A systematic review of interventions to promote social support and parenting skills in parents with an intellectual disability.

The family support needs of parents with an intellectual disability (ID) are relatively unknown. This paper reviewed two types of intervention for parents with ID: those designed to strengthen social relationships and those teaching parenting skills. A literature search was conducted using electronic databases and a limited number of evaluative studies were found. The evidence for interventions aimed at strengthening social relationships was inconclusive; although positive changes were observed, there were limitations in study design which restricted the generalizability of the results. The evidence for parental skills teaching suggested that behavioural based interventions are more effective than less intensive forms such as lesson booklets and the provision of normal services, although these studies also had limitations. There is a need for further large scale controlled studies in this area to provide clearer evidence and to explore additional factors relating to child, parent and family which may impact on outcomes.

A survey of trainees' opinions and current clinical practice after behaviour therapy training.

The widespread use of cognitive behaviour therapy principles in psychiatric/mental settings has been an ongoing feature of health and social care since at least the 1960s. The current study evaluated the training process as well as the use of the skills by course participants on a dedicated behaviour therapy course in Ireland. A cross sectional study was undertaken, using postal distribution of a questionnaire based on a similar study undertaken in the UK. The sample comprised all graduates of the course from 1986 to 1999 (N = 257). Thirty-three per cent of respondents report using their behaviour therapy skills to a high level since completion of the course. Approximately 53% of respondents reported having changed job since completion of the course. Significant differences emerged within this group in relation to their ratings of the importance of various elements of the course and also in relation to the perceived enhancement of both general clinical skills (P = 0.000) and specific behaviour therapy skills (P = 0.000) as well as the rating of current skills (P = 0.015) and the respondents' use of behaviour therapy since completing the course (P = 0.015). While a high proportion of participants had some prior theoretical or experiential exposure to behaviour therapy, the findings report high satisfaction levels with the training they received. However, the survey signals deficits in terms of the usage of the skills. While on the one hand, the general and specific skills acquired while on the course seem to transfer quite easily across functions and levels of responsibility, it is of concern that over a 13-year period, only 17% of respondents indicated that behaviour therapy was the main focus of their work. The implications of these findings are discussed in relation to policy and practice issues.

The Impact of Iatrogenically Acquired Hepatitis C Infection on the Well-being and Relationships of a Group of Irish Women.

The views of 32 women with iatrogenic Hepatitis C on its impact on their sense of wellbeing were elicited through focus groups. The views obtained were analysed using 'interpretative phenomenological analysis'. Accounts of profound fatigue, reactive depression, and deterioration in cognitive functioning predominated. Work outside and inside the home was severely curtailed or stopped. Marital relationships were affected, sometimes adversely, as were relationships with children and other family members. Participants experienced a general lack of understanding of their level of disability, yet also felt the need to shield others from worry. Overall results suggested that participants' compromised health was having a major impact on their sense of identity.

Is there a role for compliance in the assessment of insight in chronic schizophrenia?

Current work on insight focuses on its assessment, a trend that is reflected in the inflation of newly-developed scales. Most scales assess compliance with treatment, recognition and acceptance of mental illness and relabeling of abnormal mental experience as pathological. A handful of studies indicate that compliance is weakly to moderately correlated with awareness of illness and relabelling of symptoms in acute samples. As the parameters of compliance differ between acute and chronic populations, this study investigated the relationship between the three components using the Schedule to Assess the Components of Insight in 78 outpatients with chronic schizophrenia. A weak positive correlation was found between acceptance of illness and relabelling. However, compliance was not reliably related to either the awareness or relabelling component. As the incidence of non-compliance in the present sample did not differ from comparable populations, it appears that non-compliance does not account for these findings. Non-compliance may be viewed as an evaluation of the costs and benefits of treatment on daily living rather than an insight deficit. The lack of a reliable relationship between compliance and insight suggests that the two phenomena should be viewed as distinct constructs and assessed separately in chronic schizophrenia.

Child seduction and self-representation on the Internet.

This paper presents a case study of a man charged with the offense of downloading child pornography from the Internet. He had used the Internet to traffic child pornography, and, in addition, to locate children to abuse, to engage in inappropriate sexual communication with children, and to communicate with other pedophiles. Such offenses were facilitated by self-representing in Chat rooms as both a child and an adult. The case study illustrates how such offenders move through a repertoire of offending behavior and discusses the role that the Internet can play in supporting inappropriate and disinhibited sexual behavior that victimizes children through the trading of child pornography and possible child seduction. The Internet is seen to play a unique role in allowing individuals to self-represent aspects that might otherwise remain hidden or dormant.

Stress in psychiatric nursing: fact or fiction?

Psychiatric nurses are not as stressed in their work as most research seems to indicate. The stress that does exist relates to organisational, rather than work-related matters. However, this study recommends that further investigations need to be conducted to address the needs of those who are reporting unacceptably high levels of stress.

A comparison of the in-vitro activity of antimicrobials against Chlamydia trachomatis examined by Giemsa and a fluorescent antibody stain.

Minimum concentrations for the inhibition of normal chlamydial inclusions (MICN) and abnormal inclusions (MICA) were obtained for a range of antimicrobials titrated against Chlamydia trachomatis in McCoy cell cultures. Each antibiotic titrated produced an MICN which was the same whether examined by Giemsa or fluorescent antibody staining methods (rifampicin 0.007 mg/l, tetracycline, erythromycin and penicillin 0.062 mg/l, chloramphenicol and spiramycin 0.25 mg/l, ciprofloxacin 1.0 mg/l, and cycloserine 250 mg/l). With the exception of penicillin the MICA (Giemsa) was between two- and four-fold higher than the MICN, and the MICA (fluorescent antibody) a further two-fold higher. Penicillin was alone in the wide concentration range over which abnormal inclusions were detected (0.0062 mg/l to 5 g/l).