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There is increasing interest about the fidelity with which interventions are implemented because it is theorized that better implementation fidelity by facilitators is associated with better participant outcomes. However, in the parenting program literature, there is mixed evidence on the relationship between implementation fidelity and outcomes. This paper provides a synthesis of the evidence on the relationship between facilitator delivery and outcomes in the parenting program literature. Following PRISMA guidelines, this paper synthesizes the results of a systematic review of studies on parenting programs aiming to reduce violence against children and child behavior problems. Specifically, it examines associations between observational measures of facilitator competent adherence and parent and child outcomes. A meta-analysis was not feasible due to study heterogeneity. As a result, Synthesis Without Meta-Analysis guidelines were followed. Searches in electronic databases, reference searching, forward citation tracking, and expert input identified 9653 articles. After screening using pre-specified criteria, 18 articles were included. The review found that most studies (n = 13) reported a statistically significant positive relationship with at least one parent or child outcome. However, eight studies reported inconsistent findings across outcomes, and four studies found no association with outcomes. The results suggest that better facilitator competent adherence is generally associated with positive parent and child outcomes. However, this finding is weakened by the methodological heterogeneity of included studies and due to the wide variety of ways in which studies conceptualized competent adherence-outcome relationships. [ABSTRACT FROM AUTHOR]

Background: Despite impressive strides in health, social protection, and education, children continue to experience high rates of child maltreatment in Malaysia. This mixed-methods study assessed the feasibility of a five-session, social learning-based parenting program delivered by government staff in a community setting to reduce violence against children. Methods: Parents of children from birth to 17 years were recruited from two communities near Kuala Lumpur to participate in the government-run program called the Naungan Kasih Positive Parenting Program ("Protecting through Love" in Bahasa Melayu). Quantitative data from female caregivers (N = 74) and children ages 10–17 (N = 26) were collected along with qualitative interviews and focus groups with parents, children, and facilitators. The primary outcome was child maltreatment with secondary outcomes including neglect, positive parenting, acceptability of corporal punishment, harsh parenting, positive discipline, and child behavior problems. Multilevel Poisson regression and multilevel linear regression were conducted to compare baseline and post-test outcomes. Qualitative interviews and focus groups examined how participants experienced the program utilizing a thematic analysis approach. Results: Quantitative analyses found pre-post reductions in overall child maltreatment, physical abuse, emotional abuse, attitudes supporting corporal punishment, parent sense of inefficacy, and child behavior problems. There were no reported changes on positive and harsh parenting, parental mental health, and marital satisfaction, nor were there any other significant changes reported by children. Qualitative findings suggested that the program had tangible benefits for female caregivers involved in the program, with the benefits extending to their family members. Conclusions: This feasibility study is one of the few studies in Southeast Asia that examined the feasibility and initial program impact of a parenting program delivered by government staff to families with children across the developmental spectrum from birth to 17 years. Promising results suggest that the program may reduce child maltreatment across a range of child ages. Findings also indicate areas for program improvement prior to further delivery and testing, including additional training and content on sexual and reproductive health, parenting children with disabilities, and online child protection. [ABSTRACT FROM AUTHOR]

This descriptive study examined the distribution of risk factors in a sample that was selected on the basis of existing potential for difficult child behaviors. We inquired into whether exposure to risk factors was distributed equally across different contexts of ethnicity, locality, and child gender. Participants included 731 mother–child dyads recruited from WIC Programs in rural, suburban, and urban localities. Cumulative risk indices were constructed using neighborhood, family, and individual risk factors. The findings generally revealed that African American children and children in urban localities were exposed to higher numbers of risk factors and cumulative risk in relation to other ethnic children and localities. On the other hand, Caucasian children expressed higher levels of vulnerabilities to risk for internalizing behaviors than did other children. The results are discussed in terms of differences in contextual specific rates of risk exposure, vulnerability, and their implications for prevention and intervention research. [ABSTRACT FROM AUTHOR]

Background: This study examined relations among cumulative risk, nurturant and involved parenting, and behavior problems across early childhood. Methods: Cumulative risk, parenting, and behavior problems were measured in a sample of low-income toddlers participating in a family-centered program to prevent conduct problems. Results: Path analysis was utilized to examine longitudinal relations among these constructs, with results supporting an indirect effect of cumulative risk on externalizing and internalizing problems through nurturant and involved parenting. Conclusion: Results highlight the importance of cumulative risk during early childhood, and particularly the effect that the level of contextual risk can have on the parenting context during this developmental period. Keywords: Cumulative risk, parenting, externalizing problems, internalizing problems, behavior problems, risk factors, family functioning, longitudinal studies, prevention. [ABSTRACT FROM AUTHOR]

Seven hundred thirty-one income-eligible families in 3 geographical regions who were enrolled in a national food supplement program were screened and randomized to a brief family intervention. At child ages 2 and 3, the intervention group caregivers were offered the Family Check-Up and linked parenting support services. Latent growth models on caregiver reports at child ages 2, 3, and 4 revealed decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the intervention condition improved on direct observation measures of caregivers' positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children's early problem behavior. [ABSTRACT FROM AUTHOR]

A collaborative action research project, undertaken by St Luke's Anglicare and La Trobe University's Social Work Department, guided the development of a dynamic agency-wide research culture. The research project began in early 2003, with the aim of identifying key factors and barriers in the development of a research culture and exploring ways to maximize the agency's capacity to carry out research and enhance a 'culture of inquiry'. The outcomes of the research project gave clear directions for the continued development of the research culture at St Luke's. The research facilitated an understanding of how a human services organization might define itself in relation to research, and helped clarify core research strengths and capabilities. The project demonstrates the use of action research as a methodology that clarifies and enhances the processes of planning, reflection, evaluation and practice improvements DL not only in regards to the collaborative research project itself but also in relation to the practical elements of establishing a holistic research vision. [ABSTRACT FROM AUTHOR]

By 2020, an estimated 2.3 million South African children will be orphaned by HIV/AIDS (Actuarial Society of South Africa, 2005), but little is known about risk and protective factors for their emotional and behavioural well-being. This qualitative study explores perspectives of affected families. Orphaned children (n = 60), caregivers of orphaned children (n = 42) and social care professionals (n = 20) completed semi-structured interviews and focus groups. Participants were recruited from schools, shelters and welfare services. Findings from multiple sources indicate potential risk and protective factors in a range of dimensions, including bereavement, family functioning, social support, poverty, access to education and perceived stigma. Many factors reflected international literature on children experiencing similar stressors (e.g. non HIV/AIDS-related bereavement). However, this study also identified factors which may be specific to this group, notably stigma, abuse and peer factors. Current research is quantitatively testing associations between these identified factors and psychological outcomes. [ABSTRACT FROM AUTHOR]

The objective of this paper is to describe the modelling and some of the offshore test results of the full-scale model of Archimedes wave swing (AWS) at Portugal in 2004. The AWS is a system that converts ocean wave energy into electric energy. A pilot plant of this system has been built. The paper starts with the derivation of a model for the floater motion. Next, the generator system is described and modelled. The generator system consists of a permanent-magnet linear synchronous generator with a current source inverter. Subsequently, test results are presented to validate the models for the floater motion and the generator. Finally, some conclusions are drawn. [ABSTRACT FROM AUTHOR]

Background: Clinical neonatal hip screening is performed to identify hip instability and the increased risk of later hip subluxation and dislocation. However, there is minimal information regarding the costs of such screening to parents and health services. The aim of this study was to assess these costs in association with the use of ultrasonography for the diagnosis and management of neonatal hip instability.Methods: We conducted a prospective economic analysis in conjunction with a randomized clinical trial (the Hip Trial), for which 629 patients were recruited from thirty-three centers in the United Kingdom and Ireland to be randomized to undergo either ultrasonographic hip examination (314 patients) or clinical assessment alone (315 patients). Information on clinical outcomes was obtained from hospital records and records from the Hip Trial. Resource information was obtained from hospital records and from repeated periodic cross-sectional surveys of the families. Typical unit costs were applied to resource information to obtain a cost per patient, and the mean costs in the two study groups were calculated and compared.Results: The average overall health-service cost per patient (and standard deviation) was $1298 +/- $2168 in the ultrasonography group and $1488 +/- $2912 in the group that underwent clinical assessment alone, a net difference of -$190 (95% confidence interval, -$630 to $250). Families in which the infant was examined with ultrasonography had significantly lower costs associated with splinting: $92 compared with $118 in the group that underwent clinical assessment alone, a mean difference of -$26 (95% confidence interval, -$46 to -$6). Costs associated with surgery and total costs to the family were also slightly, but not significantly, lower in the ultrasonography group.Conclusions: Our results suggest that use of ultrasonography in the management of neonates with clinical hip instability is unlikely to impose an increased cost burden and may reduce costs to health services and families. [ABSTRACT FROM AUTHOR]

Working with clients to notice change is a key issue in working in mental health services. In 2001, St Luke's Recovery Focused Mental Health Team initiated a project to develop strength-focused tools for measuring change for people using mental health recovery programs. A partnership was formed with La Trobe University Bendigo's Social Work Department. Consumers, carers and staff were involved in exploring what kinds of change it was helpful to notice and what helped people to notice change. Comments reinforced existing literature about what is important to notice and suggested the importance of having tools that allowed expression of consumer differences. Two tools were developed and trialled. From the feedback, these were refined and a third tool developed. The combination of tools allowed consumers to choose a tool that suited their style of noticing change and provided information for the agency about overall outcomes. [ABSTRACT FROM AUTHOR]

Background: The hip trial aimed to assess clinical effectiveness, economic and psychosocial costs, and benefits of ultrasound imaging (US) compared with conventional clinical assessment alone to guide the management of infants with neonatal hip instability. Objective: To report on psychosocial consequences for mothers and the developing mother-child relationship of US, and associations between abduction splinting and maternal psychosocial distress. Design: Multi centre randomised control led trial. Sewing: Thirty three hospitals in the United Kingdom and Ireland. Participants, interventions: A total of 629 infants with neonatal hip instability randomised to US examination or clinical assessment alone before treatment decision. Questionnaires were completed by 561 (89%) mothers at 8 weeks and 494 (79%) at 1 year. Main outcome measures: Anxiety, postnatal depression, parenting stress assessed by standardised questionnaires. Maternal concerns about hip problems were assessed using the Infant hip worries inventory. Results: At 8 weeks, there were no differences between US and non-US groups of the trial in maternal anxiety (mean difference (MD) -1.2, 95% confidence interval (CI) -3.2 to 0.8), depression (MD 0.0, 95% CI -0.7 to 0.8), parenting stress (MD -1.2, 95% CI -2.8 to 0.4), or other measures. The same pattern was evident at 1 year. In an explanatory analysis, early splinting was associated with increased anxiety at 8 weeks (MD 3.8, 95% CI 1.7 to 5.9) and increased level of hip worries at 8 weeks (MD 6.8, 95% CI 5.6 to 7.9) and 1 year(MD 1.3, 95% CI 0.3 to 2.4). Conclusions: Although early splinting is associated with maternal anxieties, US is not associated with any increase or reduction in psychosocial effects on mothers. Together with the clinical findings, this suggests that the use of US allows reduction in splinting rates without increased risk of adverse clinical or psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Evaluates the health and performance of teenagers who were born before 29 weeks gestation. Characteristics of teenagers who were responders and non-responders; Impact of being born at extremely low gestational age on functioning in young adult life among peers.

Objective: To investigate whether difficulties are experienced in the interaction between infants with congenital heart disease and their mothers and to identify infants who show compromised emotional development, in order to offer intervention during the early stages of postoperative compensatory growth.Methods: 20 infants and their mothers were compared with 20 non-cardiac mother-infant pairs. Infants were filmed in interaction for 30 minutes two days before and six months after corrective surgery. Fifteen minutes of film were analysed in 180 5-s units. The emotional tone (affect) and the interpersonal engagement were classified as positive or negative by prespecified criteria. The percentages of positive scores were analysed. The mental health of the mothers was also assessed.Results: Cardiac infants showed less positive affect and engagement than the noncardiac group at both sessions. There was no correlation between of positive affect or engagement and the severity of the condition in either group. Cardiac mothers showed less positive affect and engagement than the comparison group, and were psychologically distressed at both sessions. The engagement scores of the mothers of the cardiac infants were also more variable.Conclusions: Cardiac infants and their mothers have lower levels of positive affect and engagement than non-cardiac mother-infant pairs. Thus some mothers are unable to adapt to their infant. This leads to disordered interaction which is maintained at six months. This information can be used to offer intervention during the early stages of postoperative compensatory growth. [ABSTRACT FROM AUTHOR]

Following a review of thermodynamic processes in a generalized fossil-fuelled power system, the theoretical efficiencies of systems based on the isothermal oxidation of methane are discussed. The fuel cell is introduced as a device that converts the change of Gibbs free energy (ΔG) in isothermal oxidation directly to electricity. Ideal efficiencies of fuel cell systems are presented. The Gibbs free energy change in isothermal oxidation of methane is 99 per cent of its lower heating value (LHV). However, direct electrochemical oxidation is not practical yet. Taking this and other factors into account the reversible electrical work from an internally reforming fuel cell could represent ∼79 per cent of the lower heating value at 600 °C, falling to ∼67 per cent at 1000 °C. With a bottoming heat engine the combined reversible work could be >80 per cent of LHV over this range. Adding such a device as a topping element to a conventional heat engine based system seems a logical next step in the evolution of the efficient fossil-fuelled power plant. [ABSTRACT FROM AUTHOR]

This report describes the occurrence of splenic lymphoma with villous lymphocytes (SLVL) in a 56 year old white female with a family history of chronic lymphocytic leukaemia. Other unusual features included a marked lymphocytosis with counts up to 224 x 10(9)/l and marked clumping of lymphocytes in EDTA anticoagulated blood. The neoplastic cells were CD19+, CD20+, CD22+, CD22+, IgM+, lambda+, kappa-, CD5-, and CD10-. The spleen had nodular infiltrates of B lymphocytes in the region of the white pulp with minimal red pulp involvement. Electron microscopy of peripheral blood lymphocytes revealed cells with polar cytoplasmic processes. This report underlines the need for detailed analysis, including morphology and immunophenotyping, for each patient with a small B cell lymphoproliferative disorder. [ABSTRACT FROM PUBLISHER]