Family relationship and parenting practices: a pathway to adolesents’ collectivist and individualist values?

Adolescents’ perceptions of parenting and family relationships are important variables for identifying mechanisms involved in how children acquire values and how these values are transmitted through families. In a sample of 515 adolescents, we investigated whether perceptions of the quality of parental practices would predict adolescents’ collectivist and individualist values. We hypothesized that perceived quality of family relations would mediate the relationship between the quality of parental practices and collectivist values but not of individualist values. The results of structural equation modeling suggested that perception of the quality of parental practices predicted adolescents’ both collectivist and individualist values. The predicted mediation effect was found for collectivist values, but not for individualist values. The results point to different functions of parenting and family relations on value acquisition. Implications for practice, such as the development and implementation of interventions to improve the formation of adolescents’ values by enhancing the quality of parenting and family relationships are discussed.

Family doctors' consultations with people suffering from chronic pain without objective findings: Which protective practices might they develop in these challenging medical encounters?

Introduction: Consultations with patients suffering from chronic pain without objective findings represent a challenge fo r family doctors (FDs). A mutual lack of understanding may arise, which threatens the doctor-patient relationship and may lead to dissatisfaction of both patient and doctor and to a breakdown of the therapeutic alliance. Objectives: This study aims to investigate FDs' potential protective practices to preserve the doctor-patient relationship during this type of consultation. Method: In the first step of this qualitative research, I carried out a range of 10 se- mi-structured interviews with FDs to explore their reported practices and repre- sentations during consultations with people suffering from chronic pain without objective findings. The interviews' transcripts were integrally analysed with computer-assisted thematic content analysis (QSR NVivo ® ) to highlight the main themes related to the topic in the participants' talk. Results: At this point of the research, two types of FDs' protective practices can be identified: first the use of complementary sources of knowledge in addition to the medical model to provide explanations to patients, second the collaboration with multidisciplinary teams or support gr oups that allow them to share profes- sional expertise and emotional experiences. Conclusion: The findings could be useful to develop ways to improve the follow- up of patients suffering from chronic pain without objective findings and conse- quently the FDs' work satisfaction.

Involvement of family physicians in structured programs for chronic diseases or multi-morbidity in Switzerland.

The increasing prevalence of chronic diseases and multi-morbidity represents challenges for health systems worldwide. In that perspective, the current organization of healthcare delivery, fragmentation of care, limited use of evidence-based guidelines and patients'insufficient empowerment are some reasons explaining the current limited effectiveness of the management of chronically ill patients. Based on theoretical models such as the Chronic Care Model (CCM), initiatives targeting improvements in the care of patients with chronic diseases have been implemented worldwide since more than a decade. Their development in Switzerland, a health system where more than half of practices are still single handed [6], is only recent and infrequent. Structured programs for patients with chronic diseases or multimorbidity usually propose patient-centered interventions and consider an integrative multidisciplinary approach. Currently, little is known on the existence of such programs and on the role of family physicians (FPs)within these programs, in Switzerland. The objective of this study was to identify and describe current structured programs targeting chronic diseases or multi-morbidity in Switzerland. This may help in examining innovative approaches that are only developed locally but would deserve wider interest for further implementation. We conducted a telephone-based survey between June and November 2013 and contacted systematically key institutions, informants and stakeholders nationwide and in the 26 cantons...

Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

BACKGROUND: Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. METHODS: The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. RESULTS: Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. CONCLUSION: Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.

The predictive role of parenting practices and family functioning on the core symptoms of ADHD

Cette étude vise à examiner la relation entre les pratiques parentales utilisées durant la période de l'enfance et les dimensions principales du du trouble déficitaire de l'attention avec hyperactivité (TDAH) à l'adolescence, soit l’inattention, l’hyperactivité et l’impulsivité. Les pratiques spécifiques parentales (engagement, pratiques parentales appropriée, supervision, punitions corporelles, discipline appropriée, discipline sévère et incohérente, discipline verbale positive, félicitations et récompenses, et les attentes claires) et les aspects du fonctionnement familial (communication, résolution de problèmes, rôles dans la famille, sensibilité affective, engagement affectif, contrôle comportemental) ont été examinés par rapport à l'inattention et d'hyperactivité. Trente-six enfants de 6 à 9 ans et leurs parents ont participé à une étude longitudinale de 5 ans. Il y a un manque d'études longitudinales dans ce domaine et cette étude vise à combler cette lacune. Les résultats ne montrent pas de résultats significatifs dans la relation entre les pratiques parentales utilisées dans l'enfance et les symptômes principaux de l'hyperactivité et l'inattention à l'adolescence. Les études futures devraient se concentrer sur la relation entre la psychopathologie parentale et les principaux symptômes du TDAH de l'enfance à l'adolescence, ainsi que l'impact des pratiques parentales sur ces principaux symptômes.

The Environmental Theme in Representations and Practices of Family Health Professionals in the Municipality of Manaus - State of Amazonas/Brazil

There are abundant scientific evidences showing that the increased risk of exposure to diseases is a consequence of anthropogenic environmental changes. In the Family Health Strategy, tasks with a clear environmental focus are prescribed, indicating to the professional teams that they should consider these aspects in their health practices. The objective of this research was to study representations and practices of Family Health Professionals of Manaus - State of Amazonas, Northern Brazil - about environmental issues and their interface with public health. Data were collected by means of participant observation and semi-structured interviews, and the qualitative analysis was carried out through Content Analysis and Methodological Triangulation. The results showed that most professionals do not understand the environment in a systemic way, even though they recognize the great impact that environmental factors have on human health; as interventions, the educational practices follow traditional methodologies and focus on blaming the individual and on the simple transmission of knowledge; the professionals' relationship with the community is limited to personal and/or collective care. It is concluded that in order to the Family Health Strategy to contribute to restructure the system, it is essential to redirect this new health policy model so that it becomes effective as a social and environmental practice.

Family Preservation Services under Managed Care: Current Practices and Future Directions

Family preservation service agencies in the State of Kansas have undergone major changes since the implementation of a managed care model of service delivery in 1996. This qualitative study examines the successes and barriers experienced by agency directors in utilization of a managed care system. Outcome/ performance measures utilized by the State of Kansas are reviewed, and contributing factors to the successes and limitations of the program are discussed. Included in these reviews is an analysis and presentation of literature and research which has been used as support for the current program structure. Recommendations for further evolution of practice are proposed.

Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

BACKGROUND The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany. METHODS We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework. RESULTS Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions. CONCLUSIONS Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

Promising Practices to Engage Families and Support Family Preservation

The Adoption and Safe Families Act of 1997 (ASFA) is the latest legislation in two decades of important child welfare policy in the United States. The Adoption and Safe Families Act has served to shorten the period of time that caseworkers and families have to show that families are making progress toward family preservation, with permanency decisions being made after 12 months, rather than 18. The importance of engaging and motivating families in services has therefore increased. The practice directive of ASFA can be summarized as 'Act Smart, Fast, and Accountable. " Using findings from largely correlational research, concrete recommendations are made to ensure that practices to preserve families are smart, fast, and accountable, particularly critical given these new timeframes.

Illinois-- It's 1993, do we know where our children are : an examination of trends and practices in in-home family supports and out-of-home placements for children and youth with disabilities /

"First edition: December 1, 1992."

Is an integrated "child-centered, family-focused, community-based " prevention system possible? or are we just "pipe-dreaming?" /

"July 1990."

Heritage Language Maintenance and Biliteracy Development for Immigrants' Children: A Study of Chinese Immigrants' Family Language Policy and Biliteracy Practices

This study reports on research that examines the family language policy (FLP) and biliteracy practices of middle-class Chinese immigrant families in a metropolitan area in the southwest of the U.S. by exploring language practices pattern among family members, language and literacy environment at home, parents’ language management, parents’ language attitudes and ideologies, and biliteracy practices. In this study, I employed mixed methods, including survey and interviews, to investigate Chinese immigrant parents’ FLP, biliteracy practices, their life stories, and their experience of raising and nurturing children in an English-dominant society. Survey questionnaires were distributed to 55 Chinese immigrant parents and interviews were conducted with five families, including mothers and children. One finding from this study is that the language practices pattern at home shows the trend of language shift among the Chinese immigrants’ children. Children prefer speaking English with parents, siblings, and peers, and home literacy environment for children manifests an English-dominant trend. Chinese immigrant parents’ language attitudes and ideologies are largely influenced by English-only ideology. The priority for learning English surpasses the importance of Chinese learning, which is demonstrated by the English-dominant home literacy practices and an English-dominant language policy. Parents invest more in English literacy activities and materials for children, and very few parents implement Chinese-only policy for their children. A second finding from this study is that a multitude of factors from different sources shape and influence Chinese immigrants’ FLP and biliteracy practices. The factors consist of family-related factors, social factors, linguistic factors, and individual factors. A third finding from this study is that a wide variety of strategies are adopted by Chinese immigrant families, which have raised quite balanced bilingual children, to help children maintain Chinese heritage language (HL) and develop both English and Chinese literacy. The close examination and comparison of different families with English monolingual children, with children who have limited knowledge of HL, and with quite balanced bilingual children, this study discovers that immigrant parents, especially mothers, play a fundamental and irreplaceable role in their children’s HL maintenance and biliteracy development and it recommends to immigrant parents in how to implement the findings of this study to nurture their children to become bilingual and biliterate. Due to the limited number and restricted area and group of participant sampling, the results of this study may not be generalized to other groups in different contexts.