Epidemiological and nutrition transition in developing countries: impact on human health and development

Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed.

Meeting the emotional needs of parents who have a child with complex needs

The physical and financial demands of caring for a child with complex needs are acknowledged by health professionals. However, the emotional needs of parents are not often recognized by health professionals until parents are at a heightened level of stress. This paper is based on a literature review of current articles, research papers and government documentation. The focus is on the emotional impact to parents who have a child with complex needs, particularly at the point of diagnosis. The paper explores how health professionals, and nurses in particular, should meet the emotional needs of parents in order to support them more effectively. Giving birth to a child with severe health problems impacts upon parents at an emotional time of transition, particularly if there were no concerns identified during pregnancy. For some parents a grief response or state of chronic sorrow may be triggered. The reality of caring for a baby who is critically ill or disabled can be an enormous and unexpected shock for both parents. Parents need emotional support and guidance, as they may have to change their expectations for their child’s development and even life span. It is important for nurses to realise that if parents’ emotional needs are unmet it can lead to clinical depression or mental illness. Primary support often comes from parent support groups rather than health professionals. The review highlights factors affecting parents’ emotions and discusses how early support, home visits and practical help can all help to alleviate parents’ emotional stress.

Ambitious mothers – successful daughters: Mothers’ early expectations for children’s education and children’s earnings and sense of control in adult life

Background. Mothers' expectations for their children's educational attainment are related to children's educational and occupational attainment. Studies have yet to establish, however, the long-term links between maternal expectations and offspring earnings, which are not always related to occupational attainment especially in women, or between maternal expectations and offspring sense of control and self-efficacy, which are pivotal factors in career choice and development. Aims. To explore the role of mothers' expectations for their children's educational attainment in children's earnings attainment and sense of control later in life. Method. Data from sweeps of the 1970 British Cohort Study (BCS70) were used. The study sample was those cohort members with complete information on all the variables of interest. The study sample (N = 3,285) was more educated and less disadvantaged than the whole sample. If cohort members of this type are more likely to have a mother who has high expectations, then our results are biased downwards, which suggests that we underestimate the effect of expectations on our two outcome variables. Results. Mothers' expectations at the age of 10 were positively related to daughters' sense of control at the age of 30 even after controlling for ethnicity, educational attainment, and concurrent partner, parent, and labour market participation status, as well as the following confounding variables (measured at the ages of 0–10): general ability and general ability squared, locus of control, emotional and behavioural problems and emotional and behavioural problems squared, socio-economic disadvantage, parental social class, parental family structure, and mothers' education, child-rearing attitudes, and mental health. Mothers' expectations had no effect on sons' adult outcomes. Conclusions. Given that women are particularly at risk for poor psychological and economic outcomes in adulthood, and that this study likely underestimated the effect of expectations on these two outcomes, this is an important conclusion.

Meeting the emotional needs of parents who have a child with complex needs

The physical and financial demands of caring for a child with complex needs are acknowledged by health professionals. However the emotional needs of parents are not often recognised by health professionals until parents are at a heightened level of stress. This paper is based on a literature review of current articles, research papers and government documentation. The focus is on how health professionals, and nurses in particular should meet the emotional needs of parents who have child with complex needs, particularly at the point of diagnosis. Giving birth to a child with severe health problems impacts upon parents at an emotional time of transition, particularly if there were no concerns identified during pregnancy. For some parents a grief response or state of chronic sorrow may be triggered. The reality of caring for a baby who is critically ill or disabled can be an enormous and unexpected shock for both parents. Parents need emotional support and guidance, as they may have to change their expectations for their child’s development and even life span. Primary support often comes from parent support groups rather than health professionals. The review discusses how home visits, practical help and early support can all help to alleviate stress. It is important for nurses to realise that if parents’ emotional needs are unmet they can lead to clinical depression or mental illness. This literature review looks at the emotional impact on parents and explores how nurses can address this issue in order to support parents more effectively. It identifies key areas that nurses could address that would help alleviate parents’ emotional stress.