Obesity prevention in children and adolescents

Childhood and adolescent obesity has been increasing in most middle- and high-income countries, and, as with adult obesity, this has been driven by increasingly obesogenic environments, especially the food environment. This constitutes a “market failure,” signaling the need for government interventions with policies, programs, and social marketing. Population prevention strategies are critical, and children and adolescents should be the priority populations. Food marketing to children is a central policy issue for governments to address, and comprehensive regulations are needed to provide substantive protection for children. Community-based intervention programs show some real promise in reducing childhood obesity, but the 2 big challenges ahead are to ensure that there is substantial ongoing funding so that the community capacity to promote healthy weights can be scaled up to a national level and to ensure that policies are in place to support these efforts. The social and cultural shifts that support healthy eating and physical activity occur differentially, and special efforts are needed to reduce the socioeconomic gradients associated with childhood obesity. A positive public health approach encompassing environmental, regulatory, sociocultural, and educational strategies offer the best chance of reducing obesity without increasing disordered eating patterns.

Family in transition: parents, children and grandparents in lesbian families give meaning to 'doing family'

Lesbian parents, their children and grandparents ‘do family’ in rich and diverse ways. This article draws on innovative grounded theory research using qualitative, multi-generational family interviews with twenty lesbian- parented families living in Victoria, Australia. The intersection between the public and the private in lesbian family life has been seriously neglected by family researchers, and in particular the perspectives of family members other than the lesbian parents themselves. This article addresses the question of ‘How members of lesbian-parented families define and describe their family’, and the results reported here focus on children’s and grandparents’ views, because they are the voices less well represented in the literature. Children and grandparents straddle both mainstream and marginalized spaces as they negotiate contemporary family life. We examine the interface and tensions between the traditional and the transformative, and the implications of these findings for family therapists are briefly discussed.

Family correlates of fruit and vegetable consumption in children and adolescents : a systematic review

Objectives To review associations between the family environment and young people’s fruit and vegetable consumption.

Design A systematic review. Published English-language (n 60) papers were identified using electronic databases and manual searches of personal files and reference lists. Observational research reporting a measure of fruit/vegetable intake for children (aged 6–11 years) and/or adolescents (aged 12–18 years) and at least one potential family correlate of dietary intake was included.

Results Parental modelling and parental intake were consistently and positively associated with children’s fruit and fruit, juice and vegetable (FJV) consumption. There were also positive associations between home availability, family rules and parental encouragement and children’s fruit and vegetable consumption. Parental intake was positively associated with adolescents’ fruit and vegetable consumption. There were also positive associations between parental occupational status and adolescent fruit consumption and between parental education and adolescents’ FJV consumption.

Conclusions Our findings highlight the importance of targeting the family environment for the promotion of healthy eating behaviours among children and adolescents. Future interventions should encourage parents to be positive role models by targeting parental intake and to create a supportive home environment through increased encouragement and availability of fruits and vegetables and employing rules to govern eating behaviours. For adolescents, indicators of family circumstances (e.g. parental education) should be used to identify target groups for interventions aimed at promoting healthy eating.

PTSD symptomatology in children and adolescents : treatment development and evaluation

This thesis developed, implemented and evaluated a cognitive-behavioural group treatment programme for children and adolescents experiencing symptoms of PTSD (Post-traumatic stress disorder). Results of the study indicate that symptoms of sleep disturbance and flashbacks, reduced markedly in the participants, providing a useful tool in reducing synptoms experiences by individuals exposed to trauma. The Professional portfolio presents four case studies that demonstrate the clinical application of the affect of chronic illness on the psychological adjustment of the sufferer and their families.

The usefulness of suggestibility scales in predicting children's false reports of events

This thesis examined the nature and strength of the relationship between children's performance on suggestibility scales and their recall of independent events. It demonstrated that whilst standardised scales of suggestibility may be useful in predicting children's reporting of false information, there are clear boundaries to their usefulness. The clinical portfolio examines and discusses the impact that exposure to family violence has on children's functioning across development.

The impact of parental multiple sclerosis on the adjustment of children and adolescents.

Thirty-one parents with multiple sclerosis (MS) participated in a study to investigate the adjustment of their children, 24 boys and 24 girls aged 4 to 16 years. The majority of parents believed that their illness had an effect on their children. The perception of parents regarding their children's problems in the areas of emotions, concentration, behavior, or social interactions indicated that the children were at three times greater risk than the general community of developing psychological problems. In contrast, actual symptom scores reported by parents revealed that, although these children were at greater risk than the general community of developing peer problems, little difference was found on hyperactivity, emotional symptoms, conduct problems, or total difficulties. Parental negative affect predicted both parental reports of peer problems and perceptions that the parents' illness had an effect on their children. Parental relationship satisfaction and family income did not predict parental reports of children's level of adjustment. These results indicate that children of parents with MS demonstrate more difficulties in how they relate to others, the distress they experience, and how they manage their lives, rather than revealing higher levels of symptoms. Since the data were based on parental reports of their children's problems, the results may also be due to negative affect among the parents.

Use of restraint in residential care settings for children and young people

An international movement promoting the reduced use of physical restraint and other coercive practices has brought into focus the ways in which those who are responsible for the care of children and young people respond to problematic behaviour. The topic generates emotive discussion, with proponents advancing the argument that the use of coercive measures enhances the quality of care and protects young people from harm, and civil libertarians who argue that restraint is never an appropriate way of managing behaviour. Despite such debates there is an absence of good research and scholarly activity on restraint practices, leading to uncertainty about the immediate and long-term effects of particular practices on both staff and young people. Consequently, it has been difficult for agencies to develop clear, consistent, and definitive policies. Drawing on international perspectives, the aim of this article is to discuss issues relevant to the practice of restraint in residential care facilities for children and young people in Australia, highlighting a number of issues that require resolution prior to the development of practice guidelines.