Family Goals Research Articles

How do we capture child and family goals? Examining the goal setting practices used by community-based allied health professionals

Purpose This study aimed to i) identify child and family goals reported in a community allied health service, ii) map goals to ICF domains, and iii) evaluate goal characteristics against child-centred and family-centred practice principles. Methods A retrospective study design was used to extract and analyse raw goal data documented for children and families accessing a community-based allied health service. ICF linking rules were used to map goals to the ICF domains. A study-specific goal rating criterion was used to examine the extent to which child-centred and family-centred practice principles were evident in documented goals. Results 355 goals were documented for 181 children (aged 0 < 12 years). The most common goal domain was ‘Body Functions’ (57%), following by Activity and Participation (33%), then Environment (9%). Few participation-focused goals were reported (4%). Documentation showed consistent collaboration with caregivers, however, minimal information for children. Goals were often phrased in therapist-specific language without reference to the child or family’s functional context. As a result, many goal records did not meet the child-centred and family-centred criteria. Interpretation Results highlight the critical need for tools and training which can support professionals to collaboratively construct goals, to ensure that documented goals reflect meaningful child and family priorities.

Prohibition of Marriage Between Sundanese and Javanese Tribes

Indonesia is a country full of social and cultural diversity, with each element having a different historical background. One of the stories that became the forerunner of the tradition of prohibiting marriage between Sundanese and Javanese people in the year was the Bubat War between the Majapahit Kingdom and the Sunda Kingdom. The purpose of this research is to analyze the factors behind this prohibition and understand the family's goals in carrying out this tradition. The methodology used in this research is qualitative, by collecting data through literature studies and literature reviews The findings indicate that the prohibition of marriage is influenced by the history of the Bubat War and stereotypes regarding caste differences, where the Javanese are perceived to have a higher status than the Sundanese. The purpose of this prohibition is to prevent the belief that marriages between the two ethnic groups will not last long, as well as to avoid financial issues and maintain household harmony.

Breastfeeding Policies of Otolaryngology Residency Programs

Background: Women entering surgical residencies must determine which programs best fit their career and family goals. The purpose of this study was to determine if breastfeeding policies are available on otolaryngology residency program websites. Methods: A total of 122 publicly available otolaryngology residency program websites were reviewed for the presence of a breastfeeding policy and lactation information. The percentage of residents and faculty that are women in each program as well as the program’s region, size, and affiliation with a top 50 hospital for ear, nose, and throat care were determined. Frequencies and nonparametric analyses were calculated when appropriate. Results: None of the otolaryngology residency programs had a breastfeeding policy posted directly on their website. A link to a Graduate Medical Education (GME) website that contained a breastfeeding policy was present on 20 (16.4%) program websites, and 31 websites (25.4%) had information about lactation facilities on the GME website or another page that could be found through the search bar; 17 (23.0%) of the large residency programs contained the link to the GME website, whereas only 3 (6.25%) of the small programs did (p = 0.015). Residency programs that were affiliated with a top 50 hospital for ear, nose, and throat care were more likely to have a link to the GME website with a breastfeeding policy than those not affiliated (13 [29.5%] vs. 7 [8.9%], respectively; p = 0.003). Conclusion: Otolaryngology residency programs do not provide breastfeeding policies directly on their websites.

The fertility gap and economic freedom

AbstractThe difference between desired fertility and achieved fertility is called the fertility gap. This paper investigates the relationship between economic freedom and the fertility gap across the United States since greater economic freedom may empower individuals to choose work more compatible with their family goals. We test this hypothesis using individual measures of fertility preferences from a nationally representative survey of reproductive‐aged women (2020–2024) and find evidence that women are more likely to achieve their family goals in states with greater economic freedom. This effect is strongest when focusing on variation in labor market freedom.

Development of a minimum data set for a blockchain-based personal health records (PHRs), for patient/physician interaction in family medicine.

The primary requirement for a capable patient health record (PHR) that can interact appropriately with the family medicine system and collect and share qualified data is a minimum data set (MDS) aligned with family medicine's functions and goals. The aim of this research was to determine the MDS for a blockchain-based PHR system that can effectively interact with family medicine providers and collect and share qualified data. This MDS is intended to be applicable to all members of the community covered by family medicine. This applied study was conducted in 2022 in a cross-sectional and descriptive approach in three phases. In the first phase, a content analysis related to the research objectives was conducted in scientific databases, search engines, and websites of the centers and scientific research organizations with publications and policy-making in this field. Consequently, 11 studies were selected for use in the second and third phases. In the second phase, to determine information needs, a researcher-developed questionnaire including 17 classes was given to 50 people under the cover of the family medicine plan in Shiraz city. By choosing one of the two options "Yes" or "No" by them, the necessary data classes were determined. In the third phase, the second researcher-developed questionnaire was designed and administered to 100 family physicians in Shiraz city. This questionnaire included the data elements corresponding to the data classes approved in the previous phase. The family physicians were asked to rate the importance of each data element using a Likert scale with five options, ranging from "very unimportant" to "very important." The necessary data elements were determined based on these scores. In the first questionnaire, 16 of the 17 data classes received approval from individuals covered by the family medicine plan. Consequently, a questionnaire comprising 16 classes and 105 data elements was administered to the family physicians. Ultimately, the MDS was determined to include 16 classes and 72 data elements. Determining essential data elements, especially for patient/physician interaction in family medicine, should be such that they can be managed by the person while being comprehensive and providing sufficient help to the physician during the treatment process. This MDS can be used to interact with and refer PHRs to other physicians and specialists, as well as help interoperability between the PHR and other health systems, such as hospital information systems (HIS) and electronic health records (EHRs).

Individualized Mealtime Routines Support Family-Specific Feeding Goals

Abstract Date Presented 03/23/24 This study aimed to understand how family participation in a caregiver-mediated intervention, Engaged Eaters Program, affected mealtime experiences. Postintervention mealtime changes related to family goals were identified, with limited significance. Primary Author and Speaker: Karla Ausderau Additional Authors and Speakers: Hannah Laufenberg Contributing Authors: Brittany St John, Talia Joseph

Board gender diversity and cash holding: the effect of family ties

AbstractUsing a sample of 630 firm-year observations of non-financial Spanish listed companies for the period 2004–2020, this study examines linkages of family and non-family female directors and cash holding. We show that family and non-family female directors affect cash holdings differently. When the presence of family female directors is scarce, their role is eclipsed, thereby encouraging actions related to family goals and increasing cash holdings. However, when the presence of family female directors reaches a critical mass, the cohesion between the interests of the dominant family and external investors increases, thereby reducing the level of cash holdings. When the number of non-family female directors is low, the cash level of family firms is reduced, suggesting that non-family female directors encourage the family firm’s cash reduction as a result of their greater capacity to control and their orientation towards an effective corporate governance system. This cash-decreasing effect will occur even if the number of non-family female directors is low, since the purpose of appointing non-family female directors is less likely to be symbolic. In addition, non-family female directors are concerned about threats to reputational capital, such that reducing cash holdings would promote their reputation as credible supervisors, protect their current appointments, and also boost the likelihood of future appointments. However, the presence of a critical mass of non-family female directors becomes a sufficiently powerful instrument of control and legitimation for external investors, allowing for increased cash levels without increasing agency conflicts.

Inisiasi Gerakan Desa Keluarga Aktif

Family involvement in the mentoring process is a necessity. The family needs to be placed as the actor or subject. Families design forms of assistance because their basic needs are understood by the family. The family should not be placed as an object that merely receives coaching. The purpose of the community service program consists of two, namely first to initiate an active family village, and second to foster a Blessed, Safe, and Happy family based on Islamic psychology and culture. This service program uses the Sustainable Livelihood Approach (SLA) approach. This approach allows the family as an actor to design a service program. Active family involvement in every activity process. Data collection was carried out using the Participatory Rural Appraisal (PRA) method. Data was collected through a Focus Group Discussion (FGD) process and using a family schedule tool. The results of the program show that firstly the formation of four family development cadre structures, namely Old Age cadres, Youth Family Development Cadres, Integrated Service Post Cadres, and Toddler Family Development Cadres, secondly active family coaching through parenting assistance children through discussion of family goals, family and child needs, the child's personality structure in the perspective of Islamic-Bugis psychology.

Feasibility of a Serious Illness Communication Program for Pediatric Advance Care Planning

Pediatric advance care planning (ACP), which aims to ensure care is aligned with family goals and values, is associated with better end-of-life outcomes; however, ACP in pediatrics remains uncommon. To determine the feasibility and acceptability of the Pediatric Serious Illness Communication Program (PediSICP) and explore family-centered outcomes. This cohort study was a single-group pilot study of the PediSICP in adolescents and young adults (AYAs; age ≥13 y) with serious illness, parents of seriously ill children, and interprofessional clinicians from April 2021 to March 2023 in a quaternary care pediatric hospital. Duration of follow-up was 1 month. Data were analyzed from January 2022 to March 2023. The PediSICP includes clinician training preceding an ACP communication occasion supported by communication guides and a template for electronic medical record documentation. Outcomes of interest were parent, patient, and clinician experiences with and perceptions of the PediSICP. Feasibility was defined a priori as at least 70% clinician intervention completion rates. A total of 10 virtual trainings were conducted among 40 clinicians, including 27 physicians, 7 nurse practitioners, 5 nurses, and 1 respiratory therapist, and 30 trained clinicians (75%) conducted and documented 42 ACP conversations with 33 parents (median [IQR] age, 43 [35-51] years; 25 [76%] female) and 5 AYAs (median [IQR] age, 19 [17-19] years; 3 [60%] female) who completed the intervention. The median (IQR) conversation duration was 27 (10-45) minutes. Most clinicians (29 clinicians [97%]) agreed that they felt prepared for the conversation, and all clinicians recommended the PediSICP. Parents reported participation was worthwhile (27 parents [84%]), they felt listened to (31 parents [94%]), and would recommend the PediSICP (28 parents [85%]). Parents endorsed higher therapeutic alliance after the PediSICP intervention compared with before (The Human Connection scale mean [SD] score, 57.6 [6.4] vs 55.3 [7.8]; P = .03) and decreased anxiety immediately after the intervention (Generalized Anxiety Disorder-7-item mean [SD] score, 10.1 [7.3] vs 8.4 [6.9]; P = .003), which persisted at the 1-month follow-up (mean [SD] score, 7.7 [6.8]; P = .03). This pilot cohort study found that the PediSICP was feasible, acceptable, and highly valued by clinicians and parents of children with serious illness. These findings suggest that the PediSICP may empower interprofessional clinicians and improve ACP with families of children and AYAs who are seriously ill.

The Evolution of Tumor Suppressing Genes in Multicellular Organisms: Nature’s Prevention of Oncogenesis

The p53 gene family, a well-known group of genes, is the primary propagator of tumor-suppressing mechanisms in multicellular organisms. Although they are currently critical drug targets in cancer, the p53 family also serves specific functions in the development of multicellular organisms. In this paper, the current function, origin, and evolutionary purpose of the p53 family are reviewed in the evolution of multicellular organisms. The TP53 gene induces cellular responses such as apoptosis as a way to combat detrimental environmental and cellular factors that can damage the integrity of a cell’s DNA. The other two members of the p53 family are the TP63/TP73 genes. The TP63/TP73 genes are involved in the embryonic development of limbs and the neuronal system, respectively. It has been discovered that these three genes originated as an ancestral gene that later separated individually throughout the evolution of higher functioning vertebrates from invertebrates. The p53 family provides complex networks of tumor-suppressor genes that allow for the prevention of oncogenesis in multicellular organisms. The ultimate evolutionary goal of the p53 family is to preserve the integrity of their organisms from unwanted mutations, which in turn also assists their own fitness. However, the genomic evidence presented in the current literature contains gaps. Further research is needed to fill in these gaps in the genomes of multicellular organisms, in order to have a cohesive understanding of the evolutionary purpose of the p53 family, not only for the benefit of humans but for other species as well.

Conflict and Facilitation Between Work and Family Roles and Goal Realization in Entrepreneurs

Entrepreneurs running their businesses usually pursue goals associated with work and family functioning. The efficiency of goal realization in these two areas of activity varies and may depend on balance between the two domains. The study aimed to answer the question of how interplays between the work and family domains (work-to-family conflict, family-to-work conflict, work-to-family facilitation, and family-to-work facilitation) were related to the realization of work and family goals in entrepreneurs. It also tested if sex was a moderator of these relationships. A total of 246 entrepreneurs participated in the study; they were married or in stable non-marital relationships. Structural equation modeling showed that family-to-work conflict is negatively related to work goal realization and family goal realization, and work-to-family facilitation is positively related to family goal realization. Sex does not moderate the relationships analyzed. The study provides insight into the relationships of conflict and facilitation to goal realization in people running their businesses.

Core Competencies for Serious Illness Conversations: An Integrative Systematic Review.

Objective: The Serious Illness Care Program was developed to support goals and values discussions between seriously ill patients and their clinicians. The core competencies, that is, the essential clinical conversation skills that are described as requisite for effective serious illness conversations (SICs) in practice, have not yet been explicated. This integrative systematic review aimed to identify core competencies for SICs in the context of the Serious Illness Care Program. Methods: Articles published between January 2014 and March 2023 were identified in MEDLINE, PsycINFO, CINAHL, and PubMed databases. In total, 313 records underwent title and abstract screening, and 96 full-text articles were assessed for eligibility. The articles were critically appraised using the Joanna Briggs Institute Critical Appraisal Guidelines, and data were analyzed using thematic synthesis. Results: In total, 53 articles were included. Clinicians' core competencies for SICs were described in 3 themes: conversation resources, intrapersonal capabilities, and interpersonal capabilities. Conversation resources included using the conversation guide as a tool, together with applying appropriate communication skills to support better communication. Intrapersonal capabilities included calibrating one's own attitudes and mindset as well as confidence and self-assurance to engage in SICs. Interpersonal capabilities focused on the clinician's ability to interact with patients and family members to foster a mutually trusting relationship, including empathetic communication with attention and adherence to patient and family members views, goals, needs, and preferences. Conclusions: Clinicians need to efficiently combine conversation resources with intrapersonal and interpersonal skills to successfully conduct and interact in SICs.

Symptom Management in Children Who Are Neurologically Impaired for the Primary Care Medical Home.

Children with neurologic impairment are a growing population of pediatric patients who require care from a large team of physicians to maintain their health. These children often have similar clinical patterns and symptoms that occur because of their neurologic impairment. Families often seek care first from their primary care home to identify and guide initial steps in management. Identifying the symptoms outlined in the 4 cases in this article will help alleviate consequences of delayed care for these patients and provide opportunities for shared decision-making with the family's goals of care for their child. [Pediatr Ann. 2024;53(3):e82-e87.].

A study on work-family life imbalance among women administrators in UAE higher education institutions

The study explored the factors causing work-family imbalance among women administrators in higher education institutions in the UAE and how it affects their personal and organizational well-being. The research found that the existing literature doesn't give enough attention to the mismatch between women administrators' work and family goals. Furthermore, it provides little insight into the integration of work-family support systems. The study applied the Spillover theory to explain that women administrators face significant work-family imbalances that adversely impact their personal well-being and organizational effectiveness. The research also used Facilitation theory to examine how work-family support systems could reduce the adverse effects of work-family imbalances. The study surveyed 271 female administrators working in higher education institutions in the UAE. The findings, presented through structural equation modeling, showed that the demanding nature of research, teaching, and administrative work in higher education and women administrators' professional aspirations in socially demanding societies create work-life imbalance and work stress. The study proposed work-family support systems that could moderate the effect of work-family imbalances on work stress.

International Graduate Student Parenthood: Engaging in Closeting Labor to Constitute Productive Work-Family Negotiation During Transitions to Parenthood

ABSTRACT Guided by the Intersectional Theory of Closeting (ITC), our study analyzed in-depth interviews of how international graduate student-parents (IGSPs) negotiate their new parental identity, which was considered as deviating from the ideal graduate student norms at a U.S. public research university. Findings revealed that IGSPs enacted various closeting configurations— fully closeting, involuntary uncloseting, and coming out of the closet— to conceal and/or disclose their parental identity to workplace contacts. We developed the concept of closeting labor to capture IGSPs’ efforts to achieve work and family goals including labor outside the closet to “pass” as “normal” graduate students; inside the closet as IGSPs engaged in privatized work-family negotiations often without institutional support, and inbetween the closet door as IGSPs constantly assessed the necessity to (un)closet and crafting strategies to minimize negative career impact. Our analysis captures the adaptive and transformative negotiations with normative structuring of academic workplaces and advocates for systematic changes to queer ideal graduate student norms.

Family Resilience in Urban Extreme Poverty

The impact of poverty causes pressure that weakens family resilience. Although measurements of family resilience are available, there are not many up-to-date measures for urban poor families in Indonesia. The purpose of this study is to describe the profile of family resilience and the conditions of vulnerability of extreme urban poor families. The research subjects were the heads of families (N=416) spread across five sub-districts in the city of Bandung, with the highest number of poverties, where most of the subjects worked as daily laborers. The measurement uses a scale of family resilience through four dimensions: the quality of physical, economic, psychological, social, and family structure as demographic resilience. Data were analyzed with descriptive and correlational statistics using JASP 0.15. The results show that poor families have a level of fulfillment of family resilience qualities of 16.5 percent (12.62 percent on the dimensions of physical endurance, 12.46 percent on the economic dimension, 17.33 percent on the psychological dimension and 19.95 percent on the social dimension). Several dimensions have a significant positive relationship, with the highest level on the relationship between dimensions of physical and economic resilience (r=.768). Six conditions of vulnerability were found, namely related to job instability and income that is less than needed, environmental cleanliness and insufficient food consumption, misunderstanding of family goals, and lack of gratitude for conditions. The research findings show two sub-dimensions in each dimension of social resilience and psychological resilience. Suggestions and implications are directed at recommendations for urban extreme poverty alleviation programs and optimizing family quality programs, especially aspects of independence.

The strategic realignment of paradoxical family and business goals in family business: A rhetorical history perspective

Family firms are paradoxical by nature due to the interplay of two distinct goal systems: the family and the firm. These systems involve nested tensions that can create apparent paradoxes over time. Taking a rhetorical history lens, we explore how family firms can dynamically produce temporal equilibria between goal systems through the strategic use of history. Empirically, we investigate the emergence and development of two apparent paradoxes unfolding through the history of the growth of Alpha, an Italian family firm in the packaging industry. Our findings suggest that rhetorical history can alleviate the tensions emergent from the paradoxical goal systems of family businesses. Our research provides a unique contribution by revealing the emergence and agentic process of the co-construction of rhetorical history, which involves multiple agencies from both family and non-family employees. Moreover, such co-created rhetorical history can dynamically produce temporal equilibria in family business’s persistent paradoxical goal systems.

'I need to understand… so we can decide together': Difficult conversations about alopecia areata.

The management of alopecia areata (AA) in pediatric patients poses unique challenges, particularly regarding treatment discussions and decision making involving both patients and their families. This commentary presents findings from unpublished research on treatment-discontinuation discussions between AA patients and their treating providers, shedding light on the hopes, expectations, and disappointments of individuals with severe AA. The study explored patient and guardian satisfaction with these discussions, emphasizing the importance of addressing psychosocial concerns, facilitating contact with support groups, and demonstrating empathy. The role of dermatologists in conversations about treatment, prognosis, and quality of life is examined, emphasizing the need for honesty, empathy, and realistic expectations. The authors propose a patient-centered approach to initiating and guiding discussions, focusing on understanding the impact of AA on patients and their families and collaboratively deciding on treatment options. The mantra: 'I need to understand how this is affecting all of you, so we can decide together what to do next' is central to this proposed approach. Special considerations for different scenarios are discussed, highlighting the importance of individualized care and effective communication. Overall, the commentary emphasizes the significance of actively listening, acknowledging emotions, and prioritizing patient and family goals to optimize care for pediatric AA patients.

One more piece of the family firm debt puzzle: the influence of socioemotional wealth dimensions

The literature on debt financing in family firms is still inconclusive. Initial studies have usually focused on the influence of family involvement on firm’s debt levels by using the explanations of traditional economic theories. More recent studies have begun to focus on the role of family goals in family firm debt levels, particularly drawing on socioemotional wealth (SEW), which has helped in the development of financial theories of family business. Nevertheless, existing arguments have usually not considered SEW as a multidimensional construct that covers diverse family goals. In addition, literature has usually drawn on arguments considering SEW as a stock, but have not considered the importance given to SEW (SEWi), which specifically acknowledges SEW as a goal. Our paper responds to recent calls to extend theoretical arguments on the effect of diverse dimensions of SEWi on family firm behavior and to focus on the role of SEWi on the family firms’ debt. Specifically, we test how the CEOs’ assessment of the importance that their family attaches to the continuity, prominence, and enrichment dimensions of SEWi influences the level of debt. To do so, we use a sample of 126 Spanish unlisted family businesses. Our results show that the continuity dimension of SEWi leads family businesses to increase their debt level being a key determinant of this financing decision.

A Mixed-methods Examination of Culturally Responsive Adaptation to an Evidence-based Parent-mediated Intervention Implemented for Autistic Children.

Parent-mediated interventions (PMIs) are considered an evidence-based practice for fostering social communication skills in young autistic children and for promoting parent responsivity and empowerment, yet barriers to caregiver engagement are evident when PMIs are implemented within historically underserved community settings. Issues of caregiver engagement can reflect a lack of fit between PMIs and the needs of diverse families. We used a mixed methods approach to examine barriers to participating in an evidence-based PMI, Project ImPACT (Ingersoll & Dvortcsak, 2019), within an outpatient setting, as well as strategies that clinicians reported using to deliver and adapt Project ImPACT for minoritized families. Participants included 134 caregivers of a child 13 to 48 months with autism or other social communication differences and six clinicians delivering Project ImPACT. Findings suggest that caregivers experience barriers to participating in Project ImPACT and that these barriers are associated with caregivers' ability to complete the program. Although quantitative findings indicate that adaptation to Project ImPACT did not differ by caregiver and child background, qualitative findings highlighted that clinicians attempt to deliver Project ImPACT to respond to the needs of families from minoritized backgrounds by actively considering the family's culture, psychosocial experiences, goals, and specific barriers. Further, both qualitative and quantitative findings suggest that culturally responsive care and adaptations may support caregiver engagement, including rapport, trust, buy-in, and attendance. Approaches to center cultural alongside contextual/psychosocial considerations within family-centered care in the implementation of PMIs are also highlighted.