagers who are medically underserved, including federally qualified health centers (FQHCs). A sample of 423 FQHCs surveyed in 2011 provided information on their use of five selected privacy and confidentiality practices, which were examined separately and combined into an index. Regression modeling was used to assess whether various state policies and organizational characteristics were associated with FQHCs' scores on the index. In-depth case studies of six FQHCs were conducted to provide additional contextual information. Among FQHCs reporting on confidentiality, most reported providing written or verbal information regarding adolescents' rights to confidential care (81%) and limiting access to family planning and medical records to protect adolescents' confidentiality (84%). Far fewer reported maintaining separate medical records for family planning (10%), using a security block on electronic medical records to prevent disclosures (43%) or using separate contact information for communications regarding family planning services (50%). Index scores were higher among FQHCs that received Title X funding than among those that did not (coefficient, 0.70) and among FQHCs with the largest patient volumes than among those with the smallest caseloads (0.43). Case studies highlighted how a lack of guidelines and providers' confusion over relevant laws present a challenge in offering confidential care to adolescents. The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations. Copyright © 2016 by the Guttmacher Institute.

  12. Parental Practices in Families of Super-Achieving Math and Science Students.

    ERIC Educational Resources Information Center

    Lines, Patricia; Hawley, Jill Clark

    This paper examines parenting practices reported by 29 seniors who won scholarships in the 1990 Westinghouse Science Talent Search (STS) for projects in mathematics or science. It uses measures of parenting developed by Sanford Dornbusch and others: Parents are "authoritative" if they encourage family discussions of controversial topics, prefer…

  13. Associations between Family Environment, Parenting Practices, and Executive Functioning of Children with and without ADHD

    ERIC Educational Resources Information Center

    Schroeder, Valarie M.; Kelley, Michelle L.

    2009-01-01

    We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported…

  14. School Curriculum, Policies, and Practices Regarding Lesbian, Gay, Bisexual, and Transgender Families

    ERIC Educational Resources Information Center

    Bishop, Christa M.; Atlas, Jana G.

    2015-01-01

    This study examined what elementary schools in New York State are doing to recognize lesbian, gay, bisexual, and transgender (LGBT) families in terms of curriculum, policies, and practices. In all, 116 school psychologists completed an online survey regarding their districts. Findings indicated that even though most school districts serve…

  15. School Curriculum, Policies, and Practices Regarding Lesbian, Gay, Bisexual, and Transgender Families

    ERIC Educational Resources Information Center

    Bishop, Christa M.; Atlas, Jana G.

    2015-01-01

    This study examined what elementary schools in New York State are doing to recognize lesbian, gay, bisexual, and transgender (LGBT) families in terms of curriculum, policies, and practices. In all, 116 school psychologists completed an online survey regarding their districts. Findings indicated that even though most school districts serve…

  16. Family Violence and Migrant Women: Implications for Practice. Migrant Clinicians Network Clinical Supplement.

    ERIC Educational Resources Information Center

    Rodriguez, Rachel; And Others

    1993-01-01

    This newsletter supplement is devoted to the theme of domestic violence affecting migrant women. It contains four articles describing programs providing violence prevention education to migrant women and children. "Family Violence and Migrant Women: Implications for Practice" (Rachel Rodriguez) discusses the social isolation of migrant women;…

  17. Food and Nutrition Practices and Education Needs in Florida's Adult Family Care Homes

    ERIC Educational Resources Information Center

    Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.

    2014-01-01

    A statewide survey was carried out to determine food and nutrition practices and education needs of Florida's adult family care homes (AFCHs). The 30-item survey included questions on food and nutrition education, supplement use, and menu planning. Infrequent use of menus and nutrition supplements was reported. A strong need was indicated for…

  18. Food and Nutrition Practices and Education Needs in Florida's Adult Family Care Homes

    ERIC Educational Resources Information Center

    Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.

    2014-01-01

    A statewide survey was carried out to determine food and nutrition practices and education needs of Florida's adult family care homes (AFCHs). The 30-item survey included questions on food and nutrition education, supplement use, and menu planning. Infrequent use of menus and nutrition supplements was reported. A strong need was indicated for…

  19. Beliefs and Practices Regarding Autism in Indian Families Now Settled Abroad: An Internet Survey

    ERIC Educational Resources Information Center

    Ravindran, Neeraja; Myers, Barbara J.

    2013-01-01

    Beliefs and practices regarding autism were explored in Indian families living outside India. Parents (N = 24) of children (3 to 15 years) with an autism spectrum disorder wrote open-ended answers in an online questionnaire regarding their beliefs about causes, treatments and services received, use of and preference for Indian medicine and…

  20. Genres, Contexts, and Literacy Practices: Literacy Brokering among Sudanese Refugee Families

    ERIC Educational Resources Information Center

    Perry, Kristen H.

    2009-01-01

    This ethnographic study examined literacy brokering among Sudanese refugee families in Michigan. Literacy brokering occurs as individuals seek informal help with unfamiliar texts and literacy practices. Data collection involved participant observation, semi-structured interviews, and collection of artifacts over 18 months. Researcher analysis of…