The wraparound process provides a contemporary perspective on providing mental health and related services to children and families with complex needs. Wraparound is a strengths-based, family driven orientation that focuses on the uniqueness of each child and family. In this article, the professional's role in the wraparound process is highlighted. Part 1 offers a historical perspective; political and economic implications atfederal, state, and community levels focusing on wraparound; and summarizes research outcome data associated with its use. Part 2 emphasizes clinical practice implicationsforfamily nurses or service providers in other disciplines who work with these children and families. A case study demonstrates how structural family therapy may be used as a theoretical framework in concert with the wraparound process.

This qualitative, descriptive study identified specific individual and family psychosocial stressors that impact on the ability of patients with type II, non-insulin-dependent diabetes mellitus to manage the self-care regimens recommended by healthcare professionals. A series of 2 to 12 counseling sessions was incorporated into a nationally recognized outpatient diabetes education program. Data collection consisted of in-depth interviews in which six patients with type II diabetes and their families discussed current problems associated with their diabetes. Content analysis identified the following themes and problem areas: patients' inner experience with diabetes, family stressors that affect patients with diabetes, coping strategies of type II diabetes patients, and psychopathology. Based on these findings, specific interventions that emphasize family involvement and support were developed for the healthcare team to use with patients with type II diabetes.

The review included an analysis of methodolo-gies, questionnaires, recruitment strategies and raw data used in and generated by previous studies. The TWG found approximately 50% of the data needed for use in the MOT study. Methodological issues with data collection activities were identified, key questions used in population-based studies were modified and reconstructed, and formal population size estimations were recommended. The review generated substantive recommendations to enhance future data collection activities and improve programming. Stake-holder awareness about limitations of available data and the types of studies/data needed to help better understand the epidemic and determine appropriate responses. Periodic reviews of data availability and quality are critical to knowing your epidemic and the most appropriate response. The EPI-review tool increased stakeholder's awareness about the limitations of the available data and the types of studies/data needed to help better understand the epidemic and determine appropriate responses. This capacity building effort generated substantial recommendations to enhance future data collection activities. The tool saved time and effort at the country level by focusing on the data needed to conduct the MOT. enrolled 496 HIV serodiscordant couples who were followed up to 36 months. We categorised time off study drug into two; protocol defined , in which the parameters of withholding study drug was clearly outlined in the study protocol and participant-initiated interruption where the participant opted to stop taking study drug. Data on study drug interruptions were captured on monthly basis and documented on specific case report forms in pharmacy. Results We reported 152 cases of study drug interruptions, these were contributed by 128 participants. Sixty four per cent of HIV-1 uninfected participants who recorded study drug interruption were male, median age for both gender was 31.8 (IQR 26.5, 37.4) years. Sixty five (43%) of reported drug interruptions were participant initiated , cited due to marital disharmony 34 (22%), fatigue and loss of interest 24 (16%), perceived side effects in 7 (5%). The median time off study product was 90 (IQR 28, 268) days. Age, gender and education were not associated with participant-initiated interruptions. Pregnancy and possible seroconversion were some of protocol defined reasons to stop study drug. Conclusions Marital disharmony and loss of interest were two of the most common reasons for participant initiated interruption of study drug. Going forward, psychosocial support and continuous adherence counselling should be part of the package for successful implementation of PrEP for HIV prevention.

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The author first reviews the literature on denial as it pertains to coping with a serious physical illness. She then shares what she learned about denial when confronted with the diagnosis of multiple sclerosis. She highlights the therapeutic value of denial, as well as potential negative manifestations and consequences of its overusage. Dr. Handron then suggests how the nurse psychotherapist can assist clients to come to terms with the ramifications of a chronic physical illness.