Improving family functioning and child outcome in methadone maintained families: the Parents Under Pressure programme

Twelve families responded to posters displayed in a methadone clinic for inclusion in a pilot study assessing the viability and potential utility of an intensive, multi-component family-focused intervention, the Parents Under Pressure programme. The programme was designed to improve child behaviour, decrease parental stress and improve family functioning in methadone-maintained families by targeting affect regulation, mood, views of self as a parent, drug use and parenting skills. Nine of the families completed the programme delivered in their homes; eight were recontacted at 3 months. Each family reported significant improvements in three domains: parental functioning, parent - child relationship and parental substance use and risk behaviour. In addition to the changes in family functioning, the majority of families reported a decrease in concurrent alcohol use, HIV risk-taking behaviour and maintenance dose of methadone. The families reported high levels of satisfaction with the programme. It is recommended that future studies include independent measures (e.g. behavioural observations) of child outcome and parental functioning. The results were optimistic and provided the impetus to evaluate the treatment programme using a randomized controlled trial.

Mothers' mental illness and child behavior problems: Cause-effect association or observation bias

Objective: A number, of studies have consistently found that a mother's mental health (particularly her level of depression) is a strong predictor of mental health problems experienced by her child(ren). However, the validity of this finding is in doubt because the majority of these studies have relied on maternal reports as indicators of children's behavior. Method: This prospective, longitudinal study examines data an the mental health of the mother from prior to the birth of her child to when the child reaches 14 years of age. Child behavior is measured at 14 years of age using reports from mother and child. Mother and child responses are compared to provide an indication of the possible magnitude of maternal observation bias in the reporting of child behavior problems. Results: Anxious and/or depressed mothers tend to report more cases of child behavior problems than do their mentally healthy counterparts or children themselves. Differences between mothers and youths In reporting behavior problems appear to be related to the mothers' mental health. Conclusions: Current maternal mental health impairment appears to have a substantial effect on the reporting of child behavior problems by the mother, thereby raising questions about the validity of reports of child behavior by persons who are currently emotionally distressed.

Empirically validated treatments and child clinical interventions - Comment

This commentary argues that empirically validated treatments for child and youth behaviour and emotional difficulties are available, but they are relatively inaccessible to the vast majority of Australian children and their families. Although effective interventions have been developed, few children receive these services. There are many children who have identifiable problems or who are at increased risk for psychosocial problems whose needs have not been adequately addressed by either the research or the professional community. These include children in rural and remote areas, Aboriginal and Tones Strait Islander children, children of migrants, and children with chronic physical illnesses. A comprehensive, preventively focused clinical science of prevention is needed to improve the reach and impact of psychological services for children.

Family size, economics and child gender preference: A case study in the Nyeri district of Kenya

Kenyan women have more children, especially in rural areas, than in most developing nations. This is widely believed to be an impediment to Kenya’s economic development. Thus, factors influencing family size in the Kenyan context are important for its future. A brief review of economic theories of fertility leads to the conclusion that both economics and social/cultural factors must be considered simultaneously when examining factors that determine the number of children in a family. The need to do this is borne out in Kenya’s situation by utilising responses from a random sample of rural households in the Nyeri district of Kenya. Economic and social/cultural factors intertwine to influence family sizes in this district. After providing a summary of the main statistical results from the survey, we use multiple regression analysis to explore the influences of a woman’s age, level of education, whether she has outside employment, whether the family keeps livestock, whether she expresses a preference for more boys than girls, whether the family uses only family labour (including child labour) and the size of the farm, which is used as a proxy for family income. It was found that preference for male children has an important positive influence on family size in this district. Women were found to have greater preference for male children than their male counterparts possibly because of their fear of being disinherited if they do not produce an heir for their husbands. Preference for sons was also found in allocation of human capital resources at the household level in that the female respondents were found to have lower levels of education than their male counterparts. Various long-term policies are outlined that may help to reduce the number of offspring of women in Kenya.

ASCIA guidelines for prevention of food anaphylactic reactions in schools, preschools and child-care centres

These guidelines have been developed by the anaphylaxis working party of the Australasian Society of Clinical Immunology and Allergy to provide advice for minimizing the risk of food-induced anaphylaxis in schools, preschools and child-care centres. The guidelines outline four steps for the prevention of food anaphylactic reactions in children at risk and food policy measures specific to school age and preschool age children.

Optical precursors and Beer's law violations; non-exponential propagation losses in water

We develop a model for exponential decay of broadband pulses, and examine its implications for experiments on optical precursors. One of the signature features of Brillouin precursors is attenuation with a less rapid decay than that predicted by Beer's Law. Depending on the pulse parameters and the model that is adopted for the dielectric properties of the medium, the limiting z-dependence of the loss has been described as z(-1/2), z(-1/3), exponential, or, in more detailed descriptions, some combination of the above. Experimental results in the search for precursors are examined in light of the different models, and a stringent test for sub-exponential decay is applied to data on propagation of 500 femtosecond pulses through 1-5 meters of water. (C) 2005 Optical Society of America.

Family violence: Walking the tight rope between maternal alienation and child safety

Mothers are often alienated from their children when child abuse is suspected or confirmed, whether she is the primary abuser of the child or not. An abusive or violent partner often initiates the process of maternal alienation from children as a control mechanism. When the co-occurrence of maternal and child abuse is not recognised, nurses and health professionals risk further alienating a mother from her children, which can have detrimental effects in both the short and long term. Evidence shows that when mothers are supported and have the necessary resources there is a reduction in the violence and abuse she and her children experience; this occurs even in situations where the mother is the primary abuser of her children. The family-centred care philosophy, which is widely accepted as the best approach to nursing care for children and their families, creates tension for nurses caring for children who are the victims of abuse as this care generally occurs away from the context of the family. This fragmented approach to caring for abused children can inadvertently undermine the mother-child relationship and further contribute to maternal alienation. This paper discusses the complexity of family violence for nurses negotiating the 'tight rope' between the prime concern for the safety of children and further contributing to maternal alienation, within a New Zealand context. The premise that restoration of the mother-child relationship is paramount for the long-term wellbeing of both the children and the mother provides the basis for discussing implications for nursing practice.