Parenting Programmes: The Best Available Evidence

Parenting programmes have been provided to a wide range of child and parent groups across a number of countries, but are they effective? This aim of this paper is to examine the findings from a number of systematic reviews that summarise the best available research evidence on the impact of these programmes on a range of parental and child outcomes. In addition to examining the findings from systematic reviews, the paper also takes a selective look at the uptake of parenting programmes in the United Kingdom, the evidence for effectiveness and the efficacy of adopting a population-based approach to parent education.

The findings from systematic reviews indicate that parenting programmes can have a positive impact on a range of outcomes, including improved child behaviour, increased maternal self-esteem and relationship adjustment, improved mother–child interaction and knowledge and decreased maternal depression and stress. While there is a need for greater evaluation of the long-term impact of these programmes, preliminary evidence indicates that these positive results are maintained over time, with group-based, behaviourally orientated programmes tending to be more effective.

While several recent trials indicate that that these programmes can be effective within the United Kingdom, high drop-out rates may mean that they only reach a minority of parents. However, multi-level parent education strategies such as the Australian Triple P Positive Parenting Strategy that incorporate an array of mediums aimed at different levels of need may provide an opportunity to reach a wider range of parents. This approach is currently being evaluated in order to ascertain whether it is effective in improving child outcomes in the general population.

While there is no coherent strategy for parent training across the United Kingdom, within the Northern Ireland context there is a move towards the development of a family support strategy. While uptake of parent education and training is currently unknown the best available evidence highlights the positive impact that parent training can have, suggesting the importance of including parent education as one aspect of this strategy

The majority-minority conundrum in Northern Ireland::An Orange Order perspective

Researchers have argued that, depending on the framing of the Northern Ireland conflict, each group could either be a minority or a majority relative to the other. This complicates macrosocial explanations of the conflict which make specific predictions on the basis of minority or majority positions. The present paper argues that this conundrum may have arisen from the inherent variability in microidentity processes that do not fit easily with macroexplanations. In this paper the rhetoric of relative group position is analysed in political speeches delivered by leading members of an influential Protestant institution in Northern Ireland. It is apparent that minority and majority claims are not fixed but are
flexibly used to achieve local rhetorical goals. Furthermore, the speeches differ before and after the Good Friday Agreement, with a reactionary “hegemonic” Unionist position giving way to a “majority-rights power sharing” argument and a “pseudo-minority” status giving way to a “disempowered minority” argument. These results suggest a view of the Northern Ireland conflict as a struggle for “symbolic power,” i.e., the ability to flexibly define the intergroup situation to the ingroup’s advantage.

Factors Influencing the Implementation of Site Waste Management Plans on UK Projects of all sizes

The purpose of this research is to identify and assess the opportunities and challenges of implementing a Site Waste Management Plan (SWMP) on projects irrespective of size. In the UK, construction and demolition waste accounts for a third of all UK waste. There are a number of factors that influence the implementation of SWMPs. In order to identify and analyse these factors, 4 unstructured interviews were carried out and a sample of 56 participants completed a questionnaire survey. The scope of the study was limited to UK
construction industry professionals. The analysis revealed that more needs to be done if the industry is to meet government targets of reduction in construction related waste going to landfill. In addition, although SWMP may not yet be legally required on all construction projects, clients and contractors need to realise
the benefits to cut costs and implement best practice by adopting a SWMP. The benefits of implementing a SWMP will not only help to achieve this but also gain significant cost savings on projects and is also extremely beneficial to the environment. This study presents evidence that contractors need to do more to reduce waste and draws a clear link between waste reduction and the implementation of SWMPs. The findings are useful in the ongoing efforts to encourage the industry to find smarter, more efficient and less
damaging ways to operate

Interventions Targeting Child Undernutrition in Developing Countries May Be Undermined by Dietary Exposure to Aflatoxin

Child undernutrition, a form of malnutrition, is a major public health burden in developing countries. Supplementation interventions targeting the major micronutrient deficiencies have only reduced the burden of child undernutrition to a certain extent, indicating that there are other underlying determinants that need addressed. Aflatoxin exposure, which is also highly prevalent in developing countries, may be considered to be an aggravating factor for child undernutrition. Increasing evidence suggests that aflatoxin exposure can occur in any stage of life including in utero through a trans-placental pathway and in early childhood (through contaminated weaning food and family food). Early life exposure to aflatoxin is associated with adverse effects on low birth weight, stunting, immune suppression and liver function damage. The mechanisms underlying impaired growth and aflatoxin exposure are still unclear but intestinal function damage, reduced immune function and alteration in the insulin-like growth factor axis caused by liver damage, are suggested hypotheses. Given the fact that both aflatoxin and child undernutrition are common in sub-Saharan Africa, effective interventions aimed at reducing undernutrition cannot be satisfactorily achieved until the interactive relationship between aflatoxin and child undernutrition is clearly understood, and an aflatoxin mitigation strategy has taken effect in those vulnerable mothers and children.

Immunohistochemistry should undergo robust validation equivalent to that of molecular diagnostics

Immunohistochemistry (IHC) is a widely available and highly utilised tool in diagnostic histopathology and is used to guide treatment options as well as provide prognostic information. IHC is subjected to qualitative and subjective assessment, which has been criticised for a lack of stringency, while PCR-based molecular diagnostic validations by comparison are regarded as very rigorous. It is essential that IHC tests are validated through evidence-based procedures. With the move to ISO15189 (2012), not just of the accuracy, specificity and reproducibility of each test need to be determined and managed, but also the degree of uncertainty and the delivery of such tests. The recent update to ISO 15189 (2012) states that it is appropriate to consider the potential uncertainty of measurement of the value obtained in the laboratory and how that may impact on prognostic or predictive thresholds. In order to highlight the problems surrounding IHC validity, we reviewed the measurement of Ki67and p53 in the literature. Both of these biomarkers have been incorporated into clinical care by pathology laboratories worldwide. The variation seen appears excessive even when measuring centrally stained slides from the same cases. We therefore propose in this paper to establish the basis on which IHC laboratories can bring the same level of robust validation seen in the molecular pathology laboratories and the principles applied to all routine IHC tests.