Type of publicationArticle (peer-reviewed)Link to publisher's version http://dx.doi.org/10.1111/j. 1365-2648.2010.05423.x Access to the full text of the published version may require a subscription. Rights WHAT IS ALREADY KNOWN ABOUT THIS TOPIC• Psychosocial interventions are more promising than education interventions in improving glycaemic control and other outcomes for type 1 diabetes in childhood.• Improvements in the quality of randomized controlled trial methods are needed to increase effectiveness of interventions for type 1 diabetes in childhood• Theory-based interventions demonstrate greater efficacy than atheoretical interventions WHAT THIS PAPER ADDS• A systematic and rigorous approach to the scientific development of interventions is necessary in order to establish a range of effective interventions for managing type 1 diabetes in childhood• Psychosocial and family therapy interventions have been developed in recent years with greater scientific rigour than education interventions• Future reviews on the effectiveness of interventions for childhood type 1 diabetes need to include criteria for assessing the science of intervention development. IMPLICATIONS FOR PRACTICE AND/OR POLICY• Education of children and adolescents with TID, and their families, needs to be supported by psychosocial and possibly family therapy interventions.• Interventions built from theory and that are systematically-developed 4 demonstrate greater efficacy and thus potential for future application, in practice settings compared to interventions that are atheoretical and not systematically developed.• Further research is needed to test existing efficacious interventions in terms of their effectiveness in clinical practice, and prior to widespread implementation in practice settings.5

A significant body of research has shown that parents who have a child or a dependent adult with a disability experience significant and persistent levels of stress. One of the recognized strategies for coping includes the provision of in-home practical support. Enable Ireland provides a range of services for children and adults with a physical disability. The present study explored home support services with a sample of 16 families of service users of Enable Ireland Cork. Practical support was deemed to be whatever support or intervention requested by the parent of the child/dependent adult which afforded the service user the opportunity to engage in social/recreational opportunities and that gave the parent free time. Sixteen members of the chosen families were interviewed (15 mothers and one father) using a semi-structured interview schedule and a standardized stress measure before and after the introduction of Link Family Support (LFS). LFS was put in place for a period of 12 months, tailored to the families and service users' individual needs. Although levels of stress continued to be high and scores on the Parenting Stress Index (PSI) did not show a statistically significant reduction after the programme, reported stress levels had improved. Parents reported LFS to be very helpful in reducing perceived stress and improving family's quality of life through providing free time and access to leisure and recreation facilities. This study provided limited but clear evidence of the need for regular, flexible, in-home support for families with children and dependent adults with a disability. LFS provided a personal, regular and effective means of meeting this need as the findings of this study demonstrated.

This qualitative study investigated the experiences of mothers who have a child with communication difficulties resulting from cerebral palsy (CP). There is a dearth of information about parents' experiences of having a child with CP and communication difficulties. Three participants, whose children had moderate or severe CP and communication difficulties, were recruited from a voluntary organization. Participants were interviewed using an in-depth, semi-structured interview guide. Interviews were audio-recorded, then transcribed and subsequently analysed using Grounded Theory methods. Five main themes emerged, combining to form the core category of mothers dedicating their attention to their children. The information gleaned from this study could have important implications for nurses involved in facilitating communication, including speech and language therapists, occupational therapists and registered nurses. By becoming more aware of the experiences of parents with a child with CP and communication disorders, nurses may be better able to plan and implement therapy and also support communication aims. The study concludes with a discussion of further research avenues, suggesting that a study investigating the experiences of parents of children with other types of physical disabilities affecting communication should be conducted to determine the similarities and differences of parents of children with other kinds of disability. A similar study with a larger sample could be conducted to validate the findings of the current study.

In Aotearoa-New Zealand and perhaps in other countries, firefighters are increasingly required to attend highly demanding and stressful non-fire incidents. This study used a qualitative descriptive research design to examine the gaps in preparation experienced by firefighters in Aotearoa-New Zealand when responding to non-fire incidents, particularly medical calls. Forty-four firefighters and 12 selected informants were interviewed. Ten Māori firefighters took part in a face-to-face focus group. Results indicate that firefighters equated preparation with training for their role. Training was considered by some to be limited to a specific range of first aid skills and it was felt a higher level of medical training would be beneficial. A need for more training in relation to working cross-culturally was also identified, particularly in relation to Māori and the application of cultural processes and protocols when death occurs. Training to improve firefighters’ abilities to console and communicate with families at incidents was also noted. Besides training, participants identified the need to prepare for unfavourable outcomes, this included reframing what ‘success’ looks like, enhancing psychological wellbeing and encouraging help-seeking behaviours.