Comparison of prevalence of depression in mothers of twins and mothers of singletons

OBJECTIVE To determine whether the apparent additional and exceptional stresses associated with bearing and parenting twins affect the emotional wellbeing of mothers. SETTING--Great Britain, 1970-5. DESIGN Cohort study of 13,135 children born between 4 April and 11 April 1970. Mothers of all children, both singletons and twins, were interviewed by health visitors (providing demographic data) and completed a self report measure of emotional well-being (the Rutter malaise inventory) when the child was 5 years of age. The malaise scores of mothers of twins were compared with those of all mothers of singletons and then with those of mothers categorised by the age spacing of their children (only one child, widely spaced, or closely spaced), taking account of maternal age, social class, and whether the study child had a disability, by using logistic regression. SUBJECTS 139 mothers of twins--122 pairs of twins and 17 twins whose cotwin had died--and 12,573 controls, who were mothers of singletons. RESULTS A significantly higher proportion of mothers of twins at 5 years had malaise scores indicative of depression than mothers of singletons at the same age. Mothers who had borne twins, one of whom had subsequently died, had the highest malaise scores and were three times more likely than mothers of singletons to experience depression. Both mothers of twin pairs and mothers of singletons closely spaced in age were at significantly higher risk of experiencing depression than mothers of children widely spaced in age or mothers of only one child (p less than 0.0001). Odds ratios indicated that the risk of depression in mothers of twins was higher than that in mothers of closely spaced singletons. CONCLUSION Mothers of twins are more likely to experience depression. This suggests a relation between the additional and exceptional stresses that twins present and the mother's emotional wellbeing.

Developmental, functional brain imaging and electrophysiological evidence of visual and auditory working memory

Intact function of working memory (WM) is essential for children and adults to cope with every day life. Children with deficits in WM mechanisms have learning difficulties that are often accompanied by behavioral problems. The neural processes subserving WM, and brain structures underlying this system, continue to develop during childhood till adolescence and young adulthood. With functional magnetic resonance imaging (fMRI) it is possible to investigate the organization and development of WM. The present thesis aimed to investigate, using behavioral and neuroimaging methods, whether mnemonic processing of spatial and nonspatial visual information is segregated in the developing and mature human brain. A further aim in this research was to investigate the organization and development of audiospatial and visuospatial information processing in WM. The behavioral results showed that spatial and nonspatial visual WM processing is segregated in the adult brain. The fMRI result in children suggested that memory load related processing of spatial and nonspatial visual information engages common cortical networks, whereas selective attention to either type of stimuli recruits partially segregated areas in the frontal, parietal and occipital cortices. Deactivation mechanisms that are important in the performance of WM tasks in adults are already operational in healthy school-aged children. Electrophysiological evidence suggested segregated mnemonic processing of visual and auditory location information. The results of the development of audiospatial and visuospatial WM demonstrate that WM performance improves with age, suggesting functional maturation of underlying cognitive processes and brain areas. The development of the performance of spatial WM tasks follows a different time course in boys and girls indicating a larger degree of immaturity in the male than female WM systems. Furthermore, the differences in mastering auditory and visual WM tasks may indicate that visual WM reaches functional maturity earlier than the corresponding auditory system. Spatial WM deficits may underlie some learning difficulties and behavioral problems related to impulsivity, difficulties in concentration, and hyperactivity. Alternatively, anxiety or depressive symptoms may affect WM function and the ability to concentrate, being thus the primary cause of poor academic achievement in children.

Preadolescents and Their Mothers as Oral Health-Promoting Actors : Non-biologic Determinants of Oral Health among Turkish and Finnish Preadolescents

Is oral health becoming a part of the global health culture? Oral health seems to turn out to be part of the global health culture, according to the findings of a thesis-research, Institute of Dentistry, University of Helsinki. The thesis is entitled as “Preadolescents and Their Mothers as Oral Health-Promoting Actors: Non-biologic Determinants of Oral Health among Turkish and Finnish Preadolescents.” The research was supervised by Prof.Murtomaa and led by Dr.A.Basak Cinar. It was conducted as a cross-sectional study of 611 Turkish and 223 Finnish school preadolescents in Istanbul and Helsinki, from the fourth, fifth, and sixth grades, aged 10 to 12, based on self-administered and pre-tested health behavior questionnaires for them and their mothers as well as the youth’s oral health records. Clinically assessed dental status (DMFT) and self-reported oral health of Turkish preadolescents was significantly poorer than the Finns`. A similar association occurred for well-being measures (height and weight, self-esteem), but not for school performance. Turkish preadolescents were more dentally anxious and reported lower mean values of toothbrushing self-efficacy and dietary self-efficacy than did Finns. The Turks less frequently reported recommended oral health behaviors (twice daily or more toothbrushing, sweet consumption on 2 days or less/week, decreased between-meal sweet consumption) than did the Finns. Turkish mothers reported less frequently dental health as being above average and recommended oral health behaviors as well as regular dental visits. Their mean values for dental anxiety was higher and self-efficacy on implementation of twice-daily toothbrushing were lower than those of the Finnish. Despite these differences between the Turks and Finns, the associations found in common for all preadolescents, regardless of cultural differences and different oral health care systems, assessed for the first time in a holistic framework, were as follows: There seems to be interrelation between oral health and general-well being (body height-weight measures, school performance, and self-esteem) among preadolescents: • The body height was an explanatory factor for dental health, underlining the possible common life-course factors for dental health and general well-being. • Better school performance, high levels of self-esteem and self-efficacy were interrelated and they contributed to good oral health. • Good school performance was a common predictor for twice-daily toothbrushing. Self-efficacy and maternal modelling have significant role for maintenance and improvement of both oral- and general health- related behaviors. In addition, there is need for integration of self-efficacy based approaches to promote better oral health. • All preadolescents with high levels of self-efficacy were more likely to report more frequent twice-daily toothbrushing and less frequent sweet consumption. • All preadolescents were likely to imitate toothbrushing and sweet consumption behaviors of their mothers. • High levels of self-efficacy contributed to low dental anxiety in various patterns in both groups. As a conclusion: • Many health-detrimental behaviors arise from the school age years and are unlikely to change later. Schools have powerful influences on children’s development and well-being. Therefore, oral health promotion in schools should be integrated into general health promotion, school curricula, and other activities. • Health promotion messages should be reinforced in schools, enabling children and their families to develop lifelong sustainable positive health-related skills (self-esteem, self-efficacy) and behaviors. • Placing more emphasis on behavioral sciences, preventive approaches, and community-based education during undergraduate studies should encourage social responsibility and health-promoting roles among dentists. Attempts to increase general well-being and to reduce oral health inequalities among preadolescents will remain unsuccessful if the individual factors, as well as maternal and societal influences, are not considered by psycho-social holistic approaches.

The nutritional status of pre-school children, Kainji Lake communities, Nigeria: a baseline survey

This survey was carried out to provide the Kainji Lake Fisheries Promotion Project (KLFPP), whose overall goal is the improvement of the standard of living of fishing communities around Kainji Lake, Nigeria, and an increase in the availability of fish to consumers, with nutritional status baseline data for long-term monitoring and evaluation of the overall project goal. In a cross-sectional survey, baseline anthropometric data was collected from 768 children, aged 3-60 months in 389 fisherfolk households around the southern sector of Kainji Lake, Nigeria. In addition, data was collected on the nutritional status and fertility of the mothers, vaccination coverage of children and child survival indicators. For control purposes, 576 children and 292 mothers from non-fishing households around Kainji Lake were likewise covered by the survey. A standardised questionnaire was used to collect relevant information, while anthropometric measurements were made using appropriate equipment. Data compilation and analysis was carried out with DATAEASE registered and EPI-INFO registered software, using NCHS reference data for the analysis of anthropometric measurements. The prevalence of stunted children in fishing households was high at 40%, while the prevalence of wasted and underweight children was likewise high at 10% and 29% respectively. Children from non-fishing households had a marginally lower prevalence of stunting, wasting and underweight with 37%, 7% and 25 % respectively, although these differences were not statistically significant. Considering the fact that the survey was carried out during a period of relative food abundance, the prevalence of wasting and underweight children is likely to be much higher during periods of food shortage. The prevalence of stunting, wasting and underweight was relatively high for children aged 3 to 23 months, suggesting an increased risk of malnutrition during this period, most likely associated with inadequate weaning practices. The prevalence of malnourishment amongst women of child-bearing age was relatively high, irrespective of occupation of the household, with an average of 11% undernourished and 6% wasted. Vaccination coverage was very low while infant and child mortality were extremely high with about 1 in 5 children dying before their fifth birthday. Based on the ethical obligation to maximise the potential benefits of the survey, recommendations for activities to improve community nutrition and health were made for communication to relevant authorities. (PDF contains 52 pages)

The nutritional status of pre-school children, Kainji Lake communities, Nigeria: a follow-up survey

This survey was carried out to provide the Kainji Lake Fisheries Promotion Project (KLFPP), whose overall goal is the improvement of the standard of living of fishing communities around Kainji Lake, Nigeria, managing the fisheries on a sustainable basis, with follow-up data for long-term monitoring and evaluation of the overall project goal. A similar survey, conducted in 1996, provided the baseline against which data from the current survey was evaluated. In a cross-sectional survey, anthropometric data was collected from 576 children aged 3-60 months in 282 fisherfolk households around the southern sector of Kainji Lake, Nigeria. In addition, data was collected on the nutritional status and fertility of the mothers, vaccination coverage of children and child survival indicators. For control purposes, 374 children and 181 mothers from non-fishing households around Kainji Lake were likewise covered by the survey. A standardised questionnaire was used to collect relevant data, while anthropometric measurements were made using appropriate equipment. Data compilation and analysis was carried out with a specially designed Microsoft Access application, using NCHS reference data for the analysis of anthropometric measurements. Statistical significance testing was done using EPI-INFO" software. The results of the follow-up survey indicate a slight increase in the percentage of stunted pre-school children in fishing households around Kainji Lake, from 40% in 1996 to 41% in 1999. This increase is however not statistically significant (p= 0.704). Over the same period, the percentage of stunted children in non-fishing households increased from 37% to 39% (p= 0.540), which is also not statistically significant. Likewise, there were no statistically significant differences between the 1996 and 1999 results for the prevalence of either wasted or underweight children in fishing households. The same applies to children from non-fishing households. In addition, vaccination coverage remains very low while infant and child mortality rates continue to be extremely high with about 1 in 5 children dying before their fifth birthday. There has been no perceptible and lasting improvement in the standard of living of fishing households over the course of the second project phase as indicated by the persistently high prevalence of stunting. The situation is the same for the control group, indicating that for the region as a whole, a number of factors beyond the immediate influence of the project continue to negatively impact on the standard of living. The results also show that the project activities have not had any negative long-term effect on the nutritional status of the beneficiaries. (PDF contains 44 pages)

Developing Creative Solutions to the Problems of Children and their Families: Communicative Reason and the use fo Forum Theatre

Building on Habermas’s conceptualisation of modes of reasoning, the authors proposed that an application of critical theory to the present bureaucratised nature of communication between state representatives and welfare recipients (Howe 1992) might open up ways in which social workers could reconceptualise their practice. In a subsequent edition of this journal, three of the present authors introduced the radical theatre of Augusto Boal as a methodology which might provide an expressive route for social workers seeking to build a practice combining the intellectual analysis of critical theory with new ways of working (Spratt et al. 2000). Boal’s method recognises the oppressed status of groups who come to the attention of agents of the state and, through the use of a range of theatrical techniques, introduces strategies to facilitate the conscious recognition of such collective oppressions and develop dialogical ways to address them. In the last paper, the authors presented one such technique, ‘image theatre’, and demonstrated its use with social workers in consciousness raising and developing strategies for collective action.

Reception and schooling of children in schools in Catalonia: Beyond Educational Welcome Facilities

The ways of incorporating newcoming students into schools and colleges have been at the center of debate in most OECD countries in recent years. In Spain, the set of measures developed for the reception of immigrant pupils in different Autonomous Communities has also been the subject of specific research, pointing out the similarities and contradictions between pedagogic discourses and school practices. This article takes into account these considerations and presents the reflections from the results of research on the Educational Welcome Facilities (and specifically the EBE) conducted during the school years 2008-2010. This device was created in Catalonia to attend newcomers before enrolling them in the school. It was a pilot project which took place in Vic and Reus for two consecutive years. The research of the EBE has enabled us to explain the relationship between educational assessment that schools made about this facility and reception processes that schools were implementing. The conclusions that emerge from this analysis allowed us to establish relationships between educational host practices of the seven centers analyzed with three different conceptual and educational frameworks of reception.

A RCT of peer-mentoring for first-time mothers in socially disadvantaged areas (the moments study)

Objective: Interventions to reduce health inequalities for young children and their mothers are important: involving peers is recommended, but evidence of value for this approach is limited. The authors aimed to examine the effect of an innovative tailored peer-mentoring programme, based on perceived needs, for first-time mothers in socio-economically deprived communities. Design: Randomised controlled trial; parallel qualitative study with purposive samples using semistructured interviews. Setting: Socio-economically disadvantaged areas, Belfast. Participants: Primigravidae, aged 16-30 years, without significant co-morbidity. Intervention: Peer-mentoring by a lay-worker fortnightly during pregnancy and monthly for the following year, tailored to participants' wishes (home visits/telephone contacts), additional to usual care. Main outcome measures: Infant psychomotor and mental development (Bayley Scales of Infant Development (BSID-II)) at 1 year, assessed by an observer blinded to group allocation. Mothers' health at 1 year postnatal (SF-36). Results: Of 534 women invited, 343(64%) participated; 85%, with their children, completed outcome assessments (140 of 172 intervention; 152 of 171 controls). Intervention and control groups did not differ in BSID-II psychomotor (mean difference 1.64, 95% CI -0.94 to 4.21) or mental (-0.81, -2.78 to 1.16) scores, nor SF-36 physical functioning (-5.4, -11.6 to 0.7) or mental health (-1.8, -6.1 to 2.6). Women valued advice given in context of personal experience of child-rearing. Mentors gained health-related knowledge, personal skills and new employment opportunities. Conclusions: Despite possible longer-term social advantage, this peer-mentoring programme showed no benefit for infant development or maternal health at 1 year. Further rigorous evaluation of important outcomes of complex interventions promoting health for children in socially disadvantaged communities is warranted. Trial registration no: ISRCTN 55055030.

Blocking in children's causal learning depends on working memory and reasoning abilities.

A sample of 99 children completed a causal learning task that was an analogue of the food allergy paradigm used with adults. The cue competition effects of blocking and unovershadowing were assessed under forward and backward presentation conditions. Children also answered questions probing their ability to make the inference posited to be necessary for blocking by a reasoning account of cue competition. For the first time, children's working memory and general verbal ability were also measured alongside their causal learning. The magnitude of blocking and unovershadowing effects increased with age. However, analyses showed that the best predictor of both blocking and unovershadowing effects was children's performance on the reasoning questions. The magnitude of the blocking effect was also predicted by children's working memory abilities. These findings provide new evidence that cue competition effects such as blocking are underpinned by effortful reasoning processes. 

Do challenge, task experience or computer familiarity influence the learning of historical chronology from virtual environments in 8–9 year old children?

Studies examined the potential use of Virtual Environments (VEs) in teaching historical chronology to 127 children of primary school age (8–9 years). The use of passive fly-through VEs had been found, in an earlier study, to be disadvantageous with this age group when tested for their subsequent ability to place displayed sequential events in correct chronological order. All VEs in the present studies included active challenge, previously shown to enhance learning in older participants. Primary school children in the UK (all frequent computer users) were tested using UK historical materials, but no significant effect was found between three conditions (Paper, PowerPoint and VE) with minimal pre-training. However, excellent (error free) learning occurred when children were allowed greater exploration prior to training in the VE. In Ukraine, with children having much less computer familiarity, training in a VE (depicting Ukrainian history) produced better learning compared to PowerPoint, but no better than in a Paper condition. The results confirmed the benefit of using challenge in a VE with primary age children, but only with adequate prior familiarisation with the medium. Familiarity may reduce working memory load and increase children’s spatial memory capacity for acquiring sequential temporal-spatial information from virtual displays. Keywords: timeline, chronographics

Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): study design of a cluster randomized controlled trial.

Childhood obesity and physical inactivity are increasing dramatically worldwide. Children of low socioeconomic status and/or children of migrant background are especially at risk. In general, the overall effectiveness of school-based programs on health-related outcomes has been disappointing. A special gap exists for younger children and in high risk groups. This paper describes the rationale, design, curriculum, and evaluation of a multicenter preschool randomized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons. Twenty preschool classes in the German (canton St. Gallen) and another 20 in the French (canton Vaud) part of Switzerland were separately selected and randomized to an intervention and a control arm by the use of opaque envelopes. The multidisciplinary lifestyle intervention aimed to increase physical activity and sleep duration, to reinforce healthy nutrition and eating behaviour, and to reduce media use. According to the ecological model, it included children, their parents and the teachers. The regular teachers performed the majority of the intervention and were supported by a local health promoter. The intervention included physical activity lessons, adaptation of the built infrastructure; promotion of regional extracurricular physical activity; playful lessons about nutrition, media use and sleep, funny homework cards and information materials for teachers and parents. It lasted one school year. Baseline and post-intervention evaluations were performed in both arms. Primary outcome measures included BMI and aerobic fitness (20 m shuttle run test). Secondary outcomes included total (skinfolds, bioelectrical impedance) and central (waist circumference) body fat, motor abilities (obstacle course, static and dynamic balance), physical activity and sleep duration (accelerometry and questionnaires), nutritional behaviour and food intake, media use, quality of life and signs of hyperactivity (questionnaires), attention and spatial working memory ability (two validated tests). Researchers were blinded to group allocation. The purpose of this paper is to outline the design of a school-based multicenter cluster randomized, controlled trial aiming to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerland with a high migrant population. Trial Registration: (clinicaltrials.gov) NCT00674544.

Parental beliefs as predictors of children's externalizing behaviors

The relationship between maternal beliefs about children's externalizing behaviors (EB) and the frequency of their children's EB was investigated. The sample of 71 consisted of two groups of mothers of children between 8-12 years of age. The Clinic group consisted of 35 mothers of children referred to a Children's Clinic due to externalizing behavior problems. The School group consisted of 36 mothers of children attending elementary school. Mothers completed questionnaires measuring parental beliefs and the frequency of their children's EB. Results showed that mothers' endorsement of authoritarian parenting was positively related to children's EB scores. A U-shaped relationship was found between mothers' relationship-centered goals and children's EB scores. Parent-centered goals and children's EB scores were positively correlated only in the clinic group. Mothers'-hostile attribution scores were positively related to their children's EB scores in both groups. Mothers with low perceived parenting scores were associated with higher children's EB scores in both groups. Overall, results revealed potential clinical implications. Parenting programs that change parenting goals, attributions, and ii Parental Beliefs sense of parenting control, which in turn influences parenting behavior, may influence the frequency of their children's externalizing behaviors.

Child care by choice or by default? : examining the experiences of unregulated home-based child care for women in paid work and training

This thesis aims to uncover the dynamics, causes and outcomes of women's reliance on unregulated home-based child care in Ontario, Canada, and the implications ofthis form of care for women's equality. Drawing on a longitudinal qualitative study, I examine the diverse experience of 14 women using home-based child care and engaged in both paid work/training and care work for children under the age of six, and draw comparisons with users of other forms of child care. I argue that home-based child care involves high levels of instability for continuity of care and is chosen largely as a default position based on economic considerations. It represents a compromise between the demands of social reproduction and paid work/training that entangles mothers in relations of exploitation with care providers. Doing so leaves both mothers and care providers socially and economically vulnerable and relying on social networks to fill in the gaps.

The relationship between working alliance and treatment outcomes in remedial instruction for older dyslexic children

Research in psychotherapy has demonstrated that a positive working alliance between therapist and client leads to positive treatment outcomes. Though its focus is in the area of psychotherapy, the concept of working alliance holds significant value to the area of education. Current applications of the theory in educational settings have looked at relationships between teacher and students in the broad context of classroom interaction and found significant promise. The present study investigates the application of the theory of working alliance in a sample of older reading disabled children. The study examined the psychometric properties of the Reading Alliance Scale for Children (RASC) and for Teachers (RAST) in relation to student reading ability and motivation. A sample of 254 (66.1 % male, 33.9% female) grade 6-8 students (mean age 12.7 years) were enrolled in a remedial reading program for reading disabled children. The average standard score across multiple reading measures was more than 1 SD below age-level expectations. Students responded to measures of reading achievement and motivation at pretest, after 70 hours (post 70) of remediation and at the end of the program (post 125). All participants completed measures on the working alliance relationship at post 70 and post 125. Results showed that teacher reports were most predictive of outcome compared to student reports of the working alliance relationship. Working alliance was correlated with posttest reading ability and motivation. Male students and Black students obtained the weakest working alliance reports from their teacher. Overall, findings support the view that students' relationships with teachers provide an important component of success in the classroom.

Do you believe in the Loch Ness Monster? Children's influence on mothers' beliefs, values, and social/cultural practices.

Obtaining mothers' perspectives and descriptions of incidents in which their child(ren) said or did something that influenced the mothers' values, beliefs, and/or social or cultural practices, that is, the content of socialization, was the primary aim of this research. Bakhtin's (2004) metatheoretical account of dialogism was used to frame this study. From a dialogic perspective utterances (for example, the utterances of children in the present study) are events or acts and are presented as one way to view the process of socialization. In part this purpose, and the decision to utilize a qualitative research orientation, was to address a call (Lollis & Kuczynski, 1997) for qualitative or microanalytic analyses to help elucidate the processes of socialization. Mothers (N=10) in this study were able to provide descriptions of incidents in which their child(ren) said or did something that influenced the mother and hence we have some description of the concept of bidirectionality, a well accepted, but undertheorized concept in developmental psychology. While the concepts of multiple sources of influence and contexts are salient areas of research in parent-child socialization, and were mentioned in the informants reporting these areas did not appear to be as salient in the mothers' accounts. Emotions and the meaning mothers 'derived' from the interactions did, however, take much more prominence in the described incidents.