Elliott, Steve; Herndon, Anne
The family practice resident is taught that the patient's family is the most medically relevant context for viewing the patient's present symptoms and illnesses. With the removal of the necessity for family interviews, an effective training program in family dynamics was designed for family medicine residents. (Author/MLW)
Christian, Linda Garris
Working with families is one of the most important aspects of being an early childhood professional, yet it is an area in which many educators have received little preparation (Nieto 2004). Teachers spend hours learning about child development, developmentally appropriate practices, health and safety, playgrounds, and play. At times it seems that…
Elmslie, T; Rosser, W W
The primary focus of computer systems for family practice is on patient billing. Primary care physicians should be aware of the many other benefits that can and should be considered when planning a system for their practice. This article describes the type and extent of information that can be stored in a family practice data base and explores some of the applications in areas of practice and patient management, prevention and research. PMID:3942928
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…
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. PMID:24945363
Cantegreil-Kallen, Inge; Rigaud, Anne-Sophie
Alzheimer's disease has a negative impact on family relationships and may trigger conflicts between the main caregiver and other family members. The systemic approach evidences the impact of dementia on structural and functional characteristics of the family system. Systemic family therapy is especially indicated in crisis situations such as emergency hospitalization or institutionalization of the patient, and when the family members do not agree on when and how to introduce care and support services at the patient's home. In this case, the aim of the intervention is to restore the communication between all the family members in order to find an agreement for the best management of the patients. Since September 2006, systemic family therapy has been offered in the memory clinic of the Broca Hospital to families having a member suffering from Alzheimer's disease. The involvement of the families was accomplished by the direct participation of the patient, main caregiver (spouse), grown-up children and grandchildren. The aim was to obtain an agreement for the access of support and care services at home from all the family members. The intervention was based on a step-by-step procedure and comprehended five sessions. The primary results of a pilot study are presented. PMID:20031507
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
Kohut, N.; Singer, P. A.
Family physicians can play an important role in helping patients and their families to discuss life-sustaining treatments and to complete advance directives. This article reviews the legal status of, and empirical studies on, advance directives and addresses some important clinical questions about their use relevant to family practice. PMID:8499789
Many family physicians have written about how they influence, nurture, and empower people in their communities of practice. In this essay, the author writes of the personal joys that family medicine has brought him. An expression of his appreciation for his work as a family doctor, it touches on 6 themes that continue to rejuvenate his practice: love, faith, mystery, place, dance, and medicine. By examining the emotional and psychological dimensions of these themes, he offers a path by which other family physicians may be able to find sustenance and joy in their daily work. PMID:22585892
Helou, Mariana; Rizk, Grace Abi
Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843
Grierson, Lawrence E.M.; Fowler, Nancy; Kwan, Matthew Y.W.
Abstract Objective To assess residents’ practice intentions since the introduction of the College of Family Physicians of Canada’s Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. Design A survey based on Ajzen’s theory of planned behaviour was administered on 2 occasions. Setting McMaster University in Hamilton, Ont. Participants Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. Main outcome measures The survey was modeled so as to measure the respondents’ intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. Results The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents’ intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. Conclusion The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University. PMID:26889508
Bennett, Bert; Reardon, Robert
In recent years there has been a rapid increase in the number of American families in which both spouses work. The literature regarding preschoolers suggests that one cannot say that being from a dual-earner family will necessarily harm a child. Key issues center not on whether both parents work, but on the quality of substitute care and how well…
Warren, M D
The organisation of general practice in England is outlined and the independent contractor basis of the family practioner emphasised. Data from family practice, like data from hospital practice, may be used for clinical management, practice management, or research. Examples of applications in each of these fields are given. The basic records used in family practice--the medical record envelope, the prescription form and the claim for sickness benefit--are described. Some practices record morbidity (E Book or Diagnostic Index), some record systematically details of their activities (L Book or Activities Ledger) and some maintain age and sex registers and other registers of their patients; all these developments are outlined. Attention is drawn to the introduction of problem orientated records and to the use of computers in family practice, but these innovations are not discussed. Outstanding issues are the same as those in hospital record systems--accuracy, definitions, coverage, confidentiality, clerical support and costs, and the use made of the information. PMID:1085489
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…
A new computerized E Book and data base management system is under development at the discipline of family practice of Memorial University of Newfoundland. This system is capable of rapid analyses and produces detailed reports on morbidity indices and age-sex distributions of patients. Examples show how this system is being used to analyze the content of family practice, monitor and improve family practice resident learning experiences, improve patient care, and stimulate and facilitate family practice research. Future directions of this project are discussed. PMID:21283504
Rudner, Howard L.
Sources and levels of stress, as well as coping mechanisms, perceived by residents in both years of a two-year family practice residency program in Toronto are described. In addition, differences between first- and second-year residents, and between women and men residents, regardless of year, are examined. Results of the survey indicate that the levels of stress are relatively high throughout the two years of residency training. The three most stressful aspects of being a resident are time pressures, fatigue, and lack of self-confidence. Female residents appear to report a higher level of stress than males, especially in trying to combine a personal and a professional life. Specific coping mechanisms include talking to others, adjusting attitudes and feelings, or strategic use of time. Recommendations aimed at helping family medicine residency programs deal with the problem of stress in residents are suggested. A current major province-wide research study including all interns and residents in Ontario is described. PMID:21267263
Cunningham, Patricia D.
The potential of the psychiatric family nurse practitioner (Psych.F.N.P.) to contribute to family practice through physical care and mental health care exists in the here and now. This role is a synthesis of 2 advanced practice roles, the psychiatric clinical nurse specialist (Psych.C.N.S.) and family nurse practitioner (F.N.P.), both of which continue to have great utility independently. This synthesis is a practical application of concepts that have evolved to meet the changing patterns of health care delivery. At this time, dual certification as a Psych.C.N.S. and F.N.P. best reflects the broad practice expertise of the psychiatric family nurse practitioner. The experienced psychiatric family nurse practitioner provides direct care for both physical and psychological needs of patients in a family practice setting. PMID:15014701
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…
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Schmidt, H R
The concepts of "symmetry" and "complementary" of social systems in Bateson and Toman are compared. Bateson describes self-reinforcing cycles of formation of equality and inequality of social systems, whereas Toman means compatibility and incompatibility of social systems according to sibling positions of individuals involved. His concept is important to an empirical family psychology, family diagnosis and family therapy. A family diagnostic case-study shows the practical application. PMID:1470602
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. PMID:26407854
Frankel, Harvy; Frankel, Sid
This paper assesses the engagement of family therapy and family practice with families with children, who are living in poverty. It analyzes four promising models from two perspectives. The first perspective relates to critiques, which have been made of the practice of family therapy with families living in poverty; and the second relates to the…
Huzij, Teodor J.; Warner, Christopher H.; Lacy, Timothy; Rachal, James
Objective: This article outlines a psychiatry curriculum developed for family practice residents by family practice-psychiatry residents. Methods: A literature review, needs assessment, planning, implementation, and initial assessment were conducted. Conclusion: Early results demonstrated improved general psychiatric knowledge and a high level of…
Librach, S. L.
Pain is common in family practice. In dealing with chronic pain, both the family physician and the patient often have problems in defining and in understanding the origin of chronic pain and in providing effective pain relief. This article explores a practical, holistic approach to understanding and managing chronic pain. PMID:8471902
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
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. PMID:24460518
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, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518
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,…
Fenichel, Emily, Ed.
"Zero to Three is a single focus bulletin of the National Center for Infants, Toddlers, and Families providing insight from multiple disciplines on the development of infants, toddlers, and their families. Noting that sometimes practice needs to be "translated" into research, as with understanding the phenomenon of paraprofessional workers in…
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 Literacy--are…
Ballard, Sharon M.; Carroll, Elizabeth B.
This study explored internship practices in family studies programs in the United States. Specifically, procedures, supervision, purpose, benefits, integration with coursework, and evaluation were examined. Data were collected via a questionnaire e-mailed to universities and colleges with undergraduate family studies programs (N = 68). Although…
Ferrier, B. M.; Woodward, C. A.; Cohen, M.; Williams, A. P.
OBJECTIVE: To examine the attitudes toward clinical practice guidelines of a group of family physicians who had recently entered practice in Ontario, and to compare them with the attitudes of a group of internists from the United States. DESIGN: Mailed questionnaire survey of all members of a defined cohort. SETTING: Ontario family practices. PARTICIPANTS: Certificants of the College of Family Physicians of Canada who received certification in 1989, 1990, and 1991 and who were practising in Ontario. Of 564-cohort members, 395 (70%) responded. Men (184) and women (211) responded at the same rate. MAIN OUTCOME MEASURES: Levels of agreement with 10 descriptive statements about practice guidelines and analyses of variance of these responses for several physician characteristics. RESULTS: Of respondents in independent practice, 80% were in group practice. Women were more likely to have chosen group practice, in which they were more likely to use practice guidelines than men. Generally favourable attitudes toward guidelines were observed. Physician characteristics occasionally influenced agreement with the descriptors. The pattern of agreement was similar to that noted in the study of American internists, but, in general, Ontario physicians were more supportive. CONCLUSIONS: This group of relatively new-to-practice Ontario family physicians shows little resistance to guidelines and appears to read less threat of external control in them than does the US group. PMID:8616286
Simpson, Peggy; Tarrant, Marie
This article describes the development and testing of the Family Nursing Practice Scale (FNPS). This self-report questionnaire is designed to measure perceived changes in family nursing practice including attitudes toward working with families, critical appraisal of their family nursing practice and reciprocity in the nurse-family relationship. Categories were derived from a needs assessment, competence as effective application of knowledge and skill and theoretical foundations for family assessment and intervention. Psychometric testing (content, construct validity, internal consistency, and test-retest reliability) was undertaken with 140 psychiatric nurses in Hong Kong. Practice appraisal and nurse-family relationships accounted for 56.4% of the variance. Cronbach's alpha reliability coefficients were .88 and .73 for the two subscales, respectively, and .86 for the scale overall. Test-retest reliability ranged from .62 to .93 on the individual items. The results provide preliminary evidence of the reliability and validity of the FNPS. The instrument provides quantitative and qualitative evaluation components. PMID:17099118
Because patients present in the early stages of undifferentiated problems, the family physician often faces uncertainty, especially in diagnosis and management. The physician's uncertainty may be unacceptable to the patient and may lead to inappropriate use of diagnostic procedures. The problem is intensified by the physician's hospital training, which emphasizes mastery of available knowledge and decision-making based on certainty. Strategies by which a physician may manage uncertainty include (a) a more open doctor-patient relationship, (b) understanding the patient's reason for attending the office, (c) a thorough assessment of the problem, (d) a commitment to reassessment and (e) appropriate consultation. PMID:7074488
During the twentieth century there have been great advances in medicine in the area of science and technology. At the same time, there has been a trend back to a more natural, humanistic approach to counteract patients' feelings of alienation. Holistic medicine approaches the physical, emotional, spiritual, and social aspects of a person as they relate to health and disease. It emphasizes prevention; concern for the environment and the food we eat; patient responsibility; using illness as a creative force to teach people to change; the `physician, heal thyself' philosophy; and appropriate alternatives to orthodox medicine. Family medicine faces the challenge of integrating these humanistic concepts with science. PMID:21283496
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)
Dunn, Earl V.
Ethical dilemmas in family practice have increased in frequency and complexity as both the potential benefit and the potential harm of medical treatments have increased. All physicians must be aware of moral issues relating to medicine. Family physicians commonly face ethical problems concerning the patient with diminished autonomy; the right to refuse treatment; allocation of resources; informed consent; surrogate consent (for children, for the incompetent, and for those with diminished autonomy); and the appropriate level of aggressiveness in treatment. PMID:11651132
Johnson, Toni Cavanagh; Huang, Bevan Emma; Simpson, Pippa M.
A questionnaire was given to 500 mental health and child welfare professionals asking for maximum acceptable ages for siblings to engage jointly in certain family practices related to hygiene, affection, and privacy. A large proportion of respondents felt it was never acceptable for siblings to take showers together (40%), kiss on the mouth (37%),…
Modi, Amita V.
Purpura simplex, or the syndrome of “easy bruisability,” is a benign, non-progressive clinical entity that can at times mimic more serious bleeding disorders. This study investigated the incidence of spontaneous bruising in a family practice population. Results suggest that spontaneous bruising is very common, particularly in women. Postulated mechanisms for purpura simplex are briefly reviewed. PMID:21221312
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…
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…
The Teaching-Family Model was one of the earliest approaches to be supported by an extensive research base. As it has evolved over four decades, it retains the focus on teaching and learning but incorporates a strength- and relationship-based orientation. The model is also unique in gathering ongoing practice-based evidence to insure quality.
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…
Fraser, Frederick Donald
Functional symptoms are a common and at times irritating part of family practice. The expedient way of dealing with these patients is to investigate, prescribe, and reassure that nothing serious is wrong. This reassurance may not be convincing to the patient whose symptom persists. The author reviews the main issues in this field and describes a subset of patients who seem to have identification as the basis for their functional symptom. When cases are of short term, this subset can be handled by the family physician who is aware of the logic behind the functional symptoms in certain cases. An understanding of functional symptoms and a belief in their logic are important dimensions of comprehensive care in family practice. PMID:21233989
This account traces the development of family systems thinking from early pioneering thinking and practices, through the development of institutions and professional definitions, and through challenges to family systems thinking and practice from the biomedical points of view. Throughout there is a strong conviction that "thinking family" is an essential core of effective mental health treatment, because families can heal. PMID:25074645
Hidecker, Mary Jo Cooley; Jones, Rebecca S.; Imig, David R.; Villarruel, Francisco A.
Purpose: Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within…
Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve
Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693
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…
Green, Larry A; Jones, Samuel M; Fetter, Gerald; Pugno, Perry A
After two years of intensive study, in 2004 the Future of Family Medicine report concluded that the current U.S. health care system is inadequate and unsustainable, and called for changes within the specialty of family medicine to ensure the future health of the American public. With guidance and encouragement from many disciplines and health experts, a set of 10 recommendations was established to accomplish a transformative change in how family physicians serve their patients and how the essential function of primary care is achieved. From these recommendations came a period of innovation and experimentation in the training of family physicians, entitled Preparing the Personal Physician for Practice (P4). The P4 project is a carefully designed and evaluated initiative led by the American Board of Family Medicine and the Association of Family Medicine Residency Directors and administered by TransforMED, a practice redesign initiative of the American Academy of Family Physicians. Fourteen family medicine programs were chosen to participate and will put their innovations into practice from 2007 to 2012, during which time regular evaluation will be conducted. The purpose of P4 is to learn how to improve the graduate medical education of family physicians such that they are prepared to be outstanding personal physicians and to work in the new models of practice now emerging. The innovations tested by P4 residencies are expected to inspire substantial changes in the content, structure, and locations of training of family physicians and to guide future revisions in accreditation and certification requirements. PMID:18046133
Brown, Judith Belle; Thorpe, Cathy; Paquette-Warren, Jann; Stewart, Moira; Kasperski, Jan
This qualitative study examined medical students' and family practice residents' ideas, perceptions, and experiences of being mentored and their expectations of the mentoring experience. Eight focus groups and 16 individual interviews were used to collect data from 49 medical students and 29 family practice residents. Interviews and focus groups were audiotaped and transcribed verbatim. The analysis was iterative and interpretive, using both individual and team analyses. The analysis of the data revealed two central but related themes. The first theme reflected participants' overall experiences with mentors composed of three distinct elements: mentor roles (e.g. coach, advisor) and attributes (e.g. openness and approachability), interactions with mentors, and early exposure to family practice mentors (e.g. observing patient encounters). The second theme explicated the trainees' specific learning needs to be addressed by mentors that were categorised into three distinct yet overlapping levels: 1 practice level (i.e. guidance regarding the logistics of practice management) 2 system level (i.e. knowledge about the medical community as well as community resources) 3 personal level (i.e. guidance in balancing personal and professional responsibilities). Having the option of selecting multiple mentors to address unique aspects of the mentees' personal and professional development is critical in respecting the evolutionary nature and fluidity of the mentoring experience. PMID:22762878
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…
A case is presented, illustrating a problem faced by family physicians who practice obstetrics; women who present with lists of inflexible requirements for labor and delivery may be attempting to control a situation in which they feel a great deal of fear, and little trust for the physician. The physician who tries to deal with every item on the list, rather than to explore the meaning of the total presentation, risks establishing a contract that cannot be met—and attracting more demanding patients. It is better to offer to discuss the patient's fear and distrust; this is described as `contracting for trust', and is a way to promote patient and doctor flexibility. PMID:21283484
Quinby, P M
This paper traces the 7-year evolution of a required clerkship in Family Practice from the time of initial grant application to the current academic year. Results of experience in areas of student placement, preceptor recruitment, curriculum development, test construction, grading schema and course evaluation are described. Emphasis on streamlining administrative systems to decrease paperwork of course director is a major focus. Changing needs of department, medical school and student are reflected in the adaptations of the clerkship to these needs. PMID:8326845
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…
Rachal, James; Lacy, Timothy J.; Warner, Christopher H.; Whelchel, Jennifer
Objective: To evaluate how family practice-psychiatry residency programs meet the challenges of rigorous accreditation demands, clinical supervision, and boundaries of practice. Method: A 54-question survey of program directors of family practice-psychiatry residency programs outlining program demographic data, curricula, coordination, resident…
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
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
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
Promising Practices: Training Strategies for Serving Children with Serious Emotional Disturbance and Their Families in a System of Care. Systems of Care: Promising Practices in Children's Mental Health 1998 Series. Volume V.
Meyers, Judith; Kaufman, Martha; Goldman, Sybil
This is the fifth 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 examines theories of adult learning, core values, and…
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…
Murray, Christine E.; Lampinen, Autumn; Kelley-Soderholm, Erin L.
The authors present a rationale for incorporating service-learning projects into courses that teach family systems theory. A model program is presented to provide an example of the objectives, practical considerations, and student responses to such a project. Recommendations for counselor educators are made based on experience with the model…
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…
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…
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. PMID:24066636
Bang, Ki Moon; Greene, E. Josephine; Williams, Henry W.; Leath, Brenda A.; Matthews, Ruth
A comprehensive family practice clerkship program at Howard University College of Medicine has been conducted since 1970. This institution is one of three predominantly black institutions offering a family practice program. The senior clerkship is mandatory and at least 20 to 25 percent of each class elect to participate in a four-to six- week family practice preceptorship. As a result of the clerkship's success, over 50 percent of the program's graduates actively practice in primary medical manpower shortage or medically underserved areas. PMID:3246700
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. PMID:24785549
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. PMID:25375148
Fernstrom, M H
The health risks of obesity include the development of comorbid conditions and increased overall mortality. Obesity increases health-related costs for both patients and the healthcare system and significantly affects workforce productivity through increased absenteeism and higher health and insurance payments for employers. Discrimination against obese individuals exists in the workplace and in various social contexts. Obesity is a chronic condition with complex, multiple causes involving physiologic, genetic, and behavioral components, all of which must be addressed for successful treatment. Traditional treatment options include diet, exercise, and behavior modification, but recently, pharmacotherapy has been incorporated as an effective and safe adjunct for long-term treatment of obesity. Additionally, bariatric surgery is an option for selected morbidly obese individuals. Weight losses of only 5% to 10% of initial body weight confer proven clinical benefits. Such modest weight losses can be achieved and maintained within a supportive environment provided in a primary care practice. PMID:19667563
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
Zambrana, Ruth E., Ed.
This anthology examines the contemporary status of Latino families, especially their great racial and ethnic diversity. The book focuses on the strengths of Latino/Hispanic groups, structural processes that impede their progress, and cultural and familial processes that enhance their intergenerational adaptation and resiliency. Chapter 1, "The…
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…
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
Yaman, Hakan; Güneş, Evrim Didem
Objective Turkey has implemented family practice on a pilot basis as part of the reform in health care, since 2005. This paper aims to understand and describe the prevalent practice patterns and clinic characteristics during the transition period. Design A cross-sectional descriptive study design was used. Subjects An online survey was conducted among Turkish GPs working as primary care doctors (without vocational training) during the reform period. Clinic and GP characteristics are analysed with descriptive statistics. Results List size is an important factor; larger lists lead to shorter consultation time and a longer wait for patients. GPs are generally satisfied with the reform. Conclusion During the transition to family practice access of patients to health care has improved and GPs are satisfied with their job. key pointsPatients in Turkey have adequate access to primary health care services.The waiting time for consultation is relatively short.Basic prevention activities occupy the majority of the GPs’ time.Reducing the panel size and introducing appointment systems may be useful. PMID:26893201
Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim
Objectives To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Design Retrospective longitudinal study. Setting Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems of general practices in England. Participants All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Main outcome measures Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Results Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Conclusions Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system. PMID:23913774
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…
Paylo, Matthew John
In this article, the value of integrating family systems theory into a school counseling curriculum is explored. Some programs have historically placed school counselors in a difficult position by not adequately preparing them for the demands of incorporating family systems and community collaboration into clinical practice. The rationale for…
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
Beall, S. Colleen; And Others
Family physicians may lack discriminatory ability to differentiate normal aging form disease states. To assess such ability, 53 aging-related indicators or symptoms were presented to 65 physicians in 3 family practice residency programs. Respondents classified each symptom as normal aging or disease. On average, residents classified 73.4% of…
Warburton, Samuel W.; Sadler, Georgia R.
Since practicing New Jersey family physicians still consider house calls important in the delivery of quality primary care, the Department of Family Medicine of the College of Medicine and Dentistry of New Jersey-Rutgers Medical School is assisting in revising program curricula to provide house call training. (Author/LBH)
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…
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…
Small, Stephen A.
Over the past decade there has been a growing concern over the gap between research and practice in family and other human sciences. Family scientists have been troubled that the scientific knowledge base is not frequently used by practitioners, whereas practitioners have complained that the research base is often not very useful for issues faced…
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…
Yaffe, Mark J.; Tazkarji, Bachir
Abstract Objective To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse. Sources of information MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed. Main message Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index. Conclusion Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions. PMID:23242889
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…
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…
[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.
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. PMID:26173995
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)
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…
Hearst, Mary O.; Fulkerson, Jayne; Murray, David M.; Martinson, Brian; Klein, Elizabeth; Pasch, Keryn; Samuelson, Anne
Background Research is limited on how the social environment of the home is related to childhood obesity. Purpose The purpose of this research was to examine the relationships between positive family meal practices, family stressors, and the weight of youth and to examine parental weight status as a moderator of these relationships. Methods The study enrolled 368 parent/child dyads from a Minnesota sample. We used mediation analysis to examine the associations Results Families represented by an overweight parent reported fewer positive family meal practices (p<0.001), higher levels of depression (p=0.01), and fewer family rules (p=0.02) as compared to families represented by a healthy weight parent. For overweight parents, positive family meal practices mediated the relationship between some family stressors and child weight. Conclusions This research suggests that the home environment may affect the weight of children in the family, and the effect is more pronounced in families with at least one overweight parent. PMID:21136225
Leece, Pamela; Orkin, Aaron; Shahin, Rita; Steele, Leah S.
Abstract Objective To explore family physicians’ attitudes toward prescribing naloxone to at-risk opioid users, as well as to determine the opportunities and challenges for expanding naloxone access to patients in family practice settings. Design One-hour focus group session and SWOT (strengths, weaknesses, opportunities, and threats) analysis. Setting Workshop held at the 2012 Family Medicine Forum in Toronto, Ont. Participants Seventeen conference attendees from 3 Canadian cities who practised in various family practice settings and who agreed to participate in the workshop. Methods The workshop included an overview of information about naloxone distribution and overdose education programs, followed by group discussion in smaller focus groups. Participants were instructed to focus their discussion on the question, “Could this [overdose education and naloxone prescription] work in your practice?” and to record notes using a standardized discussion guide based on a SWOT analysis. Two investigators reviewed the forms, extracting themes using an open coding process. Main findings Some participants believed that naloxone could be used safely among family practice patients, that the intervention fit well with their clinical practice settings, and that its use in family practice could enhance engagement with at-risk individuals and create an opportunity to educate patients, providers, and the public about overdose. Participants also indicated that the current guidelines and support systems for prescribing or administering naloxone were inadequate, that medicolegal uncertainties existed for those who prescribed or administered naloxone, and that high-quality evidence about the intervention’s effectiveness in family practice was lacking. Conclusion Family physicians believe that overdose education and naloxone prescription might provide patients at risk of opioid overdose in their practices with broad access to a potentially lifesaving intervention. However, they
In response to a gap in the literature on student development with respect to the role of the family, and anecdotal evidence that the family's influence on the college student's development is profound, a review of the relevant literature on higher education, social psychology, psychiatry, sociology of the family, and family therapy was…
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
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 in family management practices and adolescents' behavioral outcomes and to detect predictors of interindividual differences in initial status and rate of change. The sample comprised approximately 1,000 adolescents between ages 11 years and 15 years. The results indicated that adolescents' antisocial behaviors and substance use increased and their positive behavioral engagement decreased over time. As adolescent age increased, parental knowledge of their adolescent's activities decreased, as did parental rule making and support. The level and rate of change in family management and adolescent behavioral outcomes varied by family structure and by gender. Reciprocal longitudinal associations between parenting practices and adolescent problem behavior were found. Specifically, parenting practices predicted subsequent adolescent behavior, and adolescent behavior predicted subsequent parenting practices. In addition, parental warmth moderated the effects of parental knowledge and rule making on adolescent antisocial behavior and substance use over time. PMID:21688899
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…
Midtling, J. E.; Barnett, P. G.; Blossom, H. J.; Burnett, W. H.
Although the number of physicians in California has doubled since 1963, the number of family and general practice physicians has declined. The ratio of office-based primary care physicians to population has also decreased. Graduate medical education is funded largely from patient care revenues, but the low rate of reimbursement for ambulatory care makes training in primary care specialties especially dependent on public support. Medicare, the Veterans Administration, and the University of California provide more than $325 million a year in support of graduate medical education in California. Federal and state grant programs provide $5 million a year for family physician training in the state, but appropriations to these programs have been reduced in real terms. California family practice residencies are disproportionately located at county hospitals, where funding shortfalls make them especially vulnerable to cuts in grant programs. Additional resources will be needed if more family physicians are to be trained. Images PMID:2333709
DeLisser, Horace M.
When a patient is extremely ill and/or dying, and the family expects a miraculous recovery, this situation can be very challenging to physicians, particularly when there is certainty that the miracle will occur through divine intervention. A practical approach is therefore provided to clinicians for engaging families that anticipate the miraculous healing of a sick patient. This strategy involves exploring the meaning and significance of a miracle, providing a balanced, nonargumentative response and negotiation of patient-centered compromises, while conveying respect for patient spirituality and practicing good medicine. Such an approach, tailored to the specifics of each family, can be effective in helping a family come to a place of acceptance about the impending death of their loved one. PMID:19497899
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…
Araujo, Blanca E.
Many schools face the challenge of forging partnerships with families from linguistically diverse backgrounds. Effective communication, funds of knowledge, culturally relevant teaching, and extending and accepting assistance are best practices that have been used successfully by school personnel when working with students who are identified as…
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
Julliard, Kell; Intilli, Nancy; Ryan, Jennifer; Vollmann, Sarah; Seshadri, Mahalakshmi
Investigates the themes of 16 family practice residents' art work and their characteristics (age, gender, resident year, undergraduate training location) in relationship to stress. Residents' drawing were linked by common themes of psychological pressure, anxiety, a sense of being overwhelmed, and depression. Evidence of stress was more frequently…
Wintemute, Ginger, Ed.; Messer, Bonnie, Ed.
A handbook on social work practice with Native American families, developed for use by students in undergraduate social work programs and by social service practitioners who work with Native American people, is divided into four sections. The first section contains four articles, written by Joseph A. Dudley (Methodist minister and Yankton Sioux)…
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…
Rosser, W. W.; Borins, M.; Audet, D.
Anxiety disorders are common in family practice. Although not ideal, the DSM 3-R definitions of anxiety disorders provide a framework for diagnostic precision that assists physicians in choosing the best treatment. Assessing functional status helps determine the need for psychotherapeutic or pharmacologic intervention. We evaluate specific interventions and suggest the risks and benefits for each disorder. PMID:8312758
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…
Dembo, Richard; Dudell, Gary; Livingston, Stephen; Schmeidler, James
Presents a detailed overview of the Family Empowerment Intervention (FEI), a system-oriented intervention delivered in-home by well-trained nontherapists. A clinical trial of FEI targeted arrested youths and their families. Topics covered included: theoretical foundations and goals of FEI, structural intervention strategies, and phases of the…
Mangold, W J
The doctrine of informed consent has had its practical introduction to medical malpractice litigation in the past five years. Its definition has not changed since the days when its definitive application was only a fond dream of the malpractice plaintiffs attorneys. However, with neh new methods of presenting this theory to the courts, and with the newly emerging practice fo having rulings on matters of law substituted by judges for prevailing standards of medical practice, the implications for family physicians have become tremendous. Hopefullum by understanding the principles involved in its application in the pertinent landmark cases, family physicians will be better able to abid the pitfalls engendered by the doctrine of informed consent. PMID:1127387
Denton, David R.
A study of family physicians graduating from Texas residency programs between 1979 and 1987 analyzed patterns of practice location and their relationship to residency location, focusing on size of practice community and distance from the residency program. It is concluded that state policy has effectively distributed physicians in the state. (MSE)
Hopwood, Nick; Fowler, Cathrine; Lee, Alison; Rossiter, Chris; Bigsby, Marg
A significant international development agenda in the practice of nurses supporting families with young children focuses on establishing partnerships between professionals and service users. Qualitative data were generated through interviews and focus groups with 22 nurses from three child and family health service organisations, two in Australia and one in New Zealand. The aim was to explore what is needed in order to sustain partnership in practice, and to investigate how the concept of practice architectures can help understand attempts to enhance partnerships between nurses and families. Implementation of the Family Partnership Model (FPM) is taken as a specific point of reference. Analysis highlights a number of tensions between the goals of FPM and practice architectures relating to opportunities for ongoing learning; the role of individual nurses in shaping the practice; relationships with peers and managers; organisational features; and extra-organisational factors. The concept of practice architectures shows how changing practice requires more than developing individual knowledge and skills, and avoids treating individuals and context separately. The value of this framework for understanding change with reference to context rather than just individual's knowledge and skills is demonstrated, particularly with respect to approaches to practice development focused on providing additional training to nurses. PMID:23336287
Karout, N; Altuwaijri, S
To determine the knowledge, attitude and practices concerning family planning of students attending religious schools in Lebanon, we conducted a cross-sectional study of 450 male and female students. A validated structured questionnaire was completed by the students. The majority of the students (65%) had a moderate level of knowledge, males more than females, but females had more positive beliefs and attitudes. More females agreed with family planning programmes and methods than males, but 35% had a negative attitude to family planning; a significant percentage had negative attitudes to contraceptive methods based on their view that they are not allowed (haram) in Islam. Among the married students, less than 40% used a family planning method; of those, the majority used a female method. Religion plays an important role in the health behaviour of religious students. Religious leaders can therefore inhibit or promote family planning, which will affect the success of family planning programmes. Thus, they should be included in the development and promotion of family planning programmes. PMID:22891526
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
King, Gillian; Chiarello, Lisa
This article focuses on conceptual and practical considerations in family-centered care for children with cerebral palsy and their families. In the last 5 years, there have been important advances in our understanding of the components of family-centered care, and initial attempts to understand the client change processes at play. Recent research elaborates on family-centered care by delving into aspects of family-provider partnership, and applying family-centered principles to organizational service delivery to bring about organizational cultures of family-centered care. Recent research has also begun to consider mediators of client change, and new practice models have been proposed that embrace family-centered principles and illustrate the "art" of practice. Future research directions are discussed, including explorations of causal relationships between family-centered care principles, elements of caregiving practice, client change processes, and child and family outcomes. The meaning of the recent literature for pediatric neurology practice is considered. PMID:24810084
Taylor, A D; Clark, C; Sinclair, A E
This study was based on a nationwide sample of 778 family practice residents in the mid-1980s and was conducted to determine the personality types that were most common among those residents. The results showed that the single most common personality type was that in which the individual prefers to see the world in terms of challenges and future possibilities and to make decisions based upon his or her subjective values. These results showed that the sample differed significantly in Myers-Briggs personality type from both the general practitioners of the 1950s and the early family practice residents of the 1970s, who preferred to see the world in terms of the immediate facts of experience and to make decisions objectively. There were also significant differences between the civilian and military family practice residents, but not between the community-based and university-based residents. Implications regarding future practice styles, physicians' personal values, and manpower needs are discussed. PMID:2306322
Alexander, James F.
An evaluation of the application of Systems Theory concepts to family functioning involving 21 families provides data which demonstrates that normal families behave as adaptive systems, both in generating and reciprocating high rates of supportiveness. Information is also obtained concerning a possible cause of aggressive behavior. (RP)
Background The practice of family medicine is not well established in many developing countries including Sri Lanka. The Sri Lankan Government funds and runs the health facilities which cater to the health needs of a majority of the population. Services of a first contact doctor delivered by full time, vocationally trained, Family Physicians is generally overshadowed by outpatient departments of the government hospitals and after hours private practice by the government sector doctors and specialists. This process has changed the concept of the provision of comprehensive primary and continuing care for entire families, which in an ideal situation, should addresses psychosocial problems as well and deliver coordinated health care services in a society. Therefore there is a compelling need to teach Family Medicine concepts to undergraduates in all medical faculties. Discussion A similar situation prevails in many countries in the region. Faculty of Medicine Peradeniya embarked on teaching family medicine concepts even before a department of Family Medicine was established. The faculty has recognized CanMed Family Medicine concepts as the guiding principles where being an expert, communicator, collaborator, advocate, manager and professional is considered as core competencies of a doctor. These concepts created the basis to evaluate the existing family medicine curriculum , and the adequacy of teaching knowledge and skills, related to family medicine has been confirmed. However inadequacies of teaching related to communication, collaboration, management, advocacy and professionalism were recognized. Importance of inculcating patient centred attitudes and empathy in patient care was highlighted. Adopting evaluation tools like Patient Practitioner Orientation Scale and Jefferson’s Scale of Empathy was established. Consensus has been developed among all the departments to improve their teaching programmes in order to establish a system of teaching family medicine
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. PMID:19930434
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…
Walsh, Allyn; Moore, Ainsley; Barber, Anne; Opsteen, Joanne
Abstract Objective To examine the role of nurse practitioners (NPs) as educators of family medicine residents in order to better understand the interprofessional educational dynamics in a clinical teaching setting. Design A qualitative descriptive approach, using purposive sampling. Setting A family practice centre that is associated with an academic department of family medicine and is based in an urban area in southern Ontario. Participants First-year (8 of 9) and second-year (9 of 10) family medicine residents whose training program was based at the family practice centre, and all NPs (4 of 4) who worked at the centre. Methods Semistructured interviews were conducted, which were audiotaped and transcribed. An iterative approach was used for coding and analysis. Data management software guided organization and analysis of the data. Main findings Four interconnected themes were identified: role clarification, professional identity formation, factors that enhance the educational role of NPs, and factors that limit the educational role of NPs. Although residents recognized NPs’ value in team functioning and areas of specialized knowledge, they were unclear about NPs’ scope of practice. Depending on residents’ level of training, residents tended to respond differently to teaching by NPs. More of the senior residents believed they needed to think like physicians and preferred clinical teaching from physician teachers. Junior residents valued the step-by-step instructional approach used by NPs, and they had a decreased sense of vulnerability when being taught by NPs. Training in teaching skills was helpful for NPs. Barriers to providing optimal education included opportunity, time, and physician attitudes. Conclusion The lack of an intentional orientation of family medicine residents to NPs’ scope of practice and educational role can lead to difficulties in interprofessional education. More explicit recognition of the evolving professional identity of family
Hughes, Lloyd D.
Over the last two decades in particular there has been a remarkable increase in the number of solid organ transplants being performed worldwide alongside improvements in long-term survival rates. However, the infrastructure at transplant centres has been unable to keep pace with the current volume of the transplant patient work load. These pressures on transplant specialist centres has led to calls for an increased role of the general practitioner (GP) managing particular aspects of transplant patients’ medical care. Indeed, many aspects of follow-up care such as screening for malignancies, preventing infection through immunisation programmes, and managing cardiovascular risk factors are already important aspects of family practice medicine. This paper aims to review some of the aspects of transplant patient care that is important for healthcare workers in family practice to manage. PMID:25657941
Hubbard, J R; Saathoff, G B; Bernardo, M J; Barnett, B L
The first step in the management of borderline personality disorder is making the correct diagnosis. A clinical example illustrates symptoms of a patient with borderline personality disorder in a family practice setting. Major characteristics of borderline personality disorder include severe mood instability, fear of abandonment, chronic boredom, self-injury, unstable interpersonal relationships, "splitting," identity instability and borderline rage. Early diagnosis may help prevent potential management problems and possible doctor-patient conflicts. PMID:7653428
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
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. PMID:15603505
This paper presents a summary of Murray Brown's family systems theory as it applies to the workplace, lists some indicators of when a system is working well, and cites some other guidelines for gauging and improving one's own functioning in the work system. Major concepts of Bowen's theory include: (1) the family and the workplace are systems; (2)…
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…
Zuk, Gerald H.
Family therapy is a method for resolving conflict in value systems. The family therapist has three role functions: the go-between, the side-taker, and the celebrant. The therapist selectively expresses values that disrupt and then repair destructive family interaction. Short-term therapy works best because it least violates value expectations…
Parfitt, Barbara Ann; Cornish, Flora
The health systems of former Soviet Union countries are undergoing reform away from the highly centralised, resource-intensive, specialised and hierarchical Soviet system, towards a more generalist, efficient health service with greater focus on primary health care. Family Health Nursing is a new model designed by WHO Europe in which skilled generalist community nurses deliver primary health care to local communities. This paper presents a qualitative evaluation of the implementation of Family Health Nursing in Tajikistan. Using Stufflebeam's 'Context, Input, Process, and Product' model, the paper aims to evaluate the progress of this reform, and to understand the factors that help or hinder its implementation. A four-phase research design investigates the development of the Family Health Nurse role over time. In 5 rural areas, 6 focus groups and 18 interviews with Family Health Nurses, 4 observations of their practice, 7 interviews with families and 9 interviews with physicians were carried out. Data were analysed according to the components of Stufflebeam's model. Although the legacy of the Soviet health system did not set a precedent for a nurse who is capable of decision-making and who works in partnership with the physician, Family Health Nurses were successfully implementing new practices. Crucial to their ability to do so were the co-operation of physicians and families. Physicians were impressed by the nurses' development of knowledge, and families were impressed that the nurses could offer real solutions to their problems. However, failure to pay the nurses regular salaries had led to serious attrition of the workforce. We conclude that the success of the Family Health Nurse role in other countries will depend upon its position in relation to the historical health care system. PMID:17651876
Szponar, Jarosław; Kuźniar-Placek, Justyna; Panasiuk, Lech
Doctors of many specialties, including the family doctors, encounter the problems of alcohol abuse in their patients. Due to the fact that many symptoms of dangerous diseases can be masked by the fact of alcoholism, a brief doctor's visit has to be conducted with watchfulness, caution and care. Family doctors have some brief testes (such as CAGE test, AUDIT test), besides of precise anamnesis and blood chemistry, which make it easier to identify a patient with an alcohol problem. People with disabilities are more exposed to alcohol abuse since they often experience additional factors such as unemployment, social isolation and homelessness. All of the above factors foster the more frequent alcohol usage. In Poland the main treatment method of alcohol addiction is psychotherapy practiced in the rehab centers. The detoxification treatment is voluntary and free of charge even though the patients checking into those facilities are doing it against their will. They are forced to do so by entourage, family, spouse or risk of unemployment. Acamprozate is considered as a drug, run to extend abstaining from alcohol. In the past, therapy with disulfiram substance was common, but now, it is considered as unethical behaviour. In practice of medicine, a patient with alcohol addiction creates not onlya medical but also legal problems. Therefore keeping of detailed medical documentation is very important as it may become significant evidence in the future. PMID:23243928
Ison, Ray; Blackmore, Chris; Armson, Rosalind
Learning participation only makes sense if it is purposeful. From our perspective its primary purpose is to achieve more effective managing in situations of complexity and change. We describe our evolving understandings and practices (a praxeology) for Systems Practice for managing complexity, built on 30 years of developing supported open…
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 is widespread recognition that schools cannot be successful if they function alone in their quest to educate our nation's children, but must work with families and in the context of the community. Although the field is enjoying unprecedented popularity and many more schools and afterschool programs are partnering with community agencies and organizations, the notion of engaging parents and the community has not yet become an integral part of school reform, and in the afterschool field, practitioners who work at the program level directly with students often struggle with how they can make partnerships a reality. This chapter draws upon lessons learned from the School of the 21st Century (21C) to provide practical strategies for reaching out to and working with families and the community. The School of the 21st Century includes an afterschool component and is one of several national initiatives that use a community school strategy. PMID:25537352
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…
Newsome, Barbara; And Others
Written as a basic guide, this report of the Community Coordinated Child Care Committee of Dane County, Wisconsin, aims to assist people interested in establishing family day care systems in their own communities. Practical information is provided on the prime factors that should be taken into account in selecting the ideal physical location and…
Downie, J; Shea, A; Rajotte, C
In 2005, 3974 Canadians were on waiting lists for organ transplants and 275 patients died while waiting. Canada's organ shortage has led to calls for changes to Canada's organ donation system and its legal framework. Herein we examine an issue in which law reform could both increase the number of available organs and better align practice with respect for autonomy, a core value underpinning the Canadian legal system: the issue of family overrides of a valid donor consent to postmortem donation. That is, we examine what should happen when an individual consented to postmortem donation but the family would like to override that consent. First, we examine the requirements for valid donor consent. Second, we consider the legal status of family overrides of valid donor consent in relation to postmortem donation. Third, we describe the available data with regard to the practice of permitting families to override valid donor consent and discuss the possible reasons for this practice. Finally, we describe and defend the desired results with respect to law reform and describe the actions needed to realize these results. PMID:18589083
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.
Provides strategic and structural therapy concepts to use when addressing a child's school phobia. Describes how a family systems approach, which is solution-focused, employs family resources and fosters parental competencies. Offers a case study with a careful analysis of each session. Discusses implications for school counselors. (RJM)
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…
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…
Swartwout, Ellen; Drenkard, Karen; McGuinn, Kathy; Grant, Susan; El-Zein, Ashley
Patient and family engagement is a strategy to enhance healthcare outcomes through strong clinician-patient partnerships. A new care delivery process, in which the patient is the driver of the healthcare team, is required to achieve optimal health. A summit partially funded by a seed grant from the Robert Wood Johnson Executive Nurse Fellow Alumni Foundation was held with interprofessional colleagues and patient representatives to identify needed clinical competencies and future practice changes. Recommended shifts in the care delivery process included a focus on patient strengths, including the patient as a valued team member, doing care "with me" and not "to me," and considering all entities or providers including the patient, as equal partners. PMID:26906687
The manufacture of mobile homes and prefabricated houses results in the second highest occupational injury and illness rate of any industry. The types of worker injuries sustained have never previously been characterized. This series of 138 injuries from a rural family practice categorizes the injuries sustained by workers in a manufactured housing plant. Most injuries were not judged to be serious, but did result in lost work time and morbidity. Forty-nine percent of all injuries involved lacerations or puncture wounds. Seventy-six percent of puncture wounds involved staple gun use. Two thirds of lacerations were from pieces of metal, siding, and other sharp objects; one third were from knives. Fingers, hands, and wrists were the most commonly injured anatomic sites. Nine cases of overuse injury were seen; two required carpal tunnel surgical release. Twelve injuries were serious enough to require hospitalization or consultation. There were no fatalities. Several suggestions for improved worker safety are presented. PMID:2391457
McIntosh, M. C.; Leigh, G.; Baldwin, N. J.; Marmulak, J.
OBJECTIVE: To compare the effects of three brief methods of reducing alcohol consumption among family practice patients. DESIGN: Patients randomly assigned to one of three interventions were assessed initially and at 3-, 6-, and 12-month follow-up appointments. SETTING: Family practice clinic composed of 12 primary care physicians seeing approximately 6000 adults monthly in a small urban community, population 40,000. PARTICIPANTS: Through a screening questionnaire, 134 men and 131 women were identified as hazardous drinkers (five or more drinks at least once monthly) during an 11-month screening of 1420 patients. Of 265 patients approached, 180 agreed to participate and 159 (83 men and 76 women) actually participated in the study. INTERVENTIONS: Three interventions were studied: brief physician advice (5 minutes), two 30-minute sessions with a physician using cognitive behavioural strategies or two 30-minute sessions with a nurse practitioner using identical strategies. MAIN OUTCOME MEASURES: Quantity and frequency (QF) of drinking were used to assess reduction in hazardous drinking and problems related to drinking over 12 months of follow up. RESULTS: No statistical difference between groups was found. The QF of monthly drinking was reduced overall by 66% (among men) and 74% (among women) for those reporting at least one hazardous drinking day weekly at assessment (N = 96). Men reported drinking significantly more than women. CONCLUSIONS: These results indicated that offering brief, specific advice can motivate patients to reduce their alcohol intake. There was no difference in effect between brief advice from their own physician or brief intervention by a physician or a nurse. PMID:9386883
Ricer, R E; Fox, B C; Miller, K E
Formal mentoring programs have been suggested as one strategy to increase student interest in primary care. Mentoring has long been a part of the business world but has only recently become a formal part of family medicine training. This paper reviews the literature on mentoring and provides applications to family practice. Mentoring has been found to develop a deeper relationship than role modeling or preceptoring and should benefit the student and mentor. The mentor's roles and functions are varied and numerous; the mentor guides, assists, and counsels students longitudinally through their development as professionals. Mentoring is based in the present but is directed toward the future. Mentors need to have charisma, leadership and motivational skills, inspiration, competence, compassion, empathy, and willingness to share with the student. Strategies used when developing a mentoring program need to incorporate the positive qualities of mentoring while minimizing the negative components, as described in this paper. The tasks of mentoring are of less importance than the personal characteristics of the mentor. Mentors should not be involved in formally evaluating the student. Faculty development and monitoring of the relationships on a regular basis are important aspects of a successful program. PMID:7665021
Bidmead, Christine; Cowley, Sarah
The second paper in this series of two on partnership examines the effects of family partnership (parent adviser) training which builds on health visitors' skills to facilitate partnership working with parents. This study was utilised as a pilot to identify a suitable method, to explore the interaction processes of health visitors who had undergone the training. The study draws together both quantitative and qualitative methods to seek to understand processes in depth. Three health visitors, who were part of a training group of 12, took part in the qualitative research using stimulated recall methodology. The quantitative data was collected from the whole training group using the Constructions of Helping questionnaire and the course evaluation form. The findings suggest that the family partnership training may be effective in enhancing partnership working in health visiting and that the stimulated recall methodology is an effective method of identifying the processes of interaction. The triangulation of methods led to an understanding that change in practice is dependent on the insight of the practitioner and that this may be able to be measured to some extent by the use of different methods. PMID:16095252
Annie E. Casey Foundation, Baltimore, MD.
The Family to Family initiative has encouraged states to reconceptualize, redesign, and reconstruct their foster care systems. By 1996, the initiative was being implemented in five states and six counties in two additional states. Drawing on the experiences of Family to Family participants, a framework for child welfare leaders working to reduce…
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…
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. PMID:27179138
Ellis, C. G.
PURPOSE: To investigate the experience of chronic unhappiness as it presents in family practice. DESIGN: A descriptive, qualitative study of both patients and physicians using an existential phenomenologic approach. SETTING: Two village general practices in South Africa. PARTICIPANTS: Four patients who were difficult, "heartsink" patients, who gave their doctors an overwhelming feeling of exasperation and defeat. METHOD: We investigated the clinical records thoroughly and explored patients' relationships with others. Through interpretation and reflection, we tried to discover what role the doctor could play with these patients. FINDINGS: Chronic unhappiness was found to be not only a condition of life for the patients but also for the doctor. It was an important factor in the relationship they shared. Unhappiness was revealed in part by frequent visits by the patients, a constellation of negative feelings in the doctor, and difficult patient-doctor relationships. CONCLUSION: Chronic unhappiness is not "treatable" in the normal curative or therapeutic sense. This does not prevent our quest to diagnose and cure, but enlarges our horizons to recognizing and accepting our own human reactions to patients and understanding how we can meet their needs. PMID:8653032
Sangster, J F; Gerace, T M; Seewald, R C
OBJECTIVE: To investigate hearing loss in elderly patients. DESIGN: Cohort study. SETTING: Family practice. PATIENTS: All ambulatory patients 65 years of age or older who attended the practice from June to August 1989. OUTCOME MEASURES: The Hearing Handicap Inventory for the Elderly--Screening Version (HHIE-S) and the Welch-Allyn Audioscope. Patients who failed one or both of the screening tests were referred to a speech and hearing clinic for audiologic assessment and treatment recommendations. Those with hearing aids were excluded from the main study but were given the opportunity to have them assessed at the clinic. MAIN RESULTS: Of 157 eligible patients 42 were excluded: 16 refused to participate, 13 already had hearing aids, and 13 could not be contacted. Of the remaining 115, 34 failed one or both of the tests (14 failed the HHIE-S, 9 failed the audioscope test, and 11 failed both). Of the 34, 25 completed the audiologic assessment at the clinic. Fifteen were found to have severe hearing impairment; the recommendation was hearing aids for 12, further assessment for 2 and no treatment for 1. Of the remaining 10 patients it was thought that 6 would benefit from hearing aids. Ten of the 11 patients with hearing aids who agreed to undergo testing at the clinic were found to need an adjustment or replacement of their devices. CONCLUSIONS: Hearing loss is a significant problem in elderly patients in primary practice. Further study is required to determine which of the two screening tools is most effective. Most elderly patients with hearing aids may require modification or replacement of their devices. PMID:2009476
Koch, E; Müller, M J
People of non-German background still have difficulties obtaining adequate access to the German health care system. Reasons include communication barriers, differences in the concept of disease and low level of education in addition to a frequently difficult social situation and immigration-related stress factors. The majority of the patients consult the family physician first. Taking into consideration the different cultural concepts of disease and immigration-specific stress factors opens new therapeutic options and expands the intercultural competence of the treating physician. PMID:17987716
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
McGregor, Sue L. T.
The family as a basic social unit needs strategic support and strength to carry its weight, relative to other social institutions. This article focuses on why it is important to help people learn to be in a family and presents the construct of becoming family literate (different from family literacy). This learning is a legitimate platform from…
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…
Davis, A E
Computers are now widely used in medical practice for accounting and secretarial tasks. However, it has been much more difficult to use computers in more physician-related activities of daily practice. I investigated the Desqview multitasking system on a 386 computer as a solution to this problem. Physician-directed tasks of management of patient charts, retrieval of reference information, word processing, appointment scheduling and office organization were each managed by separate programs. Desqview allowed instantaneous switching back and forth between the various programs. I compared the time and cost savings and the need for physician input between Desqview 386, a 386 computer alone and an older, XT computer. Desqview significantly simplified the use of computer programs for medical information management and minimized the necessity for physician intervention. The time saved was 15 minutes per day; the costs saved were estimated to be $5000 annually. PMID:2383848
Morris, N V; Abramson, M J; Rosier, M J; Strasser, R P
The objective of this study was to evaluate clinical history and self-perception of severity as predictors of asthma severity. A short-term longitudinal study was conducted in a family practice in Melbourne, Australia, utilizing peak flow monitoring, medication diary, and self-administered asthma severity questionnaire. Seventy-two asthmatic subjects with a positive bronchodilator or exercise test, aged between 6 and 79 years, were studied. Symptom and treatment items were correlated with peak flow variability and minimal peak expiratory flow rate (PEFR). An asthma severity scale was generated using the partial credit version of Item Response Theory and the participants' severity scores were validated against lung function tests and medication usage. Quantitative modeling procedures were used to investigate the interrelationships of factors associated with peak flow variability. Severity scores demonstrated significant relationships with peak flow variability (partial r = 0.34) and treatment items. Self-perceived severity of asthma in the preceding 2 weeks showed significant association with peak flow variability (partial rho = 0.46) and minimal PEFR (rho = -0.41). The severity module of the Monash Respiratory Questionnaire is a valid and reliable instrument. The most important symptoms appear to be the frequency of use of bronchodilator and frequency of nocturnal attacks. A carefully structured clinical history in conjunction with the peak flow criteria of variability and minimal peak flow rate would be appropriate in the evaluation of asthma severity. Patients' self-perception of the severity of their asthma needs further evaluation. PMID:8968297
Goetz, Kathy, Ed.
This double issue of the journal "Report" focuses on the collaboration among seven social service systems that support and serve children and families. Each of the sections discusses one of the seven systems, presents an overview essay, and profiles programs that execute the service. The first section, on education, emphasizes linkages between…
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. PMID:9883131
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…
Lucero, Nancy M; Bussey, Marian
Similar to families from other groups, urban-based American Indian and Alaska Native ("Native") family members involved with the child welfare system due to substance abuse issues are also often challenged by untreated trauma exposure. The link between these conditions and the history of genocidal policies aimed at destroying Native family ties, as well as experiences of ongoing discrimination, bring added dimensions for consideration when pro- viding services to these families. Practice-based evidence indicates that the trauma-informed and culturally responsive model developed by the Denver Indian Family Resource Center (DIFRC) shows promise in reducing out-of-home placements and re-referrals in urban Native families with substance abuse and child welfare concerns, while also increasing caregiver capabilities, family safety, and child well-being. This article provides strategies from the DIFRC approach that non-Native caseworkers and supervisors can utilize to create an environment in their own agencies that supports culturally based practice with Native families while incorporating a trauma-informed understanding of service needs of these families. Casework consistent with this approach demonstrates actions that meet the Active Efforts requirement of the Indian Child Welfare Act (ICWA) as well as sound clinical practice. Intensive and proactive case management designed specifically for families with high levels of service needs is a key strategy when combined with utilizing a caseworker brief screening tool for trauma exposure; training caseworkers to recognize trauma symptoms, making timely referrals to trauma treatment by behavioral health specialists experienced in working with Native clients, and providing a consistent service environment that focuses on client safety and worker trustworthiness. Finally, suggestions are put forth for agencies seeking to enhance their cultural responsiveness and include increasing workers' understanding of cultural values
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,…
Crais, Elizabeth R.; Roy, Vicky Poston; Free, Karen
Purpose: To determine the degree to which early intervention professionals and families agreed on whether specific family-centered practices were implemented in specific child assessments and which practices were viewed as important to include in future child assessments. Method: A self-rating instrument was used to survey 134 early intervention…
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…
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…
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…
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…
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.
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…
Sakurai, Akihiro; Katai, Miyuki; Hashizume, Kiyoshi; Fukushima, Yoshimitsu
Thanks to recent developments in molecular biology and cancer genetics, genetic testing has become widely available and useful in several kinds of familial tumor syndrome. However, the impact of genetic testing on medical management is not always straightforward. Clinicians have to consider the psychological impact and ethical complexities of communicating hereditary cancer risk information to families. This review notes some points on genetic counseling before and after genetic testing for familial neuroendocrine tumor syndromes. PMID:17001463
Sisler, Jeffrey J.; DeCarolis, Mary; Robinson, Deborah; Sivananthan, Gokulan
Abstract Objective To characterize the demographic characteristics, practice profile, and current work life of general practitioners in oncology (GPOs) for the first time. Design National Web survey performed in March 2011. Setting Canada. Participants Members of the national GPO organization. Respondents were asked to forward the survey to non-member colleagues. Main outcome measures Profile of work as GPOs and in other medical roles, training received, demographic characteristics, and professional satisfaction. Results The response rate was 73.3% for members of the Canadian Association of General Practitioners in Oncology; overall, 120 surveys were completed. Respondents worked in similar proportions in small and larger communities. About 60% of them had participated in formal training programs. Most respondents worked part-time as GPOs and also worked in other medical roles, particularly palliative care, primary care practice, teaching, and hospital work. More GPOs from cities with populations of greater than 100 000 worked solely as GPOs than those from smaller communities (P = .0057). General practitioners in oncology played a variety of roles in the cancer care system, particularly in systemic therapy, palliative care, inpatient care, and teaching. As a group, more than half of respondents were involved in the care of each of the 11 common cancer types. Overall, 87.8% of respondents worked in outpatient care, 59.1% provided inpatient care, and 33.0% provided on-call services; 92.8% were satisfied with their work as GPOs. Conclusion General practitioners in oncology are involved in all cancer care settings and usually combine this work with other roles, particularly with palliative care in rural Canada. Training is inconsistent but initiatives are under way to address this. Job satisfaction is better than that of Canadian FPs in general. As generalists, FPs bring a valuable skill set to their work as GPOs in the cancer care system. PMID:23766068
Puig, Ana; Koro-Ljungberg, Mirka; Echevarria-Doan, Silvia
The purpose of this article is to illustrate how theory and particularly the theoretical perspective of social constructionism can influence the ways in which scholars conduct qualitative research studies in the area of family systems. The authors argue for the importance of theory in qualitative research projects and promote researchers' clear…
Rourke, James T. B.
To produce more rural physicians, the College of Family Physicians of Canada recommends providing earlier and more extensive rural medicine experience for all undergraduate medical students, developing rural postgraduate training programs, providing third-year optional special and advanced rural family-medicine skills training, and making advanced…
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…
Freeman, Ramona Gail; Vakil, Shernavaz
The work in family child care is becoming increasingly more professional, moving from an image of "mothering" toward one of educare. The growing demand for expertise and competence in family child care providers can be examined in light of their pedagogical experiences and the ways in which children engage in learning in providers' homes. This…
Family physicians are in a unique position to help patients with sexual problems. They know their patients over a long time and often have both partners as patients. Most problems require minimal intervention, usually by providing information. Family physicians are sometimes the only professionals who are trusted enough to be told of abusive or incestuous situations. PMID:8471906
This article outlines a graduate-level, one-time-only family therapy course that prepares counseling trainees to be competent at entry-level family therapy in the United States. The approach outlined addresses the training concerns of programs that significantly emphasize individual-focused paradigms and that have limited time to train counseling…
Roberto, Karen A.; Blieszner, Rosemary; Allen, Katherine R.
We examine the extent to which theory has been used in empirical studies of families in later life, identify prevalent types of theoretical frameworks, and assess connections between theory and both focal topics and analytic methods in the family gerontology literature. The paper is based on content and methodological analysis of 838 empirical…
Zimmerman, Heather Toomey; Reeve, Suzanne; Bell, Philip
In this paper, we examine the interactional ways that families make meaning from biological exhibits during a visit to an interactive science center. To understand the museum visits from the perspectives of the families, we use ethnographic and discourse analytic methods, including pre- and postvisit interviews, videotaped observations of the…
Fiese, Barbara H; Rhodes, Holly G; Beardslee, William R
Pediatricians are in the unique position of being on the front line of care for children and having access to their families. This article presents both a rationale and the evidence base for identifying the family characteristics and processes that affect child health and suggests approaches that pediatricians can implement to improve the care of children, using data from 3 recent reports of the Institute of Medicine and National Research Council, as well as other recent family research. Evidence regarding the impact on child health of 3 family factors in particular (family composition and living arrangements, family routines, and parental depression) is highlighted, and implications for pediatric practice are described. PMID:23918891
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…
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…
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…
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. PMID:26593100
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. PMID:23336328
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. PMID:22558029
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. PMID:22558029
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. PMID:25091031
Qualls, Sara Honn
Long-term care services and supports are primarily a family industry that warrants psychologists' involvement through practice, research, and policy advocacy. Families are poorly integrated into service systems despite the dominance of family caregiving work within health care and long-term care. This article positions family caregiving work within the context of family life across the life span, noting overlaps and distinctions between normal family life and caregiving work for older adults whose physical or cognitive challenges require assistance. The prevalence, work, and consequences of family caregiving for older adults are described. Families are identified as key partners in long-term care, despite substantial policy and practice barriers to integrating them into care structures and systems. Policy options for reducing or eliminating barriers are suggested, as are professional practice opportunities for psychologists to support caregiving families. Approaches to assessment and interventions for caregivers across a variety of settings are described. Gaps in research are highlighted, with a focus on how to understand caregiving as embedded within context of family, long-term care services and supports, and health care. Caregiving work presents an imperative for expanding psychologists' engagement in integrating and supporting the families whose caregiving is so critical to a rapidly aging society. (PsycINFO Database Record PMID:27159435
Chambers, L. W.; Burke, M.; Ross, J.; Cantwell, R.
The standards of patient care were maintained in five urban medical practices after the introduction of family practice nurses. Evaluations were achieved before and after their appointment by the indicator condition method. Minimal explicit criteria for the management of patients with 12 indicator conditions and by the use of 14 drugs were approved by an ad hoc peer group of community physicians. These cirteria were applied to the five practices by the use of a single-blind design and the abstraction of unaltered medical records. A standardized score for each practic e permitted comparison of scores for the management of indicator conditions and for the clinical use of drugs before and after attachment of the family practice nurses. For each of the indicator conditions and the drugs assessed in the five practices similar levels of adequacy were observed in the two study periods. These explicit (objective) audit resutls agreed with the implicit (subjective) assessments of the family practice nurses by their physician colleagues. PMID:647590
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…
Discusses family systems theory as a framework for understanding the common family dynamics observed in families where there is sibling abuse. Presents a case example using family systems theory as a framework for conceptualizing and developing treatment. (Contains 45 references.) (GCP)
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…
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. PMID:21901899
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…
Grose, Nellie P.; And Others
The development of professional identity as a family physician is better understood by referring to Erikson's description of the development of personal identity. Erikson describes eight stages, each one defined by its alternative outcomes--the best versus the worst that can happen. (MLW)
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.…
Eliason, Michele J.; Skinstad, Anne Helene
Family medicine physicians were surveyed about their knowledge of substance abuse and wishes for continuing education. Results showed 10% had no substance abuse training in medical school, 15% had none during residency, and 21% had no continuing education on substance abuse. Most preferred continuing education programs as part of an annual…
Rosenberg, Mark L.; And Others
Discusses the role of public health (PH) professionals in preventing family and intimate violence including findings from PH research, such as the cycle of violence and need to include abuse issues across the lifespan into medical education. Proposes that incorporating PH principles into medical education can help forge an effective partnership…
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…
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…
Research and Training Center on Family Support and Children's Mental Health, 2006
"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" examines research on the "contribution of informal support linkages in the achievement of treatment outcomes" in three models of family-based practice: Intensive Family…
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 possible to end…
McGonigel, Mary J., Ed.; And Others
This monograph presents identified best practices in the development of Individualized Family Service Plans (IFSP) as required for families who have young children with disabilities, by Public Law 99-457, the Education of the Handicapped Act Amendments (1986). Chapter One presents an overview of the monograph's development and use. Chapter Two…
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…
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…
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…
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…
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'…
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…
Before 1971, when Idaho became the 1st state to authorize expanded scope of functions for registered nurses, nearly all states made it illegal for any nurse to perform diagnosis or prescribe treatment, creating an ambiguity as more and more nurses were equipped by education and technology to perform new tasks. Today 30 states have liberalized the scope of nursing functions, making it possible for nurses and nurse-midwives to assume, among other tasks, family planning functions. A table gives the status of legislation and regulations governing nurse practitioners and nurse-midwives in each state. The area of greatest controversy is the prescription of oral contraceptives. In some states it is allowed under doctor's supervision or in rural areas or in areas where clear need exists for a nurse to dispense such medication. Usually this dispensing is limited to a single course of treatment. Nurse-midwives are rapidly being accepted as extensions of scarce medical facilities. Generally nurse-midwives are authorized to provide prenatal and postpartum care, to handle normal deliveries, and do family planning work including fitting diaphragms and inserting and removing IUDs. An innovation is the family planning nurse practitioner. Several courses for such practitioners have been set up across the U.S. Graduates may, with medical direction, perform bimanual pelvic examinations and breast examinations, take blood pressure, prescribe contraception, fit diaphragms, insert IUDs, examine vaginal secretions microscopically, and refer patients with problems to physicians. In a California program both registered and nonregistered nurses are being trained as women's health specialists who may make routine examinations in both pregnant and nonpregnant women and give family planning advice. Non-RN family planning specialists being trained include licensed vocational nurses, baccalaureate degree holders in nonnursing fields, and qualified persons with less formal education. The 24-week
Lee, Linda; Weston, W. Wayne; Heckman, George; Gagnon, Micheline; Lee, F. Joseph; Sloka, Scott
Abstract Objective To provide family physicians with a structured approach to patients presenting with memory difficulties. Sources of information The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Memory Clinic in partnership with the Ontario College of Family Physicians. Main message Use of a structured clinical reasoning approach can assist physicians in achieving an accurate diagnosis in patients presenting with memory difficulties. Delirium, depression, and reversible causes need to be excluded, followed by differentiation among normal cognitive aging, mild cognitive impairment, and dementia. Obtaining collateral history and accurate functional assessment are critical. Common forms of dementia can be clinically differentiated by the order in which symptoms appear and by how cognitive deficits evolve over time. Typically, early signs of Alzheimer dementia involve impairment in episodic memory, whereas dementia involving predominantly vascular causes might present with early loss of executive function and relatively preserved episodic memory. Frontotemporal dementia and Lewy body spectrum disorders might have early loss of executive function and visuospatial function, as well as characteristic clinical features. Conclusion A clinical reasoning approach can help physicians achieve early, accurate diagnoses that can guide appropriate management and improve care for patients with memory difficulties. PMID:23486793
Anetzberger, G J
This article on elderly adult survivors of domestic violence (usually women) reviews the literature that examines the impact on later life of domestic violence experienced earlier in life and that examines the effects of elder abuse perpetrated by adult family members. The discussion is illustrated with case studies and figures that list the physical, psychological, behavioral, and social effects of each type of violence as well as intervening variables. Next, the paper reviews the influence of culture and ethnicity on the meaning attached to elder abuse and on help-seeking or accepting behavior. The article then proposes a conceptual framework that uses contributing factors (cultural background, individual influences, and cohort influences), modifying factors (the nature of violence, personal circumstances, and relationship with perpetrator), the meaning of violence, and the effects on the survivor to explain the effects of early or late family violence on elderly adult survivors. The discussion notes that the framework focuses on negative effects but that survivors of domestic violence can experience positive effects, such as the development of personal coping skills. The article ends by noting that this proposed framework has clinical implications because it recognizes that the effects of domestic violence on elderly adults may be complicated, it helps practitioners link symptoms to domestic violence, it helps practitioners realize that the meaning of domestic violence may vary among elderly victims, and it shows that family violence occurs in a social context. PMID:12322016
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. PMID:18953193
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…
Warner, Christopher H.; Morganstein, Joshua; Rachal, James; Lacy, Timothy
Objective: The authors evaluate the current practices and perceptions of graduates of combined family medicine-psychiatry residency programs in the following areas: preparation for practice, boundary formation, and integration of skills sets. Method: The authors conducted an electronic cross-sectional survey of all nationwide combined family…
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…
Caspe, Margaret; Lopez, Elena M.
The purpose of the brief is to help educators, service providers, and local evaluators in schools, intermediary and community-based organizations, and social service agencies become more effective by highlighting the best program and evaluation practices of family-strengthening intervention programs. At a time when evidence-based practice matters,…
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...
Xu, Gang; And Others
Information about practice problems was solicited through a structured questionnaire completed by 59 family physicians, 101 pediatricians, and 102 orthopedic surgeons. Across all three groups, a lack of personal time was the major concern. Practice concerns vary among the specialties, a finding of interest to physician education. (SLD)
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); "Understanding the Meaning of…
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. PMID:25666300
Dickie, Gordon L.; Hoddinott, Susan N.
The authors studied 46 eldest or only children under school age and their parents to determine the relationship between parents' recollections of their own childhoods and the way they use their family physician for care of their children. The parents completed a questionnaire that measured the caring and overprotection dimensions of the parenting they themselves remember. Positive correlations were found between perceptions of maternal overprotection and the frequency of children's visits. Negative correlations were found between perceptions of parental affection and children's visits and non-routine diagnoses. Neuroticism was found to be a confounding variable that slightly weakened the relationship between maternal caring and children's visits. PMID:20469500
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. PMID:26994738
Kozlowska, Kasia; Hanney, Lesley
In this article we discuss the network paradigm as a useful base from which to integrate attachment and family systems theories. The network perspective refers to the application of general systems theory to living systems, and provides a framework that conceptualizes the dyadic and family systems as simultaneously distinct and interconnected. Network thinking requires that the clinician holds multiple perspectives in mind, considers each system level as both a part and a whole, and shifts the focus of attention between levels as required. Key epistemological issues that have hindered the integration of the theories are discussed. These include inconsistencies within attachment theory itself and confusion surrounding the theoretical conceptualizations of the relationship between attachment and family systems theories. Detailed information about attachment categories is provided using the Dynamic Maturational model. Case vignettes illustrating work with young children and their families explore the clinical implications of integrating attachment data into family therapy practice. PMID:12395561
Ting, T Y
This paper uses map analysis to study the transition of family limitation practice in Taiwan between 1961-80. The innovation-diffusion perspective emphasizes that birth control, particularly contraception, is a recent innovation and is essentially new in human culture. The innovation-diffusion theory assumes that the decline of fertility began in a setting where there was no, or at most very limited, previous practice of birth control. The theory emphasizes the importance of the spread of information. It also assumes that innovation starts in metropolitan centers, diffuses to other urban places with some delay, and penetrates to rural areas still later. Innovation behavior also diffuses from 1 area to another which is culturally and linguistically similar. Although there was some urban to rural diffusion from the Taiwan family planning program, the government supported program provided services more evenly between urban and rural areas, thus somewhat limiting the diffusion effect from the program. For the diffusion of family practice in Taiwan, it is expected that the availability of of information about and means of family limitation practice may effect the rate of the increase of small m values -- an index of family limitation -- in an area. The case study of Pingtung county shows that the demand-side diffusion from urban to rural areas was important in the earlier decade of the transition of family plimitation practice, but distance from urban center was less important as practice became more uniform through diffusion. Ethnicity, whether or not the township was dominated by Hakka or Fukienese, also seems to have played an important role in determining the pace at which the local residents adopted family practice limitation. Hakka townships seem to have adopted family limitation practice more slowly than Fukienese townships about the same distance from the urban center. The map analysis of Pingtung county provides descriptive evidence to support the diffusion of
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.
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 Children" (B.…
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
Fosco, Gregory M.; Grych, John H.
Several dimensions of family functioning are recognized as formative influences on children's emotion regulation. Historically, they have been studied separately, limiting our ability to understand how they function within the family system. The present investigation tested models including family emotional climate, interparental conflict,…
Whittaker, L A
The Human Genome Project is an international effort to map and sequence the human genome. The information it will generate has been referred to by some as the "new anatomy," and may play an important role in the future of medicine. However, as with any new technological advancement, the outcome of the Human Genome Project and the subsequent availability of new technology will raise a myriad of ethical, legal, and social concerns. The fear is that this technology will be applied in the clinical setting before the appropriate infrastructure is in place to deal with the issues it will raise. The family physician, far from being merely an interested observer in this process, will be responsible for the delivery of much of this technology as it becomes available. As an intermediary between the technology and the individual patient, the physician has a unique obligation to join in the thoughtful consideration and debate of these issues. PMID:1517727
Goh, Lay Hoon; How, Choon How; Lau, Tang Ching
In Singapore, male osteoporosis is gaining greater importance due to our ageing population. Family physicians should screen for osteoporosis in elderly men and men with risk factors or secondary causes for the condition. A bone mineral density (BMD) test is used for diagnosis. FRAX® can be used to predict the absolute ten-year fracture risk. Management includes reduction of risk factors or secondary causes, fall prevention, appropriate physical activity and a diet adequate in calcium and vitamin D. Referrals to specialists for evaluation and therapy can be considered, particularly for younger men with more severe disease. Current first-line drug treatment includes bisphosphonates and teriparatide. Testosterone increases BMD of the spine, but data on fracture risk reduction is unavailable. Public and physician education with the involvement of health authorities can create greater awareness of this silent condition, which can lead to complications, morbidity and death, if left untreated. PMID:25091882
From the clinical records of a country doctor, this vignette concerns a teenaged girl who, having refused treatment, is persuaded, under near duress, to accept a regimen that her family physician considers best for her. Although apparently arrogant paternalism, the practitioner's approach proves, on reflection, to possess considerable merit. The author discusses the ethical principles that have led to rejection of paternalism in the West. Formulated as absolute maxims, they soon require, like all absolutes, a multitude of explanations and additions. Some logical, social, and other “exceptions” are briefly mentioned, because the old doctor's intuitive actions seem to have oddly coincided with a number of them. Yet the questions remain: Should this medical practitioner have become so deeply involved? Should he have interfered with his patient's autonomy to the extent he did? Was he justified? PMID:11659246
Kelly, S. Ann; Joffres, Michel R.
A questionnaire was mailed to a random sample of 532 members of the Alberta Chapter of the College of Family Physicians in order to assess the role of physicians in providing nutrition education to their patients. Of the 255 respondents (53% response rate), over 97% agreed that “educating patients about nutrition is an important role for physicians.” Physicians most often gave nutrition information on obesity, constipation, heart disease and hypertension, alcohol, coffee, infant feeding, osteoporosis, and prenatal nutrition. Female physicians gave nutrition information significantly more often than male physicians on four maternal and child health topics. Perceived barriers to nutrition education included lack of reimbursement for physicians (86%), lack of time (48%), and limited access to patient information (42%). Most physicians often informed patients on the seven most common nutrition topics despite these concerns. PMID:21249103
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 limited guidance on how to prepare their programs for broad dissemination in practice settings. We describe Three Cs of Translation, which are key areas that are essential for developers to translate their EBPs from research to practice settings: (1) Communicate the underlying theory in terms easily understandable to end users, (2) Clarify fidelity and flexibility, and (3) Codify implementation lessons and examples. Program developers are in the best position to describe their interventions, to define intervention core components, to clarify fidelity and flexibility, and to codify implementation lessons from intervention studies. We note several advantages for developers to apply the Three Cs prior to intervention dissemination and provide specific recommendations for translation. PMID:26375189
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…
Sawyers, Janet K.; Moran, James D., III
The purpose of this article is to advance understanding of the individual and family from a systems perspective and to facilitate interdisciplinary communication between individual and family theorists. This article outlines the systems concepts in human development and family theories to show that the groundwork for unification is already…
Cameron, Stewart; Sadler, Laura; Lawson, Beverley
ABSTRACT PROBLEM ADDRESSED Patients have to wait too long to see their family physicians. Open access, a new approach to office scheduling, has shown promise in reducing patient wait times to see primary care physicians. OBJECTIVE OF PROGRAM To offer same-day appointments to most patients who call the office, thus reducing wait times as measured by the third available appointment. Reductions in no-show rates have also been reported by those who have adopted the open-access system. PROGRAM DESCRIPTION Following extensive preparation, a 2-site academic practice in Halifax, NS, adopted open-access booking in October 2008. Data on third available appointment times, no-show appointments, and patient volumes were tracked before and during the yearlong implementation. CONCLUSION The clinics recorded a substantial, sustained reduction in third available appointment time, indicating improved patient access. There was also a decline in no-show appointments. Patient volumes were unaffected. PMID:20841595
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. PMID:11715598
Moore, Shirley M; Jones, Lenette; Alemi, Farrokh
The adoption and maintenance of healthy living behaviors by individuals and families is a major challenge. We describe a new model of health behavior change, SystemCHANGE (SC), which focuses on the redesign of family daily routines using system improvement methods. In the SC intervention, families are taught a set of skills to engage in a series of small, family self-designed experiments to test ideas to change their daily routines. The family system-oriented changes brought about by these experiments build healthy living behaviors into family daily routines so that these new behaviors happen as a matter of course, despite wavering motivation, willpower, or personal effort on the part of individuals. Case stories of the use of SC to improve family healthy living behaviors are provided. Results of several pilot tests of SC indicate its potential effectiveness to change health living behaviors across numerous populations. PMID:27301950
Describes the initial evaluation phase of family therapy, which clarifies the circular interaction maintaining the symptom, the family structure, and its relationship to the therapist. Suggests using first sessions to collect data and organize it meaningfully. Presents phenomenological and mythical models of family functioning as guides for…
Schatz, Mona Struhsaker; Glenn, David
This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module's learning objectives address: (1) the organization of a social services foster care system; (2) the functioning of human systems and the rules governing their operation; and (3) the difficulties complex systems…
Ross, M; Pinto, I; Sparks, B
This study sought to determine the prevalence of family practitioners (FPs) in Johannesburg, South Africa, who are consulted by travelers. The study quantified the extent of medical activity of FPs and determined sources of physicians' updating information. Data were obtained from a random sample of 180 of the 576 nonspecialists listed as private medical practitioners in 1992-93 in the Johannesburg telephone directory. Interviews were obtained from 109 practitioners, of whom 105 were consulted by travelers. The average rate of consultations was an estimated 30/FP. Over 90% of FPs were asked about malaria prevention and/or immunization. 98% provided advice on malaria, and over 80% administered immunizations. The most common vaccine was Hepatitis B (63%), followed by gamma globulin for Hepatitis A (58%), and tetanus toxoid (50%). It was common for FPs to recommend antidiarrheal medications. Clients did not generally ask about diarrhea prevention. 47% gave preventive advice alone on diarrhea or recommendations for medication. FPs kept up to date on medical affairs by reading professional journals and following local experts or colleagues. In 1992, an estimated 100,000 travelers visited FPs in Johannesburg. PMID:12178510
Weber, Stacy L; Segal, Summer; Packman, Wendy
Inborn errors of metabolism result in psychosocial crises that challenge individual and familial modes of functioning across the life cycle. Increased stress, mood disorders, interpersonal challenges, decreased quality of life, and grief reactions are all common for patients and their families. To effectively care for these patients, a holistic approach to their care, which incorporates their social context, is essential. Patients and their families need support as they focus on immediate practical demands, grieve over illness-related losses, and reorient future expectations. A family systems based model provides a flexible and individualized approach to care that allows for optimal psychosocial adjustment throughout the disease process. PMID:22532988
Kang, R; Barnard, K; Oshio, S
The purpose of this study was to describe the scope of clinical practice of advanced practice nurses who were involved in a project designed to increase access of families with at-risk and disabled young children, newborn to 3 years of age, to early intervention services in rural Washington State. The findings from this study are based on the retrospective review of records of clients seen by the advanced practice nurses. Nursing diagnoses and nursing interventions were assigned to chart recordings. The most frequently occurring nursing diagnoses assigned to parents were Altered Parenting, Altered Family Processes, Fear, Noncompliance, and Knowledge Deficit. The most frequently occurring nursing diagnoses assigned to children were Impaired Physical Mobility, Impaired Verban Communication, Altered Nutrition: Less than Body Requirements, Sensory-Perceptual Alteration, and Altered Thought Processes. Categories of nursing intervention recorded most frequently were Monitoring, Planning and Information. Discussion of findings addresses the roles and reimbursement of advanced practice nurses who provide family-centered early intervention services in rural communities. PMID:7870654
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
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…
Johnston, C. A. M.; Taunton, J. E.; Lloyd-Smith, D. R.; McKenzie, D. C.
OBJECTIVE: To present a practical approach for preventing running injuries. QUALITY OF EVIDENCE: Much of the research on running injuries is in the form of expert opinion and comparison trials. Recent systematic reviews have summarized research in orthotics, stretching before running, and interventions to prevent soft tissue injuries. MAIN MESSAGE: The most common factors implicated in running injuries are errors in training methods, inappropriate training surfaces and running shoes, malalignment of the leg, and muscle weakness and inflexibility. Runners can reduce risk of injury by using established training programs that gradually increase distance or time of running and provide appropriate rest. Orthoses and heel lifts can correct malalignments of the leg. Running shoes appropriate for runners' foot types should be selected. Lower-extremity strength and flexibility programs should be added to training. Select appropriate surfaces for training and introduce changes gradually. CONCLUSION: Prevention addresses factors proven to cause running injuries. Unfortunately, injury is often the first sign of fault in running programs, so patients should be taught to recognize early symptoms of injury. PMID:14526862
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
Azimi, Y Nor; Atiya, A S
The role of husband-wife communication in the practice of family planning was studied among the rural Malay couples in Mukim Rusila, Terengganu. It was a cross-sectional study in which a cluster sampling was used to select the study sample. A total of 193 (100.0%) wives and 74 (38.3%) husbands responded to a face-to-face interview. Visual Analogue Scale was used to measure the level of husband-wife communication. Husband-wife communication score was lower on family planning compared to other matters. There was a significant fair agreement on the scores between the husbands and the wives (p > 0.05) on family planning. There was a significant association between husband-wife communication on family planning and the current practice of family planning (p = 0.002). The 'likelihood' that couples who had had good husband-wife communication to practice family planning was about 2.8 times higher compared to those couples with poor husband-wife communication (95% C.I.: 1.4, 5.3). Further research need to be carried out, as the study was limited by certain constraints. PMID:14569742
Background Licensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice. Methods Retrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group. Results Reports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings – practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence. Conclusion This study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians. PMID:24010980
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
Hare-Mustin, Rachel T.
Examines theories of gender differences. Discusses alpha bias, exaggeration of gender opposition, as characteristic of psychodynamic and sex role theories; and beta bias, denial of gender differences, as evident in systems theories. Calls for new model of gender differences which recognizes asymmetry in women's and men's roles and…
Douketis, James; Bell, Alan David; Eikelboom, John; Liew, Aaron
Abstract Objective To compare key features of the new oral anticoagulants (NOACs)—dabigatran, rivaroxaban, and apixaban—and to address questions that arise when comparing the NOACs. Sources of information PubMed was searched for recent (January 2008 to week 32 of 2013) clinical studies relating to NOAC use for stroke prevention in atrial fibrillation (AF) and for the treatment of acute venous thromboembolism (VTE). Main message All NOACs are at least as effective as warfarin for stroke prevention in patients with nonvalvular AF, and are at least as safe in terms of bleeding risk according to 3 large trials. Meta-analyses of these trials have shown that, compared with warfarin therapy, NOACs reduced total mortality, cardiovascular mortality, and intracranial bleeding, and there was a trend toward less overall bleeding. Practical advantages of NOACs over warfarin include fixed once- or twice-daily oral dosing without the need for coagulation monitoring, and few known or defined drug or food interactions. Potential drawbacks of NOACs include a risk of bleeding that might be increased in patients older than 75 years, increased major gastrointestinal bleeding with high-dose dabigatran, increased dyspepsia with dabigatran, the lack of a routine laboratory test to reliably measure anticoagulant effect, and the lack of an antidote for reversal. No direct comparisons of NOACs have been made in randomized controlled trials, and the choice of NOAC is influenced by individual patient characteristics, including risk of stroke or VTE, risk of bleeding, and comorbidity (eg, renal dysfunction). Conclusion The NOACs represent important alternatives in the management of patients with AF and VTE, especially for patients who have difficulty accessing regular coagulation monitoring. The companion to this article addresses common “what if” questions that arise in the long-term clinical follow-up and management of patients receiving NOACs. PMID:25392438
Tanser, Paul H.
Verapamil, nifedipine, and diltiazem are drugs which decrease intracellular calcium in cardiac muscle, smooth muscle, and nodal cardiac cells. Unlike B-blockers, each drug acts at a different site on the cell membrane and has an important difference in overall action. Verapamil is used to treat angina, systemic hypertension, hypertrophic cardiomyopathy, and supraventricular and junctional tachyarrhythmias. Nifedipine is useful in angina, vasospastic disorders, and hypertension. A specific role for diltiazem is now being defined. PMID:21283319
Mpangile, G S
This article contains the findings of a 1990 knowledge, attitude, and practice (KAP) survey conducted in Mgeta, a subdivision of the rural district of Morogoro, Tanzania. The Family Planning Association of Tanzania (UMATI) carried out the survey with the goal of obtaining baseline information with which to measure the success of an Integrated Family Planning, Nutrition, and Parasite Control (IP) Project, scheduled to be introduced in Mgeta following the survey. UMATI interviewed 310 people (113 males and 197 females) from Mgeta, who comprised 5% of the total target population. The majority of the respondents were between the ages of 20-45, had completed primary education, and made a living from farming. They were also predominantly Roman Catholic. With 4/5 of the respondents already having at least 1 child, the average number of preferred children was 6. 16.5% of the respondents reported that they or their partner had undergone at least 1 abortion. 1/3 (104) of the respondents were aware of a method--modern or otherwise--for preventing unwanted pregnancies. But only 13.8%of all those surveyed (41.3% of those who were aware of family planning) had ever used contraception, and only 6.7% of all the respondents were using contraception at the time of the survey. Despite the low contraceptive prevalence, the overwhelming majority of those with knowledge of family planning believed it is important for improving family and child health, and that is not contrary to their religious beliefs. These findings suggest that in addition to raising awareness, communication programs must also emphasize motivation. The survey also highlights the problem of abortion, which is more widely practiced than contraception, and reveals a positive attitude towards family planning. PMID:12284677
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…
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,…
Abstract Objective To document family medicine research in the 25 EGPRN member countries in 2010. Design Semi-structured survey with open-ended questions. Setting Academic family medicine in 23 European countries, Israel, and Turkey. Subjects 25 EGPRN national representatives. Main outcome measures Demographics of the general population and family medicine. Assessments, opinions, and suggestions. Results EGPRN has represented family medicine for almost half a billion people and > 300 000 general practitioners (GPs). Turkey had the largest number of family medicine departments and highest density of GPs, 2.1/1000 people, Belgium had 1.7, Austria 1.6, and France 1.5. Lowest GP density was reported from Israel 0.17, Greece 0.18, and Slovenia 0.4 GPs per 1000 people. Family medicine research networks were reported by 22 of 25 and undergraduate family medicine research education in 20 of the 25 member countries, and in 10 countries students were required to do research projects. Postgraduate family medicine research was reported by 18 of the member countries. Open-ended responses showed that EGPRN meetings promoted stimulating and interesting research questions such as comparative studies of chronic pain management, sleep disorders, elderly care, healthy lifestyle promotion, mental health, clinical competence, and appropriateness of specialist referrals. Many respondents reported a lack of interest in family medicine research related to poor incentives and low family medicine status in general and among medical students in particular. It was suggested that EGPRN exert political lobbying for family medicine research. Conclusion Since 1974, EGPRN organizes biannual conferences that unite and promote primary care practice, clinical research and academic family medicine in 25 member countries. PMID:24191874
Shank, J C
The purpose of this paper is to present the content of office family practice problems seen over a 2 1/2-year residency period and to afford comparison with the well-known Virginia Study. It illustrates the usefulness of the diagnostic E-Book, with which all the data were collected and preserved. Over a 2 1/2-year period, the author cared for 592 patients in the family practice office. The ratio of one physician to 592 patients compares to the Virginia Study's one physician to approximately 745 patients. A total of 1,640 problems were coded in the E-Book. In this study 55 problems/physician/month were seen, whereas in the Virginia Study approximately 177 problems/physician/month were noted. Respiratory illnesses were the most common diagnostic category in both studies. Among specific problems, obesity ranked first at Hershey, with afebrile colds second, hypertension and Beta streptococcal pharyngitis third, and smoking fourth. Obesity and smoking were ranked considerably lower in the Virginia Study, whereas "health maintenance examinations" were ranked number one. Finally, for age-sex practice profiles, the present data revealed two peak age groups for both sexes, whereas the Virginia work noted only one peak age range. PMID:903750
Nuovo, Jim; Balsbaugh, Thomas; Barton, Sue; Davidson, Ellen; Fox-Garcia, Jane; Gandolfo, Angela; Levich, Bridget; Seibles, Joann
Improving the quality of care for patients with chronic illness has become a high priority. Implementing training programs in disease management (DM) so the next generation of physicians can manage chronic illness more effectively is challenging. Residency training programs have no specific mandate to implement DM training. Additional barriers at the training facility include: 1) lack of a population-based perspective for service delivery; 2) weak support for self-management of illness; 3) incomplete implementation due to physician resistance or inertia; and 4) few incentives to change practices and behaviors. In order to overcome these barriers, training programs must take the initiative to implement DM training that addresses each of these issues. We report the implementation of a chronic illness management curriculum based on the Improving Chronic Illness Care (ICIC) Model. Features of this process included both patient care and learner objectives. These were: development of a multidisciplinary diabetes DM team; development of a patient registry; development of diabetes teaching clinics in the family practice center (nutrition, general management classes, and one-on-one teaching); development of a group visit model; and training the residents in the elements of the ICIC Model, ie, the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Barriers to implementing these curricular changes were: the development of a patient registry; buy-in from faculty, residents, clinic leadership, staff, and patients for the chronic care model; the ability to bill for services and maintain clinical productivity; and support from the health system key stakeholders for sustainability. Unique features of each training site will dictate differences in emphasis and structure; however, the core principles of the ICIC Model in enhancing self-management may be generalized to all sites. PMID:15671788
Stead, William W.; Hammond, William E.
The disk space requirements of small and medium sized group practices using a comprehensive medical information system supported by either a micro-computer or a mini-computer are analyzed. Efficient operation requires that 23%-54% of a typical system disk be used for files other than patient records. Data is presented to allow prediction of both the number of records that will need to be maintained for a practice and the average size of each record based upon the type of data required by the practice.
Miller, Brenda A; Byrnes, Hilary F; Cupp, Pamela K; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Fongkaew, Warunee; Rosati, Michael J; Chookhare, Warunee; Zimmerman, Rick S
Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics. PMID:24511362
Miller, Brenda A.; Byrnes, Hilary F.; Cupp, Pamela K.; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Fongkaew, Warunee; Rosati, Michael J.; Chookhare, Warunee; Zimmerman, Rick S.
Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics. PMID:24511362
Rosenblatt, Paul C.
Metaphoric analysis of family systems theory illustrates how metaphors and alternatives to those metaphors identify what a psychological theory has highlighted and obscured about the phenomena at its focus and how it has structured that phenomena. The most commonly used metaphors in family systems theory are the metaphors of system (system…
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…
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…
Lawler, Frank H.
A study of patterns in second- and third-year family practice residents' requests for referrals found higher rates for the senior students, suggesting possible differences in approach to case management, lack of experience in referral among younger students, and differences in case mix. (MSE)
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…
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…
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…
Menard-Warwick, Julia; Dabach, Dafney Blanca
The purpose of this paper is to critically re-examine the popular concept of a developing "digital divide." Based on qualitative studies of the computer practices of two Mexicano families resident in California, the paper argues with Warschauer (2001) that the "digital divide" should be seen as a continuum of varying degrees of engagement with…
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…
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…
Simons, Leslie Gordon; Chen, Yi-Fu; Simons, Ronald L.; Brody, Gene; Cutrona, Carolyn
This article uses a sample of 867 African American households to investigate differences in parenting practices and child outcomes by type of household. Results indicate that mothers provide similar levels of parenting regardless of family structure. Secondary caregivers, however, show a great deal of variation in quality of parenting. Fathers and…
Phillips, Gwenneth; McNaughton, Stuart
Reports findings from 2 studies investigating the social practice of book reading in the homes of 10 mainstream New Zealand families. Finds that with unfamiliar storybooks both adults and children aged 3 and 4 initiated insertions most often focused on the meaning of the immediate text rather than on print or illustrations. (KEH)
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;…
Wright, Doris J.
Professional ethics are designed to set minimum standards of practice and service for school psychologists. Ways in which professional ethics standards of school psychology can be used to build and strengthen work relationships with parents, legal guardians, and other family members are described here. Suggestions for how school psychologists can…
Epps, Susan; Kroeker, Rose
This study of the effects of child age (20 and 40 months) and level of developmental delay (mild and severe) on identification of developmental disorders by 155 family practice physicians provided evidence that identification of developmental delay was generally high across conditions, with mild delay being less likely to be detected. (Author/JDD)
Perry, Kristen H.
This ethnographic study examined literacy brokering among Sudanese refugee families in Michigan. Literacy brokering occurs as individuals seek informal help with unfamiliar texts and literacy practices. Data collection involved participant observation, semi-structured interviews, and collection of artifacts over 18 months. Researcher analysis of…
Phillips, Beth M.; Morse, Erika E.
This paper presents findings from a stratified-random survey of family child care providers' backgrounds, caregiving environments, practices, attitudes, and knowledge related to language, literacy, and mathematics development for preschool children. Descriptive results are consistent with prior studies suggesting that home-based providers are…
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,…
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 resources, as…
Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.
A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…
Oakley, Claire; Moore, Douglas; Burford, Duncan; Fahrenwald, Roxanne; Woodward, Kathryn
To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while…
Tazouti, Youssef; Malarde, Amelie; Michea, Aurelie
The present study examines the relationships between parental beliefs relating to development and education, parenting practices, and the intellectual and academic performances of children. Data were collected for 128 families with a child in the second or third year of primary school. Investigations of the factors affecting the children's…
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 engage in…
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…
Bonter, Katherine; Currier, Nathan; Pun, Jason; Ashbury, Fredrick D
Introduction In order to provide baseline data on genetic testing as a key element of personalised medicine (PM), Canadian physicians were surveyed to determine roles, perceptions and experiences in this area. The survey measured attitudes, practice, observed benefits and impacts, and barriers to adoption. Methods A self-administered survey was provided to Canadian oncologists, cardiologists and family physicians and responses were obtained online, by mail or by fax. The survey was designed to be exploratory. Data were compared across specialties and geography. Results The overall response rate was 8.3%. Of the respondents, 43%, 30% and 27% were family physicians, cardiologists and oncologists, respectively. A strong majority of respondents agreed that genetic testing and PM can have a positive impact on their practice; however, only 51% agreed that there is sufficient evidence to order such tests. A low percentage of respondents felt that they were sufficiently informed and confident practicing in this area, although many reported that genetic tests they have ordered have benefited their patients. Half of the respondents agreed that genetic tests that would be useful in their practice are not readily available. A lack of practice guidelines, limited provider knowledge and lack of evidence-based clinical information were cited as the main barriers to practice. Differences across provinces were observed for measures relating to access to testing and the state of practice. Differences across specialties were observed for the state of practice, reported benefits and access to testing. Conclusions Canadian physicians recognise the benefits of genetic testing and PM; however, they lack the education, information and support needed to practice effectively in this area. Variability in practice and access to testing across specialties and across Canada was observed. These results support a need for national strategies and resources to facilitate physician knowledge
This popular text provides essential knowledge and skills for conducting creative, strengths-based group work with adolescents. A rich introduction to the field, enlivened by numerous illustrations from actual sessions, the book provides principles and guidelines for practice in a wide range of settings. The book covers all phases of group work,…
Looman, Wendy S.; Erickson, Mary M.; Garwick, Ann W.; Cady, Rhonda G.; Kelly, Anne; Pettey, Carrie; Finkelstein, Stanley M.
Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special health care needs. The purpose of this paper is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special health care needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special health care needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data. PMID:22948406
Alderette, Paula; deGraffenried, Donald F.
Argues that nonorganic failure-to-thrive syndrome (NFTT) in infants is the result of family disengagement--the family system's maladaptive style of interaction. Proposes a systems-based approach to diagnosis and to treatment, focusing on the process of disengagement and other interaction factors. (Author/ABB)
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…
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
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…
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…
Background Although obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP) Questionnaire for use with Mexican American parents. Items reflected both parent’s use of control over child eating and child-centered feeding practices. Methods In the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8–10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members. Results Confirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI) percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles. Conclusions Results indicate good initial validity and reliability for the PFP. It can be
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…
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
Ozbolt, Judy G.; Schultz, Samuel; Swain, Mary Ann P.; Abraham, Ivo L.; Farchaus-Stein, Karen
The American Nurses' Association has set eight Standards of Nursing Practice related to the nursing process. Computer-aided information systems intended to facilitate the nursing process must be designed to promote adherence to these professional standards. For each of the eight standards, the paper tells how a hypothetical expert system could help nurses to meet the standard. A prototype of such an expert system is being developed. The paper describes issues in conceptualizing clinical decision-making and developing decision strategies for the prototype system. The process of developing the prototype system is described.
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…
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. PMID:25287585
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
Davis, Delilah A.
The purpose of this study was to explore the tenacities, practices, and discourse of family-based literacy practices and their connection in African American families. It scrutinized the influence of the practices of African American families on the multiple contexts of literacy practices in their passageway across the school-community periphery.…
Peterson, Lars E.; Blackburn, Brenna E.; Puffer, James C.; Phillips, Robert L.
PURPOSE Practice performance assessment is the fourth requirement of Maintenance of Certification for Family Physicians (MC-FP). American Board of Family Medicine (ABFM) diplomates have many options for completing Part 4 requirements, including Web-based Performance in Practice Modules (PPMs) developed by the ABFM. Our objective was to describe the actions and outcomes of family physicians who completed the ABFM diabetes PPM. METHODS We undertook a descriptive study of all diabetes PPMs completed by physicians in the 50 United States and Washington, DC, from 2005 to October 2012. Successful completion required quality measure abstraction from 10 patient charts before and after a plan-do-study-act cycle improvement effort. We used descriptive statistics to assess physician demographics and quality outcomes. RESULTS Family physicians completed 7,924 diabetes qualitative improvement modules. Their mean age was 48.2 years, they had practiced a mean of 13.8 years, and three-fourths lived in urban areas (76.9%). Nearly one-half selected diabetic foot examination or eye examination as their quality improvement measure. Performance on all quality measures improved. Significant improvement was seen in rates of hemoglobin A1c control (<7.0%; 57.4% to 61.3%), blood pressure control (<130/90 mm Hg; 53.3% to 56.3%), foot examinations (68.0% to 85.8%); and retina examinations (55.5% to 71.1%). The most common interventions were standing orders (51.6%) and patient education (37.1%). CONCLUSIONS Family physicians participating in MC-FP implemented improvement projects and showed quality improvements in caring for patients with diabetes. Emphasis on quality of care by payers will increasingly require physicians to embrace quality measurement and improvement. PMID:24445099
Ramsey-Kemper, Valerie Ann
Problem. The purpose of this study was to review the literature which presents the latest advancements in the field of family therapy theory. Since such advancement has relied on the scientific developments in the study of autopoietic self-organizing complex systems, then the review began with an historical overview of the development of these natural scientific concepts. The study then examined how the latest scientific concepts have been integrated with family therapy practice. The document is built on the theory that individuals are living, complex, self-organizing, autopoietic systems. When individual systems interact with other individual systems (such as in family interaction, or in interaction between therapist and client), then a third system emerges, which is the relationship. It is through interaction in the relationship that transformation of an individual system can occur. Method. The historical antecedents of the field of family therapy were outlined. It was demonstrated, via literature review, that the field of family therapy has traditionally paralleled developments in the hard sciences. Further, it was demonstrated via literature review that the newest understandings of the development of individuals, family systems, and therapeutic systems also parallel recent natural science developments, namely those developments based on the science of self-organizing complex systems. Outcome. The results of the study are twofold. First, the study articulates an expanded theory of the therapist, individual, and family as autopoietic self-organizing complex systems. Second, the study provides an expanded hypothesis which concerns recommendations for future research which will further advance the latest theories of family therapy. More precisely, the expanded hypothesis suggests that qualitative research, rather than quantitative research, is the method of choice for studying the effectiveness of phenomenological therapy.
Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai
A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. PMID:27122625
Fries, Christopher J
ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not. PMID:19005130
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…
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…
Shue, Carolyn K; Whitt, Justin K; Daniel, Linda; Shue, Christian B
Childhood obesity rates have incrementally increased since the 1980s, sparking calls for initiatives focused on addressing this public health concern. In response, the family medicine residency clinic profiled in this research designed, executed, and evaluated a practice improvement initiative focused on physician communication behaviors and clinic processes that impact the management of unhealthy pediatric weight. The results of the evaluation effort demonstrated increased physician knowledge of communication principles, improvements in weight management counseling rates, and opportunities for health delivery system changes to promote the effective clinical management of unhealthy pediatric weight. PMID:26362560
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. PMID:25921774
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
Klemenc-Ketiš, Zalika; Kersnik, Janko; Ojsteršek, Janja
Aim To determine the prevalence of difficulties in managing ethical dilemmas in family practice. Methods The study included a random sample of 259 family medicine physicians, representing 30% of the population of family physicians in Slovenia. Participants were given a self-administered questionnaire on perceived ethical dilemmas in their practice, with responses on a 5-point scale and a maximum score of 100. The main outcome measure was the percentage of family physicians reporting difficulties in solving perceived ethical dilemmas. Results The response rate was 55%. Physicians reported having difficulties in solving ethical dilemmas often or very often (mean score ± standard deviation, 56.1 ± 12.1). The most difficult ethical issue included abandoned and unattended patients and patients with insufficient means of support (48.6%), followed by suspicion of physical abuse, sexual abuse, or other criminal behavior (40.9%), and use of limited health care resources (21.1%). Female physicians reported greater difficulties in solving ethical dilemmas than male physicians (57.7 ± 10.6 vs 53.0 ± 14.1, P = 0.036, t test). Older physicians solved ethical issues more easily than younger ones (53.9 ± 12.6 vs 58.2 ± 11.2, P = 0.043, t test). Specialists and residents in family medicine considered solving ethical dilemmas to be more difficult than general practitioners without specialization (57.3 ± 11.6 vs 47.1 ± 11.8, P = 0.001, t test). Multivariate regression analysis of physician and practice characteristics did not yield any significant model to explain the differences in the perceived level of difficulties in solving ethical dilemmas. Conclusion Although managing ethical dilemmas is an important part of daily work of family physicians in Slovenia, it is perceived as a considerable burden in their work. Family physicians need more training in addressing and managing ethical issues. PMID:19090605
Waller, Maureen; Plotnick, Robert
This report examines why the child support system breaks down for so many low-income families, presenting information from interviews with unmarried mothers and fathers nationwide. Four chapters focus on: (1) "Introduction" (child support policy in California and nationwide); (2) "The National and California Child Support Systems" (California's…
Describes a program developed by the Children's Aid Society of Montgomery County, Pennsylvania, called Intergenerational Support System (ISS), in which senior volunteers serve as support persons for problem families. (SAK)
Chockie, Alan; Bjorkelo, Kenneth
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 of maintenance programs on addressing the system and component aging degradation issues. An effective maintenance program was found to be essential to the management of system and component aging. Four key elements of an effective maintenance program that are important to an aging management were identified: (1) the selection of critical systems and components; (2) the development of an understanding of aging through the collection and analysis of equipment performance information; (3) the development of appropriate preventive and predictive maintenance tasks to manage equipment and system aging degradation; and (4) 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.
Darney, Blair G.; Weaver, Marcia R.; Stevens, Nancy; Kimball, Jeana; Prager, Sarah W.
BACKGROUND AND OBJECTIVES Non-complicated spontaneous abortion cases should be counseled about the full range of management approaches, including uterine evacuation using manual vacuum aspiration (MVA). The Residency Training Initiative in Miscarriage Management (RTI-MM) is an intensive, multidimensional intervention designed to facilitate implementation of office-based management of spontaneous abortion using MVA in family medicine residency settings. The purpose of this study was to test the impact of the RTI-MM on self-reported use of MVA for management of spontaneous abortion. METHODS We used a pretest/posttest one group study design and a web-based, anonymous survey to collect data on knowledge, attitudes, perceived barriers, and practice of office-based management of spontaneous abortion. We used multivariable models to estimate incident relative risks and accounted for data clustering at the residency site level. RESULTS Our sample included 441 residents and faculty from 10 family medicine residency sites. Our findings show a positive association between the RTI-MM and self-reported use of MVA for management of spontaneous abortion (adjusted RR=9.11 [CI=4.20-19.78]) and were robust to model specification. Male gender, doing any type of management of spontaneous abortion (eg, expectant, medication), other on-site reproductive health training interventions, and support staff knowledge scores were also significant correlates of physician practice of MVA. CONCLUSIONS Our findings suggest that the RTI-MM was successful in influencing the practice of management of spontaneous abortion using MVA in this population and that support staff knowledge may impact physician practice. Integrating MVA into family medicine settings would potentially improve access to evidence-based, comprehensive care for women. PMID:23378077
Budimir, Danijela; Curić, Ivo; Curić, Snjezana
The aim of this study was to examine the characteristics of acute tonsillopharyngitis diagnosis and treatment in the family care physicians in Mostar, Bosnia and Herzegovina. All patients diagnosed with acute tonsillopharyngitis in the Center of Family Medicine in Mostar in 2005 and 2006 were included in this study. Data were collected from medical records, including age and sex, month in which they visited their physician, symptoms and signs that they had (McIsaac's clinical score was calculated accordingly) and treatment. Results showed that there were no gender differences regarding diagnosis. Mean age was 32.6 +/- 16.9 years. The most patients were recorded during the January-March period. Total of 65.6% patients received antibiotic treatment. Phenoxymethylpenicillin, considered as the recommended antibiotic was used in 46.3% cases only. In conclusion, this first critical assessment of the existing family practice records on treating patients with tonsillopharyngitis suggested that physicians have to be more critical when treating patients with this diagnosis and that the knowledge and treatment of patients with pharyngitis need to be continuously improved in general medical practice. PMID:19408639
Labrum, Travis; Walk, Marlene; Solomon, Phyllis L
Family members often set limits with relatives with psychiatric disorders (PD), however, no scale currently exists measuring the use of such limit-setting practices. The present article describes the development and results of a new measure, the Family Limit-Setting Scale (FLSS). Via a national online survey, the FLSS was completed by 573 adults residing in the U.S. who report having an adult relative with PD. We conducted exploratory and confirmatory factor analyses, examined internal consistencies and other indicators of construct validity, and performed invariance analyses assessing the generality of the optimal factor model to men, women, Caucasian respondents, and non-Caucasian respondents. Results indicate that the FLSS has an acceptable two factor structure (routine limit-setting and crisis prevention limit-setting) with both factors being highly generalizable to all groups of respondents examined. Internal consistencies and other indicators provide additional evidence of the FLSS' construct validity. Use of the FLSS will enable the conduction of quantitative research in this area. In addition, this measure may be employed in education/support organizations for families with a member with mental illness in an effort to identify persons using high levels of limit-setting practices who may benefit from extra support and/or guidance. PMID:26518780
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…
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 (LAC-DCFS). Some of the major findings include (1) Cambodian child maltreatment cases were most frequently reported to the LAC-DCFS among various Asian Pacific ethnic groups; (2) Cambodian refugee families were more likely to be charged with neglect, while their Asian Pacific counterparts were more likely charged with physical abuse; (3) the circumstances under which maltreatment occurred most frequently were parental substance abuse and mental illness; and (4) while fathers who maltreated their child were likely to use alcohol, mothers were also more likely to have a mental health problem such as depression. This study suggests the importance of collaboration between Child Protective Service agencies, substance abuse programs, traditional healers, mental health services, and other social service agencies for effective child abuse prevention and intervention efforts. PMID:18575261
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
Dumka, Larry E; Gonzales, Nancy A; Wheeler, Lorey A; Millsap, Roger E
Drawing on social cognitive theory, this study used a longitudinal cross-lagged panel design and a structural equation modeling approach to evaluate parenting self-efficacy's reciprocal and causal associations with parents' positive control practices over time to predict adolescents' conduct problems. Data were obtained from teachers, mothers, and adolescents in 189 Mexican American families living in the southwest United States. After accounting for contemporaneous reciprocal relationships between parenting self-efficacy (PSE) and positive control, results indicated that parenting self-efficacy predicted future positive control practices rather than the reverse. PSE also showed direct effects on decreased adolescent conduct problems. PSE functioned in an antecedent causal role in relation to parents' positive control practices and adolescents' conduct problems in this sample. These results support the cross-cultural applicability of social cognitive theory to parenting in Mexican American families. An implication is that parenting interventions aimed at preventing adolescent conduct problems need to focus on elevating the PSE of Mexican American parents with low levels of PSE. In addition, future research should seek to specify the most effective strategies for enhancing PSE. PMID:20954762
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.
Kim, Meesook; Hong, Soon Myoung
We examined dietary habits, food intakes, health status, and school and community life of meal skipping children, and investigated factors predicting meal skipping of children. A sample was composed of 944 children in low-income families who were provided with public meal service. The sample was obtained from the Survey of Meal Service for Poor Children conducted by the Korea Institute for Health and Social Affairs in 2007. Meal skipping was significantly associated with a lower nutrition and health status, and poor school performance of children, as hypothesized. The school age of child, family structure, region, job of caretaker, concern about diet, and the child's visit to welfare center significantly predicted frequency of meal skipping. We suggested a few implications for community practice to reduce meal skipping of children. PMID:20126373
Grant, Anne; Reupert, Andrea
Government policy and organizational factors influence family-focused practice (FFP) in adult mental health services. However, how these aspects shape psychiatric nurses' practice with parents who have mental illness, their dependent children, and families is less well understood. Drawing on the findings of a qualitative study, this article explores the way in which Irish policy and organizational factors might influence psychiatric nurses' FFP, and whether (and how) FFP might be further promoted. A purposive sample of 14 psychiatric nurses from eight mental health services completed semi-structured interviews. The analysis was inductive and presented as thematic networks. Both groups described how policies and organizational culture enabled and/or hindered FFP, with differences between community and acute participants seen. This study indicates a need for policies and organizational supports, including child and family skills training, to promote a whole family approach in adult mental health services. PMID:27090512
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…
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…
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)…
Qureshi, Nadeem; Weng, Stephen; Tranter, Jennifer; El-Kadiki, Alia; Kai, Joe
Objectives To assess the feasibility of improving identification of familial hypercholesterolaemia (FH) in primary care, and of collecting outcome measures to inform a future trial. Design Feasibility intervention study. Setting 6 general practices (GPs) in central England. Participants 831 eligible patients with elevated cholesterol >7.5 mmol/L were identified, by search of electronic health records, for recruitment to the intervention. Intervention Educational session in practice; use of opportunistic computer reminders in consultations or universal postal invitation over 6 months to eligible patients invited to complete a family history questionnaire. Those fulfilling the Simon-Broome criteria for possible FH were invited for GP assessment and referred for specialist definitive diagnosis. Outcome measures Rates of recruitment of eligible patients, identification of patients with possible FH, referral to specialist care, diagnosis of confirmed FH in specialist care; and feasibility of collecting relevant outcome measures for a future trial. Results Of 173 general practices, 18 were interested in participating and 6 were recruited. From 831 eligible patients, 127 (15.3%) were recruited and completed family history questionnaires: 86 (10.7%) through postal invitation and 41 (4.9%) opportunistically. Among the 127 patients, 32 (25.6%) had a possible diagnosis of FH in primary care. Within 6 months of completing recruitment, 7 patients had had specialist assessment confirming 2 patients with definite FH (28.6%), and 5 patients with possible FH (71.4%). Potential trial outcome measures for lipid tests, statin prescribing and secondary causes of hypercholesterolaemia were extracted using automated data extraction from electronic records alone without recourse to other methods. Conclusions The intervention is feasible to implement in GP, and facilitates recruitment of patients with raised cholesterol for targeted assessment and identification of FH. Extracting
Hill, Robert V
Between 1585 and 1738, four members of the celebrated Bartholin family made significant contributions to anatomical science and medicine. Caspar Bartholin (the elder), two of his sons (Thomas and Rasmus), and his grandson (Caspar the younger) all served on the medical faculty of the University of Copenhagen, and helped to gain international acclaim for the institution. Over three generations, the Bartholins challenged traditional ideas about science and the human body, and discovered anatomical structures and phenomena that would prove crucial to the practice of modern medicine. PMID:16795028
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…
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…
Hamabe, Ryuji; Taketa, Norihiro
We propose a constitution technique of small-scale Home Health Care system for family doctor that has been developed by applying various API of JAVA. One function is vital data transmission which allows a family doctor to check the data of elderly persons with ease via Internet. Vital data is encrypted and transmitted for the purpose of security. The other function is telecommunication with voice and face image for care consulting.
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. PMID:25077729
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…
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 authorities. The…
Lee, Kee Hyuck; Kim, Ju Young; Lee, Kiheon; Cho, Belong; Yang, Jeong Hee; Goh, Eurah
Attending conferences is important for doctors and residents in family medicine. Nevertheless, departments of family medicine at many hospitals find it difficult to hold regular conferences. Holding joint videoconferences between Family Medicine Departments of several hospitals through a videoconferencing system could solve this problem. Therefore, Family Medicine Departments of Seoul National University Hospital, Seoul National University Bundang Hospital, and Kangwon National University Hospital decided to hold regular joint videoconferences via a videoconferencing system. Eighty-one joint videoconferences were held from April 1 to October 29, 2010. PowerPoint slideshows were transferred to the other two locations in the same resolution as presenter's monitor. Image and voice of the speaker were transferred in real time and in acceptable quality. Joint videoconferences are feasible, satisfactory and useful for medical education, especially when individual family medicine departments are small and lack resources to hold face-to-face conferences. We expect that more family medicine departments will choose to participate in implementing similar joint videoconferencing systems in the future. PMID:22745869
This study sought to learn from Latino immigrant families what services they need to promote their families' well-being within a context of stringent anti-immigrant legislation. Fifty-two Latino immigrant parents participated in focus groups. Focus groups took place following the passage of Senate Bill 1070. Findings reveal five major categories of need: mental health, physical health care, education, information and support services, and community efforts. Participants' experiences as immigrants played a significant role in their narratives. The narratives reveal that families need assistance navigating systems of care, coping with discrimination and oppressive environments, strengthening ties among community members, and advocating for policy change. Social workers are called to address the needs of this community and advocate for human rights and social justice. PMID:24640227
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. PMID:25730721
Liang, Yiqing; Wolf, Wayne H.; Liu, Bede; Huang, Jeffrey R.
We integrated a practical digital video database system based on language and image analysis with components from digital video processing, still image search, information retrieval, closed captioning processing. The attempt is to utilize the multiple modalities of information in video and implement data fusion among the multiple modalities; image information, speech/dialog information, closed captioning information, sound track information such as music, gunfire, explosion, caption information, motion information, temporal information. Effort is made to allow access video contents at different levels including video program level, scene level, shot level, and object level. Approaches of browsing, subject-based classification, and random retrieving are available to gain access to the contents.
Horváth, Zsolt; Boér, Katalin; Dank, Magdolna; Kahán, Zsuzsanna; Kocsis, Judit; Kövér, Erika; Pajkos, Gábor; Pikó, Béla; Rubovszky, Gábor; Eckhardt, Sándor
The article presents the practice guideline of systemic treatment of breast cancer and recommendations of the 3rd Hungarian Breast Cancer Consensus Conference. It reflects the recent international guidelines (ESMO, NCCN, ABC2, St Gallen's) irrespectively of the current financial opportunities. Here we follow the early - locally advanced - locally relapsed - metastatic breast cancer line for didactic considerations and we discuss the different subgroups of breast cancer based on hormone receptor and HER2 receptor status. Diagnosis and treatment options of rare clinical entities are summarised at the end of the paper. PMID:27579723
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…
SvavarsdÃ³ttir, A. E.; JÃ³nasson, M. R.; Gudmundsson, G. H.; Fjeldsted, K.
OBJECTIVE: To describe diagnostic distribution and outcome of chest pain among patients attending an urban family practice. DESIGN: Retrospective, descriptive chart review. SETTING: Primary care practice. PARTICIPANTS: All patients contacts for chest pain at Fossvogur Health Centre in the years 1989 and 1990 (193 contacts with 189 patients) were examined. One patient died before follow up and two could not be reached for follow up; they were excluded from the study. Of the 190 contacts and 186 patients studied, one patient who had two contacts with the clinic died during the study. MAIN OUTCOME MEASURES: Age and sex distribution, physical examination, investigations, diagnosis, and treatment; well-being of every patient was checked 3 to 4 years after initial contact. We asked about evolution of symptoms and looked for possible misdiagnosis. RESULTS: Musculoskeletal pain was diagnosed in 48.9% of contacts, heart diseases in 17.9% and 9.5% had undiagnosed chest pain. The history was the main diagnostic tool for patients with musculoskeletal diseases, while patients with heart diseases were examined more carefully and underwent more diagnostic procedures. Follow up showed that no serious disease had been missed in spite of restrictive use of laboratory investigations. CONCLUSIONS: The working methods of family doctors who examined patients with chest pain in this health centre can differentiate between patients with serious diseases and those with benign conditions. PMID:8704488
Bowman, M A; Murray, J L
A survey of family practice residency programme directors in the United States was undertaken to look at the impact of malpractice and malpractice insurance on residency education. Of 385 programmes 276 (71.7%) responded to the 20 question survey. The results indicated a mean rate of 0.043 claims per resident or faculty member in the previous year. One-fifth of the respondents did not report the type of malpractice insurance retained for residents and over half did not report the cost of insurance for residents. Current problems with liability were most often related to the region of the country, number of visits to the family practice centre, the number of residents, the number of faculty, the type of faculty employer and the type of resident employer. Programmes which anticipated future problems with liability were most likely to be those with current problems. The areas identified as most concerning to residents included: obstetrics, cost of malpractice insurance, difficulty obtaining coverage, and the general anxiety created by malpractice litigation. PMID:2744300
Vukovich, M C
The purpose of this study was to determine the prevalence of sexual harassment as defined by the AMA among female family practice residents in the United States. Of all 1,802 U.S.FP female resident physicians surveyed, a total of 916, or 51%, completed a survey of which 32% reported unwanted sexual advances, 48% reported use of sexist teaching material, 66% reported favoritism based on gender, 36% reported poor evaluation based on gender, 37% reported malicious gossip, 5.3% reported punitive measures based on gender, and 2.2% reported sexual assault during residency. Thirty two percent of respondents reporting sexual harassment experienced negative effects including poor self-esteem, depression, psychological sequelae requiring therapy, and in some cases, transferring training programs. Sexual harassment is a common occurrence among family practice residents during residency training. Further studies are needed to examine the effect of sexual harassment policies instituted by the American Graduate Council on Medical Education on the prevalence of sexual harassment in medical training since the time of this study. PMID:8933712
O'Beirne, Maeve; Sterling, Pam D
A safety learning system (SLS) is a system that monitors patient safety incident information and analyzes it to develop and implement improvement strategies to increase patient safety. The purpose of this paper is to discuss the necessary elements of a community-based family medicine practice SLS in Alberta Health Services - Calgary zone, and barriers to, and facilitators of, the implementation of this system. An SLS was developed in the research program Medical Safety in Community Practice. To determine the elements necessary to implement an SLS in community-based family medicine practice, we performed a comprehensive literature review, internal investigator discussions and internal investigator and external stakeholder reviews of key design elements. The system is currently being implemented and tested in community-based family practices as part of the program. Steps identified for implementation: included determining key design elements including creating a website and ascertaining a classification system or taxonomy; developing recruitment strategies; establishing an incident analysis methodology; building a knowledge translation strategy; and pursuing sustainability. These elements produced an SLS that is easily incorporated into community-based family medicine clinics. PMID:19667792
Luken, Paul C.; Vaughan, Suzanne
Using institutional ethnography we examine the Own-Your-Own-Home (OYOH) movement as a configuration of ideological practices designed to reorder gender, family and housing arrangements in the United States during the early 20th century. We describe the social organization of these practices -- with particular emphasis on the coordinating activity…
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
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. PMID:20141264
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.
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
Hartung, Daniel M.; Evans, David; Haxby, Dean G.; Kraemer, Dale F.; Andeen, Gabriel; Fagnan, Lyle J.
PURPOSE Little is known about the impact of recent restrictions on pharmaceutical industry detailing and sampling on prescribing behavior, particularly within smaller, independent practices. The objective of this study was to evaluate the effect of a policy prohibiting prescription drug samples and pharmaceutical industry interaction on prescribing patterns in a rural family practice clinic in central Oregon. METHODS Segmented linear regression models were used to evaluate trends in prescribing using locally obtained pharmacy claims. Oregon Medicaid pharmacy claims were used to control for secular prescribing changes. Total and class-specific monthly trends in branded, promoted, and average prescription drug costs were analyzed 18 months before and after policy implementation. RESULTS Aggregate trends of brand name drug use did not change significantly after policy implementation. In aggregate, use of promoted agents decreased by 1.43% while nonpromoted branded agents increased by 3.04%. Branded drugs prescribed for respiratory disease declined significantly by 11.34% compared with a control group of prescribers. Relative to the control group, prescriptions of promoted cholesterol-lowering drugs and antidepressants were reduced by approximately 9.98% and 11.34%, respectively. The trend in average cost per prescription for lipid-lowering drugs was significantly reduced by $0.70 per prescription per month. Overall, average prescription drug costs increased by $5.18 immediately after policy implementation. CONCLUSIONS Restriction of pharmaceutical industry representatives and samples from a rural family practice clinic produced modest reductions in branded drug use that varied by class. Although aggregate average costs increased, prescriptions for branded and promoted lipid-lowering agents and antidepressants were reduced. PMID:20843881
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…
Background The countries of Central and Eastern Europe have experienced a lot of changes at the end of the 20th century, including changes in the health care systems and especially in primary care. The aim of this paper is to systematically assess the position of family medicine in these countries, using the same methodology within all the countries. Methods A key informants survey in 11 Central and Eastern European countries and Russia using a questionnaire developed on the basis of systematic literature review. Results Formally, family medicine is accepted as a specialty in all the countries, although the levels of its implementation vary across the countries and the differences are important. In most countries, solo practice is the most predominant organisational form of family medicine. Family medicine is just one of many medical specialties (e.g. paediatrics and gynaecology) in primary health care. Full introduction of family medicine was successful only in Estonia. Conclusions Some of the unification of the systems may have been the result of the EU request for adequate training that has pushed the policies towards higher standards of training for family medicine. The initial enthusiasm of implementing family medicine has decreased because there was no initiative that would support this movement. Internal and external stimuli might be needed to continue transition process. PMID:22409775
Bray, James H.; And Others
Reports a series of studies in the development of the Personal Authority in the Family System (PAFS) questionnaire, designed to measure family processes based on aspects of current intergenerational family theory. Results indicated that the scales have good internal consistency, and test-retest reliability, and supported construct validity. (JAC)
Mitrani, Victoria B.; Feaster, Daniel J.; McCabe, Brian E.; Czaja, Sara J.; Szapocznik, Jose
Purpose: This study adapted the Structural Family Systems Ratings (SFSR), an observational measure of family interactions, for dementia caregivers. This article presents the development of the SFSR-Dementia Caregiver adaptation (SFSR-DC) and examines relationships between specific family-interaction patterns and caregiver distress. Design and…
Santisteban, Daniel A.; Mena, Maite P.; Abalo, Clara
There is growing interest in identifying interventions that have been tested and found efficacious with minority families. This interest is fueled in part by the growth of Hispanics in the U.S. as well as by research findings that suggest that Hispanics have better outcomes when treatments are adapted to their unique experiences, and risk and protective factors. Family-based treatments for culturally diverse populations require the integration of advances from both the cultural and family systems domains. Current intervention research has begun to move towards developing and advancing individualized interventions for patients/clients. Adaptive interventions, tailored interventions, adapted interventions, and targeted interventions have all been identified in the literature as appropriate for addressing distinct cultural characteristics which generic interventions may not address effectively. To date, research has focused less on tailored or adaptive interventions partly due to the fact that they require decision rules, more careful implementation, and measurement of individualized outcomes. In this article we present evidence for the usefulness of adaptive interventions that can address not only subgroup variability but within group variability as well. Culturally Informed and Flexible Family-Based Treatment for Adolescents is presented as an adaptive treatment that allows for the tailoring of treatment to the unique clinical and cultural variations of individual adolescents and families, but that does so in a systematic and replicable fashion. By building decision-making processes into the manualized treatment, the transportability of the treatment may be enhanced as family therapists appreciate it’s flexibility to address the complexity of clinical work. PMID:24772378
Taylor, Ronald D.
Examined relationships among kinship support, family management, and adolescence in 135 African American adolescents, ages 14 to 19. Found that kin social support was positively related to self-reliance and grades, family organization, and parental involvement in schooling, and negatively associated with problem behavior. Poor kin relations were…
Elfert, Maren, Ed.
Family literacy emphasises the intergenerational transfer of language and literacy from parents to their children or from one generation to another. A range of family literacy programmes exists, varying according to the groups at which each is aimed. Some programmes focus on children, some on adults, and others on both. Some programmes are run at…
Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien
Background: In response to the current fragmented context of health systems, it is essential to support the revitalization of primary health care in order to provide a stronger sense of direction and integrity. Around the world, family medicine recognized as a core discipline for strengthening primary health care setting. Objective: This study aimed to understand the perspectives of policy makers and decision makers of Iran’s health system about the implementation of family medicine in Iran urban areas. Materials/Patients and Methods: This study is a qualitative study with framework analysis. Purposive semi-structured interviews were conducted with Policy and decision makers in the five main organizations of Iran health care system. The codes were extracted using inductive and deductive methods. Results: According to 27 semi-structured interviews were conducted with Policy and decision makers, three main themes and 8 subthemes extracted, including: The development of referral system, better access to health care and the management of chronic diseases. Conclusion: Family medicine is a viable means for a series of crucial reforms in the face of the current challenges of health system. Implementation of family medicine can strengthen the PHC model in Iran urban areas. Attempting to create a general consensus among various stakeholders is essential for effective implementation of the project. PMID:25948450
O'Connor, T G; Hetherington, E M; Reiss, D
The primary goal of this research is to increase the goodness-of-fit between the theoretical tenets of family systems theory and quantitative methods used to test systems hypotheses. A family systems perspective is applied to two specific research questions concerning family influences on adolescent development: To what extent are familial risk and protective factors for psychopathology and competence shared or not shared by siblings and are different family relationship patterns associated with optimal adolescent adjustment in nondivorced and remarried families? Multirater and multimethod data from a national sample of 516 nondivorced and remarried families from the Nonshared Environment and Adolescent Development (NEAD) project were examined using a combination of cluster, factor, and regression analyses. Results indicated that the effects of an individual relationship on adolescent adjustment is moderated by the larger network of relationships in which it is embedded. Evidence for nonshared familial processes in predicting adolescent psychopathology was also found but only in a subset of families, and the mechanisms of influence were neither main effects nor linear, as has been assumed by research to date. Results are discussed in light of family systems models of relationship influence on development. These results illustrate how family systems theory provides a specific example of contextualism as regards the development of psychopathology in adolescence. PMID:9635228
Sleutels, Tom H J A; Ter Heijne, Annemiek; Buisman, Cees J N; Hamelers, Hubertus V M
Bioelectrochemical systems (BESs) hold great promise for sustainable production of energy and chemicals. This review addresses the factors that are essential for practical application of BESs. First, we compare benefits (value of products and cleaning of wastewater) with costs (capital and operational costs). Based on this, we analyze the maximum internal resistance (in mΩ m(2) ) and current density that is required to make microbial fuel cells (MFCs) and hydrogen-producing microbial electrolysis cells (MECs) cost effective. We compare these maximum resistances to reported internal resistances and current densities with special focus on cathodic resistances. Whereas the current densities of MFCs still need to be increased considerably (i.e., internal resistance needs to be decreased), MECs are closer to application as their current densities can be increased by increasing the applied voltage. For MFCs, the production of high-value products in combination with electricity production and wastewater treatment is a promising route. PMID:22674691
Curtis, Patrick A., Ed.; Dale, Grady, Jr., Ed.; Kendall, Joshua C., Ed.
Noting that one of the biggest obstacles to reforming the foster care system has been the relative unavailability of research data from the field, this book provides an overview of the current state of foster care, describes the special needs of children living in foster care, and identifies policies and practices that address the foster care…
Services for developmentally delayed children from birth to age three consider the family first. Eligibility for services is determined through a multidisciplinary assessment. Once a child qualifies for service, a multidisciplinary team that includes the family develops an IFSP. The SLP may serve as the service coordinator for the plan or as a team member. The plans must contain specific information that includes documentation of current status and major outcomes for the coming year. An SLP may find that contributing effectively to an IFSP requires new competencies. First, the SLP will need to learn to function in the family-centered, multidisciplinary process of early intervention. Second, the SLP may need to develop creative models to deliver effective service. SLPs can contribute valuable information to the IFSP by finding ways to activate daily life routines to promote a child's communication skills. SLPs can explore the child's life-space, including routines and partners, as a source of contexts for treatment. SLPs also can explore partner communication strategies, note their effects on the child's communication experiences, and recommend additional strategies for treatment. The case study illustrated an individual, home-based intervention program (Gillette, 1989; Lombardino and Magnan, 1983). Other service delivery models can include classroom-based approaches (Wilcox, Kouri, and Caswell, 1991); group parent training approaches (Weistuch, Lewis, and Sullivan, 1991; Cheseldine and McConkey, 1979); and video-assisted approaches (McConkey, 1988; Johnson and Harrison, 1990; Gillette, in press). Many SLPs may find that the process of early intervention with the birth-to-three population offers unique opportunities for practice in their profession. To function effectively in this process, the SLP needs communication-based information to promote the child's communication skills within his or her daily life and sensitivity with which to design a plan that considers
Walker, Deborah Klein
This paper examines the legal mandates as well as the definitions and indicators for a family-centered early childhood system of care for children with special needs. Legislation discussed includes the Individuals with Disabilities Education Act and the Maternal and Child Health Block Grant (Title V of the Social Security Act). Various definitions…
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…
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.…
Kaslow, Florence W.
Approaches divorce from a combined family systems, individual life cycle and stage theory of development perspective. Recommends that therapy encompass interventions that are likely to be the most effective in the various stages rather than be a rigid adherence to one dogma. Several illustrative case vignettes are presented. (JAC)
Wisconsin Univ., Madison. School of Family Resources and Consumer Sciences.
This bibliography contains more than 400 annotated references on the topic of the father's role in family systems. In addition to the standard bibliographic citation, each entry includes an annotation which summarizes, discusses, or evaluates the item. The annotations range in length from a few sentences to several paragraphs. An alpha-numeric…
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
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
Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy
Summarizes the initial results of the regional geriatric medicine curriculum retreats for family practice residency directors provided as part of the American Academy of Family Physicians multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. (EV)
Khattab, M S; Abolfotouh, M A; Alakija, W; al-Humaidi, M A; al-Wahat, S
To study risk factors of attitudes and behaviour towards coronary heart disease (CHD), 280 Saudis > or = 20 years attending a family practice answered a structured health and lifestyle questionnaire and had their weight, height, blood pressure and random total cholesterol measured. Significant difference was found between males and females in the mean number of cardiovascular risk factors (t = -3.03, P < 0.01). Few people with high dietary fat intake, obesity or physical inactivity perceived their behaviour as harmful. The number of people who perceived an associated risk to their health increased with incidence of smoking and obesity but not with high fat intake. Physically inactive people were least likely to perceive their behaviour as harmful. PMID:10793779
Yick, Alice G; Shibusawa, Tazuko; Agbayani-Siewert, Pauline
Because the Chinese tend to display psychological problems such as depression in somatic This article examines cultural aspects, experiences, and the mental health consequences of partner violence among families of Chinese descent. A total of 262 Chinese men and women participated in a telephone survey about partner violence and psychological well-being. Symptoms, two indicators of mental health were employed in the research study. Findings indicated a high level of verbal aggression both perpetrated and sustained by participants. Rates of physical abuse were lower; however, these figures dispel the model minority myth associated with Asian Americans. In addition, findings showed a positive correlation between depression and partner violence. Those who experienced verbal and physical aggression by a spouse/intimate partner in the last 12 months were more likely to experience depression. Those who perpetrated physical aggression were more likely to experience somatic symptoms. Practice and research implications are highlighted. PMID:14692179
Strelnick, A H; Bateman, W B; Jones, C; Shepherd, S D; Massad, R J; Townsend, J M; Grossman, R; Korin, E; Schorow, M
The Residency Program in Social Medicine at Montefiore Medical Center is a collaborative, integrated training program for primary care pediatricians, internists, and family physicians within one interdisciplinary organization. Since 1970 we have trained more than 200 physicians, prepared them for board certification in their specialty, emphasized the psychosocial aspects and social determinants of health and illness, and shared a faculty, curriculum, and commitment to provide medical care for inner-city, underserved populations. We discuss the program's history and curriculum, administrative and academic structure, shared "cross-track" faculty units (psychosocial; social medicine; and research, education, and evaluation), and graduates' practice outcomes. The interdisciplinary character of the Residency Program in Social Medicine helps physicians successfully serve the underserved and exemplifies that interdisciplinary medical education succeeds when interdisciplinary health care teams are organized for optimal patient care. Only the federal government has the perspective and power to foster more interdisciplinary collaboration and strengthen primary care education in a period of shrinking resources. PMID:3395040
Health services are multi-unit enterprises providing multi-component services, and organisationally are equivalent to very large, diversified companies. Although public health services like Britain's National Health service (NHS) are not for-profit enterprises, they may share characteristics of such enterprises, particularly where these characteristics offer methods of cost-containment. Since all health services, however organised, face the same problem of resources being insufficient to meet demand for health care, they exhibit an underlying tendency towards solving problems in health care using mechanisms borrowed from other industries. This paper attempts to answer the question: to what extent has general practice (family medicine) in Britain's NHS adopted industrial modes of organisation from productive (for-profit) industries? PMID:12013714
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
Mounesan, Leila; Sayarifard, Azadeh; Haghjou, Leila; Ghadirian, Laleh; Rajabi, Fatemeh; Nedjat, Saharnaz
Background: Development of a manual or well-defined criterion for prioritizing the topics of clinical practice guidelines (CPGs) will help validate and organize this process evermore. This study was conducted to design an applicable manual that would prioritize the CPG topics for family physicians. Methods: This study was a multi-stage method using a qualitative approach that was conducted for the manual developing. The manual development process took place in four steps, as follows: Literature review, interviews with ten experts, preparing a list of criteria and determining its appropriateness by applying the RAND/UCLA Appropriateness method, and development of the final draft of the manual and pilot study. Results: Interview transcripts went under content analysis and were classified into eight main groups, 12 subgroups, and 85 themes. A comprehensive list consisting of fifty preliminary criteria were extracted. After summarizing and classifying the criteria, 12 appropriate criteria were evaluated using the RAND appropriateness method. Eventually, based on the literature review and our own results of the interview analysis, a manual consisting of five main sections and one clause on ethics was developed. Later, a pilot study was conducted on ten family physician topics, and prioritized by nine experts. Conclusions: The manual can be eyed as a tool ensuring the quality of the process of prioritizing CPG topics for family physicians, as it takes into account the issues involved in priority-setting. Selecting informed stakeholders for rating the criteria and ranking the topics was an issue that was greatly emphasized by the experts. Eventually, the application of this manual can be the first step toward systematizing the process of prioritizing CPG topics in the country. PMID:27141283
Perez, Jose A.; Faust, Cheryl; Kenyon, Angie
Background Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. Approach At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Results Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system. PMID:21975715
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.
Michaelson, Valerie; Pickett, William; King, Nathan; Davison, Colleen
Holism is an ancient theory that can be applied contemporarily to adolescent health and its determinants. This theory suggests that there is value in considering factors that influence health together as integrated wholes, in addition to consideration of individual components. Characteristics of families are fundamental determinants of health and provide opportunity for exploration of this theory. In a "proof-of-concept" analysis we therefore: (1) developed a multidimensional, composite (holistic) measure to be used to characterize family systems; and (2) related this measure and its individual components to adolescent health outcomes, in order to test the theory of holism. Cross-sectional analyses of survey reports from the 2014 Canadian Health Behaviour in School-aged Children study (weighted n = 19,333) were performed. Factor analysis was used to confirm the psychometric properties of the holistic measure to describe a family system (the "holistic measure"). Associations between this holistic measure, its individual components, and various indicators of health were examined descriptively and using binomial regression. The holistic measure (4 items, α = 0.62; RMSEA = .04; SRMR = 0.01; AGFI = 0.99) included components describing family: material wealth, meal practices, neighbourhood social capital, and social connections. It was consistently associated with various health behaviours, and social and emotional health outcomes. In 22/24 comparisons, this holistic measure related to positive health outcomes more strongly than did its individual components; for negative health outcomes this occurred in 20/24 comparisons. Study findings suggest that it is possible to assess family systems holistically. Such systems are strongly associated with adolescent health outcomes, and there is etiological and theoretical value in considering family systems as integrated wholes. PMID:27486561
We propose to finalize our search for moonlet companions around Trojan asteroids using the Keck LGS AO capability at their opposition (Aug. for L5). We will focus on Trojans members of a collisional family to maximize the chance of detection, since recent study indicated than ~20% of the main-belt asteroid of the Koronis family are binary (Merline et al. 2005) and the discovery two moonlets orbiting around 87 Sylvia rubble-pile asteroid (Marchis et al. 2005) confirms that the collisions play a major role in the formation of binary systems. A search for binary Centaur asteroids, which may be connected to the Trojan family, will be initiated to complete the night.
Martin, E; Sophocles, A M
A family practice in rural Breckenridge, Colorado began an evening clinic during the winter months of 1981-82 to serve the extra 1,000 to 2,000 residents that that community accommodated each year during the ski season. The clinic was staffed by a PA, who was aided by an office assistant, on weekdays from 5 P.M. to 10 P.M.; after 10 P.M., the PA took calls at home until the office again opened at 9 A.M. The pilot program was successful enough to warrant continuation. This article analyzes the Breckenridge Medical Center's experience during that first year with a PA-staffed evening clinic, in terms of morbidity profile of the after-hours cases, the amount of physician involvement required, the economic aspects of maintaining evening hours, and the ratio of day to evening patients that can be expected. The authors conclude that their extended office hours have proven to be an effective, affordable solution to their practice's after-hours medical care problem. PMID:10314588
Integrating concepts from family systems theory, attachment theory, and family socialization theory within a systems theory of public opinion and social movements, this paper concentrates on linkages between family socialization and political attitudes, adding the influence of social structure. The paper holds that family systems theory…
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. PMID:24065458
The booklet explains ten principles of family-centered health care and six components of community based programs for children with significant medical problems. The principles are: The child and the family have basic rights of self-determination and autonomy. Health care services should be family oriented and maximize family control. Service…
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…
Kohl, Patricia L.; Kagotho, Jacqueline Njeri; Dixon, David
The purpose of this study was to analyze a nationally representative sample of families referred to Child Protective Services (CPS) agencies, the National Survey of Child and Adolescent Well-Being, to examine the association between maternal depression and parenting practices over a 36-month follow-up period. Three hypotheses were tested: (1)…
Zimmerman, Sheryl; Cohen, Lauren W; Reed, David; Gwyther, Lisa P; Washington, Tiffany; Cagle, John G; Beeber, Anna S; Sloane, Philip D
Nursing homes and residential care/assisted living settings provide care to 2.4 million individuals. Few studies compare the experience of, and relationships between, family and staff in these settings, despite ongoing family involvement and evidence that relationships are problematic. Data from 488 families and 397 staff members in 24 settings examined family involvement and family and staff burden, depressive symptoms, and perceptions; and staff absenteeism and turnover. There were few differences across setting types. Although conflict rarely occurred, there was room for improvement in family-staff relations; this area, and preparing family for their caregiving roles, are appropriate targets for social work intervention. PMID:23869592
Weiss, Herbert; Muschaweck, Julius; Hadrath, Stefan; Kudaev, Sergey
On the general lighting market of LED lamps for professional applications there are still mainly products for single purpose solutions existing. There is a lack of standardised lamp systems like they are common for conventional lighting technologies. Therefore, an LED lamp family system was studied using high power LED with the objective to entirely substitute standard conventional lamp families in general lighting applications in the professional market segment. This comprises the realization of sets of lamp types with compact and linear shapes as well as with light distribution characteristics ranging from diffuse to extreme collimation and exceptionally high candle power. Innovative secondary optics concepts are discussed which allow both, the design of lamps with non-bulky shape and to obtain sufficient colour mixing when using multicolour LED combinations in order to achieve a very high colour rendering quality.
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. PMID:12266135
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…
Loop, Bertine; Hitzing, Wade
The monograph provides an historical overview of services for families of disabled children and considers strategies for increasing family support. The historical analysis traces factors influencing the lack of priority placed on family services and describes trends in family resource services. Advantages and drawbacks of the continuum and array…
Howard, Michelle; Brazil, Kevin; Akhtar-Danesh, Noori; Agarwal, Gina
Abstract Objective To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Design Cross-sectional study using a mailed survey. Setting Family health teams in Ontario. Participants Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Main outcome measures Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. Results The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Conclusion Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams. PMID:21571706
Jedrychowski, W; Boeing, H; Popiela, T; Wahrendorf, J; Tobiasz-Adamczyk, B; Kulig, J
In the framework of a nationwide case-control study of risk factors for stomach cancer, a household survey was conducted on those food habits at the family level which were considered relevant for stomach cancer. The practices of 741 case and 741 control households were compared and relative risks calculated by the unconditional maximum likelihood method. For each household, the person responsible for cooking completed the survey. Respondents to the household survey were 35% of the cases and 40% of the controls of the case-control study and otherwise other household members. Case households relied more frequently on their own gardens as a major source of vegetables and fruit, and they cooked their vegetables more often than control households. The vegetable and fruit consumption during the summer period per family member was significantly less in case households compared to control households. The difference in per capita vegetable and fruit consumption between case and control households persisted, but was considerably less pronounced when the consumption of the index person (case or control) was subtracted from the household consumption. The consumption of mainly wholemeal bread showed a relative risk (RR) of 0.18 (95% CI 0.07-0.44) compared with mainly white bread consumption, whereas frequent frying and stewing of meat was associated with an increased risk compared to boiling of meat (RR = 2.06, 95% CI 1.48-2.87). No association with risk was found for long-term refrigerator use or other storage modalities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1467778
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
Doerr, Megan; Edelman, Emily; Gabitzsch, Emily; Eng, Charis; Teng, Kathryn
Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management. PMID:25563219
Ritchey, Ferris J.
Family-physician relationships were examined in terms of solo vs group physician practices in two rural southern counties of different socioeconomic status. Comparatively speaking, County B was poorer, had a much higher representation of blacks, had lost considerable population during 1960-70, depended to a much lesser degree on manufacturing, and…
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…
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…
Piotrkowski, Chaya S.; And Others
Secondary analyses of data collected in the Mothers in the Workplace study examined how family-relevant workplace policies and practices may influence childbearing women's labor force participation during pregnancy and after childbirth. It focused on 2,375 women who held wage and salary jobs during pregnancy and 1,761 of these women who were…
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...
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…
Bergeron, Jessica Page
The purpose of this study was to examine the effects of parent training on shared reading practices in families of children with hearing loss. This intervention augmented a multifaceted school program in emergent literacy. In a community based format, parents were explicitly taught three shared reading strategies that have evidence to support the…
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…
Taylor, Joanne Labish
New family child care (FCC) providers often have little understanding of standard business practices, including zoning, contracts and policies, insurance, and record keeping for tax purposes. This lack of knowledge contributes to low income, high turnover, and other problems. A practicum project set out to improve entry-level FCC providers'…
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…
The main aim of this article is to consider how the 5-Step Method could be developed to meet the needs of affected family members (AFMs) with children under the age of 18. This would be an entirely new development. This article examines opportunities and challenges within practice and policy and makes suggestions on how the Method could be taken…
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…
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,…
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…
Patel, S G; Lowery, J T; Gatof, D; Ahnen, D J
Colorectal cancer (CRC) incidence and mortality are steadily declining and CRC screening rates are increasing in the United States. Although this a very good news, several definable groups still have very low screening rates including younger (under age 50) members of high-risk CRC families. This opinion piece describes five strategies that could be incorporated into routine practice to improve identification and guideline-based screening in members of high-risk families. Routine incorporation of a simple family history screening tool and outreach to high-risk family members could substantially improve guideline-based screening in this population. Identification of CRCs and advanced adenomas in the endoscopy suite defines another group of high-risk families for similar outreach. Lynch syndrome families can be identified by testing CRCs and selected adenomas for microsatellite instability or loss of DNA repair protein expression. Finally, selective addition of aspirin to surveillance endoscopy can decrease the risk of new adenomas and CRCs. The rationale for these strategies as well as mechanisms for their implementation and evaluation in clinical practice is described. PMID:25698379
Kossek, Ellen Ernst; Leana, Carrie; MacDermid, Shelley; Pitt-Catsouphes, Marcie; Raskin, Patricia; Secret, Mary; Sweet, Stephen
The contents of this module have been prepared to address some of challenges associated with teaching about work-family issues from a human resource management and employment perspective. The goals of this module are: (1) To develop an understanding that work-family policies are part of a human resource management system and the employment…
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 the healthy parent-child relationship. A community collaborative of government agency directors has signed a memorandum of agreement to implement the PSoC principles. The researchers will use multiple methods to evaluate DFI's efficacy. PMID:15068214
Coco, E. Lane; Courtney, Linda J.
Utilizes a family therapy approach to restructure family relationships in order to prevent further runaway behavior of a 15-year-old Mexican-American female. The approach involves a family interview, genogram, and family therapy. The Family Satisfaction Scale was administered to evaluate the effectiveness of the approach. (Author/MKA)
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.
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. PMID:24211815
After our successfull search for binary moonlet in the L4 Trojan swarm, leading to the discovery of a moonlet around 624 Hektor (Marchis et al., 2006), we propose to conduct the same program in the L5 Trojan population at opposition in Apr. 2007. We will focus also on Trojans members of a collisional family to maximize the chance of detection, since recent study indicated than ~20% of the main-belt asteroid of the Koronis family are binary (Merline et al. 2005) and the discovery two moonlets orbiting around 87 Sylvia rubble-pile asteroid (Marchis et al. 2005) confirms that the collisions play a major role in the formation of binary systems.
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. PMID:23766738
Dobrof, Rose; Litwak, Eugene
This manual is based upon a study of 247 old people and their families and five long-term care facilities in New York City. The data indicate that what families do for their aged kin in institutions makes a difference to the older person, and that the ability of families to maintain contact with their institutionalized relative depends, in part,…
Curdt-Christiansen, Xiao Lan
Informed by family language policy (FLP) as the theoretical framework, I illustrate in this paper how language ideologies can be incongruous and language policies can be conflicting through three multilingual families in Singapore representing three major ethnic groups--Chinese, Malay and Indian. By studying their family language audits, observing…
Doherty, Gillian; Lero, Donna S.; Tougas, Jocelyne; LaGrange, Annette; Goelman, Hillel
Four Canadian provinces license or contract with family child care agencies, which in turn recruit and monitor child care providers. These family child care agencies have two primary roles: monitoring and supervising providers, and supplying their affiliated family child care providers with professional development opportunities and other types of…
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)
Cooper, Camille Wilson; Riehl, Carolyn J.; Hasan, Angela Laila
In this article, we draw on critical philosophies and theories related to diversity, leadership, and learning to suggest that successful school-family partnerships not only encompass collaborative structures but involve educators who reject deficit-based views of diverse families. We marshal data from our studies of school-family relations in two…
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…
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…
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…
Fewell, Christine Huff; And Others
Surveyed 198 social workers to determine prevalence of alcohol and other drug problems among colleagues, family members, and friends. Forty-three percent of respondents reported knowing at least one social worker who had alcohol or drug problem; 60% had close friends or family with problems; 39% had nuclear family member with problem; and 11% were…
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…
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…
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. PMID:20604637
Kiefer, F; des Etangs, A Lecavelier; Boissier, J; Vidal-Madjar, A; Beust, H; Lagrange, A-M; Hébrard, G; Ferlet, R
The young planetary system surrounding the star β Pictoris harbours active minor bodies. These asteroids and comets produce a large amount of dust and gas through collisions and evaporation, as happened early in the history of our Solar System. Spectroscopic observations of β Pictoris reveal a high rate of transits of small evaporating bodies, that is, exocomets. Here we report an analysis of more than 1,000 archival spectra gathered between 2003 and 2011, which provides a sample of about 6,000 variable absorption signatures arising from exocomets transiting the disk of the parent star. Statistical analysis of the observed properties of these exocomets allows us to identify two populations with different physical properties. One family consists of exocomets producing shallow absorption lines, which can be attributed to old exhausted (that is, strongly depleted in volatiles) comets trapped in a mean motion resonance with a massive planet. Another family consists of exocomets producing deep absorption lines, which may be related to the recent fragmentation of one or a few parent bodies. Our results show that the evaporating bodies observed for decades in the β Pictoris system are analogous to the comets in our own Solar System. PMID:25341784
Barnett, Melissa A.
Economic disadvantage is associated with multiple risks to early socioemotional development. This article reviews research regarding family stress frameworks to model the pathways from economic disadvantage to negative child outcomes via family processes. Future research in this area should expand definitions of family and household to incorporate…
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
Purpose: This paper aims to provide an overview of education system reform in China since 1978, and its practical implications. Design/methodology/approach: Data were collected from literature review and interview. An overview of education system reform and its practical implications was found through data analysis. Findings: There has been two…
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
The Japanese Family Planning (FP)/Maternal and Child Health (MCH) programs can be devided into 2 major categories: 1) health services or preventive and health promotion programs, and 2) medical care services or curative programs. Health examinations of pregnant women are performed throughout pregnancy. After birth, each child is screened for inbornn metabolism defects. Vaccination programs covers both women and children. Additionally, health promotion services such as health guidance, including guidance for various groups as well as counselling for individuals, are carried out. The FP/MCH programs are conducted under the auspices of the Ministry of Health and Welfare. This division supervises the FP/MCH programs in 47 prefectures and 54 specially-selected cities and wards, makes policy, provides financial aid and oversees administration. The prefectures and wards independently plan and execute family planning and health administration. There are 856 health centers and 3271 local governments directly in charge of executing the programs. Population per prefecture ranges from 600,000 to 12 million for Tokyo. Population per health center varies from 10,000 to 750,000 with an average of about 140,000. Center staff includes doctors, public health nurses, veterinarians, pharmacists, x-ray specialists, nutritionists, hygiene inspectors and specialists in inspecting environmental contamination. Local governments coordinate programs with the centers to prevent program overlap. The Maternal and Child Health Promoter System, established in 1971, links public health nurses with families and is staffed by housewife volunteers appointed by local government heads. They play an especially important role in spreading family planning. PMID:12279991
OBJECTIVE--To measure the change in cardiovascular risk factors achievable in families over one year by a cardiovascular screening and lifestyle intervention in general practice. DESIGN--Randomised controlled trial in 26 general practices in 13 towns in Britain. SUBJECTS--12,472 men aged 40-59 and their partners (7460 men and 5012 women) identified by household. INTERVENTION--Nurse led programme using a family centred approach with follow up according to degree of risk. MAIN OUTCOME MEASURES--After one year the pairs of practices were compared for differences in (a) total coronary (Dundee) risk score and (b) cigarette smoking, weight, blood pressure, and random blood cholesterol and glucose concentrations. RESULTS--In men the overall reduction in coronary risk score was 16% (95% confidence interval 11% to 21%) in the intervention practices at one year. This was partitioned between systolic pressure (7%), smoking (5%), and cholesterol concentration (4%). The reduction for women was similar. For both sexes reported cigarette smoking at one year was lower by about 4%, systolic pressure by 7 mm Hg, diastolic pressure by 3 mm Hg, weight by 1 kg, and cholesterol concentration by 0.1 mmol/l, but there was no shift in glucose concentration. Weight, blood pressure, and cholesterol concentration showed the greatest difference at the top of the distribution. If maintained long term the differences in risk factors achieved would mean only a 12% reduction in risk of coronary events. CONCLUSIONS--As most general practices are not using such an intensive programme the changes in coronary risk factors achieved by the voluntary health promotion package for primary care are likely to be even smaller. The government's screening policy cannot be justified by these results. PMID:8124121
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…
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); however, the…
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
Yanmaz, Muyesser Nergiz; Özcan, Ayşet Jane; Savan, Kadir
Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent attacks of fever, peritonitis, pleuritis, arthritis, or erysipelas-like skin lesion. FMF is the most common periodic febrile syndrome affecting more than 150,000 people worldwide. The majority of patients develop FMF before the age of 20. FMF may cause amyloidosis, which mainly affects the kidneys but may also be accumulated in other organs such as the heart, gastrointestinal tract, and reproductive organs. FMF being a systemic disorder with a risk for amyloidosis, affecting patients in their childbearing years, and with its lifelong colchicine therapy raises concern about its effect on the reproductive system. In this article, we review the impact of FMF and its treatment to the reproductive system of male and female patients, pregnancy, and lactation. PMID:24924605
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. PMID:22692838
Covey, Stephen R.
Intended to help families build rewarding relationships, this set of audio tapes communicates the importance of family, shows the role of leadership in creating "beautiful family culture," and provides a frame of reference in which to solve problems. The first of the four tapes explores the concept of principles as the foundation of family, and…
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 "Family Support…
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. PMID:25178898
Mayne, Stephanie; Karavite, Dean; Grundmeier, Robert W.; Localio, Russell; Feemster, Kristen; DeBartolo, Elena; Hughes, Cayce C.; Fiks, Alexander G.
We developed an electronic medical record (EMR)-based HPV vaccine decision support intervention targeting clinicians, (immunization alerts, education, and feedback) and families (phone reminders and referral to an educational website). Through telephone surveys completed by 162 parents of adolescent girls, we assessed the acceptability of the family-focused intervention and its effect on information-seeking behavior, communication, and HPV vaccine decision-making. The intervention was acceptable to parents and 46% remembered receiving the reminder call. Parents reported that the call prompted them to seek out information regarding the HPV vaccine, discuss the vaccine with friends and family, and reach a decision. Parents whose adolescent girls attended practices receiving the clinician-focused intervention were more likely to report that their clinician discussed the HPV vaccine at preventive visits. The results of this study demonstrate the acceptability and potential impact on clinical care of a comprehensive decision support system directed at both clinicians and families. PMID:23304334
Cheng, An-Lin; Kelly, Patricia J; Carlson, Kimberly; Witt, Jacki
Federally funded Title X Family Planning Clinics are critical safety nets for reproductive health services in which advanced practice nurses (APRNs) provide the majority of care. The goal of this study was to identify factors affecting APRN's intention to remain in positions at these clinics. An Internet-administered survey was completed by 406 APRNs working in Title X clinics. The survey, based on a causal model of retention adapted for APRN practice, included 10 factors. Factor significance and model selection criteria were used to determine model fit. Intention to remain in current positions was associated with greater family responsibilities and lower levels of involvement in professional associations. Less routinization, more integration, and a greater sense of distributive justice were significant causal paths to job satisfaction (a significant mediator for intention to remain). Results provide Title X administrators information that can guide them in policy development to maximize APRN retention. PMID:24503318
Pus, Laura; Stanaitis, Ian; Ivers, Noah; Baker, G. Ross; Lockhart, Elizabeth; Hawker, Gillian
This paper focuses on successful engagement strategies in recruiting and retaining primary care physicians (PCPs) in a quality improvement project, as perceived by family physicians in small practices. Sustained physician engagement is critical for quality improvement (QI) aiming to enhance health system integration. Although there is ample literature on engaging physicians in hospital or team-based practice, few reports describe factors influencing engagement of community-based providers practicing with limited administrative support. The PCPs we describe participated in SCOPE: Seamless Care Optimizing the Patient Experience, a QI project designed to support their care of complex patients and reduce both emergency department (ED) visits and inpatient admissions. SCOPE outcome measures will inform subsequent papers. All the 30 participating PCPs completed surveys assessing perceptions regarding the importance of specific engagement strategies. Project team acknowledgement that primary care is challenging and new access to patient resources were the most important factors in generating initial interest in SCOPE. The opportunity to improve patient care via integration with other providers was most important in their commitment to participate, and a positive experience with project personnel was most important in their continued engagement. Our experience suggests that such providers respond well to personalized, repeated, and targeted engagement strategies. PMID:26904284
A large body of research indicates that suicidal behavior in adolescence is related to dysfunctional family processes. The purpose of this paper was to investigate this relationship focusing on the concepts of boundary transgression, double bind interactions, and the demarcation of kinship roles in the family. The possibility is explored that suicidal behavior is a double bind response to contradictions in the way roles and responsibilities are distributed in the family, and that as a response, suicide attempts may contain a simultaneous appeal for help and an assertion of independence from the family. A case vignette is presented to illustrate these processes. PMID:7625266
Glenn, Christine G.; And Others
This paper focuses on the systems approach in family therapy and attempts to further the development of this approach by defining its assumptions and delineating the relationship between the assumptions and their operationalization in assessment and therapy. The first section identifies two basic assumptions of a systemic approach, i.e., that the…
Brotman, Laurie Miller; Calzada, Esther; Huang, Keng-Yen; Kingston, Sharon; Dawson-McClure, Spring; Kamboukos, Dimitra; Rosenfelt, Amanda; Schwab, Amihai; Petkova, Eva
This study examines the efficacy of ParentCorps among 4-year-old children (N = 171) enrolled in prekindergarten in schools in a large urban school district. ParentCorps includes a series of 13 group sessions for parents and children held at the school during early evening hours and facilitated by teachers and mental health professionals. ParentCorps resulted in significant benefits on effective parenting practices and teacher ratings of child behavior problems in school. Intervention effects were of similar magnitude for families at different levels of risk and for Black and Latino families. The number of sessions attended was related to improvements in parenting. Study findings support investment in and further study of school-based family interventions for children from underserved, urban communities. PMID:21291441
Desmond, Kimberly J.; Kindsvatter, Aaron
Supervisors perform various roles in helping to guide the supervisee through the challenging process of family counseling. The use of letters in supervision helps to focus the supervisory processes in family counseling. Following the discrimination model of supervision, three types of supervisory letters are suggested for intentional supervision…
Granlund, Mats; Bjorck-Akesson, Eva
This article discusses in-service training of Swedish professionals in family-centered intervention for families with children with disabilities. The training, which has been implemented on an interdisciplinary team basis in the context of ordinary habilitation services, is described as one of several options for fostering improvement within an…
This case study considers pedagogical techniques used in family childcare to promote children's learning experiences. Data extracted from an earlier study were used to inform this examination of four family childcare providers' pedagogy. In the current study, I use socio-cultural theory and the Reggio Emilia approach to address the following…
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…
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…
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…
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 purpose of receiving…
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…
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…
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…
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…
Raver, Sharon A.
Early childhood special educators often use a family-based approach to working with children and their families (Cook, Klein, Tessier, & Daley, 2004; Raver, 2004). Although this approach is not new, it is used inconsistently and is misunderstood by many early childhood teachers. Part of the difficulty stems from the discipline-specific training of…
This article examines how migrant parents' gender affects transnational families' economic well-being. Drawing on 130 in-depth interviews with Salvadoran immigrants in the United States and adolescent and young adult children of migrants in El Salvador, I demonstrate that the gender of migrant parents centrally affects how well their families are…
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…
Haboush, Karen L.
Individuals of Arab descent residing within the United States currently number between 1.2 million and 3.9 million. These families are characterized by considerable diversity depending upon their nationality, religion, and extent of acculturation to both Western and Arab cultures. More recently, Arab families have immigrated to the United States…
The present study analyses the Family Language Policy (FLP) in regards language literacy development of children in Ethiopian immigrant families. Bridging the gap between linguistic literacy at home and at school hinders a smooth societal integration and a normative literacy development. This study describes the home literacy patterns shaped by…
De Gennaro, Richard
Discussion of information and misinformation about integrated online library systems highlights capabilities and functions that should be offered by an integrated system, practicalities of purchasing a system, visions versus reality, library versus information automation, origins of integrated online systems in the 1960s and 1970s, and future…
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.
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. PMID:24948531
Morón Merchante, Ignacio; Pergolizzi, Joseph V.; van de Laar, Mart; Mellinghoff, Hans-Ulrich; O'Brien, Joanne; Perrot, Serge; Raffa, Robert B.
The family practitioner plays an important role in the prevention, diagnosis, and early management of chronic pain. He/she is generally the first to be consulted, the one most familiar with the patients and their medical history, and is likely the first to be alerted in case of inadequate pain control or safety and tolerability issues. The family practitioner should therefore be at the center of the multidisciplinary team involved in a patient's pain management. The most frequent indications associated with chronic pain in family practice are of musculoskeletal origin, and the pain is often multimechanistic. Fixed-dose combination analgesics combine compounds with different mechanisms of action; their broader analgesic spectrum and potentially synergistic analgesic efficacy and improved benefit/risk ratio might thus be useful. A pain specialist meeting held in November 2010 agreed that the fixed-dose combination tramadol/paracetamol might be a useful pharmacological option for chronic pain management in family practice. The combination is effective in a variety of pain conditions with generally good tolerability. Particularly in elderly patients, it might be considered as an alternative to conventional analgesics such as NSAIDs, which should be used rarely with caution in this population. PMID:24959571
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.
Kramer, Douglas A
From early twentieth century social reform movements emerged the ingredients for both child and family psychiatry. Both psychiatries that involve children, parents, and families began in child guidance clinics. Post-World War II intellectual creativity provided the epistemological framework for treating families. Eleven founders (1950-1969) led the development of family psychiatry. Child and family psychiatrists disagreed over the issues of individual and family group dynamics. Over the past 25 years the emerging sciences of interaction, in the context of the Primate Social Organ System (PSOS), have produced the evidence for the family being the entity of treatment in psychiatry. PMID:26092732
Grogg, Jill E.
Electronic resource management (ERM) systems have inundated the library marketplace. Both integrated library systems (ILS) vendors and subscription agents are now offering products and service enhancements that claim to help libraries efficiently manage their electronic resources. Additionally, some homegrown and open-source solutions have emerged…
van der Klauw, C. F.; Plomp, Tj
After a short characterization of individualized study systems (ISS) and a survey of the number and subject fields of individualized courses in the USA and Europe, the construction and evaluation of an ISS system in freshman mathematics at the Twente University of Technology, in the Netherlands, is discussed. (Editor)
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…
Lindsay, Elizabeth; Wooltorton, Eric; Hendry, Paul; Williams, Kathryn; Wells, George
Background As part of needs assessment processes, our Faculty of Medicine (FOM) continuing professional development office investigated the differences between physicians who do and those who do not frequently participate in planned group learning to gain insight into their interest in new forms of continuing professional development (CPD). Method We sent a 19 item questionnaire to 485 randomly selected physicians of the 1050 family physicians in Eastern Ontario. The questionnaire examined present participation and satisfaction with CPD activities and perceptions regarding the potential impact of those; and appetite for new opportunities to meet their learning needs. Results Of the 151 (31%) physicians responding, 61% reported attending at least one FOM group learning program in the past 18 months (attenders) and 39% had not (non-attenders). Non-attenders indicated less satisfaction (p = 0.04) with present opportunities and requested development in newer approaches such as support for self-learning, on-line opportunities, and simulation. Conclusions Although there are high levels of satisfaction with the present CPD system that predominantly offers large group learning options, a substantial number of physicians expressed interest in accessing new options such as personal study and on-line resources. PMID:27103951
Nuttall, Ena Vazquez; Nuttall, Ronald L.
Knowledge gained from the theoretical and empirical literature on social support theory, family systems theory, and social ecology provide the foundation for a model which studies stress, support systems, and coping patterns within the family. Puerto Rican (N=87) and Italian (N=49) families were interviewed to identify stress factors and coping…
This document uses family systems constructs to explain the onset and maintenance of clinical symptoms such as depression and their relation to life cycle issues among the elderly. The basic assumptions of family systems thinking about structure and function are summarized. Figures and tables are used to illustrate changing family circumstances…
Doherty, William J.; Harkaway, Jill Elka
Presents model for conceptualizing interactional patterns in families presenting for treatment of obesity and method for organizing assessment and for prioritizing treatment strategies. Uses the Family FIRO Model as a framework to organize complex assessment issues, to assign priorities for treatment of issues, and to select appropriate treatment…
Ng, Kit S., Ed.
The heterogeneous groups that make up Asian cultures with their diversity of educational, political, socioeconomic, and religious backgrounds are highlighted, and culturally relevant treatment strategies are presented. Chapters in Part 1 "Understanding and Assessing Asian Families" are: (1) "Theoretical Framework for Therapy with Asian Families"…
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. PMID:19042733
Ab Razak, R
This paper presents findings from a follow-up survey to the 1982 Malaysian Health and Family Planning Survey in Johore and Perak states. The survey aimed to provide more information on traditional methods of contraception and their practice by specific socioeconomic groups, to assess the use of folk methods, and to gauge the perception of effectiveness. The sample includes 1616 women. Findings indicate that people were more familiar with modern methods, particularly the pill. 33.4% of respondents had ever heard of a folk method, such as incantations, exercise, "majun," the Indonesian pill, applications of heat to the abdomen, and herbal preparations. Among the knowledgeable folk methods population, 16.6% had ever heard of herbs, 14.7% knew about jamu, 11.2% knew about majun, 6.3% knew about exercise, 3.3% knew about Indonesian pills, and 1.2% knew about heat applications. 19.8% knew about a variety of other folk methods that were not classified by kind. 62% knew about the traditional method of rhythm; 41.4% knew about withdrawal; and 34.2% knew about abstinence. Knowledge of these three traditional methods was highest among the Chinese. Knowledge of folk methods was highest among the Malays (79.2%). Only 3.5% of Chinese and 2.9% of Indians knew about folk methods. 64% of respondents had ever used modern methods, and about 49% had ever used traditional methods or folk methods. The most popular method of current use was the pill (13.7%), followed by the condom (11.7). Rhythm was the most popular traditional method (7.1%) among current users. 6.2% currently used folk methods. 46.0% currently used some form of contraception. Modern method use was higher among the Chinese, and sterilization was higher among Indians. Knowledge of folk methods increased with an increase in level of education and age. Folk use was higher in urban areas. 46.8% of Malay ever users of folk methods perceived it was very effective, and 45.0% considered it somewhat effective. 70.8% of Malay
Dever, Greg; Finau, Sitaleki A; McCormick, Ross; Kuartei, Stevenson; Withy, Kelley; Yano, Victor; Palafox, Neal; Ueda, Masao; Pierantozzi, Sandra; Pretrick, Eliuel; Ngaden, Victor; Durand, A Mark
The U.S. Institute of Medicine in its 1998 review of the health care systems among the U.S.-Associated Pacific Islands (USAPI) identified promotion of primary health care (PHC) and training of the regional health workforce including postgraduate training for physicians as priorities. With the support of the health leadership of the USAPI and the Republic of Palau, the John A. Burns School of Medicine (JABSOM) of the University of Hawaii captured U.S. federal Area Health Education Center (AHEC) funds to implement a postgraduate program to train Family Practitioners - physician specialists in primary care for the region. The Palau AHEC has evolved into ajoint activity of JABSOM, the University of Auckland Faculty of Medicine and Health Sciences (UAFMHS), the School of Public Health & Primary Care--Fiji School of Medicine, and Palau Community College to provide Diploma-level training in Family Practice and Community Health for Micronesian physicians. PMID:12737433
A 1996 survey conducted in Orissa by the British Council for the British Overseas Development Administration (ODA) on opportunities and barriers to contraceptive uptake found that while women are aware of the health and financial benefits of child spacing, attitudinal and economic obstacles interfere with their ability to act upon that awareness. 3360 women and 840 men from 28 urban and periurban neighborhoods of 14 towns in 8 districts were sampled in the survey. The survey also found that men and women held similar desires with regard to birth spacing patterns; more than 50% wanted to have no additional children and 63% wanted to wait at least 2 years between births. However, despite the considerable observed interest in birth spacing and birth limiting, 78.4% of the women who expressed the desire to use modern methods of contraception were not doing so. While some couples in Orissa practice traditional methods of family planning, the current extent of such use is inadequate. Furthermore, while women in Orissa are overwhelmingly relegated the responsibility for contracepting, and the age at marriage remains approximately 22 years, most women are ignorant about contraceptive methods and their side effects. PMID:12293802
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.
By modifying the Health Belief Model (HBM) nurses can provide health promotion guidance for families through the revised HBM for young families. The constructs 'perceived behavioral control' and 'behavioral intention' from Ajzen's Theory of Planned Behavior were added to the HBM to provide a health orientation. An initial qualitative study informed the second quantitative study through thematic data obtained by interviewing parents about family health. The second comparative study of low and high socioeconomic status families of preschool-aged children living in western Sydney, Australia, measured family health through the Parental Health Behavior Questionnaire (PHBQ). After a small pilot study, the researcher distributed 150 questionnaires to center directors from preschools, kindergartens and long day care, who then handed out questionnaires to interested parents. Data collection occurred in 1998 with consenting parents returning the questionnaires for collection by the researchers. A convenience sample of 103 was obtained with a 69% return rate. Analysis was undertaken through MANCOVA. Justification for validity occurred through logical analysis and hypothesis testing, based on the literature, while reliability was acknowledged by undertaking Cronbach coefficient alphas on small variable clusters. Results support the constructs 'perceived behavioral control' and 'behavioral intention' in the revised model, suggesting that for families of different socioeconomic background, differences emerge in terms of their perceived control over their child's health and the initiation of health behaviors for their child. Recommendations for further research are for refinement of the PHBQ, new research with different families, and further testing of all the model constructs. PMID:15507045
Ling, B C
Standard prosthodontic procedures require five visits to construct a set of complete maxillary and mandibular dentures. Various attempts have been made to reduce these procedures to four or three appointments. However, most of these techniques require the use of visible light polymerized resin as the final denture base materials. Visible light-cured resin materials have inferior physical properties and biocompatibility problems as compared with heat cured polymethylmethacrylate. This paper describes a system of complete denture construction which requires three clinical appointments instead of the usual five visits. This system is made possible by using the VLC base/tray material as the preliminary impression material as well as the application of a new biometric wax occlusion rim. It retains the use of polymethylmethacrylate as the denture base material. This system also utilizes all the procedures used in the conventional five appointment system of complete denture construction. PMID:11709981
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