Parent management training and Asperger syndrome - A randomized controlled trial to evaluate a parent based intervention

This controlled trial of a parent management intervention aimed to increase parental competence in management of problem behaviours associated with Asperger syndrome. The intervention compared two formats, a 1 day workshop and six individual sessions. Measures were taken on three occasions: pre-intervention, at 4 weeks, and at 3 month follow-up. Variables of interest were number and intensity of problem behaviours, and parent evaluation of social interaction skills. Results showed parents reporting fewer and lower intensity of problem behaviours and increased social interactions at 4 weeks and 3 months. Results held across formats and suggest that parent management training can provide an effective intervention for parents of a child with Asperger syndrome. Group differences on outcome measures and in the use of strategies are discussed along with limitations of the study.

Screening for physical activity in family practice - Evaluation of two brief assessment tools

Background: Physical activity (PA) is relevant to the prevention and management of many health conditions in family practice. There is a need for an efficient, reliable, and valid assessment tool to identify patients in need of PA interventions. Methods: Twenty-eight family physicians in three Australian cities assessed the PA of their adult patients during 2004 using either a two- (2Q) or three-question (3Q) assessment. This was administered again approximately 3 days later to evaluate test-retest reliability. Concurrent validity was evaluated by measuring agreement with the Active Australia Questionnaire, and criterion validity by comparison with 7-day Computer Science Applications, Inc. (CSA) accelerometer counts. Results: A total of 509 patients participated, with 428 (84%) completing a repeat assessment, and 415 (82%) accelerometer monitoring. The brief assessments had moderate test-retest reliability (2Q k = 58.0%, 95% confidence interval [CI] = 47.2-68.8%; 3Q k = 55.6%, 95% CI = 43.8-67.4%); fair to moderate concurrent validity (2Q k = 46.7%, 95% CI = 35.657.9%; 3Q k = 38.7%, 95% CI = 26.4-51.1%); and poor to fair criterion validity (2Q k = 18.2%, 95% CI = 3.9-32.6%; 3Q k = 24.3%, 95% CI = 11.6-36.9%) for identifying patients as sufficiently active. A four-level scale of PA derived from the PA assessments was significantly correlated with accelerometer minutes (2Q rho = 0.39, 95% CI = 0.28-0.49; 3Q rho = 0.31, 95% CI = 0.18-0.43). Physicians reported that the assessments took I to 2 minutes to complete. Conclusions: Both PA assessments were feasible to use in family practice, and were suitable for identifying the least active patients. The 2Q assessment was preferred by clinicians and may be most appropriate for dissemination.

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.

Seclusion of children and adolescents: Psychopathological and family factors

This paper describes the use of seclusion in a child and adolescent inpatient unit, including precipitating events, management strategies, details of seclusion episodes and individual and family risk factors. Inpatient ward documentation of seclusion episodes, demographic data and measures of individual psychopathology and impairment, parent mental health, life events and family functioning were used to compare secluded, non-secluded and outpatient groups. Secluded individuals had elevated psychopathology compared with non-secluded inpatients and outpatients. Their families reported poorer parental mental health and family functioning and more recent stressful life events. The results indicate that seclusion is most common among high-risk inpatients.

Perspectives on quality of life by people with aphasia and their family: Suggestions for successful living

Understanding the client's perspective is essential for good practitioner care in rehabilitation after stroke, and nothing is more relevant than enquiring directly about our clients' quality of life to inform our management. Relatively little is known about how older people with aphasia consider the quality of their current lives, and this article seeks to explore this issue. Four women's accounts of their life quality are presented, as well as their husbands' or daughter's accounts of their lives. Their stories share some common elements. Who you love or share your life with; where you live; feeling independent and/or in control; and engaging in satisfying activities mattered to these women's life quality. The impact of aphasia varies across the cases, and the need to accept change for successful living is illustrated in all accounts.

Challenges for expatriate managers:an exploration of cross-cultural management, adjustment, and training issues faced by Anglo-American managers in Hong Kong

This field work study furthers understanding about expatriate management, in particular, the nature of cross-cultural management in Hong Kong involving Anglo-American expatriate and Chinese host national managers, the important features of adjustment for expatriates living and working there, and the type of training which will assist them to adjust and to work successfully in this Asian environment. Qualitative and quantitative data on each issue was gathered during in-depth interviews in Hong Kong, using structured interview schedules, with 39 expatriate and 31 host national managers drawn from a cross-section of functional areas and organizations. Despite the adoption of Western technology and the influence of Western business practices, micro-level management in Hong Kong retains a cultural specificity which is consistent with the norms and values of Chinese culture. There are differences in how expatriates and host nationals define their social roles, and Hong Kong's recent colonial history appears to influence cross-cultural interpersonal interactions. The inability of the spouse and/or family to adapt to Hong Kong is identified as a major reason for expatriate assignments to fail, though the causes have less to do with living away from family and friends, than with Hong Kong's highly urbanized environment and the heavy demands of work. Culture shock is not identified as a major problem, but in Hong Kong micro-level social factors require greater adjustment than macro-level societal factors. The adjustment of expatriate managers is facilitated by a strong orientation towards career development and hard work, possession of technical/professional expertise, and a willingness to engage in a process of continuous 'active learning' with respect to the host national society and culture. A four-part model of manager training suitable for Hong Kong is derived from the study data. It consists of a pre-departure briefing, post-arrival cross-cultural training, language training in basic Cantonese and in how to communicate more effectively in English with non-native speakers, and the assignment of a mentor to newly arrived expatriate managers.

To move or not to move - a question of family?

Relocation is one organizational phenomenon where the influence of family is prominent. Our paper thus uses it as a backdrop against which to study the work–family interface. In-depth qualitative analysis of 62 interviews with Royal Air Force personnel is used to complement the literature by demonstrating the impact on and the impact of the immediate family in relocation. The analysis provides evidence that relocation influences an employee's role as family member, other family members and the family as a whole. Findings also illustrate that families influence employees' relocation behaviour, organizational tenure and work focus. In summary, this paper supports the bidirectional nature of the work-family interface and also demonstrates that regardless of whether examining the work-to-family influence or the family-to-work influence the effects are not always negative.