Longitudinal examination of the family food environment and weight status among children

Objective. To examine whether aspects of the family food environment were associated with body mass index (BMI) z-score and weight status in children, cross-sectionally and prospectively over 3 years.

Methods. Four aspects of the family food environment (breakfast eating patterns, food consumption while watching television, parental provision of energy-dense foods and child consumption of energy-dense food at home and away from home) were assessed with a questionnaire completed by parents of 161 children aged 5-6 years and 132 children aged 10-12 years in Melbourne, Australia in 2002/03. In 2002/03 and 2006, children's BMI z-score and weight status (non-overweight or overweight) was calculated from measured height and weight. Results. At baseline, 19% of younger and 21% of older children were overweight. Three years later, a greater proportion of younger (now aged 8-9 years) compared with older (aged 13-15 years) children were classified as overweight (28% versus 18%). Few of the family food environment variables were associated with children's BMI z-score and weight status cross-sectionally and longitudinally. However, among older children, more frequent dinner consumption while watching television was associated with a higher BMI z-score longitudinally (B = 0.3, 95% CI = 0.0, 0.6), less frequent breakfast consumption was associated with higher odds of overweight longitudinally (OR = 2.2, 95% CI = 1.1-4.7), and more frequent fast food consumption at home was associated with higher odds of overweight cross-sectionally (OR = 3.1, 95% CI = 1.4-7.0).

Conclusions. This study found few significant associations between aspects of the family food environment and BMI z-score or weight status in a sample of Australian children.

Are parental concerns for child TV viewing associated with child TV viewing and the home sedentary environment?

Background
Time spent watching television affects multiple aspects of child and adolescent health. Although a diverse range of factors have been found to be associated with young people's television viewing, parents and the home environment are particularly influential. However, little is known about whether parents, particularly those who are concerned about their child's television viewing habits, translate their concern into action by providing supportive home environments (e.g. rules restricting screen-time behaviours, limited access to screen-based media). The aim of this study was to examine associations between parental concerns for child television viewing and child television viewing and the home sedentary environment.
Methods
Parents of children aged 5-6 years ('younger' children, n = 430) and 10-12 years ('older children', n = 640) reported usual duration of their child's television (TV) viewing, their concerns regarding the amount of time their child spends watching TV, and on aspects of the home environment. Regression analyses examined associations between parental concern and child TV viewing, and between parental concern and aspects of the home environment. Analyses were stratified by age group.
Results
Children of concerned parents watched more TV than those whose parents were not concerned (B = 9.63, 95% CI = 1.58-17.68, p = 0.02 and B = 15.82, 95% CI = 8.85-22.80, p < 0.01, for younger and older children respectively). Parental concern was positively associated with younger children eating dinner in front of the television, and with parental restriction of sedentary behaviours and offering sedentary activities (i.e. TV viewing or computer use) as a reward for good behaviour among older and young children. Furthermore, parents of older children who were concerned had fewer televisions in the home and a lower count of sedentary equipment in the home.
Conclusions
Children of concerned parents watched more TV than those whose parents who were not concerned. Parents appear to recognise excessive television viewing in their children and these parents appear to engage in conflicting parental approaches despite these concerns. Interventions targeting concerned parents may be an innovative way of reaching children most in need of strategies to reduce their television viewing and harnessing this parental concern may offer considerable opportunity to change the family and home environment.

The relationship between divorce and the psychological well‐being of children with ADHD: differences in age, gender, and subtype

It is generally accepted that Attention‐Deficit/Hyperactivity Disorder (ADHD) results from a dysfunction of the central nervous system, which has led to a commonly held belief that environmental factors play little role in the behavioural problems of children identified as having ADHD. Therefore, the two studies reported in this article investigated the relationship between parental divorce and the psychological well‐being of children with ADHD. Subjects, aged 6 to 18 years, were diagnosed with either the inattentive or combined subtype of the disorder. Firstly, differences in children's behaviour between divorced and non‐divorced families were examined, and subtype, age, and gender differences were evaluated in terms of symptom severity and comorbid conditions. Secondly, parents' perceptions of the impact of their children's behaviour on marital status and family/parental functioning were examined. Parental divorce was associated with greater symptom severity, more externalizing/ internalizing behaviours, and poorer social functioning, but less with academic underachievement. Further, parental divorce was related to adjustment differences in ADHD subtypes, age, and gender. However, the correlation between behaviour problems of children with ADHD and marital/family dysfunction was weak. It may be concluded that parental divorce was associated with the psychological well‐being in children with ADHD, and there is some suggestion that ADHD should be viewed as a bio‐psychosocial disorder.

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

BackgroundChildren's exposure to other people's cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children are also at risk of exposure to ETS in child care or educational settings. Preventing exposure to cigarette smoke in infancy and childhood has significant potential to improve children's health worldwide.ObjectivesTo determine the effectiveness of interventions aiming to reduce exposure of children to ETS.Search methodsWe searched the Cochrane Tobacco Addiction Group Specialized Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, ERIC, and The Social Science Citation Index & Science Citation Index (Web of Knowledge). Date of the most recent search: September 2013.Selection criteriaControlled trials with or without random allocation. Interventions must have 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 to 12 years). All mechanisms for reduction of children's ETS exposure, and smoking prevention, cessation, and control programmes were included. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions.Data collection and analysisTwo authors independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcome measures, no summary measures were possible and results were synthesised narratively.Main resultsFifty-seven studies met the inclusion criteria. Seven studies were judged to be at low risk of bias, 27 studies were judged to have unclear overall risk of bias and 23 studies were judged to have high risk of bias. Seven interventions were targeted at populations or community settings, 23 studies were conducted in the 'well child' healthcare setting and 24 in the 'ill child' healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether the visits were to well or ill children, and another included both well and ill child visits. Thirty-six studies were from North America, 14 were in other high income countries and seven studies were from low- or middle-income countries. In only 14 of the 57 studies was there a statistically significant intervention effect for child ETS exposure reduction. Of these 14 studies, six used objective measures of children's ETS exposure. Eight of the studies had a high risk of bias, four had unclear risk of bias and two had a low risk of bias. The studies showing a significant effect used a range of interventions: seven used intensive counselling or motivational interviewing; a further study used telephone counselling; one used a school-based strategy; one used picture books; two used educational home visits; one used brief intervention and one study did not describe the intervention. Of the 42 studies that did not show a significant reduction in child ETS exposure, 14 used more intensive counselling or motivational interviewing, nine used brief advice or counselling, six used feedback of a biological measure of children's ETS exposure, one used feedback of maternal cotinine, two used telephone smoking cessation advice or support, eight used educational home visits, one used group sessions, one used an information kit and letter, one used a booklet and no smoking sign, and one used a school-based policy and health promotion. In 32 of the 57 studies, there was reduction of ETS exposure for children in the study irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure, but rather aimed to reduce symptoms of asthma, and found a significant reduction in symptoms in the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions.Authors' conclusionsWhile brief counselling interventions have been identified as successful for adults when delivered by physicians, this cannot be extrapolated to adults as parents in child health settings. Although several interventions, including parental education and counselling programmes, have been used to try to reduce children's tobacco smoke exposure, their effectiveness has not been clearly demonstrated. The review was unable to determine if any one intervention reduced parental smoking and child exposure more effectively than others, although seven studies were identified that reported motivational interviewing or intensive counselling provided in clinical settings was effective.

Parental awareness and attitudes about food advertising to children on Australian television

Objective: To assess parents' concern regarding television food advertising to children and the marketing methods used, their awareness of existing regulations and support for strengthening restrictions, and to determine whether these factors differ across sociodemographic groups.

Methods: A randomly selected sample of 400 parents of children under 14 years in all Australian States and Territories completed the cross-sectional telephone survey in March 2007. Data were weighted by metropolitan and regional population proportions.

Results: Parents were concerned about unhealthy food advertising to children (67.3%), use of popular personalities (67.7%), toys (76.4%), and advertising volume (79.7%). Older parents, of high socioeconomic status (SES), with fewer household televisions were more likely to be concerned. Only 47.4% of parents were aware of current regulations and those with a tertiary education were more likely to be aware: odds ratio (OR) 2.96 (95% CI: 1.55-5.65). Parents supported a change from self-regulation (92.8%), a ban on unhealthy food advertising to children (86.8%) and, to a lesser extent, a ban on all food advertising (37.3%).

Conclusions and implications: There was widespread parental concern about food advertising and strong support for tighter restrictions. Given that the existing regulations rely on complaints and awareness is low, particularly among parents with lower education levels, a system of external monitoring and enforcement is essential. Clearly more effective regulations are needed to protect children and parental support for this is high.

Disorganized attachment and reproductive strategies

Del Giudice provides an extension of the life history theory of attachment that incorporates emerging data suggestive of sex differences in avoidant male and preoccupied female attachment patterns emerging in middle childhood. This commentary considers the place of disorganized attachment within this theory and why male children may be more prone to disorganized attachment by drawing on Trivers’s parental investment theory.

Influence of the family environment on children's physical activity

This study examined the influence of the family environment on children's physical activity via four inter-related studies of over 1500 children. Findings indicated mothers' modelling of physical activity, barriers, family rules and restrictions, self-efficacy and physical features within the home environment were significant predictors of children's physical activity.

Just call me dad: health and social benefits to fathers and their children

In the past 20 years, social change and expectations for both maternal and paternal responsibilities have highlighted the need for services for families to better understand the role of a father in family relationships. In Australia, as well as internationally, there have been many contested understandings about what constitutes ‘good fathering’ in research, social media and in the political sphere. More specifically, there has also been an emerging trend to understand the challenging task of recruiting and maintaining men's involvement in child and family services programmes, particularly those fathers who are deemed a risk to children and mothers, violent or have been separated from their children. That many child and family/welfare services have exercised dedicated effort to work with fathers is still a relatively recent phenomenon, and has only emerged following criticism that services have been too geared towards working only with mothers. Despite this increasing interest, there is still ongoing need for more research to be undertaken in Australia. An important area of focus is the views of professionals about their perception and engagement of fathers, particularly the views of fathers who are described as being absent from family-based services. The purpose of this article is to report briefly on a study undertaken to examine how child and family welfare workers engage fathers in their work. First, this paper will describe some of the social and health benefits to fathers and their children, focusing on the key role of attachment through play. Research into effective service delivery involving fathers will then be presented, concluding with key practice factors necessary for fathers to be involved in family life.

Spatio-temporal selectivity of loss of colour and luminance contrast sensitivity with mutiple sclerosis and optic neuritis

Colour and luminance-contrast thresholds were measured in the presence of dynamic Random Luminance-contrast Masking (RLM) in individuals who had had past diagnoses of optic neuritis (ON) some of whom have progressed to a diagnosis of multiple sclerosis (MS). To explore the spatio-temporal selectivity of chromatic and luminance losses in MS/ON, thresholds were measured using three different sizes and modulation rates of the RLM displays: small checks modulating slowly, medium-sized checks with moderate modulation and large checks modulating rapidly. The colour of the chromatic stimuli used were specified in a cone-excitation space to measure relative impairments in red–green and blue–yellow chromatic channels. These observers showed chromatic thresholds along the L/(L + M) axis that were higher than those along the S-cone axis for all display sizes/modulation rates and both red-green and blue-yellow colour thresholds were higher than luminance-contrast thresholds. The principal change in thresholds with spatio-temporal changes in the display was a reduction in thresholds for L/(L + M) and S-cones with increasing check size and modulation rate. However, luminance contrast thresholds did not change with display size/rate. These results are consistent with MS/ON selectively affecting processing in colour pathways rather than in the magnocellular pathway, and that within the colour pathways neurones with opposed L- and M-cone inputs are more damaged than colour-opponent neurons with input from S-cones.

Investigative interviewing of children with intellectual disabilities

This research was designed to examine two broad issues in relation to the investigative interviewing of children (aged 9 to 13 years) with mild and moderate intellectual disabilities. First, how do children with intellectual disabilities perform (relative to children matched for chronological and mental age) when recalling an event in response to various questions? Second, what question types and interview strategies do police officers and caregivers use to elicit accurate and detailed accounts about an event from children with intellectual disabilities? The rationale for exploring each of these issues was to determine possible ways of improving the elicitation of evidence from children with intellectual disabilities. While children with intellectual disabilities constitute a high proportion of all child victims of abuse (Conway, 1994; Goldman, 1994; Morse, et ah, 1970), they rarely provide formal reports of abuse and of those incidents that are reported, few cases progress to court (Henry & Gudjonsson, 1999). Study 1 used a standard interview protocol containing a variety of questions and an interview structure commonly used in investigative interviews. Specifically, the memory and suggestibility of eighty children with either a mild and moderate intellectual disability (M age = 10.85 years) was examined when recalling an innocuous event that was staged at their school. The children's performance was compared with that of two control groups; a group of mainstream children matched for mental age and a group of mainstream children matched for chronological age. Overall, this study showed that children with both mild and moderate intellectual disabilities can provide accurate and highly specific event-related information hi response to questions recommended in best-practice guidelines. However, their recall was less complete and less clear in response to free-narrative prompts and less accurate in response to specific questions when compared to both mainstream age-matched groups. Study 2 provided an in-depth analysis of the types of questions and strategies used by twenty-eight police officers and caregivers when interviewing children with either mild or moderate intellectual disabilities (M age = 11.13 years) about a repeated event that was staged at their school. The results revealed that while the approach used by the police officers was generally consistent with best-practice recommendations (i.e., their interviews contained few leading, coercive or negative strategies), there were many ways in which their approach could be improved. This study also showed that the caregivers used a high proportion of direct and negative strategies to elicit information from their children. Even when caregivers used open-ended questions, their children provided less event-related information than they did to police interviewers. The results of both studies were discussed in relation to current 'best-practice' guidelines for interviewing children and recommendations were offered for improving the quality of field interviews with children who have intellectual disabilities.

The impact of caring for a child with cerebral palsy : quality of life for mothers and fathers

Background:  Although it is expected that caring for a child with cerebral palsy (CP) can impact on the quality of life (QOL) of caregivers, the QOL of carers' has yet to be adequately examined. The aims of this study are to: (1) explore the QOL of mothers and fathers of children with CP aged 3–18 years; and (2) examine whether the impact of caring for a child with CP changes from childhood to adolescence.

Method: A qualitative study was conducted utilizing a grounded theory framework. Twenty-four mothers and 13 fathers of children and adolescents with CP aged 3–7 years (n = 15), 8–12 years (n = 10) and 13–18 years (n = 12) and with varying levels of impairment (GMFCS Level I = 1, II = 4, II = 3, IV = 5, V = 12) participated in semi-structured interviews about their QOL. The transcripts were analysed to identify issues affecting parental QOL.

Results: There were no differences in parental QOL among subgroups (i.e. mothers and fathers, age groups, GMFCS levels). Parental QOL ranged across a wide spectrum. Caring for a child with CP affects a parent's physical well-being, social well-being, freedom and independence, family well-being and financial stability. Parents indicated that they often feel unsupported by the services they access.

Conclusions: Caring for a child with CP can both positively and negatively impact on a parent's life. There is value for both parents and children if parental concerns and determinants of QOL are considered in overall programme planning and service delivery for children and their families.

Subjective quality of life of people with MS and their partners

The findings of this thesis supported a model proposed to explain the influence of psychological factors on subjective quality of life. In comparison with their partners, and with a control group, people with MS reported a lowered subjective quality of life and self-esteem, an increased need for social support, and maladaptive use of control. Recommendations for interventions were made based on these findings.

Survivin : a target from brain cancer to neurodegenerative disease

Apoptosis is an important contributing factor during neuronal death in a variety of neurodegenerative disorders, including multiple sclerosis, Parkinson's disease and sciatic nerve injury. Whereas several clinical and preclinical studies have focused on the neuroprotective effects of caspase inhibitors, their clinical benefits are still unclear. Here, we discuss novel alternative strategies to protect neuronal cells from apoptotic death using members of the inhibitors of apoptosis (IAP) family. We specifically review the different roles of survivin, which is an important member of the IAP family that serves a dual role in the inhibition of apoptosis as well as a vital role in mitosis and cell division. Due to the various roles of survivin during cell division and apoptosis, targeting this protein illustrates a new therapeutic window for the treatment of neurodegenerative diseases.

The specifics of coping : parents of daughters with anorexia nervosa

In this article, the authors report on an interview study in which parents described the coping strategies they used to deal with the demands of having a daughter diagnosed with anorexia nervosa. They compare parents’ accounts with commonly used categorizations in quantitative studies of parental coping and adjustment. The study indicates that parents attribute multiple, complex, and unique motives to their actions that problematize quantitative constructions of types of coping. Parents often defined their actions differently and reported using coping strategies that were not considered or measured by the most widely used quantitative coping instruments. The analysis indicates that when the focus is on understanding and assisting parental coping in particular circumstances, situated, contextspecific analyses are necessary to design measures that accurately reflect parents’ coping efforts.