Contrasting perspectives of parents and service providers on respite care in Queensland,Australia

Abstract

Parent-carers need support to continue to care for their child with significant disability in their home. There has, however, been little evidence that respite interventions have consistent or enduring beneficial effects on carer well-being. This article reports the findings of a qualitative study which adopted an Appreciative Inquiry philosophy to interview parent-carers of children with significant intellectual and/or developmental disabilities on how formal support services have helped them maintain their health and well-being, and disability support staff on how they help such parent-carers foster their health and well-being. We conclude that better communication and collaboration between service providers and users, more targeted training of workers, and embracing a person-centred and family-centred approach to respite services are needed. In addition, clearer definition and communication of the scope of respite services are required to best support families of children with significant disability in their home.     

Instability,investment, disasters,and demography: natural disasters and fertility in Italy (1820–1962) and Japan (1671–1965)

This article examines whether natural disasters affect fertility—a topic little explored but of policy importance given relevance to policies regarding disaster insurance, foreign aid, and the environment. The identification strategy uses historic regional data to exploit natural variation within each of two countries: one European country—Italy (1820–1962), and one Asian country—Japan (1671–1965). The choice of study settings allows consideration of Jones’ (The European miracle, Cambridge University Press, Cambridge, 1981) theory that preindustrial differences in income and population between Asia and Europe resulted from the fertility response to different environmental risk profiles. According to the results, short-run instability, particularly that arising from the natural environment, appears to be associated with a decrease in fertility—thereby suggesting that environmental shocks and economic volatility are associated with a decrease in investment in the population size of future generations. The results also show that, contrary to Jones’ (The European miracle, Cambridge University Press, Cambridge, 1981) theory, differences in fertility between Italy and Japan cannot be explained away by disaster proneness alone. Research on the effects of natural disasters may enable social scientists and environmentalists alike to better predict the potential effects of the increase in natural disasters that may result from global climate change.     

Cultural Responses to Changing Gender Patterns of Migration in Georgia

In this paper, we explore how individual women cope with the tensions between economic forces encouraging temporary labour migration and cultural norms tying “proper” women to their homes and families. Combining in‐depth interviews with returned migrant women in the Georgian capital of Tbilisi with secondary migration data for the region, we illustrate the recent increases in Georgian women’s participation in international labour migration. Deteriorating economic conditions in Georgia leave women with few local opportunities to financially support their families, while institutional changes have altered the accessibility and attractiveness of international destinations, leading to increasing motivations and opportunities for women’s migration. Focusing on the contradictions between growing female migration and persistent adherence to cultural norms stigmatizing migration in Georgia, we explore the cognitive strategies migrant women employ in an attempt to balance internalized perceptions of acceptable gendered behaviour with their migration choices. Two key pathways of adaptation emerge: framing migration as a necessity rather than a choice and stressing the unique and individually exceptional nature of their own migration experience. We posit that these strategies may serve to limit the norm‐challenging nature of women’s migration in Georgia. Although migration is often described as an empowering experience for women, if women migrants work to present their migration in a way that fits within the bounds of traditional gender norms, these norms may be strengthened rather than challenged.     

Family therapy for drug abuse: review and updates 2003-2010

Just 15 years ago, Liddle and Dakof (Journal of Marital and Family Therapy, 1995; 21, 511) concluded, based on the available evidence, that family therapy represented a "promising, but not definitive" approach for the treatment of drug problems among adolescents and adults. Seven years later, Rowe and Liddle (2003) review described considerable progress in this specialty with encouraging findings on adolescent-focused models based on rigorous methodology, as well as advances with adult-focused family-based treatments. The current review brings the field up to date with highlights from research conducted in the intervening 7 years, cross-cutting issues, recommendations for new research, and practice implications of these findings. Adolescent-focused family-based models that attend to the ecology of the teen and family show the most consistent and strongest findings in recent studies. Adult-focused models based on behavioral and systems theories of change also show strong effects with drug abusers and their families. The overarching conclusion is that family-based models are not only a viable treatment alternative for the treatment of drug abuse, but are now consistently recognized among the most effective approaches for treating both adults and adolescents with drug problems.     

Improving wheelchair prescription: an analysis of user needs and existing tools

Wheelchair users experience many situations that affect the stability and associated performance of their wheelchair. Stability is affected by user characteristics and abilities, environmental features and conditions, and wheelchair modification and accessories. Wheelchair prescribers need effective tools and methods to provide quantitative evaluation and prediction of the behavior of the user-wheelchair system in a variety of static and dynamic situations. Such information is very important to guide efficient management of associated risks and adjust chairs accordingly. This project involves a user-centered approach for design and evaluation of a load cell based wheelchair stability assessment system (Wheel-SAS). Here, the current methods for assessing stability are described, and their shortcomings explained. The user-centered design approach being applied to the development of the associated Wheel-SAS hardware and software is described. Future work including semi-structured interviews and an online survey with wheelchair prescribers and associated healthcare professionals for deriving user requirements and a design specification for a load cell system for measuring dynamic wheelchair stability are detailed.     

New procedures of ergonomics design in a large oil company

This study presents the challenge involved in the negotiation and construction of a standard process in a major petroleum company that has the purpose of guiding the implementation of ergonomic studies in the development of projects, systemising the implementation of ergonomics design. The standard was created by a multi-disciplinary working group consisting of specialists in ergonomics, who work in a number of different areas of the company. The objective was to guide "how to" undertake ergonomics in all projects, taking into consideration the development of the ergonomic appraisals of work. It also established that all the process, in each project phase, should be accompanied by a specialist in ergonomics. This process as an innovation in the conception of projects in this company, signals a change of culture, and, for this reason requires broad dissemination throughout the several company leadership levels, and training of professionals in projects of ergonomics design. An implementation plan was also prepared and approved by the corporate governance, complementing the proposed challenge. In this way, this major oil company will implement new procedures of ergonomics design to promote health, safety, and wellbeing of the workforce, besides improving the performance and reliability of its systems and processes.     

The effects of urbanization on North American amphibian species: Identifying new directions for urban conservation

Urbanization is a pervasive and growing threat to amphibian populations globally. Although the number of studies is increasing, many aspects of basic amphibian biology have not been investigated in urban settings. We reviewed 32 urban studies from North America and quantified the number of species studied and their response to urbanization. We examined existing research on breeding habitats, life-history stages, movement patterns, and habitat use relative to urbanization. We found amphibians as a whole respond negatively to urbanization (69 reported responses were negative, 6 were positive and 35 showed no effect). We caution, however, that many North American species still lack or are associated with conflicting information regarding species-specific responses (e.g., 89 potential responses were unknown). Approximately 40% of all anuran and 14% of caudate species in North America were investigated in the literature; however, the most diverse genera (e.g., Plethodon and Eurycea) were the most understudied likely due to their cryptic terrestrial lifestyles and biases in sampling protocols that assess wetland habitats via call surveys. Research on movement and small scale habitat use was deficient. Adult, juvenile, tadpole, and egg mass life-history stages commonly served as direct measures of species presence and abundance; however, such data do not accurately reflect recruitment into subsequent age classes and population persistence. The lack of data on many North American species may be contributing to poor management of urban amphibian populations and their habitats.     

Functional disability among chronic pain patients receiving long-term opioid treatment

This study of 2,163 adult chronic, non-cancer-pain, long-term opioid therapy patients examines the relationship of depression to functional disability by measuring average pain interference, activity limitation days, and employment status. Those with more depression symptoms compared to those with fewer were more likely to have worse disability on all 3 measures (average pain interference score >5, OR = 5.36, p < .0001; activity limitation days ≥ 30, OR = 4.05, p < .0001; unemployed due to health reasons, OR = 4.06, p < .0001). Depression might play a crucial role in the lives of these patients; identifying and treating depression symptoms in chronic pain patients should be a priority.     

Statistical modeling for Bayesian extrapolation of adult clinical trial information in pediatric drug evaluation

Children represent a large underserved population of “therapeutic orphans,” as an estimated 80% of children are treated off‐label. However, pediatric drug development often faces substantial challenges, including economic, logistical, technical, and ethical barriers, among others. Among many efforts trying to remove these barriers, increased recent attention has been paid to extrapolation; that is, the leveraging of available data from adults or older age groups to draw conclusions for the pediatric population. The Bayesian statistical paradigm is natural in this setting, as it permits the combining (or “borrowing”) of information across disparate sources, such as the adult and pediatric data. In this paper, authored by the pediatric subteam of the Drug Information Association Bayesian Scientific Working Group and Adaptive Design Working Group, we develop, illustrate, and provide suggestions on Bayesian statistical methods that could be used to design improved pediatric development programs that use all available information in the most efficient manner. A variety of relevant Bayesian approaches are described, several of which are illustrated through 2 case studies: extrapolating adult efficacy data to expand the labeling for Remicade to include pediatric ulcerative colitis and extrapolating adult exposure‐response information for antiepileptic drugs to pediatrics.