Meeting the emotional needs of parents who have a child with complex needs

The physical and financial demands of caring for a child with complex needs are acknowledged by health professionals. However the emotional needs of parents are not often recognised by health professionals until parents are at a heightened level of stress. This paper is based on a literature review of current articles, research papers and government documentation. The focus is on how health professionals, and nurses in particular should meet the emotional needs of parents who have child with complex needs, particularly at the point of diagnosis. Giving birth to a child with severe health problems impacts upon parents at an emotional time of transition, particularly if there were no concerns identified during pregnancy. For some parents a grief response or state of chronic sorrow may be triggered. The reality of caring for a baby who is critically ill or disabled can be an enormous and unexpected shock for both parents. Parents need emotional support and guidance, as they may have to change their expectations for their child’s development and even life span. Primary support often comes from parent support groups rather than health professionals. The review discusses how home visits, practical help and early support can all help to alleviate stress. It is important for nurses to realise that if parents’ emotional needs are unmet they can lead to clinical depression or mental illness. This literature review looks at the emotional impact on parents and explores how nurses can address this issue in order to support parents more effectively. It identifies key areas that nurses could address that would help alleviate parents’ emotional stress.

Recovery or decline of the Northwestern Black Sea: A societal choice revealed by socio-ecological modelling

During recent decades anthropogenic activities have dramatically impacted the Black Sea ecosystem. High levels of riverine nutrient input during the 1970s and 1980s caused eutrophic conditions including intense algal blooms resulting in hypoxia and the subsequent collapse of benthic habitats on the northwestern shelf. Intense fishing pressure also depleted stocks of many apex predators, contributing to an increase in planktivorous fish that are now the focus of fishing efforts. Additionally, the Black Sea's ecosystem changed even further with the introduction of exotic species. Economic collapse of the surrounding socialist republics in the early 1990s resulted in decreased nutrient loading which has allowed the Black Sea ecosystem to start to recover, but under rapidly changing economic and political conditions, future recovery is uncertain. In this study we use a multidisciplinary approach to integrate information from socio-economic and ecological systems to model the effects of future development scenarios on the marine environment of the northwestern Black Sea shelf. The Driver–Pressure–State-Impact-Response framework was used to construct conceptual models, explicitly mapping impacts of socio-economic Drivers on the marine ecosystem. Bayesian belief networks (BBNs), a stochastic modelling technique, were used to quantify these causal relationships, operationalise models and assess the effects of alternative development paths on the Black Sea ecosystem. BBNs use probabilistic dependencies as a common metric, allowing the integration of quantitative and qualitative information. Under the Baseline Scenario, recovery of the Black Sea appears tenuous as the exploitation of environmental resources (agriculture, fishing and shipping) increases with continued economic development of post-Soviet countries. This results in the loss of wetlands through drainage and reclamation. Water transparency decreases as phytoplankton bloom and this deterioration in water quality leads to the degradation of coastal plant communities (Cystoseira, seagrass) and also Phyllophora habitat on the shelf. Decomposition of benthic plants results in hypoxia killing flora and fauna associated with these habitats. Ecological pressure from these factors along with constant levels of fishing activity results in target stocks remaining depleted. Of the four Alternative Scenarios, two show improvements on the Baseline ecosystem condition, with improved waste water treatment and reduced fishing pressure, while the other two show a worsening, due to increased natural resource exploitation leading to rapid reversal of any recent ecosystem recovery. From this we conclude that variations in economic policy have significant consequences for the health of the Black Sea, and ecosystem recovery is directly linked to social–economic choices.

Emotional speech: towards a new generation of databases

Research on speech and emotion is moving from a period of exploratory research into one where there is a prospect of substantial applications, notably in human-computer interaction. Progress in the area relies heavily on the development of appropriate databases. This paper addresses the issues that need to be considered in developing databases of emotional speech, and shows how the challenge of developing apropriate databases is being addressed in three major recent projects - the Belfast project, the Reading-Leeds project and the CREST-ESP project. From these and other studies the paper draws together the tools and methods that have been developed, addresses the problems that arise and indicates the future directions for the development of emotional speech databases.

Cooperativism, entrepreneurship and economic development: a linking theoretical model

Cooperatives, as a kind of firms, are considered by many scholars as an remarkable alternative for overcoming the economic crisis started in 2008. Besides, there are other scholars which pointed out the important role that these firms play in the regional economic development. Nevertheless, when one examines the economic literature on cooperatives, it is detected that this kind of firms is mainly studied starting from the point of view of their own characteristics and particularities of participation and solidarity. In this sense, following a different analysis framework, this article proposes a theoretical model in order to explain the behavior of cooperatives based on the entrepreneurship theory with the aim of increasing the knowledge about this kind of firms and, more specifically, their contribution to regional economic development.

Drug use amongst young people attending emotional and behavioural difficulty units during adolescence: A longitudinal anlaysis

This paper reports on the findings from a longitudinal survey of the drug use behaviours of young people who were attending Emotional and Behavioural Difficulty (EBD) units from the age of 11-16 years. It forms part of the Belfast Youth Development Study, a longitudinal study of adolescent drug use. This paper presents a follow-up report to a cross-sectional paper that reported on drug use behaviours of a sample of young people attending EBD units when aged 12/13 years at school year 9 (McCrystal et al 2005a). In the present paper reported drug use and behaviours associated with increased risk of its use between the ages of 11-16 years were examined. The findings show that those attending EBD Units consistently reported higher levels of licit and illicit drug use throughout adolescence. Compared with young people in mainstream school, higher levels of behaviours associated with drug use including antisocial behaviour, disaffection with school, and poor communication with their parents/guardians were noted. These findings have implications for the development and timing of targeted prevention initiatives for young people attending EBD units at all stages of adolescent development.

Social Inclusion or Market Competitiveness? A Comparison of Rural Development Policies in the European Union and the United States

The language of EU rural development policy appears more interested in social inclusion and that of US policy more interested in market competitiveness. We seek to determine why policies directed at rural development in the EU and the USA differ. In both contexts new rural development policies emphasize partnership and participation but we find local participation is used to promote social inclusion in the EU and market competitiveness in the USA. An examination of these dimensions illustrates important transcontinental differences and similarities in rural development policies. We explore the socio-historical reasons for differences in the commitment to social inclusion, while also noting similarities in the priority of market competitiveness.

Longitudinal Pathways Between Political Violence and Child Adjustment: The Role of Emotional Security about the Community in Northern Ireland

Links between political violence and children's adjustment problems are well-documented. However, the mechanisms by which political tension and sectarian violence relate to children's well-being and development are little understood. This study longitudinally examined children's emotional security about community violence as a possible regulatory process in relations between community discord and children's adjustment problems. Families were selected from 18 working class neighborhoods in Belfast, Northern Ireland. Participants (695 mothers and children, M=12.17, SD=1.82) were interviewed in their homes over three consecutive years. Findings supported the notion that politically-motivated community violence has distinctive effects on children's externalizing and internalizing problems through the mechanism of increasing children's emotional insecurity about community. Implications are considered for understanding relations between political violence and child adjustment from a social ecological perspective.

The Architecture of Home in Cairo: Socio-Spatial Practice of the Hawari's Everyday Life

The hawari of Cairo - narrow non-straight alleyways - are the basic urban units that have formed the medieval city since its foundation back in 969 AD. Until early in the C20th, they made up the primary urban divisions of the city and were residential in nature. Contemporary hawari, by contrast, are increasingly dominated by commercial and industrial activity. This medieval urban maze of extremely short, broken, zigzag streets and dead ends are defensible territories, powerful institutions, and important social systems. While the hawari have been studied as an exemplar for urban structure of medieval Islamic urbanism, and as individual building typologies, this book is the first to examine in detail the socio-spatial practice of the architecture of home in the city. It investigates how people live, communicate and relate to each other within their houses or shared spaces of the alleys, and in doing so, to uncover several new socio-spatial dimensions and meanings in this architectural form.

In an attempt to re-establish the link between architecture past and present, and to understand the changing social needs of communities, this book uncovers the notion of home as central to understand architecture in such a city with long history as Cairo. It firstly describes the historical development of the domestic spaces (indoor and outdoor), and provides an inclusive analysis of spaces of everyday activities in the hawari of old Cairo. It then broadens its analysis to other parts of the city, highlighting different customs and representations of home in the city at large. Cairo, in the context of this book, is represented as the most sophisticated urban centre in the Middle East with different and sometimes contrasting approaches to the architecture of home, as a practice and spatial system.

In order to analyse the complexity and interconnectedness of the components and elements of the hawari as a 'collective home', it layers its narratives of architectural and social developments as a domestic environment over the past two hundred years, and in doing so, explores the in-depth social meaning and performance of spaces, both private and public.

Development of a risk model for adverse drug events in the elderly

The aim of this study was to develop a predictive model for adverse drug events (ADEs) in elderly patients. Socio-demographic and medical data were collected from chart reviews, computerised information and a patient interview, for a population of 929 elderly patients (aged greater than or equal to 65 years) whose admission to the Waveney/B raid Valley Hospital in Northern Ireland was not scheduled. A further 204 patients formed a validation group. An ADE score was assigned to each patient using a modified Naranjo algorithm scoring system. The ADE scores ranged from 0 to 8. For the purposes of developing a risk model, scores of 4 or more were considered to constitute a high risk of an ADE.

Might how you look influence how well you are looked after?:A study which demonstrates that GPs perceive socio-economic gradients in attractiveness

To test the hypothesis that more disadvantaged patients are perceived by general practitioners (GPs) as being less attractive than their more affluent peers.

“It’s like a problem that doesn’t exist”: The emotional well-being of mothers caring for a child with brain injury.

Background: Although research has shown that significant burden and adverse psychological impact are associated with caring for a child with brain injury, limited knowledge exists concerning the qualitative experience and impact of this burden.
Objective: To provide an account of the experiences of mothers who care for a childhood survivor of brain injury.
Research design: Postal survey.
Methods and procedures: A self-report questionnaire was sent to a consecutive sample of mothers (n=86) of children (aged 8-28) with acquired brain injury, registered with a UK children’s brain injury charity. Five essay style questions enabled mothers to reflect on and describe at length their caring experiences, with particular emphasis placed on the perceived impact on emotional well-being.
Main outcomes and results: Thematic analysis identified five key themes: Perpetually Anxious, The Guilty Carer, The Labour of Caring, A Self-Conscious Apologist and Perpetually Grieving. Collectively, these themes highlight two core processes shaping mothers’ caring experiences and concomitant mental well-being. Firstly, the collective and enduring nature of caregiver burden over time. Second, the crucial role played by socio-cultural values in perpetuating caregiver burden.
Conclusions: Societal norms, particularly those relating to the nature and outcome of brain injury and motherhood, serve to marginalise mothers and increase feelings of isolation. Findings suggest the value of peer support programs as an effective means of providing appropriate social support.

Evidence and Spatial Planning for Sustainable Development: A Model for Spatially Allocating Material Flows

The aspiration the spatial planning should act as the main coordinating function for the transition to a sustainable society is grounded on the assumption that it is capable of incorporating both a strong evidence base of environmental accounting for policy, coupled with opportunities for open, deliberative decision-making. While there are a number of increasingly sophisticated methods (such as material flow analysis and ecological footprinting) that can be used to longitudinally determine the impact of policy, there are fewer that can provide a robust spatial assessment of sustainability policy. In this paper, we introduce the Spatial Allocation of Material Flow Analysis (SAMFA) model, which uses the concept of socio-economic metabolism to extrapolate the impact of local consumption patterns that may occur as a result of the local spatial planning process at multiple spatial levels. The initial application the SAMFA model is based on County Kildare in the Republic of Ireland, through spatial temporal simulation and visualisation of construction material flows and associated energy use in the housing sector. Thus, while we focus on an Ireland case study, the model is applicable to spatial planning and sustainability research more generally. Through the development and evaluation of alternative scenarios, the model appears to be successful in its prediction of the cumulative resource and energy impacts arising from consumption and development patterns. This leads to some important insights in relation to the differential spatial distribution of disaggregated allocation of material balance and energy use, for example that rural areas have greater resource accumulation (and are therefore in a sense “less sustainable”) than urban areas, confirming that rural housing in Ireland is both more material and energy intensive. This therefore has the potential to identify hotspots of higher material and energy use, which can be addressed through targeted planning initiatives or focussed community engagement. Furthermore, due to the ability of the model to allow manipulation of different policy criteria (increased density, urban conservation etc), it can also act as an effective basis for multi-stakeholder engagement.

Temper outbursts in Prader-Willi syndrome: causes, behavioural and emotional sequence and responses by carers

Background: Temper outbursts are common in Prader-Willi syndrome but rarely described in detail. This study investigated the phenomenology of temper outbursts in terms of antecedents, sequence of behaviours and emotions and intervention strategies used.

Method: A semi-structured interview about temper outbursts was conducted with the main carers of seven children (9.5 to 16.7 years) and seven adults (24.7 to 47.10 years) with Prader-Willi syndrome (10 male, 4 female). Reliability and validity of the interview results was established.

Results: Various setting events increased and reduced the likelihood of temper outbursts. The most common antecedent was a change to routine or expectation. There were marked similarities in the sequence of behaviours and emotions during temper outbursts, with anger rising quickly followed by expressions of remorse and distress at the end of an outburst.

Discussion: The sequence of behaviours and emotions within outbursts was similar to that described in temper tantrums in typical development. Cognitive and emotional processes are likely to be important in the understanding of temper outbursts with implications for early intervention.

Attention during social interaction in children with autism: Comparison to specific language impairment, typical development, and links to cognition

Eye-tracking studies have shown how people with autism spend significantly less time looking at socially relevant information on-screen compared to those developing typically. This has been suggested to impact on the development of socio-cognitive skills in autism. We present novel evidence of how attention atypicalities in children with autism extend to real-life interaction, in comparison to typically developing (TD) children and children with specific language impairment (SLI). We explored the allocation of attention during social interaction with an interlocutor, and how aspects of attention (awareness checking) related to traditional measures of social cognition (false belief attribution). We found divergent attention allocation patterns across the groups in relation to social cognition ability. Even though children with autism and SLI performed similarly on the socio- cognitive tasks, there were syndrome-specific atypicalities of their attention patterns. Children with SLI were most similar to TD children in terms of prioritising attention to socially pertinent information (eyes, face, awareness checking). Children with autism showed reduced attention to the eyes and face, and slower awareness checking. This study provides unique and timely insight into real-world social gaze (a)typicality in autism, SLI and typical development, its relationship to socio-cognitive ability, and raises important issues for intervention.