Patterns of change in family-based aggression prevention

Patterns of change on three intervention targets were examined in 151 families that participated in a family intervention designed to reduce and prevent children's aggressive behavior. Measures of parents' alliance and parenting skills and children's aggressive behavior were obtained at five times during the intervention. Three cluster analyses were conducted to identify patterns of change on each target. Linear and nonlinear patterns of improvement as well as two distinct patterns of no change were obtained. The patterns were differentiated by net improvement, overall level of skill, and trajectory of change. Family characteristics also differentiated the patterns and relations were found among patterns across intervention targets. The clinical implications of these findings are discussed.     

GAPS between MFT supervision assumptions and common practice: suggested best practices

This article summarizes gaps between assumptions that appear in the literature, research, and accepted standards for marital and family therapy (MFT) supervision, and the common practice of supervisors. Issues that stem from these gaps are highlighted and recommendations are made for closing them. In an effort to refine the standard of practice for MFT supervision, best practice recommendations are offered for MFT supervision.     

Beyond enmeshment: evidence for the independence of intrusiveness and closeness-caregiving in married couples

In a 1996 article on family theory, we (Green & Werner) proposed that family enmeshment should not be equated with high cohesion and that the construct of enmeshment fails to discriminate between two distinct relationship processes: Closeness-caregiving and intrusiveness. In this study, our model of these two independent dimensions of family connectedness was tested by assessing spouses from 264 couples, using the California Inventory for Family Assessment (CIFA). The CIFA scales showed acceptable reliability. Significant interspouse validity correlations also were obtained. As predicted by our theory, factor analyses distinguished dimensions of intrusiveness (blurring of boundaries) from dimensions of closeness-caregiving (such as warmth and nurturance). On all but two factors, behaviors of only one spouse (but not of both) had interpretable loadings. That is, in most areas, the two spouses' behaviors did not load together to form meaningful factors. The latter finding suggests that family systems theory--with its central notion of reciprocally contingent behaviors between family members--may be useful in understanding only a few dimensions of spouses' behavior (such as reciprocal aggression) whereas personality-in-context theories may be better for understanding most other dimensions (such as warmth and nurturance).     

Reiki. A complementary therapy for nursing practice

1. Reiki is an ancient healing art involving the gentle laying on of hands. It can be practiced anytime and anywhere. 2. Reiki can be used as a complementary treatment to medical protocols. 3. Hand positions customarily correspond to the body's endocrine and lymphatic systems and major organs, focusing on seven main chakras. 4. More research investigating the effects of Reiki on persons with psychiatric and medical disorders is necessary.     

Outbreaks of acute gastroenteritis associated with Norwalk-like viruses in campus settings

Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, water, fomites, and person-to-person contact. They are a leading cause of acute gastroenteritis epidemics in industrialized countries. NLV outbreaks are characterized by a 12- to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infections spread rapidly on college and university campuses because of close living quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact through sports and recreational activities. The illness is generally mild and self-limited but an outbreak can strain the resources of campus health services and cause high absenteeism among both students and staff. Treatment is primarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of strict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.     

Problematic White Identities and a Search for Racial Justice

Blauner (1995, Racism and Antiracism in World Perspective. Thousand Oaks, CA: Sage), Winant (1998, Ethnic and Racial Studies 24(4): 755–766) and Bonnett (1997, New Communities 22(1): 97–110) all express concern over the construction of racism as a white-only phenomenon and the corresponding degree to which whiteness is essentialized as a negative identity. This paper explores how white antiracism activists mediate between a static construction of white racism and a more contextual understanding of racism and possibilities for white activism. While whiteness is clearly hegemonic in the larger social world, within movements for racial justice, whiteness is often seen as suspect. Given this, white antiracism activists spend a fair amount of their activist hours negotiating a problematic identity. This paper explores the mechanisms by which such an identity is negotiated. I conclude that while white activism is complicated by a definition of racism that tends to essentialize whiteness, the activists have found ways to empower themselves and to conceptualize their relationship to racism and antiracism activism in a less rigid way. All of this contributes to our understanding of the complexity of white identity and efforts to demonstrate how it is an identity that, like other identities, is always in formation.     

Recent developments in aged care policy in Australia

A series of major reforms implemented through the mid 1980s sought to contain residential care and expand community care in Australia's long-term care system. While this goal has been maintained, a number of new policy initiatives followed the change of federal government in 1996. This article presents a systematic account of current policy objectives, implementation measures, and outcomes in three major policy areas: changing the balance between residential and community care, targeting in community care, and support for family caregivers. This analysis shows that while there have been shifts in emphasis from time to time, concerted policy efforts over the last 20 years have contained the growth of expenditure on long-term care and realized significant change in the service system.     

The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment

OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses.     

Work hardening: Outdated fad or effective intervention?

OBJECTIVES: The purpose of this outcome measurement study was to determine the effectiveness of a work hardening program as measured by the participants' work status at three months after program completion. Predictors of successful return to work were explored. STUDY DESIGN: The sequential case series design was employed, and data were gathered at three points: the initial work hardening assessment, the discharge assessment, and three months post-discharge from the work hardening program. Seventy-nine participants were included. RESULTS: Eighty-two percent (82%) of the clients who completed a work hardening program reported that they were working in some capacity three months after program completion. They listed their employment status in 5 sub-categories. Significant predictors of employment included "single" marital status, lower perceived disability scores at program entry, reduction in reported pain during program duration, and funding source. CONCLUSION: Work hardening remains an effective treatment strategy which promotes successful return to the workplace. Ongoing analyses of these programs is imperative.     

$7.8 Billion for Everglades Restoration: Why Do Environmentalists Look So Worried?

The Comprehensive Everglades Restoration Plan, enacted in 2000, is a $7.8 billion federal/state investment in restoring the Florida Everglades ecosystem. The plan is a negotiated compromise between divergent interests in south Florida and promises to provide water and flood control for urban and agricultural users while maintaining a priority commitment to the natural system when allocating water produced by the 30-year project. The environmental community calls for independent scientific review of un-tested technologies, early and substantial hydrologic benefits to the remaining Everglades, including Everglades National Park, and strong programmatic regulations of the federal project to ensure that ecological restoration remains its primary purpose in spite of inherently conflicting interests at the state and local level.