The adjustment of children of Australian Vietnam veterans: is there evidence for the transgenerational transmission of the effects of war-related trauma?

Objective: The presence of posttraumatic stress disorder (PTSD) in trauma survivors has been linked with family dysfunction and symptoms in their children, including lower self-esteem, higher disorder rates and symptoms resembling those of the traumatized parent. This study aims to examine the phenomenon of intergenerational transfer of PTSD in an Australian context.

Method: 50 children (aged 16–30) of 50 male Vietnam veterans, subgrouped according to their fathers' PTSD status, were compared with an age-matched group of 33 civilian peers. Participants completed questionnaires with measures of self-esteem, PTSD symptomatology and family functioning.

Results: Contrary to expectations, no significant differences were found between the self-esteem and PTSD symptomatology scores for any offspring groups. Unhealthy family functioning is the area in which the effect of the veteran's PTSD appears to manifest itself, particularly the inability of the family both to experience appropriate emotional responses and to solve problems effectively within and outside the family unit.

Conclusion: Methodological refinements and further focus on the role of wives/mothers in buffering the impact of veterans' PTSD symptomatology on their children are indicated. Further effort to support families of Veterans with PTSD is also indicated.

Midwifery: a profession in transition

This paper presents the findings of a pilot study carried out in one regional center in Queensland, Australia. The study aimed to develop a snapshot image of teenage mothers. Of the thirty mothers who participated; just over half (16/30; 53%) reported using contraceptives, less than a third (8/30; 27%) used condoms to protect themselves from STDs and the majority (23/30; 77%) said their pregnancy was unplanned. Despite this, 16 (53%) attended prenatal classes, 16 (53%) breast-fed their infants and 27 (90%) were satisfied with motherhood. On average the fathers were almost four years older than the mother were (range 17 to 29 years), most fathers (23/30; 77%) were not teenagers themselves and only 11 (37%) were resident fathers following the birth of the baby. Exploratory analysis suggests that the fathers were significantly older than the teenage mothers were (t=−6.73, df 29, p=0.0001). Although these preliminary results are similar to those reported in the American literature further research is needed to confirm if the findings presented are representative of teenage mothers in Australia. While we await the results of future studies, practitioners are encouraged to continue to educate young women about appropriate and safer sexual practices.

The development of eating pathology in Chinese-Australian women: acculturation versus culture clash

Objective
Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The current study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women.

Method
Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, self-perceptions of physical appearance, sociability and global self-worth, and the strength of their ethnic identity.

Results
It was found that, overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care reported the greatest eating pathology.

Discussion
The findings suggest that there are both similarities and differences between the risk factors that correlate with eating pathology between acculturated and traditional women. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 579-588, 2004.

Association of family environment with children's television viewing and with low level of physical activity

Objective: This study examined associations between the family environment and children's television (TV) viewing and likelihood of being low-active.
Research Methods and Procedures: In 2001, children were recruited from 19 primary schools in Melbourne, Australia. Parents completed a questionnaire about their child's TV viewing and the family environment. Children also completed a questionnaire and wore an accelerometer for 8 days. Movement counts were used to identify low-active children (lowest quartile). Data were analyzed in May 2004.
Results: The sample consisted of 878 children (mean age = 11.5 0.6 yrs). Multiple logistic regression revealed that socioeconomic status [adjusted odds ratios (AOR) = 0.4 boys], frequency families watched TV together (AOR = 2.0 boys), mothers' (AOR = 1.8 boys; AOR = 2.5 girls) and fathers' (AOR = 2.6 boys; AOR = 2.8 girls) TV viewing, and rules prohibiting TV during mealtimes (AOR = 0.6 boys; AOR = 0.6 girls) related to children watching TV 2 h/d. Variables associated with low-level physical activity included self-reported enjoyment of Internet use (AOR = 1.7 boys) and preference for watching TV (AOR = 2.3 girls), perception that mother uses computer a lot (AOR = 1.9 boys) and likes using the computer (AOR = 0.6 girls), fathers' reported computer/electronic games use (AOR = 1.7 girls), frequency families used computer together (AOR = 0.4 girls), rules that TV viewing must be supervised (AOR = 1.9 boys; AOR = 0.6 girls), and having pay TV (AOR = 0.6 boys) and electronic games at home (AOR = 2.6 boys).
Discussion: These findings suggest that the relationships between the family environment and TV viewing and low-level activity are complex and that these behaviors are distinct.

A longitudinal study of body image and strategies to lose weight and increase muscles in children

A longitudinal study was used to examine age differences in the role of body mass index (BMI) and sociocultural pressures in predicting changes in body image and strategies to both lose weight and increase muscles among 443 children aged between 8 and 12 years (207 boys, 236 girls) over a 16-month period. The strongest predictors of body image and these strategies were BMI, the media and mothers, and to a lesser extent fathers and best friends. Girls were focused on losing weight, whereas boys were focused on both increasing muscle and losing weight. Surprisingly, there was a reduction in strategies both to lose weight and increase muscles as children approached adolescence. The implications of these findings for preventative educational programs for boys and girls are discussed.

A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls

The current study was designed to evaluate the role of sociocultural influences over a 16 month period on strategies to lose weight, extreme weight loss strategies, and strategies to increase muscles among adolescent boys (n=344) and girls (n=246). All participants completed measures of body dissatisfaction, body image importance, strategies to lose weight, extreme weight loss strategies, and strategies to increase muscles. Measures of perceived pressure to lose weight or increase muscles from mother, father, best male friend, best female friend and the media were also evaluated. Data were gathered on three occasions, 8 months apart. The results demonstrated that boys showed a decrease in strategies to lose weight and increase muscles over time, whereas girls showed an increase. Both boys and girls showed an increase in extreme weight loss strategies with girls demonstrating a greater increase than boys. The sociocultural influences generally were perceived by girls to relate to messages to lose weight, whereas for boys they were perceived to relate to increasing muscles. Messages from parents, particularly fathers, were strong predictors of both strategies to lose weight and increase muscles among boys, with the media and best male friend playing a limited role. For girls, the strongest influences were mothers and best female friends, with few influences from fathers or the media. The results of this study are discussed in terms of the importance of the various sociocultural influences in shaping body change strategies among young adolescent boys and girls, and the implications of these findings for intervention programs for adolescents.

Children's television viewing and objectively measured physical activity: associations with family circumstances

Background: The contribution of family circumstance to physical activity and television viewing has not been widely investigated in pre-adolescents, and available information is inconsistent. This study examines whether television viewing and objectively measured physical activity vary by different indicators of family circumstance.
Methods: Data from the 2001 Children's Leisure Activity Study and the 2002/3 Health, Eating and Play Study, involving Australian children in Grades Prep (mean age 6y) and 5–6 (mean age 11y), were combined. Children wore accelerometers for six consecutive 24 hour periods. Average min/day in low-intensity activity (1.0–1.9 METs) and moderate-to-vigorous-intensity activity (≥3 METs) were calculated. Parents reported children's television viewing and family circumstance. Linear regression analyses were conducted separately for young girls, young boys, older girls and older boys. Results: Complete data were available for 2458 children. Parental education and, to a lesser extent, employment level were inversely associated with television viewing. Children in single-parent families, those whose fathers were not in paid employment, and those without siblings tended to spend more time in low-intensity activity than their peers. Children with siblings spent more time in moderate-to-vigorous-intensity activity; associations were stronger for girls. Maternal education was positively associated with moderate-to-vigorous-intensity activity for younger children. Maternal employment was positively associated with moderate-to-vigorous-intensity activity for older children. Multivariable models did not demonstrate a cumulative explanatory effect.
Conclusion:  Individual measures of family circumstance were differentially associated with television, low-intensity activity and moderate-to-vigorous-intensity activity and associations were often not consistent across age-by-gender groups. Interventions may need to be tailored accordingly.

Whose socioeconomic status influences a women's obesity risk: her mother's, her father's, or her own?

Background Evidence on the relative influence of childhood vs adulthood socioeconomic conditions on obesity risk is limited and equivocal. The objective of this study was to investigate associations of several indicators of mothers', fathers', and own socioeconomic status, and intergenerational social mobility, with body mass index (BMI) and weight change in young women.

Methods This population-based cohort study used survey data provided by 8756 women in the young cohort (aged 18–23 years at baseline) of the Australian Longitudinal Study on Women's Health. In 1996 and 2000, women completed mailed surveys in which they reported their height and weight, and their own, mother's, and father's education and occupation.

Results Multiple linear regression models showed that both childhood and adulthood socioeconomic status were associated with women's BMI and weight change, generally in the hypothesized (inverse) direction, but the associations varied according to socioeconomic status and weight indicator. Social mobility was associated with BMI (based on father's socioeconomic status) and weight change (based on mother's socioeconomic status), but results were slightly less consistent.

Conclusions Results suggest lasting effects of childhood socioeconomic status on young women's weight status, independent of adult socioeconomic status, although the effect may be attenuated among those who are upwardly socially mobile. While the mechanisms underlying these associations require further investigation, public health strategies aimed at preventing obesity may need to target families of low socioeconomic status early in children's lives.

A preliminary investigation of the relationship between parental empathy and social anxiety and children's social anxiety

This study investigated the association between parents' social anxiety and empathy, and their children's social anxiety, Twenty-one mothers, 12 fathers and 24 children aged between 7 and 12 years were recruited from state primary schools in the eastern metropolitan region of Melbourne, Australia. Parents completed self-report questionnaires assessing their parental empathy and level of social anxiety. Children completed a modified version of the social anxiety questionnaire. All parent variables, except for maternal anxiety, were related to children's social anxiety. Overall, parental empathy was found to have a considerable association with child social anxiety, which is consistent with arguments that micro-level family mechanisms are important influences on child social anxiety. Future studies of parental empathy with clinical populations and data collection from multiple sources are recommended.

The development of eating pathology in Chinese-Australian women: acculturation versus culture clash

Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The present study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women. Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, selfperceptions of physical appearance, sociability and global self worth, and the strength of their ethnic identity. It was found that overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care, reported the greatest eating pathology. The findings suggest that there are both similarities and differences between the risk factors that correlate with the eating pathology among acculturated and traditional women.

Associations between family circumstance and weight status of Australian children

To examine associations between weight status and multiple indicators of family circumstance in Australian elementary school children. Data were combined from the 2001 Children's Leisure Activities Study (CLAS Study) and 2002/3 Health, Eating and Play Study (HEAP Study), involving 2520 children in Grades Prep (mean age 6 years) and 5-6 (mean age 11 years) in Melbourne, Australia. Children's body mass index (BMI) was calculated from measured height and weight. Weight status (non-overweight or overweight) was determined according to International Obesity Taskforce cut-off points and BMI was transformed to z-scores based on the 2000 US growth chart data. Parents reported family circumstance (number of parents in the home, marital status, presence of siblings, parental education, parental employment status, parental work hours [HEAP Study only]) and parental BMI. Regression analyses were conducted for the sample overall and separately for young girls, young boys, older girls and older boys. Children in single-parent homes, those without siblings, and those with less educated mothers and fathers tended to have higher z-BMIs (p=0.002, p=0.003, p<0.001 and p<0.001, respectively) and were more likely to be overweight (p=0.003, p<0.001, p<0.001 and p=0.02, respectively). Associations were stronger for older children. Parental employment and work hours were not consistently associated with child weight status. The multivariable models did not demonstrate a cumulative explanatory effect (R2=0.02), except when maternal BMI was included (R2=0.07). Individual measures of family circumstance were differentially associated with child weight status and appeared to be largely independent of other measures of family circumstance. Childhood overweight interventions may need to be tailored based on the age, gender, maternal BMI and family circumstances of the target group.

C'mon guys! A program to facilitate father involvement in the primary school environment

This article is written to provide a case study example of a program developed to encourage fathers' engagement with their children in the primary school environment. C'mon Guys! was delivered in a Primary School in Victoria, Australia (unnamed to protect the privacy of the participants). The article begins by first describing the community in which C'mon Guys! was offered and goes on to outline the literature related to aspects pertinent to the program such as father involvement in the lives of children at school, and the role of the social worker in facilitating this type of groupwork in the school setting. Next, the aims of the program are discussed with particular reference to its design, social learning theory, systems theory and groupwork principles and processes. The outcomes of C'mon Guys! are then discussed noting the limitations of the program as well as identifying the extrinsic and intrinsic benefits for the children, their fathers and the community.

Family and home correlates of television viewing in 12-13 year old adolescents: the Nepean study

Background
Few young people meet television viewing guidelines.
Purpose
To determine the association between factors in the family and home environment and watching television, including videos and DVDs, in early adolescence.
Methods
Cross-sectional, self-report survey of 343 adolescents aged 12–13 years (173 girls), and their parents (338 mothers, 293 fathers). Main measures were factors in the family and home environment potentially associated with adolescents spending ≥ 2 hours per day in front of the television. Factors examined included family structure, opportunities to watch television/video/DVDs, perceptions of rules and regulations on television viewing, and television viewing practices.
Results
Two-thirds of adolescents watched ≥ 2 hours television per day. Factors in the family and home environment associated with adolescents watching television ≥ 2 hours per day include adolescents who have siblings (Adjusted Odds Ratio [95%CI] AOR = 3.0 [1.2, 7.8]); access to pay television (AOR = 2.0 [1.1, 3.7]); ate snacks while watching television (AOR = 3.1 [1.8, 5.4]); co-viewed television with parents (AOR = 2.3 [1.3, 4.2]); and had mothers who watched ≥ 2 hours television per day (AOR = 2.4 [1.3, 4.6]).
Conclusion
There are factors in the family and home environment that influence the volume of television viewed by 12–13 year olds. Television plays a central role in the family environment, potentially providing a means of recreation among families of young adolescents for little cost. Interventions which target family television viewing practices and those of parents, in particular, are more likely to be effective than interventions which directly target adolescent viewing times.

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke

Background: Exposure to other people’s cigarette smoke (environmental tobacco smoke, or ETS) is an important child health issue.
Objectives: To determine the effectiveness of interventions aiming to reduce exposure of children to ETS.
Search strategy: The Tobacco Addiction Group register of studies was searched.MEDLINE, EMBASE and four other health and psychology databases were searched electronically, bibliographies of retrieved primary studies were checked and specialists in the area consulted.
Selection criteria: Controlled trials with or without random allocation were included in this review if they addressed participants (parents and other family members, child care workers and teachers) involved with the care and education of infants and young children (aged 0-12 years). All mechanisms for reduction of children’s environmental tobacco smoke exposure, and smoking prevention, cessation, and control programmes targeting these participants are included. These include smoke free policies and legislation, health promotion, social behavioural therapies, technology, education and clinical interventions.
Data collection and analysis: Two reviewers independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcomes, no summary measures were possible and results were synthesised using narrative summaries.
Main results: Nineteen studies met the inclusion criteria, one of which was subsequently excluded. Three interventions were targeted at populations or community settings, seven studies were conducted in the well child health care setting and eight in the ill child health care setting. Twelve of these studies are from North America. In 12 of the 18 studies there was reduction of ETS exposure for children in both intervention and comparison groups. In only four of the 18 studies was there a statistically significant intervention effect. Three of these successful studies employed intensive counselling interventions targeted to smoking parents. There is little difference between the well infant, child respiratory illness and other child illness settings as contexts for parental smoking cessation interventions. The fourth successful intervention was in the school setting targeting the ETS exposure of children from smoking fathers.
Authors’ conclusions: Brief counselling interventions, successful in the adult health setting when coming from physicians, cannot be extrapolated to adults in the setting of child health. There is limited support for more intensive counselling interventions. There is no clear evidence for differences between the respiratory, non-respiratory ill child, well child and peripartum settings as contexts for reduction of children’s ETS exposure.

A longitudinal study of body change strategies among children

This study was designed to examine changes in body image and strategies to lose weight and increase muscles among 443 children (207 boys, 236 girls) aged 8-12 years over 16 months. Boys were more likely than girls to receive messages from sociocultural influences to increase msucles, and to adopt strategies to increase muscles. The strongest infuences were Body Mass Index, media and mothers, and to a lesser extent fathers and best friend. Girls were focused on losing weight, whereas boys were focused on both incrasing muscle and losing weight. The implications of these findings for preventative eductation programs are discussed.