Hofman, M N; Hughes, R L
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.
Bujnowska-Fedak, M M; Staniszewski, A; Steciwko, A; Puchala, E
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.
Rolland, John S; Emanuel, Linda L; Torke, Alexia M
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
Fontana, S A; Kelber, S T; Devine, E C
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.
Trivette, Carol M.; Dunst, Carl J.; Hamby, Deborah W.
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…
Forchuk, C; Dorsay, J P
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.
Ada, Serkan; Bal, Canan Gamze; Çelik, Adnan; Akgemci, Tahir
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.
Ozsahin, Akatli Kursad
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.
Duhamel, Fabie; Dupuis, France; Turcotte, Annie; Martinez, Anne-Marie; Goudreau, Johanne
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.
Maybery, Darryl; Goodyear, Melinda; O'Hanlon, Brendan; Cuff, Rose; Reupert, Andrea
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.
Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.
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
Rubenstein, H.; Levitt, C.
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
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.
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
Denham, Sharon A
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.
Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.
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…
McHale, James P.; Phares, Vicky
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…
Hodgson, Kate; Darling, Marcia
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.
Baker, Ed; Schmitz, David; Epperly, Ted; Nukui, Ayaka; Miller, Carissa Moffat
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…
Walker, Sarah Cusworth; Bishop, Asia S; Pullmann, Michael D; Bauer, Grace
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.
Dettlaff, Alan J.; Rycraft, Joan R.
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…
Smith, John A.
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
MacDonald, Peter J.; Brown, Alan
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
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,…
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
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.
Walters, David J.
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
Ranson, Peter J.
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.
Rohrbaugh, Michael J
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.
Dunst, Carl J; Trivette, Carol M; Hamby, Deborah W
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.
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…
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)
Cavers, William J.R.; Tregillus, Valerie H.F.; Micco, Angela; Hollander, Marcus J.
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
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.
And Others; Rood, Stewart R.
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…
Amato, Paul R.; Fowler, Frieda
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…
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…
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…
Segaric, Cheryl A; Hall, Wendy A
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.
Banks, Duren; Landsverk, John; Wang, Kathleen
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…
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)…
Herrin, Jeph; Harris, Kathleen G; Kenward, Kevin; Hines, Stephen; Joshi, Maulik S; Frosch, Dominick L
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
Palacios-Derflingher, Luz; O'Beirne, Maeve; Sterling, Pam; Zwicker, Karen; Harding, Brianne K; Casebeer, Ann
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.
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…
Konkarikoski, K.; Ritala, R.; Ihalainen, H.
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.
Booker, Angela; Goldman, Shelley
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…
Chadda, Rakesh K.; Deb, Koushik Sinha
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
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
Reynolds, J. L.
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
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…
Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M
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.
Atkinson, Anne; Gonet, Patricia
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…
Lobo Prabhu, Sheila; Molinari, Victor; Bowers, Theron; Lomax, James
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.
Prescott, Dana E
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.
Hunter, Jerry L.; Snyder, Frank
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)
Noor, Norhayati Mohd.
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…
Hile, Kimberly A.; Milagros Santos, Rosa; Hughes, Mary-alayne
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…
Pickwell, S M
Relatively little data has been collected documenting the scope of family nurse practitioner (FNP) clinical practice, and virtually no research definitively describes the quality of that practice. Physicians have led the way in quantitative collection of practice content information. The resulting analyses have determined not only the most common diagnoses in primary care but also the content of teaching and research in family practice. Nurse clinicians, educators, and researchers have assumed this content to be pertinent to FNP practice as well. This article describes the major studies of family physician practice and the few studies of nurse practitioner/FNP practice, and advocates intensified review of FNP clinical content as an empirical basis for practice, education, and research.
Casas Patiño, Donovan; Jarillo Soto, Edgar; Rodríguez Torres, Alejandra
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.
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.
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.
Bembry, James X.
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…
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,…
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…
Swanson, J. G.
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
Brown, J. B.; Sangster, M.; Swift, J.
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
Twohig, P. L.; Burge, F.; MacLachlan, R.
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
Dodd, Jenny; Saggers, Sherry; Wildy, Helen
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…
Carroll, June C.
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
Park, Hae Seong; Bonner, Patricia
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…
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…
Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.
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…
Pell, Bryan A.
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
[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
Musham, C.; Hainer, B.
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.
Beaton, John; Dienhart, Anna; Schmidt, Jonathan; Turner, Jean
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…
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…
Bordeau, Wendy Charkow; Briggs, Michele Kielty; Staton, A. Renee; Wasik, Suzan Zuljani
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.
South-Paul, J E; Grumbach, K
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.
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
McWhirter, Ellen Hawley; And Others
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)
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.
Gunes, Evrim Didem; Yaman, Hakan
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…
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
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
Goh, R. H.; Somers, S.; Jurriaans, E.; Yu, J.
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
Ma, Joyce L. C.; Wong, Timothy K. Y.; Lau, Luk King; Pun, Shuk Han
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…
Palma Cabrera, Y; Suarez Morales, J
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.
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
Hudock, Anthony M., Jr.; Warden, Sherry A. Gallagher
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…
van der Goes, T.; Grzybowski, S. C.; Thommasen, H.
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
Rourke, James T. B.; Incitti, Filomena; Rourke, Leslie L.; Kennard, MaryAnn
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
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
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…
Pawlson, L G; Watkins, R
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.
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)
Domenech Rodriguez, Melanie; Davis, Melissa R.; Rodriguez, Jesus; Bates, Scott C.
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…
Kilmer, Ryan P; Cook, James R; Palamaro Munsell, Eylin
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.
Hudson, Peter; Quinn, Karen; O'Hanlon, Brendan; Aranda, Sanchia
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
Sanborn, M. D.; Scott, E. A.
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
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
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.
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.
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
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
Taylor, Robert B; And Others
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…
Fenichel, Emily, Ed.
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…
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
Harris, Stewart B.; Stewart, Moira; Brown, Judith Belle; Wetmore, Stephen; Faulds, Catherine; Webster-Bogaert, Susan; Porter, Sheila
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
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.
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…
Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.
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…
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.
Marsanić, Vlatka Boricević; Kusmić, Enes
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.
Saywell, R M; Jay, S J; Lukas, P J; Casebeer, L L; Mybeck, K C; Parchman, M L; Haley, A J
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.
Knishkowy, Barry; Schein, Moshe; Kiderman, Alexander; Velber, Aliza; Edman, Richard; Yaphe, John
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.
Braun, Joseph A., Jr.; Garrett, Joyce Lynn
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)
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…
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,…
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…
Navarre, S E
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.
Rabinowitz, H K
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.
Ciriacy, E W; Liang, F Z; Godes, J R; Dunn, L D
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.
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.
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…
Lopez, Frederick G.; Andrews, Scott
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…
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"…
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…
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…
Widerman, James L.; Widerman, Eileen
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…
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.
Chase, Sabrina M.; Miller, William L.; Shaw, Eric; Looney, Anna; Crabtree, Benjamin F.
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
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Yektatalab, Shahrzad; Seddigh Oskouee, Fatemeh; Sodani, Mansour
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.
Blow, Adrian J; Karam, Eli A
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.
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.
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…
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…
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…
Doherty, William J; McDaniel, Susan H; Hepworth, Jeri
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.
Fairbrother, Hannah; Curtis, Penny; Goyder, Elizabeth
Reducing childhood obesity is an international priority and children's diets, food knowledge and practices have come under intense scrutiny in both policy and popular discourse. Notwithstanding evidence that health interventions which resonate with children's own views are the most effective, there is still relatively little research which mobilises children's everyday perspectives on food to inform public health policy. We report key findings from a qualitative study with 53 children aged 9-10, attending two socio-economically contrasting schools in the UK. The study explored children's understandings of food in everyday life and their ideas about the relationship between food and health. Throughout the study, despite recent attempts to position schools as key sites for public health interventions, children consistently emphasised families as the locus for enduring food practices. The research highlights the value of listening to children and applying our understanding of their perspectives to ensure that public health initiatives work with the important influences on their diet and health that they themselves identify.
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
Fraenkel, Peter; Hameline, Thomas; Shannon, Michele
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…
Rodriguez, M. Victoria
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…
Triscott, Jean A.C.; Waugh, Earle H.; Torti, Jacqueline M.I.; Barton, Martina
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
Horsford, Sheena R; Parra-Cardona, José Rubén; Schiamberg, Larry; Post, Lori A
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.
Ume-Nwagbo, Pearl N; DeWan, Sharon A; Lowry, Lois W
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.
Singh, Sunita; Sylvia, Monica R.; Ridzi, Frank
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…
Vera-Becerra, Luz Elvia; Lopez, Martha L; Kaiser, Lucia L
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.
Klein, Michael; Reynolds, J. L.; Boucher, Francois; Malus, Michael; Rosenberg, Ellen
Family practice obstetricians are an endangered species. Our practices and teaching sites must provide the correct attitudinal as well as technical messages to result in a practitioner who will be able to meet the psychosocial and medical needs of the pregnant couple. Family practice obstetrics can be as safe as care given by obstetricians provided that the family practice group functions well, that obstetrical consultants are available and supportive, and assuming that technical approaches are reserved for those truly in need. In rural areas, obstetrical ability is essential, whilst in the urban setting it helps the family physician maintain a practice involving young families. Those trainees who fail to learn basic obstetrical skills (including family centered attitudes and approaches) may in any setting come to feel, belatedly, that their training programs failed in this respect. PMID:21279123
Hsiao, Chiu-Yueh; Tsai, Yun-Fang
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.
Rosser, W. W.; Starkey, C.; Shaughnessy, R.
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
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…
Weiss, Heather Bastow, Ed.; Kreider, Holly Marie, Ed.; Lopez, M. Elena, Ed.; Chatman, Celina M., Ed.
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…
Price, Christine A.; Brosi, Whitney A.
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…
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.
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.
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.
Bogenschneider, Karen; Little, Olivia M.; Ooms, Theodora; Benning, Sara; Cadigan, Karen; Corbett, Thomas
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…
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.
Cowell, Daniel David
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)
Kilburn, M. Rebecca, Ed.
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…
Verdon, Sarah; Wong, Sandie; McLeod, Sharynne
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,…
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…
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…
Dervin, John V.; Rodnick, Jonathan E.
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)
Taylor, R.D.; Lopez, E.I.
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…
Ensher, Gail L.; Clark, David A.
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…
Davis, Heather S.; Gonzalez, Jorge E.; Pollard-Durodola, Sharolyn; Saenz, Laura M.; Soares, Denise A.; Resendez, Nora; Zhu, Leina; Hagan-Burke, Shanna
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…
Chang, Janet; Rhee, Siyon; Berthold, S. Megan
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…
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…
Jennett, Penny A.; Lockyer, Jocelyn M.; Parboosingh, I. John P.; Maes, William R.
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
Salinas, J L; Pérez, M P; Viniegra, L; Armando Barriguete, J; Casillas, J; Valencia, A
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.
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…
Noel-Storr, J.; Drobnes, E.; Mitchell, S. E.
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.
Rubin, David; Springer, Sarah H; Zlotnik, Sarah; Kang-Yi, Christina D
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.
Gregg, Katy; Rugg, Mary; Souto-Manning, Mariana
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…
Marcella, Jennifer; Howes, Carollee; Fuligni, Allison Sidle
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…
Curry, Daphney L.; Reeves, Emily; Mcintyre, Christina J.
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…
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…
Marks, Loren D; Hatch, Trevan G; Dollahite, David C
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.
Yegidis, B L
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.
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.
Visser, Sanne Siete; Hutter, Inge; Haisma, Hinke
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.
Lee, S B
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
Rothbaum, Fred; Rosen, Karen; Ujiie, Tatsuo; Uchida, Nobuko
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.
Cridland, Elizabeth K.; Jones, Sandra C.; Magee, Christopher A.; Caputi, Peter
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…
Liebhardt, Hubert; Niehues, Johanna; Fegert, Jörg M
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.
Kim, S Y; Ge, X
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.
Fraenkel, Peter; Hameline, Thomas; Shannon, Michele
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.
Austin, Michael J; Lemon, Kathy; Leer, Ericka
This review of promising practices for meeting the multiple needs of low-income families in poverty neighborhoods reveals four main themes: (1) The challenges facing low-income families living in poverty neighborhoods are not discrete-but are multidimensional; (2) Integrated family and neighborhood strengthening practices, such as the Making Connections (MC) Initiative (funded by the Annie E. Casey Foundation), and the Harlem Children's Zone (HCZ), represent innovative strategies to address the multifaceted issues facing low-income families living in poverty neighborhoods; (3) The organizational structure, challenges and successes of the MC and HCZ provide insight into the nature of integrated family and neighborhood approaches; (4) A framework for the design of an integrated family and neighborhood program includes a focus on internal organizational processes, neighborhood processes, and external processes. This framework can assist social service agencies in moving their services toward a more integrated family and neighborhood approach.
Snyder, Elizabeth H; Lawrence, C Nicole; Weatherholt, Tara N; Nagy, Paul
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.
Gabb, Jacqui; Singh, Reenee
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
Gabb, Jacqui; Singh, Reenee
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.
Bouati, Noureddine; Sagne, Alain; Hunsicker, Morgane; Gavazzi, Gaëtan; Couturier, Pascal
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.
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…
Damman, Olga C; de Boer, Dolf; Hendriks, Michelle; Meuwissen, Liesbeth E; Rademakers, Jany; Delnoij, Diana M J; Groenewegen, Peter P
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.
Patterson, G R; Stouthamer-Loeber, M
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.
Lewis, Tisha Y.
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…
Cridland, Elizabeth K; Jones, Sandra C; Magee, Christopher A; Caputi, Peter
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.
Kakli, Zenub; Kreider, Holly; Little, Priscilla; Buck, Tania; Coffey, Maryellen
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…
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…
Withrow, Rebecca L.
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…
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,…
Branson, Diane M.; Bingham, Ann
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.,…
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.
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…
Fish, Linda Stone; Piercy, Fred P.
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…
Carter, Ross E.
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…
Hernandez, Barbara Couden; Doherty, William J.
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…
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…
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…
Haddock, Shelley A.; MacPhee, David; Zimmerman, Toni Schindler
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…
Nelson, Thorana S.; Chenail, Ronald J.; Alexander, James F.; Crane, D. Russell; Johnson, Susan M.; Schwallie, Linda
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…
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…
Davis, Kelly A.; Epkins, Catherine C.
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'…
Goetz, Kathy, Ed.
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"…
Michalopoulos, Lynn; Ahn, Haksoon; Shaw, Terry V.; O'Connor, Julia
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…
Ochieng, Bertha M. N.
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…
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.
Gibson, P A; Ruby, C; Craig, M D
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
Halliday, Joyce; Wilkinson, Tina
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.
Leon, Ana M; Knapp, Sandra
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.
Jung, Sunyoung; Fuller, Bruce; Galindo, Claudia
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…
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...
Hashimoto, Kumi; Lee, Jin Sook
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…
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);…
Alm, Siril; Olsen, Svein Ottar; Honkanen, Pirjo
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.
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…
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.
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
Lee, Jinhee; Danes, Sharon M
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.
Keshavjee, K; Holbrook, AM; Lau, E; Esporlas-Jewer, I; Troyan, S
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.
Sato, Priscila de Morais; Lourenço, Bárbara Hatzlhoffer; Trude, Angela Cristina Bizzotto; Unsain, Ramiro Fernandez; Pereira, Patrícia Rocha; Martins, Paula Andrea; Scagliusi, Fernanda Baeza
This study investigates family meals among mothers and explores associations between eating with family and sociodemographic characteristics, body mass index, and eating practices. A population-based cross-sectional study, using complex cluster-sampling, was conducted in the city of Santos, Brazil with 439 mothers. Frequency of family meals was assessed by asking if mothers did or did not usually have a) breakfast, b) lunch, and c) dinner with family. Linear regression analyses were conducted for the number of meals eaten with family per day and each of the potential explanatory variables, adjusting for the mother's age. Poisson regression with robust variance was used to analyze each factor associated with eating with family as classified categorically: a) sharing meals with family, b) not eating any meals with family. Only 16.4% (n = 72) of participants did not eat any meals with family. From the 83.6% (n = 367) of mothers that had at least one family meal per day, 69.70% (n = 306) ate dinner with their families. Mothers aged ≥40 years reported significantly fewer meals eaten with family compared to mothers aged 30-39 years (β: -0.26, p = 0.04). Having family meals was 54% more prevalent among mothers with ≥12 years of education (PR for no meals eaten with family: 0.54, 95% CI: 0.30; 0.96, p = 0.03), when compared to mothers with less than nine years of education. Eating no meals with family was 85% more prevalent among mothers who reported that eating was one of the biggest pleasures in their lives (PR: 1.85, 95% CI: 1.21; 2.82, p = 0.004). We suggest the need for further research investigating the effects of family meals on mothers' health through nutritional and phenomenological approaches.
Shaw, Sara E; Bailey, Julia
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.
Forti, E M; Martin, K E; Jones, R L; Herman, J M
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.
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
Dayton, Lauren; Buttress, Amelia; Agosti, Jen; Aceves, Javier; Kieschnick, Meredith; Popejoy, Agatha; Robbins, Robyn; Farinholt, Kate
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.
Zubatsky, Max; Harris, Steven M; Mendenhall, Tai J
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.
Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim
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
Edwards, Kay P.
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)
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…
Mack-Canty, Colleen; Wright, Sue
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…
van Es, J C
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.
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.
Terras, Melody M; Ramsay, Judith
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
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
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
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.
Charlesworth, Jennifer M; McManus, Evelyn
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
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…
Ren, Li; Hu, Guangwei
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…
Harris, D L; Ebbert, P
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.
Brown, J. B.; Dickie, I.; Brown, L.; Biehn, J.
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
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
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,…
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…
Beam, Rita J; O'Brien, Ruth A; Neal, Michelle
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.
Fogelman, Yacov; Goldfracht, Margalit; Karkabi, Khaled
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.
Wright, Lorraine M
Nurses are engaged and encounter suffering routinely and commonly in their everyday practice. It is therefore a moral and ethical obligation for nurses to soften the emotional, physical, and spiritual suffering of the individuals and families in their care. Softening suffering is the heart of nursing. However, this article ponders the question, "What happened to suffering in nursing care?" A discussion of suffering is explored from many aspects, such as what invites suffering and the connection of suffering to spirituality. Lessons learned from the author's clinical practice and research are described, such as acknowledging suffering, social support, hope and prayer, and individual and family counseling. Finally, seven spiritual care practices within the Trinity Model that have shown to be useful in softening suffering are offered. An actual clinical example is woven throughout to illustrate the benefits of these spiritual care practices in the mission of softening illness suffering.
Thind, Amardeep; Freeman, Tom; Thorpe, Cathy; Burt, Andrea; Stewart, Moira
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
Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna
Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…
US Senate, 2007
This report was prepared by the Chairman's Staff of the Senate Health, Education, Labor and Pensions Committee setting forth the findings of an investigation into marketing practices in the Federal Family Education Loan program ("FFEL"). Evidence uncovered by the Chairman's investigation demonstrates that many FFEL lenders routinely…
Southern Poverty Law Center (NJ1), 2013
Fueled by two decades of historic immigration, American demographics are changing. Many school districts are often ill prepared to meet the needs of limited English proficient (LEP) students and families. This Teaching Tolerance booklet points administrators to best practices in the effort to create a supportive learning environment for all…
Vigo Arrazola, Begoña; Soriano Bozalongo, Juana
Parental involvement is interpreted as a key form of support that can contribute to the establishment of inclusive practices in schools, but this can be difficult in sparsely populated areas. Using ethnographic methods of participant observation, informal conversations and document analysis, this article therefore focuses on family involvement…
Environment Canada, Edmonton (Alberta). Public Affairs.
Suggestions and practical advice are offered for all members of a family in this guide on environmental stewardship. This publication contains information on a variety of home and work related environmental concerns. The environmental consequences of daily activities are discussed and specific recommendations are offered for saving energy,…
Natale, Ruby; Page, Monica; Sanders, Lee
Obesity rates among preschool-aged children have doubled in the past 10 years, and 60% of these children spend the majority of their day in childcare facilities. Few studies have examined the quality of nutrition and physical activity practices in childcare centers as compared to family childcare homes. The purpose of this study is to determine if…
California Univ., San Francisco. Div. of Family and Community Medicine.
Information is provided on family practice clerkships (25 available at the time of publication in California and 1 in Nevada) to assist students in choosing a clerkship. For each clerkship, information is presented on the following: school/course, residency affiliation, site, address and phone number, clerkship director, clerkship coordinator,…
Gotto, George S.; Beauchamp, Donna; Simpson, Mary-Margaret
In this article, the authors describe Early Childhood Family Support Community of Practice (CoP), which was launched and facilitated by the Beach Center on Disability at the University of Kansas. A CoP is a group of people who share concerns or passions about a topic and who regularly interact based on their shared interests. The goal of Early…
Ravindran, Neeraja; Myers, Barbara J.
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…
Schroeder, Valarie M.; Kelley, Michelle L.
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…
Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.
Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…
This paper discusses findings from a small-scale empirical exploration of the views, experiences and educational practices of middle-class minority ethnic families in the United Kingdom. It draws on semi-structured interviews conducted with 36 parents, pupils and "young professionals". Analyses consider to what extent generic class…
Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.
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…
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…
Rodriguez, Rachel; And Others
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;…
Bishop, Christa M.; Atlas, Jana G.
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…
Montano, Daniel E.; And Others
The Fishbein Model of attitude formation was used as a framework for developing a questionnaire to measure students' attitudes toward a career in family practice and the social support students perceived they had for that career. Both the attitude and social support scales had excellent psychometric characteristics. (Author/MLW)
van Sleuwen, B E; L'Hoir, M; Engelberts, A; Westers, P; Schulpen, T
From 1979 to 1993 Turkish infants had a significantly higher cot death risk compared to Dutch infants. In contrast Moroccan infants had a risk of cot death that was approximately three times lower compared to Dutch infants during the same period. This study shows that these differences have disappeared, while differences still exist in infant care practices between these ethnic groups. At 28 well-baby clinics, questionnaires were distributed for this sample selection. The response was 82%. Data were collected on 55 Turkish, 54 Moroccan, and 210 Dutch families. Less than 7% of these three ethnic groups still placed infants in the prone position. Moroccan mothers hardly smoked. Turkish people used pillows and Moroccan people used soft mattresses more often. Moroccan families practised swaddling more widely. Length of maternal residence influenced some care giving practices. As a result of this study, subgroup specific intervention campaigns for safe sleeping can be developed for Turkish and Moroccan families. PMID:12937097
Joanning, Harvey; And Others
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…
Tajino, Akira; Smith, Craig
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…
Lander, Laura; Howsare, Janie; Byrne, Marilyn
The effects of a substance use disorder (SUD) are felt by the whole family. The family context holds information about how SUDs develop, are maintained, and what can positively or negatively influence the treatment of the disorder. Family systems theory and attachment theory are theoretical models that provide a framework for understanding how SUDs affect the family. In addition, understanding the current developmental stage a family is in helps inform assessment of impairment and determination of appropriate interventions. SUDs negatively affect emotional and behavioral patterns from the inception of the family, resulting in poor outcomes for the children and adults with SUDs. Social workers can help address SUDs in multiple ways, which are summarized in this article. PMID:23731414
Lander, Laura; Howsare, Janie; Byrne, Marilyn
The effects of a substance use disorder (SUD) are felt by the whole family. The family context holds information about how SUDs develop, are maintained, and what can positively or negatively influence the treatment of the disorder. Family systems theory and attachment theory are theoretical models that provide a framework for understanding how SUDs affect the family. In addition, understanding the current developmental stage a family is in helps inform assessment of impairment and determination of appropriate interventions. SUDs negatively affect emotional and behavioral patterns from the inception of the family, resulting in poor outcomes for the children and adults with SUDs. Social workers can help address SUDs in multiple ways, which are summarized in this article.
Burton, Linda M; Winn, Donna-Marie; Stevenson, Howard; Clark, Sherri Lawson
In this article, we discuss perspectives on the "homeplace" that are important to consider in marriage and family therapy involving African American clients. The homeplace comprises individual and family processes that are anchored in a defined physical space that elicits feelings of empowerment, rootedness, ownership, safety, and renewal. Critical elements of the homeplace include social relationships that shape individuals' and families' sense of social and cultural identity. We draw on our ethnographic and clinical research with African American families in urban and rural settings to describe typical schisms between therapists and African American clients when communicating about the homeplace. We also explore the impact of homeplace disruptions on experiences of "yearning." Recommendations for integrating a homeplace perspective into therapy practices are provided.
Marceglia, Sara; Bonacina, Stefano; Braidotti, Andrea; Nardelli, Marco; Pinciroli, Francesco
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
Marceglia, Sara; Bonacina, Stefano; Braidotti, Andrea; Nardelli, Marco; Pinciroli, Francesco
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.
Prest, Layne A.; Protinsky, Howard
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…
Paget, Kathleen D.
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)
Background It is increasingly becoming evident that a strong primary health care system is more likely to provide better population health, more equity in health throughout the population, and better use of economic resources, compared to systems that are oriented towards specialty care. Developing and maintaining a strong and sustainable primary health care requires that a substantial part of graduating doctors go into primary care. This in turn requires that general practice/family medicine (GP/FM) strongly influences the curricula in medical schools. In the present paper we aim at describing the extent of GP/FM teaching in medical schools throughout Europe, checking for the presence of GP/FM curricula and clinical teaching in GP offices. Methods A brief questionnaire was e-mailed to GP/FM or other professors at European medical universities. Results 259 out of 400 existing universities in 39 European countries responded to our questionnaire. Out of these, 35 (13.5%) reported to have no GP/FM curriculum. These 35 medical faculties were located in 12 different European countries. In addition, 15 of the medical schools where a GP/FM curriculum did exist, reported that this curriculum did not include any clinical component (n = 5), or that the clinical part of the course was very brief - less than one week, mostly only a few hours (n = 10). In total, 50 universities (19%) thus had no or a very brief GP/FM curriculum. These were mainly located in the Eastern or Southern European regions. Conclusion It is still possible to graduate from European medical universities without having been exposed to a GP/FM curriculum. The European Academy of Teachers in General Practice (EURACT) will launch efforts to change this situation. PMID:24289459
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.
Ludwig, Claudia; Baliga, Nitin S.
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…
Nathanson, M; Baird, A; Jemail, J
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.
Zlot, A I; Cox, S L; Silvey, K; Leman, R
Family history is an independent risk factor for many chronic conditions. Therefore, efforts to prevent these diseases among asymptomatic people at high familial risk are justified to reduce the health burden of these chronic conditions. We analyzed 2006-2009 Oregon Behavioral Risk Factor Surveillance System data to examine associations between family history of diabetes, cardiovascular disease (CVD), colorectal cancer (CRC), breast cancer (BC), and: (1) patient-reported clinician recommendations, (2) adoption of preventive and screening behaviors, and (3) chronic disease risk factors among respondents without a personal history of the condition. A positive family history was associated with a higher likelihood of reported discussion by clinicians of CRC and BC screening and a greater likelihood of respondents having cholesterol and CRC screening. The combination of family history and clinician recommendations significantly increased the odds of CRC and BC screening compared to family history alone. A positive family history was also associated with respondents reporting lifestyle changes to prevent diabetes, CVD, and CRC, but not BC. Awareness of family history prompts clinicians to recommend screening and may motivate patients to be screened. Understanding positive family history may also motivate patients to adopt healthy lifestyles.
Bredfeldt, R; Colliver, J A; Wesley, R M
A survey of 800 active members of the American Academy of Family Physicians 1985-1987 membership directory was conducted for the purpose of determining the impact, over time, of malpractice issues upon the practice of obstetrics by family physicians. The survey response rate was 60.4 percent. Almost 20 percent of all respondents reported that they have never provided obstetric care of any type. Another 40 percent have provided obstetric care previously but have now discontinued this care, while the remaining 40 percent currently offer obstetric care to their patients. The proportion of respondents who discontinued the practice of obstetrics because of increased risk of malpractice litigation increased significantly over the years from 1947 to 1986 (P = .0084). The proportion of respondents who discontinued obstetric practice because of increased malpractice insurance costs also increased significantly from 1945 to 1986 (P = .0002). The proportion of those entering practice during the past five years who decided not to offer obstetric services because of malpractice risks was significantly greater than the proportion entering practice earlier (21.0 percent vs 2.0 percent, P = .0090). Although the current patterns of obstetric practice showed regional variation, the accelerating impact of malpractice risk and insurance cost on these patterns was similar throughout the nation.
Karsh, Ben-Tzion; Beasley, John W; Brown, Roger L
Objective Test a model of family physician job satisfaction and commitment. Data Sources/Study Setting Data were collected from 1,482 family physicians in a Midwest state during 2000–2001. The sampling frame came from the membership listing of the state's family physician association, and the analyzed dataset included family physicians employed by large multispecialty group practices. Study Design and Data Collection A cross-sectional survey was used to collect data about physician working conditions, job satisfaction, commitment, and demographic variables. Principal Findings The response rate was 47 percent. Different variables predicted the different measures of satisfaction and commitment. Satisfaction with one's health care organization (HCO) was most strongly predicted by the degree to which physicians perceived that management valued and recognized them and by the extent to which physicians perceived the organization's goals to be compatible with their own. Satisfaction with one's workgroup was most strongly predicted by the social relationship with members of the workgroup; satisfaction with one's practice was most strongly predicted by relationships with patients. Commitment to one's workgroup was predicted by relationships with one's workgroup. Commitment to one's HCO was predicted by relationships with management of the HCO. Conclusions Social relationships are stronger predictors of employed family physician satisfaction and commitment than staff support, job control, income, or time pressure. PMID:20070386
Saul, Robert A; Trotter, Tracy; Sease, Kerry; Tarini, Beth
Family health history collection and genetic testing are core elements for the successful translation of genomics into primary care practice. Yet, little is known about how pediatric providers implement these elements in practice. We surveyed the membership of the American Academy of Pediatrics regarding family health history (FHH) collection and genetic testing in the primary care setting. Three hundred forty-nine (349) responses were analyzed with the initial response rate of 43.3%. Four principal findings were noted-(1) family health history is still recognized as a critical part of the medical evaluation; (2) perceived obstacles for FHH are time in obtaining the FHH and concerns about the family's knowledge of their FHH; (3) a 3-generation family history is out of the scope of routine care and alternate methods should be considered; (4) most primary care providers (PCPs) do not feel comfortable ordering, interpreting, and counseling regarding current genetic testing. Expanded genetic/genomic education at multiple levels (undergraduate medical education, graduate medical education, and maintenance of certification) is clearly indicated to allow PCPs to integrate these vital elements into a current evaluation (acute care or health maintenance) in the primary care setting.
Paley, Blair; Lester, Patricia; Mogil, Catherine
The scope of sustained military operations in Iraq and Afghanistan has placed great demands on the Armed Forces of the United States, and accordingly, military families have been faced with deployments in more rapid succession than ever before. When military parents fulfill occupational duties during wartime, military children and families face multiple challenges, including extended separations, disruptions in family routines, and potentially compromised parenting related to traumatic exposure and subsequent mental health problems. Such challenges can begin to exert a significant toll on the well-being of both individuals and relationships (e.g., marital, parent-child) within military families. In order to respond more effectively to the needs of military families, it is essential that mental health clinicians and researchers have a better understanding of the challenges faced by military families throughout the entire deployment experience and the ways in which these challenges may have a cumulative impact over multiple deployments. Moreover, the mental health field must become better prepared to support service members and families across a rapidly evolving landscape of military operations around the world, including those who are making the transition from active duty to Veteran status and navigating a return to civilian life and those families in which parents will continue to actively serve and deploy in combat zones. In this article, we utilize family systems and ecological perspectives to advance our understanding of how military families negotiate repeated deployment experiences and how such experiences impact the well-being and adjustment of families at the individual, dyadic, and whole family level.
Parfitt, Ylva; Pike, Alison; Ayers, Susan
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…
Family-centred practice has been included in the Victoria, Australia Early Years Learning and Development Framework as a key practice principle for professionals working across all early years programs in that state. While this model of partnership for engaging and collaborating with families has long been used in the early intervention sector,…
Cartwright, Cynthia A; Korsen, Neil; Urbach, Lynn E
Faculty members in family practice residencies are increasingly being asked to help residents develop skills in the use of informatics and evidence-based medicine (EBM). In order to do this successfully the teachers themselves must be skilled in the use of these tools. Recognizing the need for such training, the Maine Medical Center Family Practice Residency Program designed a faculty development project to increase knowledge and skills in the use of information technology. This project, which was carried out in 1999-2001, utilized a multifaceted approach that included improving the residency's technology infrastructure, conducting two instructional workshops, and offering EBM mentoring for preceptors. Faculty members also designed and carried out independent informatics projects. Pre- and post-project assessments of faculty members demonstrated a significant improvement in computer and EBM skills, and informal feedback from residents indicates that these skills have been successfully applied to the faculty members' teaching of residents and their practice of family medicine. This project had a positive impact on the faculty members in the residency program, increasing both their ability to employ information technology in individual and group teaching sessions and their use of EBM in clinical practice. Also, the culture within the residency program has been changed to one of utilizing computers and the Internet as principal resources for up-to-date information.
Neale, Anne Victoria; Bowman, Marjorie A; Seehusen, Dean A
Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices. Visit entropy is negative for hospital readmissions. Another article reaffirms the importance of family physicians in rural obstetrics, including Cesarean deliveries. Two articles address changing Latino health care access. New Mexico's innovative health extension agent implementation now includes research in ways that benefit all. And a glass half-full: the growth in the diversity of family medicine faculty is above average, but is not occurring as quickly as in the general population.
Mulvaney, C. A.; Watson, M. C.; Smith, S.; Coupland, C.; Kendrick, D.
Objective: To determine the prevalence of home safety practices and use of safety equipment by disadvantaged families participating in a national home safety equipment scheme in England. Design: Cross-sectional postal survey sent to a random sample of 1,000 families. Setting: England, United Kingdom. Results: Half the families (51%) returned a…
Valenzuela, Rafael; Codina, Nuria
Based on Bourdieu's idea that cultural capital is strongly related to family context, we describe the relations between family musical cultural capital and optimal experience during compulsory primary school musical practice. We analyse whether children from families with higher levels of musical cultural capital, and specifically with regard to…
Fox, Kathy R.
Homework is a constant yet often controversial practice in homes and other settings. This study set out to determine answers to the question: "What practices were used to support children with homework in families deemed as at risk due to low socioeconomic factors?" Homework was examined as a common practice that routinely took place in…
Moynihan, Christy; And Others
This study examined the relationship between graduate medical education (GME) and practice profiles in three specialties: family practice, psychiatry, and obstetrics/gynecology. Two analyses were performed, the first assessing the relationship between GME and current practice patterns and the second assessing the relationship between GME and…
Urwin, Sean; Whittaker, William
Objective To test for differences in primary care family practitioner usage by sexual orientation. Design Multivariate logistic analysis of pooled cross-sectional postal questionnaire responses to family practitioner usage. Setting Patient-reported use and experience of primary care in England, UK. Data from several waves of a postal questionnaire (General Practice Patient Survey) 2012–2014. Population 2 807 320 survey responses of adults aged 18 years and over, registered with a family practitioner. Main outcome measures Probability of a visit to a family practitioner within the past 3 months. Results Lesbian women were 0.803 times (95% CI 0.755 to 0.854) less likely to have seen a family practitioner in the past 3 months relative to heterosexual women (bisexual women OR=0.887, 95% CI 0.817 to 0.963). Gay men were 1.218 times (95% CI 1.163 to 1.276) more likely to have seen a family practitioner relative to heterosexual men (bisexual men OR=1.084, 95% CI 0.989 to 1.188). Our results are robust to the timing of the family practitioner visit (0–3, 0–6, 0–12 months). Gay men were more likely to have seen a family practitioner than heterosexual men where the proportion of women practitioners in the practice was higher (OR=1.238, 95% CI 1.041 to 1.472). Conclusions Inequalities in the use of primary care across sexual orientation in England exist having conditioned on several measures of health status, demographic and family practitioner characteristics. The findings suggest these differences may be reduced by policies targeting a reduction of differences in patient acceptability of primary care. In particular, further research is needed to understand whether lower use among heterosexual men represents unmet need or overutilisation among gay men, and the barriers to practitioner use seemingly occurring due to the gender distribution of practices. PMID:27173816
Held, Barbara S.; Bellows, David C.
Discusses the conceptualization and treatment of crisis reactions in college students, explained as feeling the need to both achieve for, and remain overinvolved with, the family system. Presents a treatment approach that incorporates the use of strategic and structural interventions within a predominantly family-of-origin framework. (JAC)
Keefe, Dennis R.
The purpose of the paper is to present a model and suggest hypotheses relating the family as a social system to the concepts of human and natural energy. Human energy is interpreted as the capacity of humans, in this case, family members, for doing work and natural energy as resources such as natural gas, carbon dioxide, and heat. A behavioral…
Lv, Nan; Brown, J. Lynne
Objective: To investigate the family food system in first-generation Chinese American families. Design: Qualitative interviews using reciprocal determinism constructs to understand influences on food choices. Setting: Weekend Chinese schools in Pennsylvania. Participants: Twenty couples with at least 1 child aged 5 or older enrolled in a Chinese…
Holtrop, Kendal; McNeil Smith, Sharde'; Scott, Jenna C
This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population.
Holtrop, Kendal; Smith, Sharde' Mcneil; Scott, Jenna C.
This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population. PMID:25287585
Carten, Alma; Goodman, Harriet
Implemented in New York City, the Child Welfare Fellowship Project is an international collaboration between social work educators in the United States and Jamaica, the West Indies, the public child welfare agency, and selected community-based agencies. This model educational program prepared selected Masters of Social Work (MSW) Fellowship students for exemplary child welfare practice with English-speaking Caribbean families by providing enhanced programs designed to support culturally competent skill development and a preventive approach to child welfare practice. These educational enhancements, combined with academic course work, increased professionalism, self-efficacy, and culturally competent skill development among participants and averted foster care placement for families seen over the duration of the project.
In the 1960s, general practitioners organized themselves into a state-based nationwide political movement that lobbied state legislators and state-funded medical schools to create departments of family practice. They framed their calls in the context of the national shortages of primary care physicians by arguing that those medical schools that received state funding had an obligation to the state to train sufficient numbers of primary care physicians to ensure the health care needs of the state's residents would be met. As this article reveals, two defining features of this activism were rural politics and the politics of town and gown. The history of family practice thus introduces a new dimension to the familiar dyad of town and gown relations: the plow-rural physicians who brought to the medical politics of the post-World War II United States a distinctive and powerful set of political, social, and economic interests.
Background Chronic obstructive pulmonary disease (COPD) is frequent and often coexists with other diseases. The aim of this study was to quantify the prevalence of COPD and related chronic comorbidity among patients aged over 40 years visiting family practices in an area of Madrid. Methods An observational, descriptive, cross-sectional study was conducted in a health area of the Madrid Autonomous Region (Comunidad Autónoma de Madrid). The practice population totalled 198,670 persons attended by 129 Family Physicians (FPs), and the study population was made up of persons over the age of 40 years drawn from this practice population. Patients were deemed to have COPD if this diagnosis appeared on their clinical histories. Prevalence of COPD; prevalence of a further 25 chronic diseases in patients with COPD; and standardised prevalence ratios, were calculated. Results Prevalence of COPD in family medicine was 3.2% (95% CI 3.0–3.3) overall, 5.3% among men and 1.4% among women; 90% of patients presented with comorbidity, with a mean of 4 ± 2.04 chronic diseases per patient, with the most prevalent related diseases being arterial hypertension (52%), disorders of lipid metabolism (34%), obesity (25%), diabetes (20%) and arrhythmia (15%). After controlling for age and sex, the observed prevalence of the following ten chronic diseases was higher than expected: heart failure; chronic liver disease; asthma; generalised artherosclerosis; osteoporosis; ischaemic heart disease; thyroid disease; anxiety/depression; arrhythmia; and obesity. Conclusions Patients with COPD, who are frequent in family practice, have a complex profile and pose a clinical and organisational challenge to FPs. PMID:23324308
Campos, Joseph J.; And Others
Examined the possibility that relations in the family system are affected when infants begin to crawl. Parents' expressions of prohibition and anger, and their use of physical punishment, increased after infants began to crawl. (BG)
Limbers, Christine A; Young, Danielle; Bryant, William; Stephen, Matthew
The objective of the present study was to assess the associations among family religious practices, internalizing/externalizing behaviors, and body mass index in a sample of severely obese youth referred to an outpatient pediatric endocrinology clinic. The sample consisted of 43 obese youth (body mass index > 95th percentile) aged 6-16 years (mean age = 12.67 years). Approximately 93% of families endorsed their religious faith as Christian or Catholic. Parents of youth were administered a demographic questionnaire, religiosity questionnaire, and the Child Behavior Checklist. Three multiple linear regression models were examined with body mass index percentile, Child Behavior Checklist Internalizing Scale, and Child Behavior Checklist Externalizing Scale as outcome variables. A parent endorsing greater importance of religious faith in shaping family life was associated with lower child body mass index percentile (p < 0.05) in the present sample. Greater family attendance at religious services was associated with higher child body mass index percentile (p < 0.05). Our data suggest that church-based interventions may be one viable option for the delivery of lifestyle interventions in families of youth with severe obesity.
Martin-Storey, Alexa; Crosnoe, Robert
Objectives. We investigated how state-level firearms legislation is associated with firearm ownership and storage among families with preschool-aged children. Methods. Using 2005 nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (n = 8100), we conducted multinomial regression models to examine the associations between state-level firearms legislation generally, child access prevention (CAP) firearms legislation specifically, and parental firearm ownership and storage safety practices. Results. Overall, 8% of families with children aged 4 years living in states with stronger firearm laws and CAP laws owned firearms compared with 24% of families in states with weaker firearm laws and no CAP laws. Storage behaviors of firearm owners differed minimally across legislative contexts. When we controlled for family- and state-level characteristics, we found that firearm legislation and CAP laws interacted to predict ownership and storage behaviors, with unsafe storage least likely among families in states with both CAP laws and stronger firearm legislation. Conclusions. Broader firearm legislation is linked with the efficacy of child-specific legislation in promoting responsible firearm ownership. PMID:24825210
Lines, Cathy; Miller, Gloria; Arthur-Stanley, Amanda
Ongoing, strategic family-school partnering (FSP) is an essential component of every educational community. FSP is a multi-dimensional process in which schools, families, and communities engage in shared actions to ensure a child's academic, social, and emotional success. With this text, the authors intend to offer a practical guide that…
Ouyang, Li-Ming; Zhang, Hui-Zhan
Genomics is the core subject of "omics" theories and research methods in modern life science. Teaching of genomics has characteristics such as more content, more difficult points, higher demands on English and comprehensive expertise etc. We proposed the course system established for Genomics and summarized some experiences based on our teaching practice that emphasizes on increasing the study autonomy and course interactivity by group study on stimulating questions, innovative experiment, multi-media materials, and bilingual exercises etc.
Background Providing support for research is one of the key issues in the ongoing attempts to improve Primary Care. However, when patient care takes up a significant part of a GP's time, conducting research is difficult. In this study we examine the working conditions and profile of GPs who publish in three leading medical journals and propose possible remedial policy actions. Findings The authors of all articles published in 2006 and 2007 in three international Family Medicine journals - Annals of Family Medicine, Family Practice, and Journal of Family Practice - were contacted by E-mail. They were asked to complete a questionnaire investigating the following variables: availability of specific time for research, time devoted to research, number of patients attended, and university affiliation. Only GPs were included in the study. Three hundred and ten relevant articles published between 2006 and 2007 were identified and the authors contacted using a survey tool. 124 researchers responded to our questionnaire; 45% of respondents who were not GPs were excluded. On average GPs spent 2.52 days per week and 6.9 hours per day on patient care, seeing 45 patients per week. Seventy-five per cent of GPs had specific time assigned to research, on average 13 hours per week; 79% were affiliated to a university and 69% held teaching positions. Conclusions Most GPs who publish original articles in leading journals have time specifically assigned to research as part of their normal working schedule. They see a relatively small number of patients. Improving the working conditions of family physicians who intend to investigate is likely to lead to better research results. PMID:21615943
The purpose of this article is to describe a new educational practice that demonstrates new teaching strategies used to help nursing students better integrate a family systems approach in their clinical practice. This narration emerges from a qualitative study aiming to include the components of teaching practice, facilitating a change in family care approach toward a practice that considers the "person-family" as a unit of care. The methodological course of this qualitative research is guided by interrelationship of action research and introspective analysis globally supported by systemic constructivist perspectives towards the construction of an educational practice for teaching the family systems approach in nursing science, and the development of new knowledge concerning this practice. This article presents one of the six narratives from an educational situation. A partial description of the results demonstrates that the professor-researcher being present in a different manner creates and uses innovative strategies in her teaching, such as narratives, self dialogue and dramatization which helped nursing bachelor students in transforming their thoughts towards acting in a systemic way towards the family.
Kazak, Anne E.; Hoagwood, Kimberly; Weisz, John R.; Hood, Korey; Kratochwill, Thomas R.; Vargas, Luis A.; Banez, Gerard A.
Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Improving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of…
Rana, Meenakshi; Chowdhury, Papia
Micellar systems have attracted a great deal of interest, especially in the field of biomedical sciences. The paper deals with the encapsulation behavior of Pyrrole-2-carboxyldehyde (PCL) an anti-cancer drug in different micellar systems. The inculsion capability of PCL is verified experimentally (UV-Vis, Photoluminescence and Raman spectroscopy) in polymer matrix. Two-micellar systems sodium dodecyl sulfate (SDS) and Polysorbate 80 (TWEEN 80) have been studied with a poorly water soluble PCL. The present work provides the effects of biocompatible organic PCL molecule entrap in micellar system in polymer phase due to its vast applicability in drug industry.
Zoorob, R J; Mainous, A G
The purpose of this study was to examine practice patterns of rural family physicians in the care of non-insulin-dependent diabetes mellitus based on the standards of care of the American Diabetes Association (ADA). One hundred patient charts were randomly chosen, twenty for each physician, from the practices of five family physicians in rural Ohio. A standardized collection protocol was used, based upon the ADA recommendations. The charts were reviewed for compliance with the ADA parameters. The patients' records demonstrated 66% compliance with dietary counseling and 33% with counseling about exercise. Moreover, there was low compliance with physical examination guidelines. Specifically, 66% of the patients had fundoscopic examination and 64% had a complete foot examination done. With respect to the laboratory guidelines, 70% of the charts reviewed had a urinalysis ordered and 45% annual lipids measured. However, glycosylated hemoglobin was performed in only 15% of the patients. The results suggest that rural family physicians do not consistently follow the ADA standards of care.
Addiction patients are usually perceived as problematic patients in primary care practices: Encounters often are time-consuming and the approach to the patient is difficult. Moreover, patients sometimes are hiding their addictive behaviour and behave shameful. Other barriers are a lack of experience in communication skills among physicians or their own addictive behaviour. Nevertheless, to diagnose and treat addiction as early as possible is an important task for family doctors, as patients' confidence in them is an important factor to induce a behaviour change. We present four screening tests for the early diagnosis of addiction to alcohol (AUDIT, AUDIT-C, CAGE, SMAST-G) and discuss their strengths and shortcomings. The family doctor's practice is also a useful setting for brief interventions based on motivational interviewing (MI) techniques and the transtheoretical model of behaviour change (TTM). We shortly introduce to these techniques and attitudes using addiction to alcohol and nicotine as examples, and we present innovative methods as "defined drinking" and new quit smoking methods. A respectful attitude towards the patient and communication skills seem to be key factors for family physicians to successfully approach their addiction patients.
Zebracki, Kathy; Kichler, Jessica C.; Fitzgerald, Christopher J.; Neff Greenley, Rachel; Alemzadeh, Ramin; Holmbeck, Grayson N.
Objective To examine reliability and validity data for the Family Interaction Macro-coding System (FIMS) with adolescents with spina bifida (SB), adolescents with type 1 diabetes mellitus (T1DM), and healthy adolescents and their families. Methods Sixty-eight families of children with SB, 58 families of adolescents with T1DM, and 68 families in a healthy comparison group completed family interaction tasks and self-report questionnaires. Trained coders rated family interactions using the FIMS. Results Acceptable interrater and scale reliabilities were obtained for FIMS items and subscales. Observed FIMS parental acceptance, parental behavioral control, parental psychological control, family cohesion, and family conflict scores demonstrated convergent validity with conceptually similar self-report measures. Conclusions Preliminary evidence supports the use of the FIMS with families of youths with SB and T1DM and healthy youths. Future research on overall family functioning may be enhanced by use of the FIMS. PMID:21097956
Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.
We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774
Timmins, Richard P
There is considerable evidence that humans can benefit both physically and emotionally from a relationship with companion animals, a phenomenon known as the human-animal bond (HAB). This has not only increased the demand for veterinary services to meet the needs of these non-human family members and their owners, but it has also transformed the nature of those services from reactive medicine and surgery to proactive prevention and wellness. The emotional component of the HAB requires the veterinarian to have a solid understanding of the nature of the attachment between client and pet, and an ability to educate the client about proper care of the animal in order to optimize the relationship. Paying attention to the relationship between client and patient also positions the veterinary family practitioner to refer the client to appropriate community resources for physical, emotional, or other needs of the client that may become apparent during the veterinarian-client interaction. By achieving physical and mental health objectives for patients and collaborating with human health care services, the veterinary family practitioner contributes to the well-being of both patient and client. This new face of veterinary family practice requires research and education in fields that have not traditionally been a part of veterinary training.
Wilson, Melvin N.
We investigated the reported parenting practices of fifty incarcerated African American fathers. Fathers were interviewed using hypothetical vignettes adapted from the Parenting Dimensions Inventory (PDI) and received scores on two parenting practices: responsive and restrictive. Father's individual level (education and length of time spent incarcerated) and family level (number of relationships that have borne children) characteristics were significantly associated with their parenting practices. Based on canonical correlation analysis, on function one, responsive parenting was positively associated with education level and negatively associated with both cumulative incarceration time and more numerous partner fertility. Restrictive parenting was negatively associated with education level and positively associated with both cumulative incarceration time and more numerous partner fertility. Function 2 capitalized on variance in the restrictive parenting predictor that was not utilized in function 1, and likely captured lack of opportunity to parent. On function 2, restrictive parenting was negatively associated with cumulative time spent incarcerated and more numerous partner fertility. In all, results suggest that prison-based education programs should be part of an overall response to incarcerated fathers. These results add to the growing body of research on incarcerated fathers and fragile families. PMID:19802371
Cummings, E Mark; Koss, Kalsea J; Davies, Patrick T
Conflict in specific family systems (e.g., interparental, parent-child) has been implicated in the development of a host of adjustment problems in adolescence, but little is known about the impact of family conflict involving multiple family systems. Furthermore, questions remain about the effects of family conflict on symptoms of specific disorders and adjustment problems and the processes mediating these effects. The present study prospectively examines the impact of family conflict and emotional security about the family system on adolescent symptoms of specific disorders and adjustment problems, including the development of symptoms of anxiety, depression, conduct problems, and peer problems. Security in the family system was examined as a mediator of these relations. Participants included 295 mother-father-adolescent families (149 girls) participating across three annual time points (grades 7-9). Including auto-regressive controls for initial levels of emotional insecurity and multiple adjustment problems (T1), higher-order emotional insecurity about the family system (T2) mediated relations between T1 family conflict and T3 peer problems, anxiety, and depressive symptoms. Further analyses supported specific patterns of emotional security/insecurity (i.e., security, disengagement, preoccupation) as mediators between family conflict and specific domains of adolescent adjustment. Family conflict was thus found to prospectively predict the development of symptoms of multiple specific adjustment problems, including symptoms of depression, anxiety, conduct problems, and peer problems, by elevating in in adolescent's emotional insecurity about the family system. The clinical implications of these findings are considered.
Chockie, A.; Bjorkelo, K.
For a variety of economic and technical reasons, there has been a growing concern with the aging of complex systems and components and the role that maintenance can play in reducing this degradation. A study for the Nuclear Regulatory Commission was recently undertaken to identify effective maintenance practices that could be adapted by the nuclear industry in the United States to assist in managing the aging degradation of plant systems and components. Four organizations were examined to assess the influence that their maintenance programs have on their ability to address the systems and component aging degradation issues. An effective maintenance program was found to be essential to the management of system and component aging. The four key elements of an effective maintenance program that are important to an aging management program were identified. These are: the selection of critical systems and components; the development of an understanding of aging through the collection and analysis of equipment performance information; the development of appropriate preventive and predictive maintenance tasks to manage equipment and system aging degradation; the use of feedback mechanisms to continuously improve the management of aging systems and components. These elements were found to be common to all four organizations. In examining how the four organizations have structured their maintenance programs to include these key elements provides valuable lessons not only for the nuclear power industry, but also for any industrial organization that is concerned with the management of system and component aging degradation. This document provides detail, of these studies.
Hiebert-Murphy, Diane; Trute, Barry; Wright, Alexandra
The current study examined parents' perspectives of services within a community-based childhood disability program in the process of enhancing the family centeredness of its services. Qualitative interviews were conducted with 39 mothers and 22 fathers approximately 18 months after entering the service delivery system. Parents reported that…
Mayo, Aziza; Siraj, Iram
Given the disadvantaged position of working-class children in the education system, it is important to understand how parents and families might support their children to succeed academically. This paper reports on 35 case studies that were conducted as part of the Effective Provision of Pre-School, Primary and Secondary Education (EPPSE 3-16)…
Smithgall, Cheryl; Jarpe-Ratner, Elizabeth; Yang, Duck-Hye; DeCoursey, Jan; Brooks, LaShaun; Goerge, Robert
Launched in 2005, the Illinois Integrated Assessment (IA) program partners child welfare caseworkers with licensed clinicians to provide better information about the functioning of children entering foster care and about child and family strengths, support systems, and service needs. The information-gathering activities and the collaborative…
This paper seeks to integrate some ideas from family systems theory and attachment theory within a theory of public opinion and social movement. Citing the classic "The Authoritarian Personality," the paper states that the first authorities children know, their parents or other caregivers, shape children's attitudes toward all…
Drawing on four theories of practice--Communities of Practice (CoP), Bourdieu's theory of practice, Pickering's mangle of practice, and Actor Network Theory (ANT), the study provides an in-depth understanding about technology implementation practice. Analysis of an Enterprise System implementation project in a software manufacturing…
Khoo, Hwee Sing; Lim, Yee Wei; Vrijhoef, Hubertus Jm
It is crucial to adapt and improve the (primary) health care systems of countries to prepare for future patient profiles and their related needs. The main aim of this study was to acquire a comprehensive overview of the perceptions of primary care experts in Singapore about the state of primary care in Singapore, and to compare this with the state of primary care in other countries. Notwithstanding ranked 2(nd) in terms of efficiency of health care, Singapore is facing significant health care challenges. Emails were sent to 85 experts, where they were asked to rate Singapore's primary care system based on nine internationally adopted health system characteristics and six practice characteristics (response rate = 29%). The primary care system in Singapore received an average of 10.9 out of 30 possible points. Lowest ratings were given to: earnings of primary care physicians compared to specialists, requirement for 24 hr accessibility of primary care services, standard of family medicine in academic departments, reflection of community served by practices in patient lists, and the access to specialists without needing to be referred by primary care physicians. Singapore was categorized as a 'low' primary care country according to the experts.
Abelson, M N
The majority of computerized systems currently available for the orthodontic office have been designed for and aimed at those offices that have a volume practice and frequently have multiple practitioners. The stand-alone practitioner and the small office have been grossly ignored. Systems designed for large practices are frequently too complex, too involved in business administration, and too costly for the small office to use effectively. This article describes how an office communications system can be assembled by using commercially available programs. For background information and definition of terms used in this article, I suggest referring to "An Introduction to the Computerization of the Orthodontic Practice," in the Oct. issue of this Journal.
Cassata, D M; Conroe, R M; Clements, P W
In an effort to enhance the medical interviewing skills of family practice residents in the clinical setting, the Minnesota Communication Program was developed. The Program, which uses video-tape feedback as the primary teaching method, stresses the integration of biological and psychosocial data as well as the establishment of a therapeutic relationship. A description of the Program including goals, teaching strategies, and guidelines for implementing video-tape feedback is presented. The Medical Interview Skills Checklist (MISC) and its use as an assessment tool are described. Results of a survey eliciting residents' responses to the Program and the implications of video-tape feedback for medical education are also discussed.
Bestvater, David; Dunn, Earl V.; Townsend, Connie; Nelson, Wendy
Data relating to wait times and time spent with nurses and physicians were recorded for 656 patients visiting a large family-practice unit. Patients were asked to provide estimates of their wait times and ratings of the acceptability of these wait intervals. Actual wait times were usually longer than those estimated by the patient, and total wait times were considered reasonable. The results of the study show high levels of patient satisfaction and indicate that few patients are dissatisfied until total wait time exceeds forty-five minutes. Different age groups appear to have different expectations, however, and younger patients are more likely to be dissatisfied with their wait times. PMID:21264021
As universal newborn hearing systems (screening, diagnosis, intervention) are being established around the world, the success of children who are identified to be deaf and hard of hearing is critically impacted by parent's reactions, acceptance, and advocacy for their child. It is imperative for professionals who are creating systems for Early Hearing, Detection, and Intervention to understand and learn from families' experiences in order to improve this process. This manuscript will identify the areas in which parents have spoken out about the professionals they have encountered through the system: what parents wish for in a healthy, productive relationship with professionals; and how parents can play a part in advocating for a system in which families needs are met so that infants identified to be deaf or hard of hearing can reach their full potential.
Brody, Gene H.; Flor, Douglas L.; Gibson, Nicole Morgan
Traced links among family financial resource adequacy, maternal beliefs and behavior, developmental goals, and child outcomes in rural, single-parent African American families of 6- to 9-year-olds. Found that financial adequacy was linked with childrearing efficacy. Efficacy beliefs were linked with parenting practices indirectly through…
Paratore, Jeanne R.
A study examined the influence of an intergenerational approach on the literacy development of parents and on the practice of family literacy at home. During a 3-year period, 367 families enrolled in multilingual, multiability literacy classes for at least one instructional cycle. The adult basic education classes were held in a community center…
Secic, Damir; Husremovic, Dzenana; Kapur, Eldan; Jatic, Zaim; Hadziahmetovic, Nina; Vojnikovic, Benjamin; Fajkic, Almir; Meholjic, Amir; Bradic, Lejla; Hadzic, Amila
Testing strategies can either have a very positive or negative effect on the learning process. The aim of this study was to examine the degree of consistency in evaluating the practicality and logic of questions from a medical school pathophysiology test, between students and family medicine doctors. The study engaged 77 family medicine doctors…
Quadros, Sabrina; Sarroub, Loukia K.
The lack of research about the Karen, one of 135 ethnic groups from Myanmar limits literacy educators charged with educating this refugee population in public schools. In this case study the authors explore the literacy practices of Karen families when at school and in their homes and within an ESL family literacy program. The case of these…
Coleman, Paul R.; Griffith, Mariellen
A brief review of systems theory provides a rationale for an underlying theoretical model within which systems theory can be more completely understood. The essence of the model is that persons are the major unit of study because the available means of satisfying "basic needs" define and shape interaction patterns in the family as in other human…
Dodge, Kenneth A.; Berlin, Lisa J.; Epstein, Matthew; Spitz-Roth, Adele; O'Donnell, Karen; Kaufman, Martha; Amaya-Jackson, Lisa; Rosch, Joel; Christopoulos, Christina
This article describes the Durham Family Initiative (DFI), an innovative effort to bring together child welfare and juvenile justice systems to reach DFI's goal of reducing the child abuse rate in Durham, North Carolina, by 50% within the next 10 years. DFI will follow principles of a preventive system of care (PSoC), which focuses on nurturing…
O'Neal, D.L.; Corum, K.R.; Jones, J.L.
The calculation of consumer discount rates implied by purchases of energy conservation options in new residences is described. The results are based on single-family residential construction practices in 1976, together with engineering evaluation of cost and energy use effects of available energy-conserving construction practices. The discount rate is estimated for ten cities and three heating fuels (gas, oil, and electricity). Sensitivity of the results to assumptions regarding financing arrangements and expected energy prices is also analyzed. The discount rates resulting from this analysis are substantially higher than market rates of interest. They vary with heating fuel choice, location, and price and financing assumptions, but two cases regarded as most realistic result in discount rates (real, net of inflation) which range from a minimum of 14% to over 100%.
Singh, Pmp; Bhalwar, R
A cross sectional epidemiological study design was undertaken on a randomly selected sample of 175 families of Armed Forces personnel staying in a large cantonment and having at least one child in the age group 3 to 24 months. The mean duration of lactational amenorrhoea was found to be 6.24 months (SD ± 3.25 months) and that of breast feeding was found to be 11.14 months (SD ± 6.37 month). The present study observed positive association between the duration of exclusive breast feeding and the duration of lactational amenorrhoea, as well as between the lack of practice of exclusive breast feeding and number of spells of upper respiratory tract infection and acute gastroenteritis. Based on the findings of the study, certain measures to promote the practice of exclusive breast feeding for the first 4-6 months of life have been suggested.
Walcott, Melonie M; Ehiri, John; Kempf, Mirjam C; Funkhouser, Ellen; Bakhoya, Marion; Aung, Maung; Zhang, Kui; Jolly, Pauline E
The objective of this study was to identify the association between gender norms and family planning practices among men in Western Jamaica. A cross-sectional survey of 549 men aged 19 to 54 years attending or visiting four government-operated hospitals was conducted in 2011. Logistic regression models were used to identify factors associated with taking steps to prevent unwanted pregnancy, intention to have a large family size (three or more children), and fathering children with multiple women. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated from the models. Reduced odds for taking steps to prevent unwanted pregnancy among men with moderate (AOR = 0.5; 95% CI = 0.3-0.8) and high (AOR = 0.3; 95% CI = 0.1-0.6) support for inequitable gender norms was observed. Desiring large family size was associated with moderate (AOR = 2.0; 95% CI = 1.3-2.5) and high (AOR = 2.6; 95% CI = 1.5-4.3) support for macho scores. For men with two or more children (41%), there were increased odds of fathering children with multiple women among those who had moderate (AOR = 2.1; 95% CI = 1.0-4.4) and high (AOR = 2.4; 95% CI = 1.1-5.6) support for masculinity norms. Support for inequitable gender norms was associated with reduced odds of taking steps to prevent unwanted pregnancy, while support for masculinity norms was associated with desiring a large family size and fathering children with multiple women. These findings highlight the importance of including men and gender norms in family planning programs in Jamaica.
Costa, J H C; Hötzel, M J; Longo, C; Balcão, L F
A survey on dairy production in family dairy farms in the northwest of Santa Catarina, Brazil, was carried out to assess husbandry practices and elements of the living environment that may influence animal welfare and productivity. Three farm systems common in the region were compared: extensive, pasture-based, and semi-intensive. Data were collected through face-to-face interviews with farmers, followed by an inspection of the production environment and of dairy cows on 124 dairy farms. Some welfare and production problems were common to the 3 systems, mainly subclinical mastitis and tick infestations, which affected one-third of cows, deficiencies in the provision of drinking water and shade, and poor hygiene practices during milking. Some problems were specific to farming systems, such as lameness and hock injuries on the semi-intensive farms, and inadequate milking infrastructure and greater frequencies of cows with low body condition scores on extensive and pasture-based farms. A greater proportion of farms in the semi-intensive group had modern, herringbone-type milking parlors, applied the California Mastitis Test, and followed teat disinfection practices, and more pasture-based farms provided shade in the paddocks. The widespread use of pasture and adapted genotypes and individual identification of animals were positive aspects present in all systems. The absence of health and production records in more than half of the farms may prevent farmers from recognizing certain problems. Results of this survey may guide public policies aiming to improve milk productivity and quality with sustainable and low-cost production practices.
Klemenc-Ketiš, Zalika; Kersnik, Janko
Primary health care is important item of political agendas since Alma Ata conference in 1978. West Balkans share common history in development of primary care since 1920s when Andrija Stampar introduced social and community based primary care concepts. The first known specialist training in general practice in the world started in former Yugoslavia in the early 1960s. Since then, much has been done in the field of general practice and family medicine and this is reflected in The European Academy of Teachers in General Practice and Family Medicine (EURACT), which is a network organisation within World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians Region Europe (WONCA Europe). Its aim is to foster and maintain high standards of care in European general practice by promoting general practice as a discipline by learning and teaching. EURACT developed several documents and teachers courses which can serve the development of family medicine curricula in new established departments of medical schools. This is also the case at Maribor Medical School, where learning outcomes and teaching methods are in concordance with EURACT teaching agenda, but also some innovative approaches are used, such as art and e-learning environment as teaching methods.
Kazak, Anne E; Noll, Robert B
Childhood cancers are life-threatening diseases that are universally distressing and potentially traumatic for children and their families at diagnosis, during treatment, and beyond. Dramatic improvements in survival have occurred as a result of increasingly aggressive multimodal therapies delivered in the context of clinical research trials. Nonetheless, cancers remain a leading cause of death in children, and their treatments have short- and long-term impacts on health and well-being. For over 35 years, pediatric psychologists have partnered with pediatric oncology teams to make many contributions to our understanding of the impact of cancer and its treatment on children and families and have played prominent roles in providing an understanding of treatment-related late effects and in improving quality of life. After discussing the incidence of cancer in children, its causes, and the treatment approaches to it in pediatric oncology, we present seven key contributions of psychologists to collaborative and integrated care in pediatric cancer: managing procedural pain, nausea, and other symptoms; understanding and reducing neuropsychological effects; treating children in the context of their families and other systems (social ecology); applying a developmental perspective; identifying competence and vulnerability; integrating psychological knowledge into decision making and other clinical care issues; and facilitating the transition to palliative care and bereavement. We conclude with a discussion of the current status of integrating knowledge from psychological research into practice in pediatric cancer.
May, Marcus; Mand, Peter; Biertz, Frank; Hummers-Pradier, Eva; Kruschinski, Carsten
Background In Germany, family physicians (FPs) are increasingly needed to participate in undergraduate medical education. Knowledge of FPs’ motivation to teach medical students in their practices is lacking. Purpose To describe a novel questionnaire that assesses the motivation of FPs to teach undergraduates in their practices and to show the results of a subsequent survey using this instrument. Methods The questionnaire was developed based on a review of the literature. Previously used empirical instruments assessing occupational values and motivation were included. A preliminary version was pretested in a pilot study. The resulting 68-item questionnaire was sent to 691 FPs involved in undergraduate medical education. Reliability was assessed and subgroups were analyzed with regard to differences in motivation. Results A total of 523 physicians in n = 458 teaching practices participated (response rate 75.7%). ‘Helping others’ and ‘interest’ were revealed as the predominant motives. Responses showed a predominantly intrinsic motivation of the participating FPs. Their main incentives were an ambition to work as a medical preceptor, to generally improve undergraduate education and to share knowledge. Material compensation was of minor importance. Time restraints were indicated as a barrier by some FPs, but were not a general concern. Conclusion German FPs involved in medical education have altruistic attitudes towards teaching medical students in their practices. Motivational features give an important insight for the recruitment of FP preceptors as well as for their training in instructional methods. PMID:23029272
ADHD symptoms "run in families". However, relatively little is known about the ways in which parents' symptoms might additively and interactively work with the parenting environment, to influence (and be influenced by) the developmental trajectory of symptoms in children and adolescents. In this commentary on the special section addressing this gap in knowledge, emphasis is placed on the importance of replicating and extending family-wide studies of ADHD symptoms and etiology. The current papers exemplify the leading-edge of such efforts, demonstrating the feasibility and rigor with which studies are being conducted, utilizing longitudinal and experimental designs. Families and parenting environments operate as a system in which individuals influence each other's symptoms and functioning. In so doing, parents produce tremendous variability within (as well as between) each family in individuals' ADHD symptoms from childhood through adulthood, via gene-environment transactions that may even begin during prenatal development.
Jacques, L B; Gray, G R
Instability of specialty choice and career after initial residency entry will affect health personnel projections. Military physicians may differ from civilian physicians in their specialty choice behaviors during their careers. A cohort of 336 graduates who chose family medicine residency training was identified from the graduating classes of 1969 through 1993 at a large private medical school. Current specialty identification was determined, and attrition from family medicine was computed. As of 1997, 275 graduates (82%) were still in family medicine careers, defined by American Academy of Family Physicians membership or current American Board of Family Practice certification. Of graduates who entered military programs, 22 of 77 (28%) had left family medicine careers; 39 of 259 (15%) of the graduates who entered civilian programs had left. This difference was statistically significant (p = 0.007). Family medicine career retention is lower for males in military programs compared with males in civilian programs or females in military programs.
R. Douglas Hamelin; Ron D. Klingler; Christopher Dieckmann
From its inception in the defense and aerospace industries, SE has applied holistic, interdisciplinary tools and work-process to improve the design and management of 'large, complex engineering projects.' The traditional scope of engineering in general embraces the design, development, production, and operation of physical systems, and SE, as originally conceived, falls within that scope. While this 'traditional' view has expanded over the years to embrace wider, more holistic applications, much of the literature and training currently available is still directed almost entirely at addressing the large, complex, NASA and defense-sized systems wherein the 'ideal' practice of SE provides the cradle-to-grave foundation for system development and deployment. Under such scenarios, systems engineers are viewed as an integral part of the system and project life-cycle from conception to decommissioning. In far less 'ideal' applications, SE principles are equally applicable to a growing number of complex systems and projects that need to be 'rescued' from overwhelming challenges that threaten imminent failure. The medical profession provides a unique analogy for this latter concept and offers a useful paradigm for tailoring our 'practice' of SE to address the unexpected dynamics of applying SE in the real world. In short, we can be much more effective as systems engineers as we change some of the paradigms under which we teach and 'practice' SE.
Jung, Piera; Kennedy, Maggie; Winder, Mary J.
Abstract Objective To explore the elements necessary for a high-quality educational experience in a family practice residency program with respect to scheduling, learning environment, and approaches to teaching and learning. Design An interpretative, qualitative study using a generative-inquiry approach. Setting The Nanaimo Site of the University of British Columbia Family Practice Residency Program. Participants Fifteen physician instructors and 16 first- and second-year residents. Methods Data were gathered from 2 qualitative focus group interviews with residents; 2 qualitative focus group interviews with physician instructors; and structured and semistructured observation of 2 in-class seminars, with a focus on residents’ engagement with the class. Results were analyzed and categorized into themes independently and collectively by the researchers. Main findings Protected block time for teaching and learning at the Nanaimo Site has been effective in fostering a learning environment that supports collegial relationships and in-depth instruction. Residents and physician instructors benefit from the week-long academic schedule and the opportunity to teach and learn collaboratively. Participants specifically value the connections among learning environment, collegiality, relationships, reflective learning, and the teaching and learning process. Conclusion These findings suggest that strategic planning and scheduling of teaching and learning sessions in residency programs are important to promoting a comprehensive educational experience. PMID:22700741
Brcic, Vanessa; Eberdt, Caroline; Kaczorowski, Janusz
Objective. The goal of this pilot study was to develop and field-test questions for use as a poverty case-finding tool to assist primary care providers in identifying poverty in clinical practice. Methods. 156 questionnaires were completed by a convenience sample of urban and rural primary care patients presenting to four family practices in British Columbia, Canada. Univariate and multivariate logistic regression analyses compared questionnaire responses with low-income cut-off (LICO) levels calculated for each respondent. Results. 35% of respondents were below the “poverty line” (LICO). The question “Do you (ever) have difficulty making ends meet at the end of the month?” was identified as a good predictor of poverty (sensitivity 98%; specificity 60%; OR 32.3, 95% CI 5.4–191.5). Multivariate analysis identified a 3-item case-finding tool including 2 additional questions about food and housing security (sensitivity 64.3%; specificity 94.4%; OR 30.2, 95% CI 10.3–88.1). 85% of below-LICO respondents felt that poverty screening was important and 67% felt comfortable speaking to their family physician about poverty. Conclusions. Asking patients directly about poverty may help identify patients with increased needs in primary care. PMID:22312547
Kazak, Anne E; Hoagwood, Kimberly; Weisz, John R; Hood, Korey; Kratochwill, Thomas R; Vargas, Luis A; Banez, Gerard A
Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Improving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of the meta-system for children with emotional or behavioral needs include families, cultural norms and values, and service sectors such as schools, pediatric health centers, specialty mental health systems, juvenile justice systems, child protection services, and substance use treatment systems. We describe each component of the meta-system, noting challenges to the provision of evidence-based practice (EBP) and highlighting ways to optimize outcomes. Our focus is on the inclusion of evidence-based assessment and interventions, including prevention, within a developmentally driven and culturally responsive contextual model. Recommendations for addressing disparities in research funding and essential steps to foster communication and coordination of EBP across settings are provided.
Radecki, S E
Low-income women's histories of pregnancies, their use or nonuse of contraception, and their marital status showed racial and ethnic differences in family formation patterns and fertility control practices. Data were analyzed from a survey of 918 low-income women in Los Angeles County. The sample contained about equal numbers of non-Hispanic whites, blacks, and Hispanics. The use of stratified samples equalized the poverty-level composition of the three racial and ethnic groups. First pregnancies for white and black women resulted primarily from nonuse of contraception while unmarried, but almost half of first pregnancies among Hispanics were intentional. Marital dissolution following pregnancy or childbearing was common among low-income whites and blacks, but Hispanics were more likely to have an intact marriage along with a higher average parity. Analyses of histories of pregnancies while controlling for demographic characteristics showed that racial and ethnic differences in rates of different types of pregnancies (classified as intended, accidental, or unprotected) and rates of abortion did not remain significant after adjustment for respondent characteristics and years of exposure to possible pregnancy. Actual parity, however, remained significant when these factors were controlled. Thus, results document distinctive patterns of family formation for low-income women in racial and ethnic subgroups of this population. Implications of these patterns of family formation for economic well-being are discussed. PMID:1910183
Morgan, Philip J.; Jones, Rachel A.; Collins, Clare E.; Hesketh, Kylie D.; Young, Myles D.; Burrows, Tracy L.; Magarey, Anthea M.; Brown, Helen L.; Hinkley, Trina; Perry, Rebecca A.; Brennan, Leah; Spence, Alison C.; Campbell, Karen J.
Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a key target for child obesity prevention programs. However, recruiting and engaging parents in such interventions can be a considerable challenge for researchers and practitioners. Members of the ‘Parenting, Child Behaviour and Well-being’ stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN) have considerable and varied expertise in conducting such interventions and can provide insights into addressing these challenges. This paper aims to highlight considerations regarding the design, implementation, and evaluation of obesity prevention interventions with families and provide practical insights and recommendations for researchers and practitioners conducting family-based research in this area. Case studies of three family-based interventions conducted by ACAORN members are highlighted to provide examples and contextualise the recommendations proposed. PMID:27834820
YAZDANI, SHAHRAM; HOSSEINI, FAKHROLSADAT; AHMADY, SOLEIMAN
Introduction Systems-Based Practice (SBP) is one of the six competencies introduced by the ACGME for physicians to provide high quality of care and also the most challenging of them in performance, training, and evaluation of medical students. This concept analysis clarifies the concept of SBP by identifying its components to make it possible to differentiate it from other similar concepts. For proper training of SBP and to ensure these competencies in physicians, it is necessary to have an operational definition, and SBP’s components must be precisely defined in order to provide valid and reliable assessment tools. Methods Walker & Avant’s approach to concept analysis was performed in eight stages: choosing a concept, determining the purpose of analysis, identifying all uses of the concept, defining attributes, identifying a model case, identifying borderline, related, and contrary cases, identifying antecedents and consequences, and defining empirical referents. Results Based on the analysis undertaken, the attributes of SBP includes knowledge of the system, balanced decision between patients’ need and system goals, effective role playing in interprofessional health care team, system level of health advocacy, and acting for system improvement. System thinking and a functional system are antecedents and system goals are consequences. A case model, as well as border, and contrary cases of SBP, has been introduced. Conclusion he identification of SBP attributes in this study contributes to the body of knowledge in SBP and reduces the ambiguity of this concept to make it possible for applying it in training of different medical specialties. Also, it would be possible to develop and use more precise tools to evaluate SBP competency by using empirical referents of the analysis. PMID:27104198
Honarvar, Behnam; Lankarani, Kamran Bagheri; Rostami, Sara; Honarvar, Fatemeh; Akbarzadeh, Armin; Odoomi, Neda; Honarvar, Hossein; Malekmakan, Leila; Rabiye, Parisa; Arefi, Nafiseh
Background: Urban family physician program has been launched as a pilot in Fars and Mazandaran provinces of Iran since 2012. Attitudes of policy makers and people toward urban family physician program have become challenging. This study shows what people know and practice toward this program. Methods: This cross-sectional population-based study was conducted by a multistage randomized sampling in Shiraz, Southern Iran. Knowledge and practice of adults toward urban family physician program were queried through filing the questionnaires. Single and multiple variable analyzes of data were performed. Results: Participation rate was 1257 of 1382 (90.9%), and the mean age of the respondents was 38.1 ± 13.2 years. Of 1257, 634 (50.4%) were men and 882 (70.2%) were married. Peoples’ total knowledge toward urban family physician program was 5 ± 2.7 of 19, showed that 1121 (89.2%) had a low level of knowledge. This was correlated positively and in order to being under coverage of this program (P < 0.001), being under coverage of one of the main insurance systems (P = 0.04) and being married (P = 0.002). The mean score of people's practice toward the program was 2.3 ± 0.9 of total score 7, showed that 942 (74%) had poor performance, and it was correlated positively and in order to being under coverage of this program (P < 0.001) and having higher than 1000$ monthly income (P = 0.004). Correlation of people's knowledge and practice toward the program was 24%. Conclusions: Current evidences show a low level of knowledge, poor practice and weak correlation of knowledge-practice of people toward urban family physician program. PMID:26124943
Madsen, William C
Collaborative, family-centered practice has become an influential approach in helping efforts across a broad spectrum of human services. This article draws from previous work that presented a principle-based, practice framework of Collaborative Helping and highlighted the use of Collaborative Helping maps as a tool both to help workers think their way through complex situations and to provide a guideline for constructive conversations between families and helpers about challenging issues. It builds on that work to examine ways to utilize Collaborative Helping maps at worker, supervisory, and organizational levels to enhance and sustain collaborative, family-centered practice and weave its core values and principles into the everyday fabric of organizational cultures in human service agencies and government agencies that serve poor and marginalized families and communities.
Brody, G H; Flor, D L; Gibson, N M
With a sample of 139 rural, single-parent African American families with a 6- to 9-year-old child, we traced the links among family financial resource adequacy, maternal childrearing efficacy beliefs, developmental goals, parenting practices, and children's academic and psychosocial competence. A multimethod, multiinformant design was used to assess the constructs of interest. Consistent with the hypothesized paths, financial resource adequacy was linked with mothers' sense of childrearing efficacy. Efficacy beliefs were linked with parenting practices indirectly through developmental goals. Competence-promoting parenting practices were indirectly linked with children's academic and psychosocial competence through their association with children's self-regulation.
Wright, George E., Jr.
The crisis in primary care has long been discussed and the dismal litany of statistics is now familiar. The G.P. is vanishing from the medical scene. Over one-third of the active general practitioners are now over 60. In 1970 the U.S. Congress responded to the declining availability of primary health care by passing the Family Practice Act. The…
Wong, Pui Ling; Fleer, Marilyn
This article draws on a cultural-historical theorization of child development alongside the Chinese concept of learning in order to study children's development in the Hong Kong Australian community. In particular, it aims to understand in detail how a 9-year-old child develops a learning motive under highly structured family practices. The data…
Shean, Glenn; Rohrbaugh, Michael
Agoraphobia is an increasingly common, often chronically incapacitating anxiety disorder. Both behavior therapy and pharmacotherapy can be effective in reducing the intensity of agoraphobic symptoms. There are promising new developments, however, from a family systems perspective. Researchers are finding that an agoraphobic's marriage and family…
Gyamfi, Phyllis; Walrath, Christine; Burns, Barbara J.; Stephens, Robert L.; Geng, Yisong; Stambaugh, Leyla
This study examines the use of family education and support (FES) services within community-based mental health systems. Using data from the national evaluation of the Children's Mental Health Initiative (CMHI), 2,853 caregivers and their children ages 6 to 18 years from 39 communities participated in this study. The findings indicated that during…
Stevens, Carolyn S.
Military families face challenges not found in other work environments. Shifting work schedules that are often longer than the typical 8-hour day, as well as the ever-present possibility of being deployed anywhere in the world on a moment's notice, require a child care system that is flexible but maintains high-quality standards. The U.S.…
This report, based on a study of delinquency cases in the Bronx and Brooklyn family courts, examines the juvenile justice system in New York City. The study considered the following questions; (1) To what extent were problems being experienced by the court at various stages in the processing of cases? and (2) To what underlying forces might the…
Michael-Tsabari, Nava; Lavee, Yoav
Despite growing research interest in family businesses, little is known about the characteristics of the families engaging in them. The present paper uses Olson's (Journal of Psychotherapy & the Family, 1988, 4(12), 7-49; Journal of Family Therapy, 2000, 22, 144-167) Circumplex Model of Marital and Family Systems to look at first-generation family firms. We describe existing typologies of family businesses and discuss similarities between the characteristics of first-generation family firms and the rigidly enmeshed family type described in the Circumplex Model. The Steinberg family business (Gibbon & Hadekel (1990) Steinberg: The breakup of a family empire. ON, Canada: MacMillan) serves to illustrate the difficulties of rigidly enmeshed first-generation family firms. Implications for understanding troubled family businesses are discussed together with guidelines for the assessment of a family business in crisis and for intervention: enhancing open communication; allowing for more flexible leadership style, roles, and rules; and maintaining a balance between togetherness and separateness.
The aim of this review is to examine two factors that may be associated with development of childhood overweight: early feeding, namely exclusive breastfeeding practices; family structure. Findings from the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study are presented in the context of the literature. IDEFICS is a multi-centre European study exploring the risks for overweight and obesity in children, which recruited 16,224 children aged 2-9 years from September 2007 to June 2008 at survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Among the IDEFICS sample, after controlling for confounders, exclusive breastfeeding for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breastfed (OR 0·73, 95% CI 0·63, 0·85). Family structure and number of siblings may also be associated with overweight. IDEFICS children without siblings were more likely (OR 1·52, 95% CI 1·34, 1·72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight such as country, parental education, parental weight, maternal age, child's age, birth weight and gender. Both early feeding practices and family structure play a role in the future development of obesity. The impact of breastfeeding on future development of overweight is dependent upon the dose. Exclusive breastfeeding for the recommended 6 months appears to be protective of overweight. Family structure is also an important component and emerging research suggests only children are at increased risk for overweight in comparison with those with siblings. In European countries, approximately 22 million children are overweight. Early dietary exposures, genetic, environmental and social factors have all been proposed as potential causal factors. Two such factors include exclusive breastfeeding and the impact of being an only child. We
Congdon, William M.; Curry, Donald M.
Advanced Ablators Program Objectives: 1) Flight-ready(TRL-6) ablative heat shields for deep-space missions; 2) Diversity of selection from family-system approach; 3) Minimum weight systems with high reliability; 4) Optimized formulations and processing; 5) Fully characterized properties; and 6) Low-cost manufacturing. Definition and integration of candidate lightweight structures. Test and analysis database to support flight-vehicle engineering. Results from production scale-up studies and production-cost analyses.
Ristovski-Slijepcevic, Svetlana; Chapman, Gwen E; Beagan, Brenda L
In this qualitative study with three ethnocultural groups in two regions of Canada, we explore how official dietary guidelines provide particular standards concerning 'healthy eating' that marginalize other understandings of the relationship between food and health. In families where parents and youth held shared ways of understanding healthy eating, the role of 'good mother' was constructed so as to include healthy eating expertise. Mothers expressed a perceived need to be personally responsible for providing skills and knowledge about healthy eating as well as guarding children against negative nutritional influences. Governing of family eating practices to conform to official nutritional advice occurred through information provision, monitoring in shopping and meal preparation, restricting and guiding food purchases, and directly translating expert knowledges into family food practices. In families where parents and youth held differing understandings of healthy eating, primarily families from ethnocultural minority groups, mothers often did not employ the particular western-originating strategies of conveying healthy eating information, or mentoring healthy meal preparation, nor did they regulate or restrict children's food consumption. Western dietary guidelines entered into the family primarily through the youth, emphasizing the nutritional properties of food, often devaluing 'traditional' knowledge about healthy eating. These processes exemplify techniques of governmentality which simultaneously exercise control over people's behaviour through normalizing some family food practices and marginalizing others.
Kaczorowski, Janusz; Myers, Martin G.; Gelfer, Mark; Dawes, Martin; Mang, Eric J.; Berg, Angelique; Grande, Claudio Del; Kljujic, Dragan
Abstract Objective To describe the techniques currently used by family physicians in Canada to measure blood pressure (BP) for screening for, diagnosing, and treating hypertension. Design A Web-based cross-sectional survey distributed by e-mail. Setting Stratified random sample of family physicians in Canada. Participants Family physician members of the College of Family Physicians of Canada with valid e-mail addresses. Main outcome measures Physicians’ self-reported routine methods for recording BP in their practices to screen for, diagnose, and manage hypertension. Results A total of 774 valid responses were received, for a response rate of 16.2%. Respondents were similar to nonrespondents except for underrepresentation of male physicians. Of 769 respondents, 417 (54.2%) indicated that they used manual office BP measurement with a mercury or aneroid device and stethoscope as the routine method to screen patients for high BP, while 42.9% (330 of 769) reported using automated office BP (AOBP) measurement. The method most frequently used to make a diagnosis of hypertension was AOBP measurement (31.1%, 240 of 771), followed by home BP measurement (22.4%, 173 of 771) and manual office BP measurement (21.4%, 165 of 771). Ambulatory BP monitoring (ABPM) was used for diagnosis by 14.4% (111 of 771) of respondents. The most frequently reported method for ongoing management was home BP monitoring (68.7%, 528 of 769), followed by manual office BP measurement (63.6%, 489 of 769) and AOBP measurement (59.2%, 455 of 769). More than three-quarters (77.8%, 598 of 769) of respondents indicated that ABPM was readily available for their patients. Conclusion Canadian family physicians exhibit overall high use of electronic devices for BP measurement, However, more efforts are needed to encourage practitioners to follow current Canadian guidelines, which advocate the use of AOBP measurement for hypertension screening, ABPM and home BP measurement for making a diagnosis, and both
Ferrouillet, Cécile; Milord, François; Lambert, Louise; Vibien, Anne; Ravel, André
BACKGROUND: Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD) with surveillance activities and education for family physicians (FPs) who are key actors in both vigilance and case management. OBJECTIVES: To describe FPs’ clinical experience with LD, their degree of knowledge, and their practices in two areas, one with known infected tick populations (Montérégie) and one without (regions nearby Montérégie). METHODS: In the present descriptive cross-sectional study, FPs were recruited during educational sessions. They were asked to complete a questionnaire assessing their clinical experience with Lyme disease, their knowledge of signs and symptoms of LD, and their familiarity with accepted guidelines for diagnosing and treating LD in two clinical scenarios (tick bite and erythema migrans). RESULTS: A total of 201 FPs participated, mostly from Montérégie (n=151). Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices. A majority of participants agreed to more education on LD. As expected, FPs from Montérégie had a higher clinical experience with tick bites (57% versus 25%), better knowledge of LD endemic areas in Canada and erythema migrans characteristics, and better management of erythema migrans (72% versus 50%). CONCLUSION: The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes. Such practices should be discouraged because they are unnecessary and overuse collective laboratory and medical resources. In addition, public health authorities must pursue their education efforts regarding FPs to optimize case management. PMID:26236357
Lee, William Keng-Mun; Hong-Kin, Kwok
Cultural aspects of aging have great importance on how older women and men are being treated, in particular in Asia where patriarchal practices dominate. Further, changes in the structure of the Chinese family alter this supportive function, and changes in traditional values affect the nature of the care and support provided to older women and men. This proposition was investigated by a quantitative study involving a survey of 390 older persons in Hong Kong. There are great discrepancies in informal support for older women and men. Older women are less likely to live with adult children; more likely to need financial assistance; and more likely to receive poor informal support. There is evidence that informal support for the elderly is changing in Hong Kong, and older women are being disadvantaged, experiencing insufficient and unavailability of informal support.
Raman, Shanti; Srinivasan, Krishnamachari; Kurpad, Anura; Razee, Husna; Ritchie, Jan
Background Globally, India contributes the largest share in sheer numbers to the burden of maternal and infant under-nutrition, morbidity and mortality. A major gap in our knowledge is how socio-cultural practices and beliefs influence the perinatal period and thus perinatal outcomes, particularly in the rapidly growing urban setting. Methods and Findings Using data from a qualitative study in urban south India, including in-depth interviews with 36 women who had recently been through childbirth as well as observations of family life and clinic encounters, we explored the territory of familial, cultural and traditional practices and beliefs influencing women and their families through pregnancy, childbirth and infancy. We found that while there were some similarities in cultural practices to those described before in studies from low resource village settings, there are changing practices and ideas. Fertility concerns dominate women’s experience of married life; notions of gender preference and ideal family size are changing rapidly in response to the urban context; however inter-generational family pressures are still considerable. While a rich repertoire of cultural practices persists throughout the perinatal continuum, their existence is normalised and even underplayed. In terms of diet and nutrition, traditional messages including notions of ‘hot’ and ‘cold’ foods, are stronger than health messages; however breastfeeding is the cultural norm and the practice of delayed breastfeeding appears to be disappearing in this urban setting. Marriage, pregnancy and childbirth are so much part of the norm for women, that there is little expectation of individual choice in any of these major life events. Conclusions A greater understanding is needed of the dynamic factors shaping the perinatal period in urban India, including an acknowledgment of the health promoting as well as potentially harmful cultural practices and the critical role of the family. This will
Objectives. The objective of this study is to explore the current knowledge, attitude, and practice of family physicians working in family medicine clinics in National Guard Health Affairs (NGHA), Riyadh, toward colorectal cancer (CRC) screening and to identify the barriers of the screening. Methods. Data were collected using a validated self-administered questionnaire adopted from the National Cancer Institute in USA, customized by adding and eliminating questions to be in line with the institution (NGHA) characteristics. Results. Of the 130 physicians, 56.2% of the physicians were not practicing CRC screening although 94.6% considered CRC screening effective. Board certified physicians had higher knowledge score and were practicing CRC screening more when compared to other physicians. Physicians who reported practicing CRC screening scored more on the knowledge score than those not practicing. Male physicians scored better on attitude score than female physicians. The study found that barriers were cited in higher rates among physicians not practicing CRC screening compared with practicing physicians. Lack of patients' awareness was the most cited barrier. Conclusion. Large percentage of family physicians in this study do not practice CRC screening, despite the knowledge level and the positive attitude. PMID:25328703
van Zyl, Marjorie; Eygelaar, Johanna
Background Interventions by community care workers within the context of community-based integrated management of childhood illness (CIMCI) may have a positive effect on child health if the health workers have adequate knowledge about key family practices. Setting The study was conducted in rural areas of the West Coast district in the Western Cape, South Africa. Objectives The objective of this study was to determine the knowledge of community care workers about five of the 16 key family practices of CIMCI. Methods A descriptive survey collected a self-administered questionnaire from 257 community care workers out of a possible total of 270 (95.2% response rate). Descriptive and inferential statistical analysis was applied. Results Only 25 of the respondents (10%) obtained a score higher than 70% on the knowledge-based items of the questionnaire. Less than 25% of respondents answered questions in these key areas correctly (pneumonia [17%], tuberculosis [13%], HIV/AIDS [9%] immunisation [3%] and recommendations for a child with fever [21%]). Statistically significant correlations were found between the total score a respondent achieved and the highest level of education obtained (p < 0.01), the level of in-service training (p < 0.01), attendance of a CIMCI five-day training course (p < 0.01), and completing a subsequent refresher course (p < 0.01). Conclusion The knowledge of CCWs was inadequate to provide safe, quality CIMCI. CIMCI refresher courses should be offered annually to improve CCWs’ knowledge and the quality of care that they render. Regular update courses could contribute to building competence. PMID:26842523
Asekun-Olarinmoye, E O; Dairo, M D; Abodurin, O L; Asekun-Olarinmoye, I O
A descriptive cross-sectional study to assess adolescents' view of the practice and content of sex education within the family setting in a rural Nigerian community and explore whether there is any association between parental communication on sex and adolescents' sexual debut and habits. Simple random sampling was utilized, while a semi-structured questionnaire was used to collect data from 350 respondents. Data analysis was by the Statistical Package for Social Sciences (SPSS version 11). Majority of the respondents (48.8%) were late adolescents, 291 (85.1%) had had sex education, most (45.7%) of whom were exposed between ages 10 and 14 years. The main content of parental sex education was HIV/AIDS prevention (51.9%), avoidance of pregnancy (40.9%), abstinence (38.1%), and basic information about reproduction and biology (35.4%). Poor attitude to parental communication on sex was associated with a higher likelihood of pre-marital sex (p = 0.001). Curiosity was the most common major reason for sexual debut. This emphasizes the importance of early sex education within the family setting and its possible impact in delaying sexual initiation. Promotion of parent-child communication about sexual issues is vital in order to improve the reproductive health of the adolescents in this environment. Community-based health education intervention programs for parents are recommended.
Glisson, Charles; Williams, Nathaniel J; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly
Peer family support specialists (FSS) are parents with practical experience in navigating children's mental health care systems who provide support, advocacy, and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. The Organizational Social Context measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians job attitudes were differentially associated with organizational culture and climate. The programs organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Both FSS' and clinicians' individual-level work attitudes were associated similarly with organizational culture and climate.
Tobler, Amy L; Komro, Kelli A; Maldonado-Molina, Mildred M
We examined relationships between alcohol-related neighborhood context, protective home and family management practices, and alcohol use among urban, racial/ethnic minority, adolescents. The sample comprised 5,655 youth who were primarily low SES (72%), African American (43%) and Hispanic (29%). Participants completed surveys in 2002-2005 (ages 11-14 years). Items assessed alcohol use, accessibility of alcohol at home and parental family management practices. Neighborhood context measures included: (1) alcohol outlet density; (2) commercial alcohol accessibility; (3) alcohol advertisement exposure; and (4) perceived neighborhood strength, reported by parents and community leaders. Structural equation modeling was used to assess direct and indirect relationships between alcohol-related neighborhood context at baseline, home alcohol access and family management practices in seventh grade, and alcohol use in eighth grade. Neighborhood strength was negatively associated with alcohol use (beta = -0.078, p < or = 0.05) and exposure to alcohol advertisements was positively associated with alcohol use (beta = 0.043, p < or = 0.05). Neighborhood strength and commercial alcohol access were associated with home alcohol access (beta = 0.050, p = 0.05 and beta = -0.150, p < or = 0.001, respectively) and family management practices (beta = -0.061, p < or = 0.01 and beta = 0.083, p < or = 0.001, respectively). Home alcohol access showed a positive association with alcohol use (beta = 0.401, p < or = 0.001). Tests for indirect effects suggest that home alcohol access may partially mediate the relationship between neighborhood strength and alcohol use (beta = 0.025, p < 0.062). Results suggest inner-city parents respond to environmental risk, such that as neighborhood risk increases, so also do protective home and family management practices. Parent engagement in restricting alcohol access and improving family management practices may be key to preventive efforts to reduce
Yun, Jeong-Ok; Kim, Ki-Nam
The purpose of this study was to investigate the degree of family support for diabetic patients and the diet therapy practice of patients themselves, and to analyze the relationship between family support and diet therapy practice and blood glucose control, and thus to prepare basic data for the development of effective education programs to improve blood glucose control in diabetic patients. The study subjects were 82 patients with type II diabetes, aged over 20 in the Chungbuk area. The gender distribution of subjects was 52.4% males and 47.6% females, and BMI showed 29.3% overweight and 35.3% obesity. Among the 82 study subjects, the relationship between diet therapy related family support and blood glucose control was examined in 67 subjects who answered practicing diet therapy, and the results showed that the family support score of a group with excellent blood glucose control was significantly higher than those of groups with fair or poor control (p<0.001) and the correlation between the two factors was very high (r=0.341, p<0.001). For the relationship between diet therapy practice by patients themselves and blood glucose control, diet therapy practice of a group with excellent blood glucose control was significantly higher than those of other groups (fair or poor control groups) (p<0.001) and the correlation between two factors was very high (r=0.304, p<0.001). For other factors influencing blood glucose control, a group with diabetes education showed significantly better blood glucose control compared to other groups without education (p<0.05). From the above results, diet therapy practice by patients, family support, and the necessity of diabetes education were confirmed to control blood glucose of diabetic patients. In conclusion, development and operation of education program should include not only patients but also their family members.
Selbekk, Anne Schanche; Sagvaag, Hildegunn
Research shows that members of the families with patients suffering from alcohol and other drug-related issues (AOD) experience stress and strain. An important question is, what options do AOD treatment have for them when it comes to support? To answer this, we interviewed directors and clinicians from three AOD treatment institutions in Norway. The study revealed that family-oriented practices are gaining ground as a 'going concern'. However, the relative position of family-orientation in the services, is constrained and shaped by three other going concerns related to: (i) discourse on health and illness, emphasising that addiction is an individual medical and psychological phenomenon, rather than a relational one; (ii) discourse on rights and involvement, emphasising the autonomy of the individual patient and their right to define the format of their own treatment; and (iii) discourse on management, emphasising the relationship between cost and benefit, where family-oriented practices are defined as not being cost-effective. All three discourses are connected to underpin the weight placed on individualised practices. Thus, the findings point to a paradox: there is a growing focus on the needs of children and affected family members, while the possibility of performing integrated work on families is limited.
DiGioia, Anthony M; Greenhouse, Pamela K; Chermak, Tanya; Hayden, Margaret A
Many healthcare organizations using Lean are becoming interested in the Patient and Family Centered Care Methodology and Practice (PFCC M/P). We suggest that integrating the two approaches can accelerate the pace of improvement and provide a powerful mechanism to keep the patient and family as the primary focus of improvement activities. We describe the two approaches and note the ways in which they are complementary. We then discuss the ways in which integrating the PFCC M/P adds value to patients, families, providers, and organizations and accelerates transformation. Finally, we suggest ways to implement PFCC M/P within Lean healthcare organizations.
Wang, Wenzhi; Zhao, Donghai; Wu, Jianzhong; Wang, Taiping; Dai, Xiuying; Ma, Guangyu; Yang, Bin; Yuan, Chenglin; Bell, Gail S; de Boer, Hanneke M; Prilipko, Leonid L; Sander, Ley
To evaluate the effectiveness of a combined intervention on knowledge, attitude, and practice (KAP) of people with epilepsy and their families in rural areas of China, random samples of people with epilepsy and their family members from the intervention populations completed questionnaires prior to the intervention (2002, N=975) and 2 years later (N=950). There was no significant difference in important demographic variables between the two samples. KAP levels of patients and their family members improved over the study period. Worry about seizures, discrimination, and medical costs are the principal factors in patients' psychological burden. Psychological burden and inability to concentrate at work are the main influences of the disease on family members. Reduction of the psychological burden of patients and their family members is a significant aspect of treatment to which more attention should be paid in similar future interventions.
Crespi, Tony D.; Rueckert, Quentin H.
Clinicians involved in family therapy are increasingly concerned with the impact of parental alcoholism on individual development and family functioning. With more than 20 million adults raised within an alcoholic family, and with widespread problems associated with parental alcoholism, clinicians providing family treatment have a potentially…
Reifel, Stuart, Ed.; Dunst, Carl J., Ed.; Wolery, Mark, Ed.
Family issues are an abiding concern for members of the profession of early education, and debate regarding government policies about families and child care continues to be timely. This volume provides a foundation for understanding programs, families, and the current social context, as well as particular areas of concern for families and child…
Xiao, S H
After the Third Meeting of the Eleventh People's Congress, the entire responsibility for agricultural production was transferred to a lower level. Peasants in various areas have adopted the so called production responsibility system, and the phenomenon of an increased population rate has also appeared in some areas. In this article, the author discusses how to solve these problems created by the new situation. The 1st step is try to control population growth through socialist propaganda education, administrative measures, economic incentives and punishments, and family planning work. The 2nd step is to popularize the practice of having only 1 child per household in the rural areas. The 2nd and 3rd child in each family should be controlled and prohibited. This policy formulated by the Central Government should be carried out thoroughly. Families which follow the policy and have only 1 child should be encouraged with economic rewards, and those families which have 2 or more children should be punished economically. The 3rd step is to establish a national work team to be in charge of family planning and birth control. There should be an ideological unity among the nation's leadership. Party members and cadres should establish themselves as good examples for the people so that the population control work may become successful.
Berryhill, Laura F.
Challenging behavior often impacts a child's education along with peer and family relationships. It is estimated that 10-30% of all typically developing preschool children have chronic, mild to moderate levels of behavior problems. Given the significant impact that challenging behavior can have on a child's development, relationships, and future…
Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew
Background Training for Australian general practice, or family medicine, can be isolating, with registrars (residents or trainees) moving between rural and urban environments, and between hospital and community clinic posts. Virtual communities of practice (VCoPs), groups of people sharing knowledge about their domain of practice online and face-to-face, may have a role in overcoming the isolation associated with general practice training. Objective This study explored whether Australian general practice registrars and their supervisors (trainers) would be able to use, and would be interested in using, a VCoP in the form of a private online network for work and training purposes. It also sought to understand the facilitators and barriers to intention to use such a community, and considers whether any of these factors may be modifiable. Methods A survey was developed assessing computer, Internet, and social media access and usage, confidence, perceived usefulness, and barriers, facilitators, and intentions to use a private online network for training purposes. The survey was sent by email link to all 139 registrars and 224 supervisors in one of Australia’s 17 general practice training regions. Complete and usable responses were received from 131 participants (response rate=0.4). Results Most respondents had access to broadband at home (125/131, 95.4%) and at work (130/131, 99.2%). Registrars were more likely to spend more than 2 hours on the Internet (P=.03), and to use social media sites for nonwork purposes (P=.01). On a 5-point Likert scale, confidence was high (mean 3.93, SD 0.63) and was negatively associated with higher age (P=.04), but not associated with training stage. Social media confidence was lower, with registrars more confident than supervisors for almost all social media activities. On a 5-point Likert scale, overall usefulness was scored positively (n=123, mean 3.63, SD 0.74), and was not significantly associated with age or training level. The
Ahmad, Zahid S.; Andersen, Rolf L.; Andersen, Lars H.; O'Brien, Emily C.; Kindt, Iris; Shrader, Peter; Vasandani, Chandna; Newman, Connie B.; deGoma, Emil M.; Baum, Seth J.; Hemphill, Linda C.; Hudgins, Lisa C.; Ahmed, Catherine D.; Kullo, Iftikhar J.; Gidding, Samuel S.; Duffy, Danielle; Neal, William; Wilemon, Katherine; Roe, Matthew T.; Rader, Daniel J.; Ballantyne, Christie M.; Linton, MacRae F.; Duell, P. Barton; Shapiro, Michael D.; Moriarty, Patrick M.; Knowles, Joshua W.
Background In the US familial hypercholesterolemia (FH), patients are underidentified, despite an estimated prevalence of 1:200 to 1:500. Criteria to identify FH patients include Simon Broome, Dutch Lipid Clinic Network (DLCN), or Make Early Diagnosis to Prevent Early Deaths (MEDPED). The use of these criteria in US clinical practices remains unclear. Objective To characterize the FH diagnostic criteria applied by US lipid specialists participating in the FH Foundation's CASCADE FH (CAscade SCreening for Awareness and DEtection of Familial Hypercholesterolemia) patient registry. Methods We performed an observational, cross-sectional analysis of diagnostic criteria chosen for each adult patient, both overall and by baseline patient characteristics, at 15 clinical sites that had contributed data to the registry as of September 8, 2015. A sample of 1867 FH adults was analyzed. The median age at FH diagnosis was 50 years, and the median pretreatment low-density lipoprotein cholesterol (LDL-C) value was 238 mg/dL. The main outcome was the diagnostic criteria chosen. Diagnostic criteria were divided into five nonexclusive categories: “clinical diagnosis,” MEDPED, Simon Broome, DLCN, and other. Results Most adults enrolled in CASCADE FH (55.0%) received a “clinical diagnosis.” The most commonly used formal criteria was Simon–Broome only (21%), followed by multiple diagnostic criteria (16%), MEDPED only (7%), DLCN only (1%), and other (0.5%), P < .0001. Of the patients with only a “clinical diagnosis,” 93% would have met criteria for Simon Broome, DLCN, or MEDPED based on the data available in the registry. Conclusions Our findings demonstrate heterogeneity in the application of FH diagnostic criteria in the United States. A nationwide consensus definition may lead to better identification, earlier treatment, and ultimately CHD prevention. PMID:27678440
Tominaga, Isao; Sato, Masayuki
This paper describes a development, practical applicatioin, problem of a system, evaluation of practical system, and development trend of machine translation. Most recent system contains next four problems. 1) the vagueness of a text, 2) a difference of the definition of the terminology between different language, 3) the preparing of a large-scale translation dictionary, 4) the development of a software for the logical inference. Machine translation system is already used practically in many industry fields. However, many problems are not solved. The implementation of an ideal system will be after 15 years. Also, this paper described seven evaluation items detailedly. This English abstract was made by Mu system.
Parrish, Danielle E.; Rubin, Allen
This article describes the results from a large, cross-sectional survey of social workers, psychologists, and licensed marriage and family therapists (LMFTs) in Texas (N = 865) regarding their orientation toward and implementation of evidence-based practice (EBP). All social workers were recruited by e-mail using the state NASW Listserv (analysis…
Allen, Michael; Ferrier, Suzanne; Sargeant, Joan; Loney, Elaine; Bethune, Graeme; Murphy, Gerard
Caring for patients with dementia is complex and demanding. Since family physicians (FPs) provide much of this care, we examined their practices, learning needs, and barriers to care concerning Alzheimer's disease and other dementias. We surveyed 392 (approximately 50%) Nova Scotia FPs and conducted focus groups and interviews with: FPs; staff of…
Kossek, Ellen Ernst; Lautsch, Brenda A.; Eaton, Susan C.
We examine professionals' use of telecommuting, perceptions of psychological job control, and boundary management strategies. We contend that work-family research should distinguish between descriptions of flexibility use (formal telecommuting policy user, amount of telecommuting practiced) and how the individual psychologically experiences…
Hamilton, Anna Rawlings
The primary purpose of this study is to determine if there is a relationship between teacher personality traits and teachers' reported attitudes and behaviors towards family-school partnerships. A secondary purpose of this study was to: 1) explore how various teacher demographic impacted attitudes and practices towards partnership, 2) examine if a…
9 2. ro Problem Noted ....... ................... . 80 3. V700 - Exam, medical .......... .................... 81 4. V7231 - Exam...97 20. 7840 - Headacne .......... ...................... 98 iv I. INTRODUCTION Conditions Which Prompted the Study Medical ...They were chosen because there is a close comparison between these medical care facilities in regard to the scope and breadth of family practice ifn
The objective of this study was to examine the moderating effects of feeding styles on the relationship between food parenting practices and fruit and vegetable intake in low-income families with preschool-aged children. Focus group meetings with Head Start parents were conducted by using the nomina...
Mazefsky, Carla A.; Farrell, Albert D.
This study examined the influence of witnessing violence, peer provocation, family support, and parenting practices (monitoring and discipline) on aggression. Participants were 1,196 ninth graders at nine schools in poor, predominantly agricultural, rural communities who completed measures of these variables. Witnessing violence, peer provocation,…
De Gioia, Katey
The use of childcare services for very young children (birth to three years) has increased dramatically in the past two decades (Department of Families, Community Services and Indigenous Affairs, 2004). This article investigates the expectations for cultural continuity of caregiving practices (with particular emphasis on sleep and feeding) between…
Wright, Alexandra; Hiebert-Murphy, Diane; Trute, Barry
This article presents findings from an exploratory, qualitative study whose objective was to identify professionals' perceptions of organizational factors that support or hinder the implementation of family-centered practice (FCP). Two disability services organizations in Manitoba, Canada, were selected as the research sites. In 2002, all staff…
Perry, Kristen H.; Moses, Annie M.
This ethnographic study explored the ways in which media, particularly television, connected with English language and literacy practices among Sudanese refugees in Michigan. Three families with young children participated in this study. Data collection included participant observation, interviews, and collection of artifacts over 18 months, with…
Moreau, Katherine A; Cousins, J Bradley
Program evaluation is becoming increasingly important in pediatric rehabilitation settings that adhere to the family-centered service (FCS) philosophy. However, researchers know little about the specific evaluation activities occurring in these settings or the extent to which evaluators/service providers uphold FCS in their program evaluation activities. Through a questionnaire survey, this study aimed to document evaluators/service providers' perceptions of the level of program evaluation occurring in their Canadian pediatric rehabilitation centers. It also investigated the extent to which evaluators/service providers perceive program evaluation practices at their centers to be consistent with the FCS context of Canadian pediatric rehabilitation settings. The findings suggested that the amount of evaluation activities occurring within the respondents' centers is variable; that the majority of individuals working in program evaluation do not have formal training in it; and that the respondents' centers have limited resources for evaluation. The study also showed that staff members believe their centers' evaluation activities are somewhat consistent with FCS philosophy, but that improvements are needed.
Dishion, Thomas; Forgatch, Marion; Chamberlain, Patricia; Pelham, William E.
This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children’s adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training–Oregon model), and family attenuation and dissolution (Treatment Foster Care–Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements. PMID:27993335
Valdez, Rodolfo; Yoon, Paula W; Qureshi, Nadeem; Green, Ridgely Fisk; Khoury, Muin J
Family history is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include family history to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of family history over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of family history in public health has been poorly explored. To establish family history as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized family histories of many diseases. Their goal is to create family history tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of family history as a public health tool.
Meysenburg, Rebecca; Albrecht, Julie A; Litchfield, Ruth; Ritter-Gooder, Paula K
Food preparers in families with young children are responsible for safe food preparation and handling to prevent foodborne illness. To explore the food safety perceptions, beliefs, and practices of primary food preparers in families with children 10 years of age and younger, a mixed methods convergent parallel design and constructs of the Health Belief Model were used. A random sampling of 72 primary food handlers (36.2±8.6 years of age, 88% female) within young families in urban and rural areas of two Midwestern states completed a knowledge survey and participated in ten focus groups. Quantitative data were analyzed using SPSS. Transcribed interviews were analyzed for codes and common themes. Forty-four percent scored less than the average knowledge score of 73%. Participants believe children are susceptible to foodborne illness but perceive its severity to be low with gastrointestinal discomfort as the primary outcome. Using safe food handling practices and avoiding inconveniences were benefits of preventing foodborne illness. Childcare duties, time and knowledge were barriers to practicing food safety. Confidence in preventing foodborne illness was high, especially when personal control over food handling is present. The low knowledge scores and reported practices revealed a false sense of confidence despite parental concern to protect their child from harm. Food safety messages that emphasize the susceptibility and severity of foodborne illness in children are needed to reach this audience for adoption of safe food handling practices.
Robbins, Michael S; Alexander, James F; Turner, Charles W; Hollimon, Amy
This article summarizes the evolution of functional family therapy (FFT) based upon four decades of clinical practice and scientific scrutiny through research evidence. FFT research has evolved from an initial focus upon clinical process research, which examined sequential exchanges between therapists and family members. A key element of this research has been an examination of the way in which clinicians acquire, consolidate, and maintain the skills needed to implement FFT effectively with youth and families. Many randomized efficacy and effectiveness studies have evaluated the impact of FFT across diverse clinical populations. Subsequent research investigated factors that influence the effectiveness of implementation across more than 300 clinical settings in which more than 2,500 trained clinicians have provided service to nearly 400,000 families. Another important set of investigations concerned the cost-effectiveness of the interventions.
Morelen, Diana; Thomassin, Kristel
The current review paper summarizes the literature on parental emotion socialization in ethnically diverse families in the United States. Models of emotion socialization have been primarily developed using samples of European American parents and children. As such, current categorizations of "adaptive" and "maladaptive" emotion socialization practices may not be applicable to individuals from different ethnic backgrounds. The review examines current models of emotion socialization, with particular attention paid to the demographic breakdown of the studies used to develop these models. Additionally, the review highlights studies examining emotion socialization practices in African American, Asian American, and Latin American families. The review is synthesized with summarizing themes of similarities and differences across ethnic groups, and implications for culturally sensitive research and practice are discussed.
Vesely, Colleen K.; Ginsberg, Mark R.
This study explores how early childhood education programs engage immigrant families in their children's learning, how programs learn about these families and incorporate their cultures into the classrooms, and what programs are doing in terms of their staff's professional development related to working with immigrant children and families. The…
Edwards, Todd M.
Discusses the role diet and nutrition play in the stress of individuals and families who seek help from a family therapist. Discusses when to assess a client's diet. Provides methods for diet inquiry using case examples for illustration. Recommendations are provided for marriage and family counselor training. (JDM)
Lucksted, Alicia; McFarlane, William; Downing, Donna; Dixon, Lisa
Among potential resources for people with serious mental illnesses (SMI) and their families, professionally delivered family psychoeducation (FPE) is designed to engage, inform, and educate family members, so that they can assist the person with SMI in managing their illness. In this article, we review research regarding FPE outcomes and…
Wynn, Ruth L.; Bowering, Jean
On the basis of published evidence of the negative effects of marital dissolution on homemaking and the implicit negative effects of father absence on mealtime, it was hypothesized that intact families and families with separated parents would differ in aspects of family life associated with food. Of particular interest were the subhypotheses that…
Harold, Rena D.
Noting that the movement from young adulthood through coupling and the transition to parenthood may be among the most universal adult developmental transitions, this book uses a qualitative analysis of family narratives to examine the meanings that family members ascribe to the developmental process of becoming a family. Addressing issues of…
Fletcher, Richard; St. George, Jennifer; May, Chris; Hartman, Deborah; King, Andrew
Because fathers are clearly important to family well-being, including fathers in services for families seems a straightforward idea. How hard can it be? Yet across health, education, and welfare services it is still mothers who attend and engage on behalf of their infants and children. The Family Action Centre, located on the east coast of…
Stamova, Ivanka; Henderson, Johnny
In this paper we obtain sufficient conditions for practical stability of a nonlinear system of differential equations of fractional order subject to impulse effects. Our results provide a design method of impulsive control law which practically stabilizes the impulse free fractional-order system.
Rada, Roy; Klawans, Chuck; Newton, Tom
The comparison of HIPAA compliance efforts at two multi-hospital networks (Children's Health System and Carilion Health System) suggests a framework for classifying practices and for facilitating the integration of further case studies into a national library of HIPAA practices.
Berkman, Lisa F; Buxton, Orfeu; Ertel, Karen; Okechukwu, Cassandra
An increasing proportion of U.S. workers have family caregiving responsibilities. The purpose of this study was to determine whether employees in extended care settings whose managers are supportive, open, and creative about work-family needs, such as flexibility with work schedules, have lower cardiovascular disease (CVD) risk and longer sleep than their less supported counterparts. From semistructured interviews with managers, we constructed a work-family balance score of manager openness and creativity in dealing with employee work-family needs. Trained interviewers collected survey and physiologic outcome data from 393 employees whose managers had a work-family score. Employee outcomes are sleep duration (actigraphy) and CVD risk assessed by blood cholesterol, high glycosylated hemoglobin/diabetes, blood pressure/hypertension, body-mass index, and tobacco consumption. Employees whose managers were less supportive slept less (29 min/day) and were over twice as likely to have 2 or more CVD risk factors (ORs = 2.1 and 2.03 for low and middle manager work-family scores, respectively) than employees whose managers were most open and creative. Employees who provide direct patient care exhibited particularly elevated CVD risk associated with low manager work-family score. Managers' attitudes and practices may affect employee health, including sleep duration and CVD risk.
Juang, Linda; Syed, Moin
We examined how family cultural socialization related to the ethnic identity of Asian American, Latino, White, and Mixed-Ethnic emerging adults (N=225). Greater family cultural socialization was related to greater ethnic identity exploration and commitment. Ethnic minority students reported higher levels of family cultural socialization and ethnic identity compared to White students. The family cultural socialization-ethnic identity link was more pronounced for females compared to males, and for White compared to ethnic minority students. The findings highlight the importance of the family for identity development beyond adolescence.
This case study explores the clinical relevance of the differences among shame, guilt that is linked with shame, and pure guilt. Empirical literature on emotion suggests that shame is instrumental in a host of psychiatric symptoms while pure guilt is prosocial and adaptive. Regulating shame and being able to feel pure guilt may be especially important for trauma patients like the one described here, who have transgressors as well as victims. The protocol of internal family systems (IFS), a mode of therapy that utilizes psychic multiplicity and actively recruits internal compassion, is described as a treatment for regulating shame and facilitating adaptive guilt.
Valentinis, Alissia; Ivers, Noah; Bhatia, Sacha; Meshkat, Nazanin; Leblanc, Kori; Ha, Andrew; Morra, Dante
Abstract Objective To determine the proportion of patients with atrial fibrillation (AF) in primary care achieving guideline-concordant stroke prevention treatment based on both the previous (2010) and the updated (2012) Canadian guideline recommendations. Design Retrospective chart review. Participants Primary care patients (N = 204) with AF. The mean age was 71.3 years and 53.4% were women. Setting Large urban community family practice in Toronto, Ont. Main outcome measures Patient demographic characteristics such as sex and age; a list of current cardiac medications including anticoagulants and antiplatelets; the total number of medications; relevant current and past medical history including presence of diabetes, stroke or transient ischemic attack, hypertension, and vascular disease; number of visits to the family physician and cardiologist in the past year and past 5 years, and how many of these were for AF; the number of visits to the emergency department or hospitalizations for AF, congestive heart failure, or stroke; if patients were taking warfarin, how often their international normalized ratios were recorded, and how many times they were in the reference range; CHADS2 (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, and stroke or transient ischemic attack) score, if recorded; and reason for not taking oral anticoagulants when they should have been, if recorded. Results Among those who had CHADS2 scores of 0, 64 patients (97.0%) were receiving appropriate stroke prevention in AF (SPAF) treatment according to the 2010 guidelines. When the 2012 guidelines were applied, 39 patients (59.1%) were receiving appropriate SPAF treatment (P < .001). For those with CHADS2 scores of 1, 88.4% of patients had appropriate SPAF treatment according to the 2010 guidelines, but only 55.1% were adequately treated according to the 2012 guidelines (P < .001). Of the patients at the highest risk (CHADS2 score > 1), 68.1% were adequately treated with
Hereditary Colorectal Cancer Syndromes: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the Familial Risk–Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guidelines
Stoffel, Elena M.; Mangu, Pamela B.; Gruber, Stephen B.; Hamilton, Stanley R.; Kalady, Matthew F.; Lau, Michelle Wan Yee; Lu, Karen H.; Roach, Nancy; Limburg, Paul J.
Purpose To provide recommendations on prevention, screening, genetics, treatment, and management for people at risk for hereditary colorectal cancer (CRC) syndromes. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. Methods The Familial Risk–Colorectal Cancer: European Society for Medical Oncology Clinical Practice Guideline published in 2013 on behalf of the European Society for Medical Oncology (ESMO) Guidelines Working Group in Annals of Oncology was reviewed for developmental rigor by methodologists, with content and recommendations reviewed by an ASCO endorsement panel. Results The ASCO endorsement panel determined that the recommendations of the ESMO guidelines are clear, thorough, and based on the most relevant scientific evidence. The ASCO panel endorsed the ESMO guidelines and added a few qualifying statements. Recommendations Approximately 5% to 6% of patient cases of CRC are associated with germline mutations that confer an inherited predisposition for cancer. The possibility of a hereditary cancer syndrome should be assessed for every patient at the time of CRC diagnosis. A diagnosis of Lynch syndrome, familial adenomatous polyposis, or another genetic syndrome can influence clinical management for patients with CRC and their family members. Screening for hereditary cancer syndromes in patients with CRC should include review of personal and family histories and testing of tumors for DNA mismatch repair deficiency and/or microsatellite instability. Formal genetic evaluation is recommended for individuals who meet defined criteria. PMID:25452455
BACKGROUND An important question for population research is whether fertility decline transforms gender systems. OBJECTIVE This paper contributes to answering this broad question by examining how fertility decline may change the relative value and roles of daughters and sons in families. First, I outline theoretical pathways, suggesting that a key factor is the gender composition of families. As fertility declines, the proportion of families with children of only one gender increases, which may facilitate greater gender symmetry between daughters and sons. Second, I explore how fertility decline may have contributed to the transformation of the relative value and roles of sons and daughters in practice in one place. METHODS The analysis draws primarily on semi-structured interviews with 30 respondents living in one Indian village. This village is located in a district where fertility has declined to at least the replacement level. RESULTS Respondents perceive changes in the gender system, including less son preference, more equal schooling for sons and daughters, more freedom in marriage and premarital relationships, and perhaps greater daughter support of parents in old age. CONCLUSIONS The results describe changes in the relative value, treatment, and behavior of sons and daughters that are consistent with the theorized effects of fertility decline. Future research is needed, however, to determine whether fertility decline makes a causal contribution to changes in the gender system. PMID:27147902
Glisson, Charles; Williams, Nathaniel J.; Green, Philip; Hemmelgarn, Anthony; Hoagwood, Kimberly
Introduction Peer family support specialists (FSS) are parents with practical experience in navigating children’s mental health care systems who provide support, advocacy and guidance to the families of children who need mental health services. Their experience and training differ from those of formally trained mental health clinicians, creating potential conflicts in priorities and values between FSS and clinicians. We hypothesized that these differences could negatively affect the organizational cultures and climates of mental health clinics that employ both FSS and mental health clinicians, and lower the job satisfaction and organizational commitment of FSS. Method The Organizational Social Context (OSC) measure was administered on site to 209 FSS and clinicians in 21 mental health programs in New York State. The study compared the organizational-level culture and climate profiles of mental health clinics that employ both FSS and formally trained clinicians to national norms for child mental health clinics, assessed individual-level job satisfaction and organizational commitment as a function of job (FSS vs. clinician) and other individual-level and organizational-level characteristics, and tested whether FSS and clinicians’ job attitudes are differentially associated with organizational culture and climate. Results The programs’ organizational culture and climate profiles were not significantly different from national norms. Individual-level job satisfaction and organizational commitment were unrelated to position (FSS vs. clinician) or other individual-level and organizational-level characteristics except for culture and climate. Conclusions Organizational culture and climate are not related to the employment of FSS. Both FSS’ and clinicians’ individual-level work attitudes are associated similarly with organizational culture and climate. PMID:24065458
Internal, external and managerial functions of husband and wife, father and mother, and child sub-systems of the nuclear family are identified and discussed. The process of becoming a family is explored. In characterizing an optimally functioning family, emphasis is placed on the ability of family members to negotiate and resolve their roles,…
Lee, Sang Kil; Yi, Hyun Sook
This study examined the relationships between family systems and high school students' career development. Family adaptability and family cohesion were considered as indicators of family function, and career attitude maturity was conceptualized as a representative factor explaining adolescents' career development. A total of 634 high school…
Koletzko, B; Bauer, C-P; Bung, P; Cremer, M; Flothkötter, M; Hellmers, C; Kersting, M; Krawinkel, M; Przyrembel, H; Rasenack, R; Schäfer, T; Vetter, K; Wahn, U; Weißenborn, A; Wöckel, A
Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester. Iodine rich foods and salt and an iodine supplement (100-150 µg/day) are recommended. Long-chain omega-3 fatty acids should be provided with ≥ 1 weekly portion of oily sea fish, or a DHA-supplement if regular fish consumption is avoided. Vitamin D supplementation is advisable unless there is regular exposure to sunlight. Iron supplements should be used based on medical history and blood testing. Vegetarian diets with nutritional supplements can provide adequate nutrition, but counselling is recommended. In contrast, a vegan diet is inadequate and requires additional micronutrient supplementation. For risk reduction of listeriosis and toxoplasmosis, raw animal foods, soft cheeses and packed fresh salads should be avoided; fresh fruit, vegetables and salad should be washed well and consumed promptly. Pregnant women should remain physically active and perform sports with moderate intensity. They should avoid alcohol, active and passive smoking. Up to 3 daily cups of coffee are considered harmless, but energy drinks should be avoided. Childhood allergy is not reduced by avoiding certain foods in pregnancy whereas oily sea fish is recommended. Health care professions should lead parents to health-promoting lifestyles. Subjects of part 1 of the article are practice recommendations on nutrition, on energy needs, micronutrient needs and body weight/weight gain in pregnancy.
Menard-Warwick, Julia; Dabach, Dafney Blanca
This investigation compares the computer practices of the Garza family, from the first study, with those of the Fuentes family, from the second study. As both families are of Mexican origin, they belong to an ethnicity that has been reported as falling on the "have-not" side of the "divide" (U.S. Department of Commerce, 1999);…
Avery, Anthony J; Savelyich, Boki S P; Teasdale, Sheila
General practice computer systems already have a number of important safety features. However, there are problems in that general practitioners (GPs) have come to rely on hazard alerts when they are not foolproof. Furthermore, GPs do not know how to make best use of safety features on their systems. There are a number of solutions that could help to improve the safety features of general practice computer systems and also help to improve the abilities of healthcare professionals to use these safety features.
Russ, M.; Singh, V.; Loughran, B.; Bednarek, D.R.; Rudin, S.
A family of imaging task-specific metrics designated Relative Object Detectability (ROD) metrics was developed to enable objective, quantitative comparisons of different x-ray systems. Previously, ROD was defined as the integral over spatial frequencies of the Fourier Transform of the object function, weighted by the detector DQE for one detector, divided by the comparable integral for another detector. When effects of scatter and focal spot unsharpness are included, the generalized metric, GDQE, is substituted for the DQE, resulting in the G-ROD metric. The G-ROD was calculated for two different detectors with two focal spot sizes using various-sized simulated objects to quantify the improved performance of new high-resolution CMOS detector systems. When a measured image is used as the object, a Generalized Measured Relative Object Detectability (GM-ROD) value can be generated. A neuro-vascular stent (Wingspan) was imaged with the high-resolution Micro-Angiographic Fluoroscope (MAF) and a standard flat panel detector (FPD) for comparison using the GM-ROD calculation. As the lower integration bound increased from 0 toward the detector Nyquist frequency, increasingly superior performance of the MAF was evidenced. Another new metric, the R-ROD, enables comparing detectors to a reference detector of given imaging ability. R-RODs for the MAF, a new CMOS detector and an FPD will be presented. The ROD family of metrics can provide quantitative more understandable comparisons for different systems where the detector, focal spot, scatter, object, techniques or dose are varied and can be used to optimize system selection for given imaging tasks. PMID:26912942
Russ, M.; Singh, V.; Loughran, B.; Bednarek, D. R.; Rudin, S.
A family of imaging task-specific metrics designated Relative Object Detectability (ROD) metrics was developed to enable objective, quantitative comparisons of different x-ray systems. Previously, ROD was defined as the integral over spatial frequencies of the Fourier Transform of the object function, weighted by the detector DQE for one detector, divided by the comparable integral for another detector. When effects of scatter and focal spot unsharpness are included, the generalized metric, GDQE, is substituted for the DQE, resulting in the G-ROD metric. The G-ROD was calculated for two different detectors with two focal spot sizes using various-sized simulated objects to quantify the improved performance of new high-resolution CMOS detector systems. When a measured image is used as the object, a Generalized Measured Relative Object Detectability (GM-ROD) value can be generated. A neuro-vascular stent (Wingspan) was imaged with the high-resolution Micro-Angiographic Fluoroscope (MAF) and a standard flat panel detector (FPD) for comparison using the GM-ROD calculation. As the lower integration bound increased from 0 toward the detector Nyquist frequency, increasingly superior performance of the MAF was evidenced. Another new metric, the R-ROD, enables comparing detectors to a reference detector of given imaging ability. R-RODs for the MAF, a new CMOS detector and an FPD will be presented. The ROD family of metrics can provide quantitative more understandable comparisons for different systems where the detector, focal spot, scatter, object, techniques or dose are varied and can be used to optimize system selection for given imaging tasks.
Banks, Duren; Dutch, Nicole; Wang, Kathleen
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 and organized collaborative groups in accordance with the Greenbook foundational principles and recommendations, including representation from multiple levels within the primary partner systems and other organizations, as well as the community. The sites struggled with how to engage consumers of the primary systems, however, and devoted a great deal of time to understanding and addressing organizational differences among the partners. Other salient collaborative influences included leadership, resources, trust, and commitment. The stakeholders noted that the collaborative relationships required a great deal of work but were ultimately one of the main successes of the initiative.
McDowall, R D
To maximize the benefits of a LIMS, the system must be integrated with the analytical instrumentation in the laboratory. This provides on-line data capture or transfer of results for matching with the corresponding sample records held within the database, which reduces transcription error checking and ensures data integrity. Furthermore, the LIMS must be integrated with existing corporate systems to ensure efficient use of resources and to avoid the development of parallel systems.
Sheps, S B; Schechter, M T; Grantham, P; Finlayson, N; Sizto, R
Are there differences in patterns of practice between actively practising physicians who have been certified after a 2-year family practice residency and matched physicians without certification who have completed the standard 1-year internship? With the use of billing files prepared by the British Columbia Medical Association a group of 65 family practice certificants in active practice in British Columbia was compared with a control group of 130 internship trainees matched by year and school of graduation, category of billing (i.e., solo or group) and region. A wide range of practice features was assessed for the fiscal years 1984-85, 1985-86 and 1986-87. No differences were detected between the groups in 1986-87 for the following practice variables: number of patients (1888 and 1842 respectively), number of personal services billed for (7265 and 7173), number of personal services per patient (3.9), amount of funding for personal services ($140,192 and $140,100) and amount per patient for personal services ($77 and $79). Age-adjusted costs for male and female patients were similar in the two groups. Of six services thought to be influenced by type of training, only maternity care generated a significantly higher number of billings in the study group (341 v. 249). These results suggest that there is no demonstrable effect of training on patterns of practice. However, the question of the effect of training on quality of care and whether the 2-year residency may have a longer effect on practice patterns should be the focus of future research.
Stenger, Kristen M; Ritter-Gooder, Paula K; Perry, Christina; Albrecht, Julie A
Children are at a higher risk for foodborne illness. The objective of this study was to explore food safety knowledge, beliefs and practices among Hispanic families with young children (≤10 years of age) living within a Midwestern state. A convergent mixed methods design collected qualitative and quantitative data in parallel. Food safety knowledge surveys were administered (n = 90) prior to exploration of beliefs and practices among six focus groups (n = 52) conducted by bilingual interpreters in community sites in five cities/towns. Descriptive statistics determined knowledge scores and thematic coding unveiled beliefs and practices. Data sets were merged to assess concordance. Participants were female (96%), 35.7 (±7.6) years of age, from Mexico (69%), with the majority having a low education level. Food safety knowledge was low (56% ± 11). Focus group themes were: Ethnic dishes popular, Relating food to illness, Fresh food in home country, Food safety practices, and Face to face learning. Mixed method analysis revealed high self confidence in preparing food safely with low safe food handling knowledge and the presence of some cultural beliefs. On-site Spanish classes and materials were preferred venues for food safety education. Bilingual food safety messaging targeting common ethnic foods and cultural beliefs and practices is indicated to lower the risk of foodborne illness in Hispanic families with young children.
Mohammad, Khader; Agaian, Sos; Saleh, Hani
Since 1970's, the need of an automatic license plate recognition system, sometimes referred as Automatic License Plate Recognition system, has been increasing. A license plate recognition system is an automatic system that is able to recognize a license plate number, extracted from image sensors. In specific, Automatic License Plate Recognition systems are being used in conjunction with various transportation systems in application areas such as law enforcement (e.g. speed limit enforcement) and commercial usages such as parking enforcement and automatic toll payment private and public entrances, border control, theft and vandalism control. Vehicle license plate recognition has been intensively studied in many countries. Due to the different types of license plates being used, the requirement of an automatic license plate recognition system is different for each country. [License plate detection using cluster run length smoothing algorithm ].Generally, an automatic license plate localization and recognition system is made up of three modules; license plate localization, character segmentation and optical character recognition modules. This paper presents an Arabic license plate recognition system that is insensitive to character size, font, shape and orientation with extremely high accuracy rate. The proposed system is based on a combination of enhancement, license plate localization, morphological processing, and feature vector extraction using the Haar transform. The performance of the system is fast due to classification of alphabet and numerals based on the license plate organization. Experimental results for license plates of two different Arab countries show an average of 99 % successful license plate localization and recognition in a total of more than 20 different images captured from a complex outdoor environment. The results run times takes less time compared to conventional and many states of art methods.
Heimsath, Clovis B.
The architecture profession needs to employ systems building design in order to raise the rate of productivity and performance in construction. Changes have been made in architecture educational programs that recognize the shift in the role of the architect from design genius to building production manager. Systems design has led to changes within…
Kim, Hye-On; Hoppe-Graff, Siegfried
Compares mothers' roles in socializing their children in traditional South Korean families with that of mothers' in modern families. While Confusion influence remains strong, significant changes in South Korean culture often create complex, ambiguous, and emotionally unstable relationships between mothers and their adolescent children. Discusses…
Richards, Leslie N.; Schmiege, Cynthia J.
Used qualitative interview data from study of 60 single-parent mothers and 11 single-parent fathers to examine family problems and strengths identified by these parents. With exception of family finances and ex-spouses, mothers and fathers seemed to have very similar experiences. About two-thirds of single parents reported that single parenting…
Orellana, Marjorie Faulstich; Reynolds, Jennifer; Dorner, Lisa; Meza, Maria
Reports on ethnographic research that explores the range of ways in which Spanish-English bilingual immigrant youth interpret English language texts for their families. Focuses on interpretations of written text for close family members, done at home, and charts the domains of these multiple literacies. Argues that bilingual youth's experiences as…
Research and Training Center on Family Support and Children's Mental Health, 2005
"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" addresses the experiences of families across the United States with regard to parent-child contact when the children are placed out of their home for the…
Pine, Barbara A.; Drachman, Diane
This article presents a multistage migration framework to broaden the lens through which child welfare personnel can view immigrant and refugee families and their children. By better understanding the family's experiences in both emigration and immigration, including reasons for leaving their home country, experiences in transit, and reception and…
Ren, Li; Hu, Guangwei
Social capital--the social relations between people--is an important component of the family environment and is crucial for the creation of human capital for the next generation. Drawing on James S. Coleman's theory of family capital, this study focuses on parents' utilization of social capital to support children's literacy acquisition in four…
Boothby, Neil; Balster, Robert L.; Goldman, Philip; Wessells, Michael G.; Zeanah, Charles H.; Huebner, Gillian; Garbarino, James
The 2011 U.S. Government Evidence Summit on Protecting Children Outside of Family Care brought together leading researchers and technical experts to assess the available evidence to inform policies, strategies, and programs relevant to protecting children outside of family care in lower and middle income countries. While child vulnerabilities are…
Hughes, Cathy; Thomas, Trang
A research review identified a range of family process variables associated with enhanced career development for adolescents and young adults. Findings were consistent with the theories of Roe (personality development and career choice) and Super (life-span, life-space) regarding the influence of family processes on career development. (Contains…
Auerbach, Susan, Ed.
School leaders are increasingly called upon to pursue meaningful partnerships with families and community groups, yet many leaders are unprepared to meet the challenges of partnerships, to cross cultural boundaries, or to be accountable to the community. Alliances are needed among educators, families, and community groups that value relationship…
Miller, Peter M.
Family homelessness has been on the rise throughout the United States in recent years. As a result, more schools and communities than ever are challenged to serve students whose lives are touched by instability, uncertainty, and crisis. To date, there has been little inquiry into how families' particular places of homelessness might shape school…
Lucey, Christopher F.; Lam, Sarah K. Y.
This study was designed to identify characteristics of family functioning that relate to suicide potential in an outpatient adolescent population. Participants included 51 adolescents between the ages of 14 and 18 who were involved in outpatient counselling. The Family Environment Scale and the Suicide Probability Scale were used to assess…
Hardin, Belinda J.; Blanchard, Sheresa Boone; Kemmery, Megan A.; Appenzeller, Margo; Parker, Samuel D.
Families with children who are deaf face many important decisions, especially the mode(s) of communication their children will use. The purpose of this focus group study was to better understand the experiences and recommendations of families who chose American Sign Language (ASL) as their primary mode of communication and to identify strategies…
Springer, Paul R.; Abbott, Douglas A.; Reisbig, Allison M. J.
Despite the growing numbers of Muslims in the United States, there is a scarcity of research dealing with mental health practitioners working with Muslim families. This lack of research may leave clinicians unprepared to adequately help Muslim patients and families faced with discrimination and misunderstanding, which may inadvertently lead to the…
Atkin, Karl; Lunt, Neil
Interviews with 56 practice nurses, 29 general practitioners (GPs), 23 health administrators, and 1 government official revealed that nurses use a variety of education and training opportunities; GPs largely let nurses take responsibility for their continuing education. The informal nature of training opportunities and lack of funding were…
Lindblom, Jallu; Peltola, Mikko J.; Vänskä, Mervi; Hietanen, Jari K.; Laakso, Anu; Tiitinen, Aila; Tulppala, Maija; Punamäki, Raija-Leena
The family environment shapes children's social information processing and emotion regulation. Yet, the long-term effects of early family systems have rarely been studied. This study investigated how family system types predict children's attentional biases toward facial expressions at the age of 10 years. The participants were 79 children from…
Office of Child Development (DHEW), Washington, DC.
The Child and Family Resource Program (CFRP) of the Office of Child Development (OCD) is described. CFRP is designed to provide family-oriented, comprehensive services to children from the prenatal period through age 8, according to their individual needs. The program description stresses the use of existing community resources in a linked program…
Breunlin, Douglas C; Jacobsen, Elizabeth
In this article, we examine the field of family therapy by drawing a distinction between two forms of practice: Whole Family Therapy (WFT), defined as treating the whole family, and Relational Family Therapy (RFT), defined as working with a subsystem of the family or an individual while retaining a systemic lens. Our thesis is that the practice of WFT has been in decline for some time and steps must be taken to keep it from becoming a defunct practice. We consider the trajectory of WFT and RFT throughout the development of family therapy through reference to the people, the literature, training, and practice patterns associated with family therapy. We remind the reader of the many benefits of WFT and suggest that today WFT is likely to be practiced in conjunction with RFT and individual therapy. Since training of family therapists today is largely located in degree-granting programs, we identify constraints to including WFT in such programs. We conclude by offering suggestions that can enhance a program's ability to train students in WFT.
Turell, Susan C; Herrmann, Molly M
"Family" is a euphemistic term that lesbian, gay, bisexual, and transgender (LGBT) people use among ourselves to designate membership in lesbian, gay, bisexual, and transgender communities. Ironically, this "family" may be the most sought, yet least successful, support for dealing with the intimate partner violence that occurs within LGBT families. This study of 11 lesbian and bisexual women's experiences seeking support revealed several tiers of unmet needs within the LGBT community. They rarely used services in the general community, although these services are often the focus of both criticism and efforts to build support systems for LGBT victim/survivors. A model presents the different stages and potential sources of support.
examination or treatment suplies, and calling waiting patients to exaixation’D Loam. 71he researcer alo noted that the physicians Prepared their own...the waiting area. The physician examines the patient in the exanination roon and prepares any necessary lab slips or other consult requests. A rnw is...health care. Fiue 2. Gateway to Care health care moess del. Figure 3. Current organization chart. Figure 4. Family Practice clinic layout. Guide to
James R. Davidson; Jason L. Wright
This paper addresses an often overlooked “backdoor” into critical infrastructure control systems created by modem connections. A modem’s connection to the public telephone system is similar to a corporate network connection to the Internet. By tracing typical attack paths into the system, this paper provides the reader with an analysis of the problem and then guides the reader through methods to evaluate existing modem security. Following the analysis, a series of methods for securing modems is provided. These methods are correlated to well-known networking security methods.
Sonne, John C.
Unrooted children who have lost parents through divorce, separation, death, or abandonment need as a model an external psychological family in order to complete their developmental task of constructing an internalized triadic family image. (Author)
Mohammad, Khader; Agaian, Sos; Saleh, Hani
Rapid growth and progress in the medical, industrial, security and technology fields means more and more consideration for the use of camera based optical character recognition (OCR) Applying OCR to scanned documents is quite mature, and there are many commercial and research products available on this topic. These products achieve acceptable recognition accuracy and reasonable processing times especially with trained software, and constrained text characteristics. Even though the application space for OCR is huge, it is quite challenging to design a single system that is capable of performing automatic OCR for text embedded in an image irrespective of the application. Challenges for OCR systems include; images are taken under natural real world conditions, Surface curvature, text orientation, font, size, lighting conditions, and noise. These and many other conditions make it extremely difficult to achieve reasonable character recognition. Performance for conventional OCR systems drops dramatically as the degradation level of the text image quality increases. In this paper, a new recognition method is proposed to recognize solid or dotted line degraded characters. The degraded text string is localized and segmented using a new algorithm. The new method was implemented and tested using a development framework system that is capable of performing OCR on camera captured images. The framework allows parameter tuning of the image-processing algorithm based on a training set of camera-captured text images. Novel methods were used for enhancement, text localization and the segmentation algorithm which enables building a custom system that is capable of performing automatic OCR which can be used for different applications. The developed framework system includes: new image enhancement, filtering, and segmentation techniques which enabled higher recognition accuracies, faster processing time, and lower energy consumption, compared with the best state of the art published
Occupational medicine has taken over from Family practice the treatment of work injuries and occupational diseases in the Republic of Croatia since January 1, 2008. The reason was too many long-lasting sick leaves which general practitioners were unable to curb adequately. The research objective was to show the results of the one-year follow-up of the carried out reform, i.e. the efficiency of Occupational medicine in the new function. The methods of data comparison and McNemar statistics were used of one-year follow-up in an Occupational medicine surgery that cares for 5800 employees in Littoral-Mountainous County. From 32 patients in February 2008, 30 work injuries and 2 occupational diseases, the overall number diminished in February 2009 to 13 patients with work injuries and no diagnosed occupational disease, p < 0.001 for work injuries. Also the number of patients on sick leave over three months fell from 14 to 4. Occupational medicine has proved to be more efficient than Family practice in assessing sick leave. This does not mean that family practice, due to a number of reasons mentioned in the research, is of less importance. For the patient can always return to his general practitioner for further treatment, and sick leave if necessary, but not on the grounds of work injury and occupational disease.
Matthews, Judith T.; Lingler, Jennifer H.; Campbell, Grace B.; Hunsaker, Amanda E.; Hu, Lu; Pires, Bernardo R.; Hebert, Martial; Schulz, Richard
Health care providers typically rely on family caregivers (CG) of persons with dementia (PWD) to describe difficult behaviors manifested by their underlying disease. Although invaluable, such reports may be selective or biased during brief medical encounters. Our team explored the usability of a wearable camera system with 9 caregiving dyads (CGs: 3 males, 6 females, 67.00 ± 14.95 years; PWDs: 2 males, 7 females, 80.00 ± 3.81 years, MMSE 17.33 ± 8.86) who recorded 79 salient events over a combined total of 140 hours of data capture, from 3 to 7 days of wear per CG. Prior to using the system, CGs assessed its benefits to be worth the invasion of privacy; post-wear privacy concerns did not differ significantly. CGs rated the system easy to learn to use, although cumbersome and obtrusive. Few negative reactions by PWDs were reported or evident in resulting video. Our findings suggest that CGs can and will wear a camera system to reveal their daily caregiving challenges to health care providers. PMID:26288888
Mulder, Martijn J.; Baeyens, Dieter; Davidson, Matthew C.; Casey, B. J.; Van Den Ban, Els; Van Engeland, Herman; Durston, Sarah
The study examines whether cerebellar systems are sensitive to familial risk for ADHD in addition to frontostriatal circuitry. The results conclude that familial vulnerability to ADHD affects activity in both the prefrontal cortex and cerebellum.
National Coalition for the Homeless, Washington, DC.
Homelessness among families is quickly reaching crisis proportions across the country. Over 30 percent of America's three million homeless people are members of families, and families are the fastest growing segment of the homeless population. Perhaps more disturbing, homelessness represents only the most extreme manifestation of a more…
Unger, Donald G., Ed.; Powell, Douglas R., Ed.
This volume seeks to refine and extend knowledge about approaches to supporting the caregiving roles of families. The chapters in the volume describe and appraise new directions in family support. After an introduction, the two parts of the volume address "New Directions for Family Resource and Support Programs" (six chapters) and…
Konstanzová, V; Koubková, B; Kašný, M; Ilgová, J; Dzika, E; Gelnar, M
Diplozoons are representatives of blood-feeding ectoparasites from the family Diplozoidae (Polyopisthocotylea, Monogenea). Although these worms have been the subject of numerous taxonomical, phylogenetic, and ecological studies, the detailed study of their excretory system has remained relatively neglected. Our observations focused on the morphological and ultrastructural features of the excretory apparatus of four diplozoid species: Diplozoon paradoxum, Eudiplozoon nipponicum, Paradiplozoon bliccae, and Paradiplozoon homoion. Observations were obtained using two microscope methods: light microscopy, equipped with differential interference contrast (Nomarski DIC) and transmission electron microscopy (TEM). The ultrastructure of two basic compartments which forms the excretory apparatus, flame cells with filtration apparatus, and canal cells forming the protonephridial ducts is revealed in this study. A unique consecutive sequence of longitudinal semi-thin sections of the excretory pore of E. nipponicum is visualized there for the first time.
Buică, Adriana; Llibre, Jaume; Makarenkov, Oleg
The paper addresses the problem of bifurcation of periodic solutions from a normally nondegenerate family of periodic solutions of ordinary differential equations under perturbations. The approach to solve this problem can be described as transforming (by a Lyapunov-Schmidt reduction) the initial system into one which is in the standard form of averaging, and subsequently applying the averaging principle. This approach encounters a fundamental problem when the perturbation is only Lipschitz (nonsmooth) as we do not longer have smooth Lyapunov-Schmidt projectors. The situation of Lipschitz perturbations has been addressed in the literature lately and the results obtained conclude the existence of the bifurcated branch of periodic solutions. Motivated by recent challenges in control theory, we are interested in the uniqueness problem. We achieve this in the case when the Lipschitz constant of the perturbation obeys a suitable estimate.
Bebtschuk, Marina; Smirnova, Daria; Khayretdinov, Oleg
This article represents the information about family and family therapy in the context of culture, traditions and contemporary changes of social situations in Russia. The legislation of family rights are mentioned within items about marriage and family in the Constitution, Civil Code and Family Code of the Russian Federation which has changed during recent years. The definition of family and description of family structure are given through the prism of the current demographic situation, dynamics of statistics of marriage and divorce rates, mental disorders, disabilities and such phenomena as social abandonment. The actual curriculum, teaching of family therapy and its disadvantages, system of continuous education, supervision and initiatives of the Institute of Integrative Family Therapy in improvement of preparing of specialists who can provide qualified psychosocial assistance for the family according to the actual needs of society are noted. The directions of state and private practice of family counselling and therapy both for psychiatric patients and medical patients, for adults and children in a family systemic approach are highlighted with an indication of the spectrum of techniques and methods used by Russian professionals. The main obstacles and perspectives of development of family therapy in Russia are summarized.
This document is both a synthesis of current notions about complex systems, and a practical approach description. A disambiguation is proposed and exposes possible reasons for controversies related to causation and emergence. Theoretical considerations about simulations are presented. A justification is then given for the development of practical tools and techniques for the investigation of complex systems. A methodology for the usage of these tools is finally suggested, illustrated by application examples.
Parish, Thomas S.
College students (n=130) described support system failures they encountered during childhood and adolescence through responses on Personal History Inventory and ratings of self and family on Personal Attribute Inventory. Found significant direct relationships between level of support system failures and negativeness expressed in ratings of both…
May 1990 n E I E C’ E JUN 2 11990 United States Army Research Institute for the Behavioral and Social Sciences Approved for public release...17 AR 215-1 The Administration of Army Morale, WIfar* e and Recreation Activities and Nonappropriated Fund Instrumentalities (NAFI...44 AR 621-5 Army Continuing Education System (ACES) .. ......... ... 45 AR 621-6 Army Learnin gCenters ............. .... 46 AR
Parra-Cardona, José Rubén; Meyer, Emily; Schiamberg, Lawrence; Post, Lori
There is a scarcity of theoretical frameworks capable of describing precursors and dynamics associated with elder abuse and neglect in Latino families. The present manuscript seeks to address this gap in the literature by presenting an integrative theoretical framework that fosters an ecological and cultural understanding of elder abuse and neglect among Latinos. The proposed model rests on the premise that Latino families caring for elder adults have the ability to adapt to the demands of aging only if they are supported by nurturing environments. The usefulness of the model is threefold. First, the proposed model describes elder abuse and neglect as multifactorial phenomena and identifies specific risk factors associated with the etiology and maintenance of elder abuse and neglect in Latino families. Second, the model provides clinical applications, including reflections about the therapists' need to extend their scope of practice beyond traditional family therapy interventions. A brief case study is presented that illustrates the clinical application of the model with a Latino family. Implications for future research are discussed.
Oguzoncul, A Ferdane; Deveci, S Erhan; Acik, Yasemin
The objective of this study was to determine the knowledge, attitudes and practices of young male soldiers about family planning. This was a cross-sectional study conducted at the Gendarmerie Command Headquarters, Elazig City, eastern Turkey, carried out on 14 April 2004. One hundred ninety-one of 209 soldiers who were present at the Gendarmerie Command Headquarters were included in the study. A questionnaire, developed by the researchers evaluating the goals of the study, was filled out by the subjects prior to the Family Planning Seminar given to the soldiers. Data were assessed using SPSS and the chi-square test was used for statistical analysis. Defining family planning correctly, being familiar with planning methods and a knowledge of sexually transmitted diseases (STD) and their prevention was found to be at low levels among soldiers. A knowledge of family planning, birth control methods, identification and prevention of STD was higher with higher levels of education. The most familiar family planning methods were condom and oral contraceptive use. Soldiers constitute one of the most significant target groups for education programs.
Mao, Chad Y; Narang, Sandeep; Lopreiato, Joseph
Breastfeeding practices in military families have not been widely investigated. The objective of this study was to measure the prevalence and duration of breastfeeding among uniformed families and identify factors associated with breastfeeding. We conducted a prospective study of 253 mothers of new infants from July to December 2004. Initial information gathered included demographic data, feeding choices, and intended duration of breastfeeding. Follow-up surveys were conducted until 12 months postpartum. 51% of mothers were breastfeeding at 6 months and 25% at 1 year. Mothers on active duty were equally likely to breastfeed than non-active duty mothers. Officer mothers were 3 times more likely to breastfeed compared to enlisted mothers (p = 0.005). Mothers with higher education were twice as likely to breastfeed longer (p = 0.015). Families participating in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were 2.5 times less likely to breastfed at 1 year (p < 0.001). Our study shows a higher percentage of women initiating and maintaining breastfeeding compared to national data, but still less than current American Academy of Pediatrics guidelines. Our study suggests that to improve breastfeeding rates among uniformed families, more attention may need to be directed to younger, enlisted mothers and those families in a lower socioeconomic status or receiving WIC assistance.
Carney, Richard W.
Intended for use in the technical program of a technical institute or community college, this student manual is designed to provide background in the metric system contributing to employability. Nine units are presented with objectives stated for each unit followed by questions or exercises. (Printed answers are supplied when necessary.) Unit 1…
Traditionally, the olfactory epithelium is considered to recognize conventional odors, while the vomeronasal organ detects pheromones. However, recent advances suggest that vertebrate pheromones can also be detected by the olfactory epithelium. In the vomeronasal organ and the olfactory epithelium, structurally distinct multiple receptor families are expressed. In rodents, two of these receptor families, V1R and V2R, are expressed specifically in the vomeronasal organ and detect pheromones and pheromone candidates. A newly isolated trace amine-associated receptor detects some of the putative pheromones in the mouse olfactory epithelium. In addition, distinct second-messenger pathways and neural circuits are used for pheromone perception mediated by each receptor family. Furthermore, the function of these receptor families in these olfactory organs appears to differ among various vertebrate species. The systems for pheromone perception in vertebrates are far more complex than previously predicted.
Naaldenberg, Jenneken; Vaandrager, Lenneke; Koelen, Maria; Wagemakers, Anne-Marie; Saan, Hans; de Hoog, Kees
Health and well-being are the result of a series of complex processes in which an individual interacts with other people and the environment. A systematic approach ensures incorporation of individual, ecological, social and political factors. However, interactions between these factors can be overlooked within a systematical approach. A systemic approach can provide additional information by incorporating interactions and communication. The opportunities of a systems thinking perspective for health promotion were investigated for this paper. Although others have also made attempts to explore systems thinking in the field of health promotion, the implications of systems thinking in practice need attention. Other fields such as agricultural extension studies, organizational studies and development studies provide useful experiences with the use of a systems thinking perspective in practice. Building on experiences from these fields, we give a theoretical background in which processes of social learning and innovation play an important role. From this background, we derive an overview of important concepts for the practical application of a systems thinking perspective. These concepts are the structure of the system, meanings attached to actions, and power relations between actors. To make these concepts more explicit and reduce the theoretical character of systems thinking, we use an illustration to elaborate on these concepts in practice. For this purpose, we describe a health promotion partnership in The Netherlands using the concepts structure, meaning and power relations. We show how a systems perspective increases insight in the functioning of a partnership and how this can facilitate processes of social learning and innovation. This article concludes by identifying future opportunities and challenges in adopting systems thinking for health promotion practice. A systems perspective towards health promotion can help projects reaching a more integral and
Part 1 of this article, published on page 1942, encourages family doctors to consider their patients' personalities in clinical assessment and management. This section discusses patient interviewing, demonstrating how family physicians can listen for `themes' in a patient's conversation that may hold clues to what is bothering him. It is also best to avoid giving a patient too much support in an attempt `to make him feel better' because such support may also prevent him from making mature decisions. It is equally important generally to avoid giving specific advice, because it may prevent patients from taking responsibility for their own actions. The clinician can use his own feelings and reactions to the patient to better understand the patient's personality and problems. Consultation with a psychiatrist can help clarify the family physician's role in assisting a particular patient. Balint groups are recommended for family doctors who are interested in further developing their interviewing skills. PMID:21283433
The government of Bangladesh is currently testing and implementing strategies to change its family planning program from a reliance on field-workers who conduct home visits to a conventional fixed-site delivery system. Researchers have made two suggestions: First, the program should encourage women to switch from nonclinical methods delivered by family planning workers to more cost-effective clinical methods such as sterilization, and second, field-workers should not be resupplying nonclinical methods, but should focus their attention on motivating nonusers to practice contraception. Longitudinal data from the Maternal and Child Health-Family Planning Extension Project of the International Centre for Diarrhoeal Disease Research, Bangladesh, are analyzed to show that a better strategy might be to target visits to women according to their educational level and area of residence. For uneducated women living far from clinics, access to contraceptives is likely to be a problem, and home visits for resupply might have a larger impact on the contraceptive prevalence rate than would field-workers' visits to motivate nonusers.
Paulson, Christina May; Monroe, Todd; McDougall, Graham J; Fick, Donna M
Delirium is burdensome and psychologically distressing for formal and informal caregivers, yet family caregivers often have very little understanding or knowledge about delirium. As part of a large multisite intervention study, the Early Nurse Detection of Delirium Superimposed on Dementia (END-DSD), the authors identified a need for family educational materials. This educational initiative's purpose was to develop a delirium admission brochure for family members to aid in the prevention and earlier identification of delirium during hospitalization. A brochure was developed using an iterative approach with an expert panel. Following three iterations, a final brochure was approved. The authors found that an iterative expert consensus approach can be used to develop a brochure for families. Major content areas were helping families understand the difference between delirium and dementia, signs and symptoms of delirium, causes of delirium, and strategies family members can use to prevent delirium. A caregiver-focused educational brochure is one intervention to use in targeting older adults hospitalized with delirium.
When Mary Cholmeley married Henry Fairfax in 1627, she carried to her new home in Yorkshire a leather-bound notebook filled with medical recipes. Over the next few decades, Mary and Henry, their children and various members of the Fairfax and Cholmeley families continually entered new medical and culinary information into this 'treasury for health.' Consequently, as it stands now, the manuscript can be read both as a repository of household medical knowledge and as a family archive. Focusing on two Fairfax 'family books,' this essay traces on the process through which early modern recipe books were created. In particular, it explores the role of the family collective in compiling books of knowledge. In contrast to past studies where household recipe books have largely been described as the products of exclusively female endeavors, I argue that the majority of early modern recipe collections were created by family collectives and that the members of these collectives worked in collaboration across spatial, geographical and temporal boundaries. This new reading of recipe books as testaments of the interests and needs of particular families encourages renewed examination of the role played by gender in the transmission and production of knowledge in early modern households.
When Mary Cholmeley married Henry Fairfax in 1627, she carried to her new home in Yorkshire a leather-bound notebook filled with medical recipes. Over the next few decades, Mary and Henry, their children and various members of the Fairfax and Cholmeley families continually entered new medical and culinary information into this ‘treasury for health.’ Consequently, as it stands now, the manuscript can be read both as a repository of household medical knowledge and as a family archive. Focusing on two Fairfax ‘family books,’ this essay traces on the process through which early modern recipe books were created. In particular, it explores the role of the family collective in compiling books of knowledge. In contrast to past studies where household recipe books have largely been described as the products of exclusively female endeavors, I argue that the majority of early modern recipe collections were created by family collectives and that the members of these collectives worked in collaboration across spatial, geographical and temporal boundaries. This new reading of recipe books as testaments of the interests and needs of particular families encourages renewed examination of the role played by gender in the transmission and production of knowledge in early modern households. PMID:23926360
Kaplan, Marvin L.; Kaplan, Netta R.
Outlines two formulations that generate conceptual perspectives of immediate phenomena: (1) the family system has a time-enduring stability; (2) the family system has an immediate and temporary organization. Integrates systems thinking and Gestalt Therapy while recognizing individual experience as embedded in a self-maintaining system of the…
Gonsoulin, S.; Read, N.W.
Interagency communication and collaboration is a key principle and practice in addressing the unmet educational needs of youth in the juvenile justice and child welfare systems. When child-serving agencies communicate and work with each other, and are committed to coordinating services and supports for the youth and families they serve, they…
Ricci-Cabello, Ignacio; Stevens, Sarah; Kontopantelis, Evangelos; Dalton, Andrew R. H.; Griffiths, Robert I.; Campbell, John L.; Doran, Tim; Valderas, Jose M.
PURPOSE The purpose of this study was to examine the association between the prevalence of both diabetes-concordant and diabetes-discordant conditions and the quality of diabetes care at the family practice level in England. We hypothesized that the prevalence of concordant (or discordant) conditions would be associated with better (or worse) quality of diabetes care. METHODS We conducted a cross-sectional study using practice-level data (7,884 practices). We estimated the practice-level prevalence of diabetes and 15 other chronic conditions, which were classified as diabetes concordant (ie, with the same pathophysiologic risk profile and therefore more likely to be part of the same management plan) or diabetes discordant (ie, not directly related in either their pathogenesis or management). We measured quality of diabetes care with diabetes-specific indicators (8 processes and 3 intermediate outcomes of care). We used linear regression models to quantify the effect of the prevalence of the conditions on aggregate achievement rate for quality of diabetes care. RESULTS Consistent with the proposed model, the prevalence rates of 4 of 7 concordant conditions (obesity, chronic kidney disease, atrial fibrillation, heart failure) were positively associated with quality of diabetes care. Similarly, negative associations were observed as predicted for 2 of the 8 discordant conditions (epilepsy, mental health). Observations for other concordant and discordant conditions did not match predictions in the hypothesized model. CONCLUSIONS The quality of diabetes care provided in English family practices is associated with the prevalence of other major chronic conditions at the practice level. The nature and direction of the observed associations cannot be fully explained by the concordant-discordant model. PMID:26553890
Levin, R P
The future of dentistry will be similar to that of many other businesses. It will be faced radical changes, new ways of thinking, new services, and greater competition. As these factors occur in all businesses, it will be those with systems and outstanding customer service that are able to not only survive, but also to thrive. Achieving practice success will be tied to having effective and efficient business systems, including customer service. While the world is changing rapidly, basic business principles and human nature have not changed. While businesses continue to work toward maximum productivity and profitability, patients will want to continue being treated with the greatest service and respect. The future may bring a gradual shift in dental practices. The top 20 percent of practices in five to seven years will have higher profitability than the top 5 percent of practices do today. On the other hand, the other 80 percent of dental practices will actually have decreased profitability. The difference will be that the top 20 percent of practices will implement outstanding business systems that allow them to be more efficient and effective than ever before. They will implement many new services of both traditional needs-based dentistry and of an elective nature. These practices are preparing today for the future regardless of the effects of the economy or changes in dental insurance or health care regulations.
Harrison, Michelle; Brodribb, Wendy; Hepworth, Julie
Evidence supports the establishment of healthy feeding practices early in life to promote lifelong healthy eating patterns protective against chronic disease such as obesity. Current early childhood obesity prevention interventions are built on extant understandings of how feeding practices relate to infant's cues of hunger and satiety. Further insights regarding factors that influence feeding behaviors in early life may improve program designs and outcomes. Four electronic databases were searched for peer-reviewed qualitative studies published between 2000 to 2014 with transitional infant feeding practice rationale from developed countries. Reporting transparency and potential bias was assessed using the Consolidated Criteria for Reporting Qualitative Research quality checklist. Thematic synthesis of 23 manuscripts identified three themes (and six sub-themes): Theme 1. Infant (physical cues and behavioural cues) focuses on the perceived signs of readiness to start solids and the feeding to influence growth and "health happiness." Theme 2. Mother (coping strategies and knowledge and skills) focuses on the early survival of the infant and the family and the feeding to satisfy hunger and influence infant contentment, and sleep. Theme 3. Community (pressure and inconsistent advice) highlights the importance of generational feeding and how conflicting feeding advice led many mothers to adopt valued familial or culturally established practices. Overall, mothers were pivotal to feeding decisions. Satisfying infant's needs to reach "good mothering" status as measured by societal expectations was highly valued but lacked consideration of nutrition, obesity, and long term health. Maternal interpretation of healthy infant feeding and successful parenting need attention when developing strategies to support new families.
Najafi-Sharjabad, Fatemeh; Rahman, Hejar Abdul; Hanafiah, Muhamad; Syed Yahya, Sharifah Zainiyah
Background: In Malaysia, contraceptive prevalence rate (CPR) during past three decades has been steady, with only 34% of women practicing modern contraception. The aim of this study was to determine the factors associated with modern contraceptive practices with a focus on spousal communication and perceived social support among married women working in the university. Materials and Methods: A cross-sectional study was carried out using self-administered structured questionnaire. The association between variables were assessed using Chi-square test, independent sample t-test, and logistic regression. Results: Overall, 36.8% of women used modern contraceptive methods. Significant association was found between contraceptive practice and ethnicity (P = 0.003), number of pregnancies (P < 0.001), having child (P = 0.003), number of children (P < 0.001), positive history of mistimed pregnancy (P = 0.006), and experience of unwanted pregnancy (P = 0.003). The final model showed Malay women were 92% less likely to use modern contraception as compared to non-Malay women. Women who discussed about family planning with their spouses were more likely to practice modern contraception than the women who did not [odds ratio (OR): 2.2, Confidence Interval (CI): 1.3–3.7]. Those women with moderate (OR: 4.9, CI: 1.6–10.8) and strong (OR: 14, CI: 4.5–26.4) perception of social support for contraceptive usage were more likely to use modern contraception than the women with poor perception of social support. Conclusion: Spousal communication regarding family planning would be an effective way to motivate men for supporting and using contraceptives. Family planning education initiatives should target both men and women, particularly high-risk cases, for promoting healthy timing and spacing of pregnancies. Ethnic disparities need to be considered in planning reproductive health programs. PMID:25949248
Chavkin, Nancy Feyl; Chavkin, Allan
The issue of research dissemination via websites is part of the larger research utilization question, and the authors begin with a review of literature on the theory and best practices in dissemination. The second part of the study involves an exploratory examination of the websites and dissemination practices of 30 research centers focusing on…
FPG Child Development Institute, 2006
Evidence-based practice emerged as a result of the gap often seen between research and practice and gained momentum with the standards and accountability movement. Yet it originates in medicine. Healthcare professionals using evidence-based medicine determine a patient's treatment based on an assessment of evidence from the literature and current…
Livas-Dlott, Alejandra; Fuller, Bruce; Stein, Gabriela L.; Bridges, Margaret; Mangual Figueroa, Ariana; Mireles, Laurie
Early research on the socialization of Latino children has posited that mothers exercise authoritarian practices, compared with lateral reasoning (authoritative) strategies emphasized by Anglo mothers. This work aimed to categorize fixed types of parenting practices tied to the mother's personality rather than to culturally bounded contexts; it…
Mathews, Anita A; Joyner, Brandi L; Oden, Rosalind P; Alamo, Ines; Moon, Rachel Y
African-American and Hispanic families share similar socioeconomic profiles. Hispanic rates of sleep-related infant death are four times lower than African-American rates. We conducted a cross-sectional, multi-modal (surveys, qualitative interviews) study to compare infant care practices that impact risk for sleep-related infant death in African-American and Hispanic families. We surveyed 422 African-American and 90 Hispanic mothers. Eighty-three African-American and six Hispanic mothers participated in qualitative interviews. African-American infants were more likely to be placed prone (p < 0.001), share the bed with the parent (p < 0.001), and to be exposed to smoke (p < 0.001). Hispanic women were more likely to breastfeed (p < .001), while African-American women were more knowledgeable about SIDS. Qualitative interviews indicate that, although African-American and Hispanic parents had similar concerns, behaviors differed. Although the rationale for infant care decisions was similar for African-American and Hispanic families, practices differed. This may help to explain the racial/ethnic disparity seen in sleep-related infant deaths.
Kitzman-Ulrich, Heather; Wilson, Dawn K; St George, Sara M; Lawman, Hannah; Segal, Michelle; Fairchild, Amanda
Rates of overweight in youth have reached epidemic proportions and are associated with adverse health outcomes. Family-based programs have been widely used to treat overweight in youth. However, few programs incorporate a theoretical framework for studying a family systems approach in relation to youth health behavior change. Therefore, this review provides a family systems theory framework for evaluating family-level variables in weight loss, physical activity, and dietary approaches in youth. Studies were reviewed and effect sizes were calculated for interventions that manipulated the family system, including components that targeted parenting styles, parenting skills, or family functioning, or which had novel approaches for including the family. Twenty-one weight loss interventions were identified, and 25 interventions related to physical activity and/or diet were identified. Overall, family-based treatment programs that incorporated training for authoritative parenting styles, parenting skills, or child management, and family functioning had positive effects on youth weight loss. Programs to improve physical activity and dietary behaviors that targeted the family system also demonstrated improvements in youth health behaviors; however, direct effects of parent-targeted programming is not clear. Both treatment and prevention programs would benefit from evaluating family functioning and parenting styles as possible mediators of intervention outcomes. Recommendations are provided to guide the development of future family-based obesity prevention and treatment programs for youth.
Granic, Isabela; Hollenstein, Tom; Dishion, Thomas J.; Patterson, Gerald R.
Used a dynamic systems (DS) approach to study changes in structure of family interactions in problem-solving sessions during the early adolescent transition of boys in 149 families. Constructed state space grids (a new DS method) for families across five waves of videotaped data collection before, during, and after the transition. Found that DS…
Distelberg, Brian; Williams-Reade, Jackie; Tapanes, Daniel; Montgomery, Susanne; Pandit, Mayuri
Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.
Yavner, S B
The success of any dental practice depends, among other factors, on the critical role of staff employees. In order to encourage desired staff behaviors, incentive systems can be designed for employee dentists, assistants/hygienists and managers. A survey of dental franchises was conducted in 1987 for the purpose of examining their incentive control systems. The specific incentives employed by these dental franchises for their employees are analyzed. The implications of these incentive systems used by dental franchise organizations for all dental practices are then discussed.
American Psychologist, 2013
Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…
Khrapak, Sergey A.; Kryuchkov, Nikita P.; Yurchenko, Stanislav O.; Thomas, Hubertus M.
Simple practical approach to estimate thermodynamic properties of strongly coupled Yukawa systems, in both fluid and solid phases, is presented. The accuracy of the approach is tested by extensive comparison with direct computer simulation results (for fluids and solids) and the recently proposed shortest-graph method (for solids). Possible applications to other systems of softly repulsive particles are briefly discussed.
Gerdner, Linda A
This pilot study used a mixed methodology to evaluate the effectiveness of individualized music for the management of agitation when implemented by trained staff and family. Music was administered daily and as needed to eight elderly individuals with dementia who resided in a long-term care facility. A statistically significant reduction in agitation was found during the presentation of music and an overall reduction in agitation was found on day shift during weeks 1 to 8 and on evening shift during weeks 5 to 8. Staff and family interviews provided convergent validity of findings. Music also promoted meaningful interaction between the resident and others.
Bardón-Cancho, Eduardo J; Haro-Díaz, Ana; Alonso-García-de la Rosa, Francisco J; Huerta-Aragonés, Jorge; García-Morín, Marina; González-Martínez, Felipe; Garrido-Colino, Carmen
The familial tumor predisposition syndrome known as DICER1-pleuropulmonary blastoma (PPB) or DICER1 tumor predisposition syndrome was first described in 2009, and it involves an increased risk in the occurrence of various tumors, like cystic nephroma and PPB. Here is presented a girl with a cystic nephroma and two cystic lung lesions who was diagnosed years later with the DICER1 gene mutation. This mutation was also found in one of her parents. Thus, the screening for the DICER1 gene mutation may be important in children with certain/multiple tumors and their families.
Rinke, Michael L.; Chen, Allen R.; Milstone, Aaron M.; Hebert, Lindsay C.; Bundy, David G.; Colantuoni, Elizabeth; Fratino, Lisa; Herpst, Cynthia; Kokoszka, Michelle; Miller, Marlene R.
Background A study was conducted to investigate (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line–associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. Methods Researchers administered a survey to patients and families in a tertiary care pediatric oncology clinic that engaged in rigorous ambulatory and inpatient CLABSI prevention efforts. Results Of 110 invited patients and caregivers, 105 participated (95% response rate) in the survey (March–May 2012). Of the 50 respondents reporting that they or another caregiver change central line dressings, 48% changed a dressing whenever it was soiled as per protocol (many who did not change dressings per protocol also never personally changed dressings); 67% reported the oncology clinic primarily cares for their child’s central line, while 29% reported that an adult caregiver or the patient primarily cares for the central line. Eight patients performed their own line care “always” or “most of the time.” Some 13% of respondents believed that it was “slightly likely” or “not at all likely” that their child will get an infection if caregivers do not perform line care practices perfectly every time. Dressing change practices were the most difficult to comply with at home. Some 18% of respondents wished they learned more about line care, and 12% received contradictory training. Respondents cited a variety of preferences regarding line care teaching, although the majority looked to clinic nurses for modeling line care. Conclusions Interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care
Miyawaki, Christina E
This study is a cross-sectional investigation of caregiving practice patterns among Asian, Hispanic and non-Hispanic White American family caregivers of older adults across three immigrant generations. The 2009 California Health Interview Survey (CHIS) dataset was used, and 591 Asian, 989 Hispanic and 6537 non-Hispanic White American caregivers of older adults were selected. First, descriptive analyses of caregivers' characteristics, caregiving situations and practice patterns were examined by racial/ethnic groups and immigrant generations. Practice patterns measured were respite care use, hours and length of caregiving. Three hypotheses on caregiving patterns based on assimilation theory were tested and analyzed using logistic regression and generalized linear models by racial/ethnic groups and generations. Caregiving patterns of non-Hispanic White caregivers supported all three hypotheses regarding respite care use, caregiving hours and caregiving duration, showing less caregiving involvement in later generations. However, Asian and Hispanic counterparts showed mixed results. Third generation Asian and Hispanic caregivers used respite care the least and spent the most caregiving hours per week and had the longest caregiving duration compared to earlier generations. These caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color. Findings suggest the importance of considering the cultural values of each racial/ethnic group regardless of generation when working with racially and ethnically diverse populations of family caregivers of older adults.
Secic, Damir; Husremovic, Dzenana; Kapur, Eldan; Jatic, Zaim; Hadziahmetovic, Nina; Vojnikovic, Benjamin; Fajkic, Almir; Meholjic, Amir; Bradic, Lejla; Hadzic, Amila
Testing strategies can either have a very positive or negative effect on the learning process. The aim of this study was to examine the degree of consistency in evaluating the practicality and logic of questions from a medical school pathophysiology test, between students and family medicine doctors. The study engaged 77 family medicine doctors and 51 students. Ten questions were taken from cardiac pathophysiology and 10 questions from pulmonary pathophysiology, and each question was assessed on the criteria of practicality and logic. A nonparametric Mann-Whitney test was used to test the difference between evaluators. On the criteria of logic, only four out of 20 items were evaluated differently by students in comparison to doctors, two items each from the fields of cardiology and pulmonology. On the criteria of practicality, for six of the 20 items there were statistically significant differences between the students and doctors, with three items each from cardiology and pulmonology. Based on these indicative results, students should be involved in the qualitative assessment of exam questions, which should be performed regularly under a strictly regulated process.
Berg, Rachelle; Hendricks, Bret; Bradley, Loretta
Major ethical considerations must be taken into account when providing counseling services to suicidal adolescents and their families. This article explores these ethical issues and the American Counseling Association and International Association of Marriage and Family Counselors ethical codes relevant to these issues. Related liability and…