The Implementation of Functional Family Therapy (FFT) as an Intervention for Youth Probationers in Singapore

Family functioning is predictive of youth recidivism in Singapore. However, there is a lack of family based interventions for youth offenders on community probation. Evidence‐based family interventions developed in Western populations, such as Functional Family Therapy (FFT), have been found to be effective in mitigating subsequent youth criminal behavior. However, no study has examined whether such interventions can be implemented and adapted for use in Eastern cultures. Thus, this paper sought to detail the implementation of FFT in Singapore. Rationale for the adoption of FFT is discussed, and key activities undertaken during the first 18 months of implementation are described. Preliminary data suggest that initial implementation efforts were successful. Challenges encountered, and implications in relation to the broader literature are discussed.     

Quality of life in workplace trauma victims seeking treatment for posttraumatic stress disorder

Traumatic events at work can have debilitating effects on employees. This pilot study aims to describe the trauma exposure, posttraumatic stress disorder (PTSD) severity, functioning level, and general and work-related quality of life of employees who experienced a workplace trauma and consequently developed PTSD. Forty-four participants with current PTSD were recruited and assessed using semistructured interviews and questionnaires. ANOVAs were performed to assess differences in outcomes between employees from different work settings. Specific types of traumatic events appear to occur in particular types of occupations. Participants manifested severe PTSD, low levels of current functioning, and poor general and work-related quality of life. Overall, these results did not significantly differ between employees in different occupations. Unemployed participants showed poorer outcomes than those who were still working despite their current difficulties. PTSD severity and the presence of comorbid major depression significantly predicted several quality-of-life outcomes. In conclusion, PTSD stemming from workplace trauma appears to have major consequences for employees. Clinical implications are discussed.     

Parenting challenges of African immigrants in Alberta,Canada

African immigrant children and youth have some of the poorest social and mental health outcomes in Canada. Although parenting challenges have been widely documented as a key driver of these outcomes, limited systematic research has investigated this phenomenon. In this paper, we report the results of a study examining parenting challenges among a sample of African immigrant parents in Alberta, Canada. We relied on the theoretical lens of transnationalism to collect and analyse data from a purposive sample of African community leaders (n = 14), African immigrant parents (n = 32), and a range of stakeholders (n = 30). Our thematic data analysis revealed several intricately intertwined parenting challenges, organized around six overarching themes, namely, cultural incompatibility, family tension, state interference, limited social supports, poor access to services, and low socioeconomic status. We present these themes and the policy and service implications of our findings.     

Block response-adaptive randomization in clinical trials with binary endpoints

In a clinical trial, response-adaptive randomization (RAR) uses accumulating data to weigh the randomization of remaining patients in favour of the better performing treatment. The aim is to reduce the number of failures within the trial. However, many well-known RAR designs, in particular, the randomized play-the-winner-rule (RPWR), have a highly myopic structure which has sometimes led to unfortunate randomization sequences when used in practice. This paper introduces random permuted blocks into two RAR designs, the RPWR and sequential maximum likelihood estimation, for trials with a binary endpoint. Allocation ratios within each block are restricted to be one of 1:1, 2:1 or 3:1, preventing unfortunate randomization sequences. Exact calculations are performed to determine error rates and expected number of failures across a range of trial scenarios. The results presented show that when compared with equal allocation, block RAR designs give similar reductions in the expected number of failures to their unmodified counterparts. The reductions are typically modest under the alternative hypothesis but become more impressive if the treatment effect exceeds the clinically relevant difference.     

Maintaining Relevance in Business Education. A Framework for Exploring Alternative Teaching Paradigms

Relevance has become a critical factor in business education programs. Such programs must deliver the skills and knowledge that enable participants to learn and thrive in a context of change, growing business complexity and technological sophistication. This paper explores the need to realign our teaching approach to the new demands of business managers in pursuit of maintaining relevance. It considers the changes this requires in the learner: teacher relationship, and the way in which information communication technologies have a powerful role to play in developing and managing this new relationship. A model is proposed to explore the alternative teaching paradigms associated wich might be best described as seismic shifts in the learning landscape. For educators it suggests a change in teaching values that emphasise stronger attention to process skills, less teacher autonomy, direction and control, and a more creative use of technology to encourage diversity, dialogue and distributed team learning. This revised version was published online in July 2006 with corrections to the Cover Date.     

Performance of phase-I dose finding designs with and without a run-in intra-patient dose escalation stage

Dose-finding designs for phase-I trials aim to determine the recommended phase-II dose (RP2D) for further phase-II drug development. If the trial includes patients for whom several lines of standard therapy failed or if the toxicity of the investigated agent does not necessarily increase with dose, optimal dose-finding designs should limit the frequency of treatment with suboptimal doses. We propose a two-stage design strategy with a run-in intra-patient dose escalation part followed by a more traditional dose-finding design. We conduct simulation studies to compare the 3 + 3 design, the Bayesian Optimal Interval Design (BOIN) and the Continual Reassessment Method (CRM) with and without intra-patient dose escalation. The endpoints are accuracy, sample size, safety, and therapeutic efficiency. For scenarios where the correct RP2D is the highest dose, inclusion of an intra-patient dose escalation stage generally increases accuracy and therapeutic efficiency. However, for scenarios where the correct RP2D is below the highest dose, intra-patient dose escalation designs lead to increased risk of overdosing and an overestimation of RP2D. The magnitude of the change in operating characteristics after including an intra-patient stage is largest for the 3 + 3 design, decreases for the BOIN and is smallest for the CRM.     

Quality, accessibility, and contraceptive use in rural tanzania

We examine how informants' reports on community perceptions of the quality and accessibility of family planning facilities relate to the use of modern contraceptives by individuals in rural Tanzania. Using information on individual-level contraceptive use in conjunction with community-level information on the accessibility and quality of family planning facilities, we employ two distinct statistical procedures to illustrate the impacts of accessibility and quality on contraceptive use. Both procedures treat the community-level variables as imperfect indicators of characteristics of the facilities, and they yield nearly identical implications. We find that a community-level, subjective perception of a family planning facility's quality has a significant impact on community members' contraceptive use whereas other community measures such as time, distance, and subjective perception of accessibility have trivial and insignificant direct impacts, net of the control variables. Future research that uncovers the determinants of perceptions of both community-level and individual-level quality could provide key insights for developing effective and efficient family planning programs.     

Adoption from care in Northern Ireland: problems in the process

ABSTRACT This is a study of the processes for freeing children for adoption in Northern Ireland. The focus was the time taken from admission to care to adoption order. The findings confirmed that the process is dogged by delay at each stage. In total the average time from the child becoming looked after to the granting of an adoption order was 4.5 years. Most of the time taken was in the stages for which social services had lead responsibility, principally the decision to pursue adoption as the plan for a child. The children were very young when admitted to care – average age 1 year 7 months. Most were admitted to care because they were being neglected. Their parents were well known to social services and had multiple problems. Most parents unsuccessfully contested the social services’ application and this contributed much to the delay. Their former foster parents adopted almost half of the children and these children tended to be placed more quickly with their adopters than those placed with adopters who were not their foster parents prior to the adoption process.     

Make-or-break during production: shedding light on change-orders,rework and contractors margin in construction

A considerable amount of research has examined the cost performance of construction projects, yet there has been a paucity of studies that have examined the impact that client initiated change-orders and rework have on contractors. This paper seeks to add further clarity to this issue by replicating previous empirically-based research to establish the validity and reliability of the key issues influencing a contractor's cost performance. A total of 98 projects were used to examine the value of rework and change-orders and their influence on a contractor's margin. Only 65% of projects experienced a cost increase, though a mean rework cost of 0.39% of the contracted value was incurred. The difference between approved client change-orders and those by the contractor for subcontractors was 0.5% of the total costs incurred, which adversely impacted the organisation's profit. Margin losses may well have been higher as rework is seldom formally documented and reported.     

Application of 'delete = replace' to deletion diagnostics for variance component estimation in the linear mixed model

Summary.  'Delete = replace' is a powerful and intuitive modelling identity. This paper extends previous work by stating and proving the identity in more general terms and extending its application to deletion diagnostics for estimates of variance components obtained by restricted maximum likelihood estimation for the linear mixed model. We present a new, fast, transparent and approximate computational procedure, arising as a by-product of the fitting process. We illustrate the effect of the deletion of individual observations, of 'subjects' and of arbitrary subsets. Central to the identity and its application is the conditional residual.