bluuebunny/crossref_metadata_2025 huggingface dataset:
Moving Beyond the Individual: Examining the Effects of Domestic Violence Policies on Social Norms
Authors: Salazar Laura F. , Baker Charlene K. , Price Ann W. , Carlin Kathleen
Published: November 2003

To be effective, criminal justice policies should affect the underlying social norms for which the policies were enacted. This study sought to determine whether public perceptionsof criminal justice policies on domestic violence affected social norms. Two waves of data were collected via a telephone survey where a random probability sample of 973 residents was drawn from 4 communities. A structural equation model was tested and confirmed. Results provided strong support for the hypothesis that perceptions of criminal justice policies have direct effects on attitudes toward criminal justice response, and indirect effects on victim‐blaming attitudes, both underlying social norms related to domestic violence. The enactment of criminal justice policies, therefore, may have an impact beyond victims and perpetrators and lead to a transformation of the community through the emergence of new social norms. Public awareness campaigns designed to disseminate criminal justice policies may be instrumental in provoking social change.
Using the ESID Model to Reduce Intimate Male Violence Against Women
Authors: Sullivan Cris M.
Published: November 2003

Described how the Experimental Social Innovation and Dissemination (ESID) model was successfully used to reduce intimate male violence against women. Following the principles of ESID, the experimental social innovation involved providing trained paraprofessional advocates to work one‐on‐one with women who had been assaulted by partners or ex‐partners. Advocates worked with women for 10 weeks, assisting them in obtaining needed community resources such as legal assistance, housing, education, and employment. Two hundred seventy eight women who had exited a domestic violence shelter program were randomly assigned to the experimental or control condition. Participants were interviewed 6 times over a period of 2 years: pre‐ and postintervention (10 weeks later), and at 6, 12, 18, and 24‐month follow‐up. Women who received the intervention reported less violence over time as well as higher social support and perceived quality of life. The relevance of the ESID model in addressing this as well as other significant social problems is discussed.
HIV, Sex, and Social Change: Applying ESID Principles to HIV Prevention Research
Authors: Fernández M. Isabel , Bowen G. Stephen , Gay Caryl L. , Mattson Tiffany R. , Bital Evelyne , Kelly Jeffrey A.
Published: November 2003

The HIV epidemic has been the most significant public health crisis of the last 2 decades. Although Experimental Social Innovation and Dissemination (ESID) principles have been used by many HIV prevention researchers, the clearest application is the series of model‐building and replication experiments conducted by Kelly and colleagues. The model mobilized, trained, and engaged key opinion leaders to serve as behavior change and safe‐sex endorsers in their social networks. This paper illustrates how ESID principles were used to develop, test, and disseminate an innovative social model and discusses the challenges of applying ESID methodology in the midst of a public health emergency.
Assessment and Aftercare for Deliberate Self-Harm Patients Provided by a General Hospital Psychiatric Service
Authors: Haw Camilla , Hawton Keith , Whitehead Linda , Houston Kelly , Townsend Ellen
Published: November 2003

Summary: We report on a sample of 135 deliberate self-harm (DSH) patients who were assessed by a general hospital DSH service, and on those who were offered aftercare by, or telephone open access to, the service. Patients' satisfaction with assessment and treatment, and their outcome were investigated at follow-up 12-20 months later. Four-fifths of patients reported the assessment following DSH to have been helpful and the assessor sympathetic. Thirty-three (24%) of the 135 patients assessed were offered treatment by the DSH service but 13 declined or failed to attend. Of the 20 who engaged in treatment, 17 (94%) were satisfied with their care. Open access to the DSH service by telephone was offered to 53 (39%) patients, nine (22%) of whom reported at follow-up that they had used this facility. A specialist DSH service can effectively assess and treat patients following DSH. It is important that the service is accessible and acceptable to patients.
Influence of diurnal heating on stratification and residual circulation of Georges Bank
Authors: Chen Changsheng , Beardsley Robert C. , Franks Peter J. S. , Van Keuren J.
Published: November 2003

The influence of the diurnal heat flux on summer stratification and residual circulation over Georges Bank was examined using a three‐dimensional primitive equation numerical circulation model. For a given spatially uniform and time‐varying heat flux the model results show that the surface water is heated much faster on the southern flank than on the northern flank and much faster in the stratified region than in the mixed region. Heating significantly strengthens the tidal mixing front and intensifies the frontward convergence near the surface. As seasonal stratification develops, the location of the tidal mixing front gradually shifts on bank on the southern flank, while remaining almost unchanged on the northern flank. Response of the tidal currents to the diurnal variation in the heat flux varies across Georges Bank. It changes periodically with tidal cycles on the southern flank but is locked to the phase of the eastward tidal current on the northern flank. This phase‐lock feature directly contributes to the intensification of the along‐bank residual current jet on the northern flank. Diagnostic analysis suggests that this intensification is mainly caused by the heat‐enhanced, cross‐bank momentum flux. Model‐computed variations of near‐surface temperature and residual currents are in good agreement with satellite‐derived sea surface temperature data and drifter measurements.
The effect of vegetation on surface temperature: A statistical analysis of NDVI and climate data
Authors: Kaufmann R. K. , Zhou L. , Myneni R. B. , Tucker C. J. , Slayback D. , Shabanov N. V. , Pinzon Jorge
Published: November 2003

We use statistical techniques to quantify the effect of interannual variations in vegetation within land covers on surface temperature in North America and Eurasia from satellite measures of surface greenness and ground based meteorological observations. During the winter, reductions in the extent of snow cover cause (in a statistical sense) temperature to rise. During the summer, increases in terrestrial vegetation within land covers cause (in a statistical sense) temperature to fall. Temperature‐induced increases in vegetation have slowed increases in surface temperature, but this feedback may be limited by the range over which temperature has a positive effect on vegetation.
Thrust fault vergence directions on Mars: A foundation for investigating global‐scale Tharsis‐driven tectonics
Authors: Okubo Chris H. , Schultz Richard A.
Published: November 2003

Insight into the mechanical and thermal structure of the Martian lithosphere and the character of Tharsis‐driven tectonics is gained from detailed mapping of the global distribution of thrust fault vergence directions with respect to the center of the Tharsis tectono‐volcanic province. Our results reveal sub‐equal frequencies of thrust faults that verge away from and toward Tharsis. Based on the observed distribution of thrust fault vergence directions, we conclude that the base of the Tharsis load was effectively welded, by frictional and cohesive strength, to the subjacent Noachian crust throughout its periods of sustained volcanism and faulting during the late Noachian to early Hesperian, rather than being detached along a ductile layer at its base.
Leptons with energy >200 MeV trapped near the South Atlantic Anomaly
Authors: Fiandrini E. , Esposito G. , Bertucci B. , Alpat B. , Ambrosi G. , Battiston R. , Burger W. J. , Caraffini D. , Cecchi C. , Di Masso L. , Dinu N. , Ionica M. , Ionica R. , Lamanna G. , Pauluzzi M. , Menichelli M. , Zuccon P.
Published: November 2003

Accurate measurements of electron and positron fluxes in the energy range 0.2–10 GeV have been performed with the Alpha Magnetic Spectrometer (AMS) at altitudes of 320–390 km in the geographic latitude interval ±51.7°. We focus on the fluxes measured in the regions nearby the South Atlantic Anomaly, defined by the local magnetic values of the magnetic field B (0.21 ≤ B ≤ 0.26 G) at the altitude of AMS. A clear transition from the Stably Trapped population typical of the Inner Van Allen belts to Quasi‐Trapped population in the regions underneath the Van Allen belts is observed. The high energy observations demonstrate the relatively higher abundance of positrons in the Inner Van Allen belts, for both the Stably Trapped and the Quasi‐Trapped populations. The flux maps as a function of the canonical adiabatic variables L, αo are presented for the interval 0.95 < L < 3, 0° < αo < 90° for electron energies below 10 GeV and positrons energies below 3 GeV. The results are compared with existing data at lower energies.
Women in families: feminist therapy and family systems*
Authors: Osborne Kate
Published: November 2003

Current family therapy has as its basis the concept of the family as a system. Systems theory has developed a set of explanations that are frequently functional in nature; they are often applied as though they assume that within a system a common goal is worked towards as in biological systems. For example, the concept of homeostasis is used in much the same way as Cannon (1929) used it to describe the mechanisms of stability within biological systems such as body temperature regulation. Here all the components of the system co‐operate to maintain body temperature within certain limits.

This functional assumption of a common aim amongst components of a system to achieve balance should be compared with a pluralist systems analysis which does not assume such commonality of goals. For example, a pluralist analysis could highlight the conflict inherent amongst different subsystems when one subsystem has more power than the other. At a theoretical level it can be seen that family systems theory has restricted itself to a limited set of assumptions about the explanatory concepts it uses. An analysis of women's psychology which has emerged through the developments of feminist therapy can enrich the theory and practice of family therapists.
The labours of Hercules: some good reasons why social workers should not try to be different, and practice family therapy
Authors: Adams Roger , Hill Gordon
Published: November 2003

Family therapy, despite being an approach to problems in a social context, has, for the most part, been developed and refined in medical settings (Adams, 1979). Family therapy propounds a methodology based on social rather than medical techniques of intervention. It is logical to suggest that workers based in socially‐orientated agencies, rather than medical settings, could be predicted to be better placed to utilize and develop this particular approach to human problems. How can it be explained that the main bulk of the innovations are still coming from practitioners who have trained primarily in medical approaches and settings? This article looks at some of the reasons why family therapy practice and development is not flourishing in Social Services Departments as it is in, for example, hospitals and clinics. The authors do not offer any positive conclusions at this stage, but will show, in a later publication, what has been achieved in some Social Services Departments, and how practice has been established despite the organizational and operational constraints implicit in the introduction of a family, or systems orientated method, to an agency traditionally and statutorily focused upon the individual.
Psychoanalysis and family therapy: Freud's Dora case reconsidered
Authors: Holmes Jeremy
Published: November 2003

Freud's Dora case is considered from the perspective of family therapy. Her illness is homeostatic; it holds two disturbed fractured families together. Freud considered his analysis a failure; from a systems point of view it was a partial success. His challenging technique is similar to that of modern family therapists. The theories of change underlying family therapy and psychoanalysis are compared. There are many similarities. They are mutually compatible disciplines, working at different levels.
Marital systems of agoraphobic women: contributions of husbands' denial and projection
Authors: Hafner R. Julian
Published: November 2003

The problems of measuring psychological concepts such as repression and denial are discussed in the context of the marital systems of agoraphobic women and the credibility of a couples approach to treatment. Repression, denial and projection in husbands were inferred from systematic measurement of mood, hostility and symptom changes after intensive behaviour therapy for the agoraphobia. The results suggested that the agoraphobic symptoms of about half of the women were reinforced by their husbands' habitual denial of affect and of personal problems; in this group, worthwhile symptomatic improvement occurred only in those women whose husbands relinquished repression and denial as major defence mechanisms, acknowledging their own personal problems, and allowing the patients to take more responsibility for their agoraphobia. The marital systems of the remaining couples were characterized by incompatible ways of dealing with hostility, with husbands' abnormal extrapunitiveness reinforcing patients' self‐blame, which inhibited problem‐solving and hence indirectly perpetuated the agoraphobia.
The psychosomatic family model. A critical analysis of family interaction concepts
Authors: Kog Elly , Vandereycken Walter , Vertommen Hans
Published: November 2003

The psychosomatic family model of Minuchin and his colleagues is one of the best known and influential viewpoints in the field of family therapy. This article critically analyses this model and related concepts, focusing on the lack of clear definitions, especially with regard to the interactional concepts: enmeshment, rigidity, overprotectiveness, and lack of conflict resolution. Each concept is discussed, concluding with the recommendation of a new definition, so that the model can be empirically verified. The authors suggest that Minuchin's model can be reduced to three fundamental interactional dimensions: the intensity of intrafamilial boundaries, the degree of the family's adaptability, and the family's way of handling conflicts. A research method is presented in which the way of assessing these interactional dimensions is demonstrated.
Beyond the family; using network meetings with statutory child care cases
Authors: Dimmock Brian , Dungworth David
Published: November 2003

This article describes and discusses the use of network meetings in child care cases. It draws on the literature of network therapy and family therapy and adapts it to a new setting. It describes two cases in detail and raises questions about the limitations of family therapy to the development of systemic thinking. It also includes a practical guide to the use of network meetings.
Family sculpting: II. Some practical examples
Authors: Hearn Jeff , Lawrence Marilyn
Published: November 2003

This paper reviews a number of practical examples of family sculpting to illustrate possibilities for its use described in a general way in an earlier companion article (Journal of Family Therapy (1981) 3: 341–352). Examples are considered first in relation to generic practical possibilities for sculpting: structural analysis and diagnosis, the inescapability of the concrete, the portrayal of ambiguity. A second set of examples is considered in relation to major practical contexts of sculpting: with children, with students, with workers. The paper concludes with a discussion of the complexity of family sculpting and a comparison of the structural interpretation of sculpting offered here with Papp et al.'s notion of choreography.
The madman theory of war: a possible application in therapy
Authors: Birch Jim
Published: November 2003

In therapeutic work a systemic approach has characteristically focused on the family or marital system. In this paper the author focuses on the patient/health care system in a particular case and argues that chronic disability can be seen as a systemic feature rather than a characteristic of the individual patient. A strategy is taken from the field of international conflict and its therapeutic value is explored.
On doing research: the dream and the reality
Authors: Gale Anthony
Published: November 2003

The principal concern of this essay is to offer practical and personal guidance to professional therapists who wish to engage in research in family therapy. It is not a paper about research design or experimental/observational/survey methods; rather the focus is upon the experience of engaging in research. It attempts to destroy a few common myths about researchers, research, and the motives of researchers and those whom they research. Research is seen as a continuing and evolving process (rather than a product) which can intrude in many aspects of the individual's life; it can affect motives, working relationships, organizational composure, personal family life, and personal self‐esteem. Research is thus like most other forms of employment. Research, as an activity, must be seen in terms of systems dynamics, resistance to change, and hopefully, in terms also, of self‐actualization and the refreshment of professional parts that other addictions cannot reach.

Recommendations are made for the structuring of research activity, in the light of the research model presented.
The image and visual analysis of the geneogram
Authors: Heinl Peter
Published: November 2003

The image and visual analysis of geneograms (family trees) drawn by subjects during the course of experiential seminars is described. Case examples are given which suggest that the visual features of the geneogram may provide useful pointers towards the exploration of relevant individual and family issues. Theoretical issues and the potential for further application of the technique in clinical practice are discussed.
Change: How do we recognize it?
Authors: Dallos Rudi , Aldridge David
Published: November 2003

The paper seeks to examine the working assumptions that guide us as therapists engaged in the attempt to facilitate change in families. It summarizes a piece of preliminary research based on the responses of a group of therapists working in different agencies. A questionnaire on change was developed and given to the therapists followed by a group discussion.

The results suggest that therapy teams, and families, have common sense ideas about:

the beginning, and end of a period of change;

types of change—those falling into four categories; of behavioural, structural, communication and experiential.

Our results suggest that difficulties in therapy may be associated with a failure amongst the therapists in a team to negotiate their mutual assumptions about change. In addition the process of therapeutic change is seen as involving a negotiation between the family and the therapists about what will count as change.

The data were gathered from a group of therapists attending a local meeting of the Association for Family Therapy in Plymouth.
Intensive family intervention in a community consultation framework
Authors: Shalit Erel , Davidson Shamai
Published: November 2003

This article describes a form of mental health consultation to community workers who have reached a state of crisis in their work with unmotivated, multi‐problem families. The central part of the consultation is a therapeutic intervention that draws on principles of time extension and network intervention. The consultant sees the family together with its community workers in a one‐time, intensive meeting of up to six hours duration. This meeting is divided into three phases, aimed at achieving respectively (1) structural, (2) emotional, and (3) cognitive imbalancing of the family system. This creates a new situation, which hopefully will enable the community workers and the family to move out of the crisis in which they had become stuck.
Violence in the family—an attempt to apply contemporary theories of non‐violent action and conflict resolution skills
Authors: Latham Tony
Published: November 2003

Recognizing the influence of ideologies on approaches to violence in the family, the author has sought to set this violence in the context of a violent society. In this same society, however, there has also evolved in recent years a range of concepts related to non‐violent problem‐solving. Examining some of these concepts the author considers the possibility of applying them to family situations as a way of developing skills useful to the family but also relevant in other life conflicts.
Family therapy in a community mother and toddler project
Authors: Koziarski M. , Hodgson S. , Nicol A. R.
Published: November 2003

A home centred family therapy approach is described based on the McMaster model. This approach was applied in a controlled trial of three forms of intervention for mother and toddler problems. In this paper the experience of applying the approach is reported.
Evaluating family therapy: a comparison of the Milan and problem solving approaches
Authors: Bennun I.
Published: November 2003

This paper describes a study comparing the Milan approach with problem solving family therapy. Twenty families were assigned to one of the treatments and data were collected assessing symptomatic (first order) and systemic (second order) changes. The results showed that families in both treatment groups achieved favourable changes in their presenting symptoms. Those families receiving the Milan approach showed a statistically significant improvement in second order changes compared with the problem solving group. Issues relating to treatment outcome, first and second order changes and methodology are presented.
Monosymptomatic hysteria in childhood, family and professional systems involvement
Authors: Goodyer I. M.
Published: November 2003

A conceptual framework for understanding childhood hysteria is presented. A family orientation for evaluating the relative contributions of the child, family and professionals is used, incorporating five previously described psychological concepts (abnormal illness behaviour, identification and imitation, family myths, childhood predicament, locus of control). Three case histories are presented to illustrate the clinical method and to emphasize the need for careful assessment and the avoidance of hastily contrived strategies for treatment. The principles of liaison psychiatry within a paediatric setting previously described in the literature are important factors in the successful management of these families.
Going over the bridge—a practical use of metaphor and analogy
Authors: Bowen Barry , Nimmo Gini
Published: November 2003

This paper deals with the use of metaphor and analogy in systems‐based therapy, with a focus upon a treatment programme developed by the authors. Following a working definition of metaphor and analogy, there is a short description of the setting in which therapy took place before the paper moves on to consider the historical development of the programme. The method is then presented in some detail with reference to a particular case example (‘the bridge’). It is concluded that this approach to therapy provides a way of dealing with a family's difficulties in a ‘safe’, positive and effective way.
Three techniques for the solo family therapist
Authors: Carr Alan
Published: November 2003

Three techniques are described which may be used by family therapists working without the aid of a co‐therapist or team. These are: (1 )the use of a ‘ghost co‐therapist’, (2) the use of the Gestalt therapy ‘empty chair’ technique in developing a systemic hypothesis, and (3) the use of self, the opinions of significant others and research findings to allow conflicting views of the family's dilemma to be presented.
A case of therapy by proxy?
Authors: Simon D. , Vine M.
Published: November 2003

Consultancy was offered to a worker requesting help, because of some concern he felt as to how best to progress with a single‐parent family where a teenage son with a mental handicap wished to move out and establish himself independently. The situation appeared to us to be ‘stuck’, with parent and son engaged in a mutually distressing cycle of antagonism with both emotional and physical violence. During the consultancy, communication was established with the parent via messages carried by the worker, and significant change was promoted through these interventions. This work was novel, unusually complex and carried implications for theory, practice and ethics.
Bowling out fears—test victory for double description*
Authors: Durrantt Michael
Published: November 2003

This paper uses a case example to discuss the importance of double description as the basic means by which new information may be gained. Drawing distinctions between different descriptions allows families and individuals to receive and respond to new information whick makes new responses possible. The fact that information, and thus double description, permeates every aspect of therapy is discussed. A detailed examination of a young man's struggle to bowl out his disabling fears illustrates a number of common therapeutic techniques and shows how they may all be understood as examples of double description.
Failures in family therapy: and then what?*
Authors: Kaffmant Mordecai
Published: November 2003

This paper reviews the conceptual framework developed by the author in cases where family therapy has reached a stalemate. Based on his clinical experience as a consultant for some 200 professionals at the Kibbutz Child and Family Clinic in Israel, the author describes several operative strategies applicable in a situation of real or apparent failure of family therapy.
Why are we ‘too busy?’ Problems of practitioner research in family therapy
Authors: Calam Rachel M. , Elliott Peter A.
Published: November 2003

Two psychologists with backgrounds in research who are currently practising family therapy consider the factors that make research a difficult enterprise. Similarities and differences in research and therapeutic processes are considered, including hypothesis formation and testing, the relative precision of research and clinical hypotheses, and the relative needs for promoting consistency or change in research and therapy. The rewards of each for the clinician are considered, together with the importance of institutional attitudes and provision of time and resources for research. The relevance of developments in other areas of psychological theory are considered, and suggestions are made for the forms of research and reporting that may be of greatest value to clinicians at present.
Video reviews
Authors: Speed Bebe
Published: November 2003

The Journal of Family Therapy intends to publish reviews of teaching videos regularly. Anyone wishing to submit videos for review is invited to contact the video reviews editor. Videos are expensive to produce. Their purchase price reflects this, and, where possible, it is recommended to readers that they sample by hiring before buying.
Family assessment: developing a formal assessment system in clinical practice
Authors: Wilkinson Ian , Barnett M. B. , Delf Lynda , Pirie Val
Published: November 2003

In a previous paper, we reviewed the literature on family assessment and set out some principles that can be derived from previous work. This paper describes the development of a system for family assessment which uses these principles and then gives a brief account of the practical difficulties encountered in applying such a system. (Empirical data on the system will be presented in subsequent papers as they become available.)
The individual interview in couples treatment
Authors: Beck Robert L.
Published: November 2003

This paper describes the use of concurrent individual and conjoint sessions in couples psychotherapy. The introduction of these individual interviews is seen as supporting the individual changes which must be made to effect change in the structure of the relationship. The benefits of this interventive scheme in dynamically oriented couples' treatment will be illustrated through the presentation of case examples.
Minor miracles or logical process? Therapeutic interventions and techniques
Authors: McLeod Wayne
Published: November 2003

This paper highlights the construction of Therapeutic Interventions. The ideas presented here, many in the form of techniques, are intended to provide therapists–experienced and not so experienced–with a new focus for problems that are frequently seen in general family therapy practice.

A detailed format has been included on how the author routinely goes about constructing interventions.
What is the question you need to answer? How consultation can prevent professional systems immobilizing families
Authors: Dare Jonathan , Goldberg David , Walinets Renee
Published: November 2003

Consultation to an outside agency is an important part of the work of departments of child and adolescent psychiatry. This article describes and illustrates one particular approach to such consultations based on the principles of structural family therapy. It is premised on the belief that outside agencies have the capacity to arrive at a decision which is in the best interest of their clients. To do this the agency needs to define what is the question they need an answer in order to make a decision regarding their client. The consultants' role is to clarify what decision the consul tee agency needs to make by following up the question, What is the question you need to answer? How this question is followed up is discussed.
Family hypnotherapy: Erickson or systems?
Authors: Fourie David P.
Published: November 2003

This paper argues that Ericksonian hypnotherapy is epistemologically at variance with the systems theory underlying most forms of family therapy. This incompatibility is not often realized, because of other shared assumptions such as focusing on positives, and the utilization of presenting behaviour. The paper highlights the epistemological differences between Systems and Ericksonian thinking and presents the concept of attribution of meaning as a possible way out of the difficulties which arise when these two opposing modes of thought are mixed in therapy.
Family work with victims and offenders in a secure unit
Authors: Robinson Sue , Vivian‐Byrne Sue , Driscoll Rick , Cordess Chris
Published: November 2003

Two examples of family therapy in a secure unit for violent mentally ill offenders are described. The model used incorporated ideas from reparation schemes for victims and offenders in addition to an emphasis on the circumstances of the offence.
Family criticism and self‐starvation: a study of expressed emotion
Authors: le Grange Daniel , Eisler Ivan , Dare Christopher , Hodes Matthew
Published: November 2003

The measure Expressed Emotion (EE) has been established as an exceptionally useful indicator of relapse in people with schizophrenia and depression. EE is now also being applied more broadly for the investigation of other disorders. EE is usually rated by conducting the Camberwell Family Interview, i.e. in the course of separate individual interviews with the relatives of the symptomatic individuals. This paper reports the rating of EE in adolescents with eating disorders within a semi‐structured family schedule ‐ the Standardized Clinical Family Interview. Consecutive referrals for eating disorders were assessed prior to family therapy and again at regular intervals during therapy. EE ratings for this sample, the prognostic value of EE, and the changes in EE that took place during the course of therapy are presented and their clinical implications discussed. The findings suggest that even low levels of Critical Comments from the parents to the anorexic adolescent are associated with continuing symptoms.
Working briefly with reluctant clients: child protective services as an example
Authors: Weakland John H. , Jordan Lynn
Published: November 2003

Therapists and counsellors often are faced with reluctant clients and constraining circumstances. Such difficulties are especially prevalent and severe in casework in child protective services ‐ the parents of abused or neglected children are all involuntary clients, case loads are large, and time is limited.

Drawing on experience in applying and modifying prior work at the Brief Therapy Center of MRI to work in child protective services of a Northern California county, this article suggests general principles for effective intervention in such difficult circumstances and illustrates these with specific case examples.

Since consideration of extreme conditions is often helpful in dealing with parallel but less extreme ones, the authors' aim and hope is that readers will find this article helpful not solely in child protective work but also in the much wider territory where similar obstacles to effective counselling also occur.
The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme
Authors: Petersen Poul Erik
Published: November 2003

Abstract –  Chronic diseases and injuries are the leading health problems in all but a few parts of the world. The rapidly changing disease patterns throughout the world are closely linked to changing lifestyles, which include diets rich in sugars, widespread use of tobacco, and increased consumption of alcohol. In addition to socio‐environmental determinants, oral disease is highly related to these lifestyle factors, which are risks to most chronic diseases as well as protective factors such as appropriate exposure to fluoride and good oral hygiene. Oral diseases qualify as major public health problems owing to their high prevalence and incidence in all regions of the world, and as for all diseases, the greatest burden of oral diseases is on disadvantaged and socially marginalized populations. The severe impact in terms of pain and suffering, impairment of function and effect on quality of life must also be considered. Traditional treatment of oral diseases is extremely costly in several industrialized countries, and not feasible in most low‐income and middle‐income countries. The WHO Global Strategy for Prevention and Control of Noncommunicable Diseases, added to the common risk factor approach is a new strategy for managing prevention and control of oral diseases. The WHO Oral Health Programme has also strengthened its work for improved oral health globally through links with other technical programmes within the Department for Noncommunicable Disease Prevention and Health Promotion. The current oral health situation and development trends at global level are described and WHO strategies and approaches for better oral health in the 21st century are outlined.
Gestational diabetes mellitus: Compliance with testing
Authors: Moses Robert G. , Webb Alison J. , Comber Christine D. , Walton John G. , Coleman Keith J. , Davis Warren S. , McCosker Clive J.
Published: November 2003

An audit of birth records of two public and one private hospital was undertaken, over a 6‐month period, to determine compliance with the local policy that all women are tested for gestational diabetes mellitus (GDM). Overall 92.1% of women were tested for GDM. When those women who delivered their babies early or who had no prenatal care were excluded, then there was 95.3% compliance with the advice for universal testing.
Placental biopsy by frozen section: Does it have a role in evaluation of fetal well‐being?
Authors: Mendilcioglu Inanc , Kilicarslan Bahar , Gurkan Zorlu Cahit , Karaveli Seyda , Uner Mine , Trak Bilal
Published: November 2003

Aim:  To assess the effectiveness of post‐partum placental biopsy and frozen section evaluation in diagnosing pregnancy disorders.

Study design:  Between January and July 1998, biopsies were carried out on 100 newly delivered placentas. Biopsies were carried out using a 14‐gauge needle, and frozen section evaluations were reviewed. These were compared to the standard evaluation of histological evaluation of the whole placenta sections. Specimens were evaluated by standard placental pathologic criteria.

Results:  Villous oedema which is associated with antenatal hypoxia was observed with a sensitivity of 78%, and specificity of 97%, yielding a positive predictive value of 84% in frozen section compared to standard placental evaluation. No statistical difference was observed in the evaluation of dysmaturity, intravillous fibrin agglutination and chronic villitis between frozen sectioning and whole placenta sections. Increased syncytial knots were detected with a sensitivity of 45% and specificity of 98%.

Conclusion:  Placental biopsy by frozen sectioning might be a useful and quick method of evaluation for placental pathology. Theoretically, fetal status could be more precisely evaluated by combining prenatal placental biopsy by permanent section with conservative ante‐partum well‐being tests.
Maternal satisfaction with childbirth and intrapartum analgesia in nulliparous labour
Authors: Dickinson Jan E. , Paech Michael J. , McDonald Susan J. , Evans Sharon F.
Published: November 2003

Objective:  To assess maternal satisfaction with childbirth and intrapartum pain relief in nulliparous women labouring at term.

Methods:  Prospective randomised clinical trial comparing epidural and non‐epidural analgesic techniques on term labour outcomes in nulliparous women. Within 24 h of delivery the women were surveyed regarding their opinions about the birthing experience and the allocated analgesic regimen. A postal survey was conducted 6 months post‐partum to assess opinions about intrapartum analgesia in a subsequent pregnancy.

Results:  A total of 992 women were randomised to receive continuous midwifery support (CMS) or epidural (EPI) analgesia on presentation for delivery. There was a high crossover rate from CMS to EPI (61.2%) and a lesser non‐compliance rate in the EPI group (27.8%). The early post‐partum recollections revealed a high satisfaction with epidural analgesia and lower satisfaction with alternative pain relief measures. Ten percent of women in the CMS group reported negative feelings about their allocated pain relief compared with 1% in the EPI group (P < 0.001), and 10% of all women reported negative feelings about their overall childbirth experience. At the 6‐month post‐partum survey factors associated with the planned use of epidural analgesia in a subsequent pregnancy were induction of labour (odds ratio (OR) 2.4, 95% confidence interval (CI) 1.2, 4.7) and prior utilisation of epidural analgesia (OR 28.1, 95% CI 14.5, 54.7).

Conclusions:  Maternal satisfaction with intrapartum analgesia was significantly higher with epidural analgesia than non‐epidural analgesic techniques. Overall satisfaction scores for labour and delivery were high regardless of analgesic approach, reflecting the multiple issues other than pain relief that are involved in the childbirth experience.
Social Class and Adolescents' Beliefs about Justice in Different Social Orders
Authors: Flanagan Constance A. , Campbell Bernadette , Botcheva Luba , Bowes Jennifer , Csapo Beno , Macek Petr , Sheblanova Elena
Published: November 2003

We report on the justice beliefs of 4508 adolescents from 4 security societies in transition to market economies (i.e., Bulgaria, the Czech Republic, Hungary, and Russia) and from 2 opportunity societies (Australia and the United States). Using a multivariate analysis of variance (MANOVA), justice beliefs were examined as a function of type of society, social class, and gender. In the security societies, working‐class teens wanted the state and schools to provide a safety net, while middle‐class teens preferred that schools promote student autonomy and competition but also reported the most negative school climates of any group. In the opportunity societies, working‐class youth believed success was based on individual merit, while middle class youth expressed more doubt about this connection.
Die “Niederlage der Zivilisation” und der “heulende Triumph der unterdrückten Triebwelt”: Die Erzählung ‘Der kleine Herr Friedemann’ als Modell der Anthropologie Thomas Manns
Authors: Kristiansen Børge
Published: November 2003

Diese Analyse der frühen Erzählung Der kleine Herr Friedemann von Thomas Mann hat zwei Zielsetzungen. Sie will einerseits durch eine hermeneutisch reflektierte close reading zu einem besseren Verständnis des Textes dieser Erzählung beitragen. Dieses Verfahren scheint angesichts der in der sich immer noch primär an der Quellenerforschung interessierten neueren Thomas‐Mann‐Forschung bestehenden Angst vor Textberührung unmittelbar gerechtfertigt zu sein. Um sich aber hermeneutisch legitimieren zu können, blieb eine solche Textanalyse auf den Horizont der strukturell entscheidenden Orientierungen Thomas Manns bezogen. Dadurch konnte nicht nur eine seit Jahren maßgebliche Auslegung dieser Erzählung (G. Kluge: 1967) in ihren grundlegenden Thesen korrigiert, sondern zugleich der Nachweis erbracht werden, wie sich die auch für einen Großteil der viel späteren Werke Thomas Manns verbindliche Anthropologie schon in dieser frühen Erzählung konstituiert. Die Arbeit schließt deshalb mit Überlegungen zur Figurendarstellung der späteren Romane und Erzählungen ab.

Und wenn uns eines Tages dieses Tun Und was an uns geschieht gering erschiene Und uns so fremd, als ob es nicht verdiene, daß wir so mühsam aus den Kinderschuhn um seinetwillen wachsen ‐: Ob die Bahn vergilbter Spitze, diese dichtgefügte blumige Spitzenbahn, dann nicht genügte, uns hier zu halten? Sieh: sie ward getan.

Ein Leben ward vielleicht verschmäht, wer weiß? Ein Glück war da und wurde hingegeben, und endlich wurde doch, um jeden Preis, dies Ding daraus, nicht leichter als das Leben und doch vollendet und so schön als sei's nicht mehr zu früh, zu lächeln und zu schweben. (Rainer Maria Rilke, Die Spitze II)
Relationship between tongue coating and secretory‐immunoglobulin A level in saliva obtained from patients complaining of oral malodor
Authors: Hinode Daisuke , Fukui Makoto , Yokoyama Nozomi , Yokoyama Masaaki , Yoshioka Masami , Nakamura Ryo
Published: November 2003

Aim: The aim of this study was to confirm the relationships between oral malodor and periodontal condition, oral malodor and tongue coating, and to investigate the secretory‐immunoglobulin A (S‐IgA) level in saliva in relation to the accumulation of tongue coating.

Methods: Fifty‐four patients complaining of oral malodor were included in the study. Their periodontal conditions, tongue coating status and salivary characteristics (flow rate, protein and S‐IgA concentrations) were assessed in addition to the level of volatile sulfur compounds (VSC) in oral cavity. The patients were divided into three groups according to their tongue coating level.

Results: There are significant relationships between oral malodor and specific periodontal parameters used. The degree of tongue coating was also significantly correlated with the amount of H2S, CH3SH and the total amount of VSC determined. The concentration of S‐IgA in the group identified as slight tongue coating was significantly higher than in the moderate or the severe group. By Western immunoblotting analysis, a high level of S‐IgA specific to Streptococcus species was recognized in all groups, whereas the reactivity of Porphyromonas gingivalis and Fusobacterium nucleatum with S‐IgA was very weak in both the slight and the moderate groups.

Conclusion: Data herein indicate that tongue coating is closely related to oral malodor. Furthermore, S‐IgA in saliva may influence the accumulation of tongue coating, and S‐IgA antibodies directed to Streptococcus species may play a role in protective immunity against the initial colonization of tongue plaque.
Effects of periodontitis and smoking on the microbiota of oral mucous membranes and saliva in systemically healthy subjects
Authors: Mager Donna L. , Haffajee Anne D. , Socransky Sigmund S.
Published: November 2003

Background/aim:  To examine the differences in the proportions of 40 bacterial species in samples from eight oral soft‐tissue surfaces and saliva in systemically healthy adult subjects with and without periodontitis and in smokers and nonsmokers.

Methods:  Saliva and microbial samples were taken from eight oral soft‐tissue surfaces in 229 systemically healthy subjects stratified by periodontal and smoking status. Subjects included 84 periodontally healthy and 145 periodontitis individuals. Of these, there were 182 nonsmokers and 47 smokers. Soft‐tissue samples were taken using a “buccal brush” and saliva was taken by expectoration. All samples were individually evaluated for their content of 40 bacterial species using checkerboard DNA–DNA hybridization. The percentage of total DNA probe count was determined for each species at each sample location and averaged across subjects. The significance of differences among the proportions of the 40 test species at different sample locations was sought in these populations using the Kruskall–Wallis test and adjusted for multiple comparisons.

Results:  When stratified for periodontal status or smoking status, microbial profiles at most sites did not differ significantly. Generally, periodontal pathogens were found at higher levels on the soft tissues of periodontitis subjects than in periodontally healthy subjects, and at higher levels in smokers than nonsmokers. Few significant differences were found, although trends in the populations were noted.

Conclusions:  Small differences in the proportions of bacterial species were observed on soft tissues and in saliva comparing periodontally healthy and periodontitis subjects. Somewhat greater differences between smokers and nonsmokers were found; however, these were not statistically significant.