Study of vitamin B6 in total parental nutrition

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Perceptions of parental pressure to eat and eating behaviours in preadolescents:the mediating role of anxiety

Previous research suggests that parental controlling feeding practices are associated with children's overeating and undereating behaviours. However, there is limited research addressing the link between children's mental health symptoms (specifically anxiety and depression) and their reports of eating behaviours, despite knowledge that these psychopathologies often co-exist. The current study aimed to identify the relationships between preadolescents' perceptions of their parents' feeding practices with reports of their own anxiety, depression and eating behaviours. Three hundred and fifty-six children (mean age 8.75 years) completed questionnaires measuring their dietary restraint, emotional eating and external eating, as well as their perceptions of their parents' use of pressure to eat and restriction of food. Children also completed measures of general anxiety, social anxiety and depression symptomology. Results indicated that preadolescents' eating behaviours were associated with their perceptions of the controlling feeding practices their parents used with them. Preadolescents' dietary restraint, emotional eating and external eating behaviours were positively associated with their reports of general and social anxiety, and depression symptomology. In addition, perceptions of parental pressure to eat were positively related to preadolescents' anxiety and depression levels. Child anxiety (general and social) was found to mediate the relationship between perceptions of parental pressure to eat and preadolescents' eating behaviours (dietary restraint, emotional eating and external eating). The results suggest that greater anxiety in preadolescents may explain why children who perceive greater pressure to eat by their parents are more likely to exhibit maladaptive eating behaviours. © 2014 Elsevier Ltd.

Parental diet, pregnancy outcomes and offspring health:metabolic determinants in developing oocytes and embryos

The periconceptional period, embracing the terminal stages of oocyte growth and post-fertilisation development up to implantation, is sensitive to parental nutrition. Deficiencies or excesses in a range of macro- and micronutrients during this period can lead to impairments in fertility, fetal development and long-term offspring health. Obesity and genotype-related differences in regional adiposity are associated with impaired liver function and insulin resistance, and contribute to fatty acid-mediated impairments in sperm viability and oocyte and embryo quality, all of which are associated with endoplasmic reticulum stress and compromised fertility. Disturbances to maternal protein metabolism can elevate ammonium concentrations in reproductive tissues and disturb embryo and fetal development. Associated with this are disturbances to one-carbon metabolism, which can lead to epigenetic modifications to DNA and associated proteins in offspring that are both insulin resistant and hypertensive. Many enzymes involved in epigenetic gene regulation use metabolic cosubstrates (e.g. acetyl CoA and S-adenosyl methionine) to modify DNA and associated proteins, and so act as 'metabolic sensors' providing a link between parental nutritional status and gene regulation. Separate to their genomic contribution, spermatozoa can also influence embryo development via direct interactions with the egg and by seminal plasma components that act on oviductal and uterine tissues. © IETS 2014.

An assessment of the accuracy of electrolyte concentrations in neonatal parental nutrition

Focal points Over a six-week period in January and February 2002, 2ml samples were removed from all neonatal PN bags dispensed Samples were submitted for analysis of sodium, potassium and magnesium in triplicate by the hospital's clinical chemistry department using a Vitros Codac 950AT, dry slide, automated analyser Only 19.3, 7.1 and 30.4 per cent of measured sodium, potassium and magnesium concentrations respectively deviated by £5 per cent from stated bag concentrations The results indicate that it is possible that some electrolyte concentrations included in neonatal PN vary significantly from stated values

A mixed methods investigation of parental factors in non-attendance at general paediatric hospital outpatient appointments

Non-attendance at paediatric outpatient appointments results in delayed diagnosis and treatment, putting children at risk of avoidable ill health, and incurring considerable health service costs. Links between missed appointments and clinical, socio-demographic, and access-related factors have been indicated, but parental cognitions associated with non-attendance have yet to be investigated. The aims of this project were to evaluate the effectiveness and theoretical bases of existing interventions designed to reduce non-attendance; to consider the ways in which missed appointments are managed by healthcare providers; to explore parents’ beliefs and experiences of attending and missing appointments; and to investigate the factors underlying these beliefs. A systematic literature review focusing on non-attendance interventions was conducted Within a mixed methods framework, interviews were conducted with healthcare professionals, subsequent interviews were conducted with parents who had attended or missed a General Paediatric outpatient appointment, and a cross-sectional questionnaire study of parents’ beliefs was implemented. The systematic review revealed that text message appointment reminders are effective at reducing non-attendance rates, but that no interventions have thus far been developed using theories of behaviour. Healthcare professionals recognised both barriers and parents’ beliefs as influences on attendance, but also believed there were ‘types’ of families who miss appointments. Healthcare professionals disagreed somewhat about how non-attendance should best be managed. The parent interview study found six themes. The findings reflect parents’ perceptions about the importance of attending and of their ability to attend. The results of the questionnaire study corroborate this structure of beliefs as the analysis produced two factors, the perceived ‘worth’ of attending and anticipated ‘worry’ when attending. This thesis demonstrates an original approach to investigating non-attendance at children’s outpatient appointments, using mixed methods and adopting a psychological rather than service-use perspective. The findings contribute to Health Psychology theory and offer recommendations for healthcare providers.

Adherence to treatment in children and adolescents with cystic fibrosis:a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

Background: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence. Methods: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence. Conclusions: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children.

Teaching our children when to eat:how parental feeding practices inform the development of emotional eating-a longitudinal experimental design

Background: Emotional eating in children has been related to the consumption of energy-dense foods and obesity, but the development of emotional eating in young children is poorly understood. Objectives: We evaluated whether emotional eating can be induced in 5-7-y-old children in the laboratory and assessed whether parental use of overly controlling feeding practices at 3-5 y of age predicts a greater subsequent tendency for children to eat under conditions of mild stress at ages 5-7 y. Design: Forty-one parent-child dyads were recruited to participate in this longitudinal study, which involved parents and children being observed consuming a standard lunch, completing questionnaire measures of parental feeding practices, participating in a research procedure to induce child emotion (or a control procedure), and observing children's consumption of snack foods. Results: Children at ages 5-7 y who were exposed to a mild emotional stressor consumed significantly more calories from snack foods in the absence of hunger than did children in a control group. Parents who reported the use of more food as a reward and restriction of food for health reasons with their children at ages 3-5 y were more likely to have children who ate more under conditions of negative emotion at ages 5-7 y. Conclusions: Parents who overly control children's food intake may unintentionally teach children to rely on palatable foods to cope with negative emotions. Additional research is needed to evaluate the implications of these findings for children's food intake and weight outside of the laboratory setting. This trial was registered at clinicaltrials.gov as NCT01122290.

Parental confidence in managing food allergy:development of the Food Allergy Self-Efficacy Scale for parents (FASE-P)

Background: Food allergy is often a life-long condition that requires constant vigilance in order to prevent accidental exposure and avoid potentially life-threatening symptoms. Parents’ confidence in managing their child’s food allergy may relate to the poor quality of life anxiety and worry reported by parents of food allergic children. Objective: The aim of the current study was to develop and validate the first scale to measure parental confidence (self-efficacy) in managing food allergy in their child. Methods: The Food Allergy Self-Efficacy Scale for Parents (FASE-P) was developed through interviews with 53 parents, consultation of the literature and experts in the area. The FASE-P was then completed by 434 parents of food allergic children from a general population sample in addition to the General Self-Efficacy Scale (GSES), the Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), the General Health Questionnaire (GHQ12) and the Food Allergy Impact Measure (FAIM). A total of 250 parents completed the re-test of the FASE-P. Results: Factor and reliability analysis resulted in a 21 item scale with 5 sub-scales. The overall scale and sub-scales has good to excellent internal consistency (α’s of 0.63-0.89) and the scale is stable over time. There were low to moderate significant correlations with the GSES, FAIM and GHQ12 and strong correlations with the FAQL-PB, with better parental confidence relating to better general self-efficacy, better quality of life and better mental health in the parent. Poorer self-efficacy was related to egg and milk allergy; self-efficacy was not related to severity of allergy. Conclusions and clinical relevance: The FASE-P is a reliable and valid scale for use with parents from a general population. Its application within clinical settings could aid provision of advice and improve targeted interventions by identifying areas where parents have less confidence in managing their child’s food allergy.

Developing a tool to support communication of parental concerns when a child is in hospital

The involvement of parents in their child’s hospital care has been strongly advocated in paediatric healthcare policy and practice. However, incorporating parental worries about their child’s condition into clinical care can be difficult for both parents and healthcare professionals. Through our “Listening To You” quality improvement project we developed and piloted an innovative approach to listening, incorporating and responding to parental concerns regarding their child’s condition when in hospital. Here we describe the phases of work undertaken to develop our “Listening To You” communications bundle, including a survey, literature review and consultation with parents and staff, before findings from the project evaluation are presented and discussed.

Parental self-efficacy in managing food allergy and mental health predicts food allergy related quality of life

BACKGROUND: Food allergy has been shown to have a significant impact on quality of life (QoL) and can be difficult to manage in order to avoid potentially life threatening reactions. Parental self-efficacy (confidence) in managing food allergy for their child might explain variations in QoL. This study aimed to examine whether self-efficacy in parents of food allergic children was a good predictor of QoL of the family. METHODS: Parents of children with clinically diagnosed food allergy completed the Food Allergy Self-Efficacy Scale for Parents (FASE-P), the Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), the GHQ-12 (to measure mental health) and the Food Allergy Independent Measure (FAIM), which measures perceived likelihood of a severe allergic reaction. RESULTS: A total of 434 parents took part. Greater parental QoL was significantly related to greater self-efficacy for food allergy management, better mental health, lower perceived likelihood of a severe reaction, older age in parent and child and fewer number of allergies (all p<0.05). Food allergy self-efficacy explained more of the variance in QoL than any other variable and self-efficacy related to management of social activities and precaution and prevention of an allergic reaction appeared to be the most important aspects. CONCLUSIONS: Parental self-efficacy in management of a child's food allergy is important and is associated with better parental QoL. It would be useful to measure self-efficacy at visits to allergy clinic in order to focus support; interventions to improve self-efficacy in parents of food allergic children should be explored. This article is protected by copyright. All rights reserved.

Eating behaviours of preadolescent children over time:stability, continuity and the moderating role of perceived parental feeding practices

The links between childhood eating behaviours and parental feeding practices are well-established in younger children, but there is a lack of research examining these variables in a preadolescent age group, particularly from the child's perspective, and longitudinally. This study firstly aimed to examine the continuity and stability of preadolescent perceptions of their parents' controlling feeding practices (pressure to eat and restriction) over a 12 month period. The second aim was to explore if perceptions of parental feeding practices moderated the relationship between preadolescents' eating behaviours longitudinally. Two hundred and twenty nine preadolescents (mean age at recruitment 8.73 years) completed questionnaires assessing their eating behaviours and their perceptions of parental feeding practices at two time points, 12 months apart (T1 and T2). Preadolescents' perceptions of their parental feeding practices remained stable. Perceptions of restriction and pressure to eat were continuous. Perceptions of parental pressure to eat and restriction significantly moderated the relationships between eating behaviours at T1 and T2. The findings from this study suggest that in a preadolescent population, perceptions of parental pressure to eat and restriction of food may exacerbate the development of problematic eating behaviours.

The future of engineering - Do primary school engineering education interventions leave a lasting impression?

This positional paper proposes a conceptual framework and methodological approach for use in a PhD study investigating the longer term educational and social impact of 'active' engineering focused interventions for children age 8-10 in the UK. The study will critically analyse how a child's participation in an engineering education activity contributes to the Engineering Capital that the child possesses; focusing on how the child's awareness and perceptions about engineering are affected. To achieve this aim it is proposed that Grounded Theory methodology be used to enable an in-depth analysis of participation from the perspective of the child participant. The study proposed will be longitudinal, taking place over three formative years for the education and career aspirations of the child, from age 8-10 to 11-13. Although the research is in its infancy, this paper will provide the opportunity to develop theory in an underdeveloped area of engineering education research.

A study of the relationship between parental self-efficacy and indicators of school involvement exhibited by Hispanic parents of elementary school children

The purpose of this study was to examine the relationship between Hispanic parents' sense of self-efficacy at various degrees of acculturation to the United States and specific indicators of school involvement in their elementary school children's education. It assessed the effects of acculturation on the level of parental self-efficacy and their degree of school involvement. The theoretical framework guiding this investigation was Bandura's theory of self-efficacy which advocates that the amount of effort a person devotes to the accomplishment of a specific outcome is related to a person's beliefs in their capabilities regardless of actual competencies.^ The research method involved a correlational design measuring levels of parental self-efficacy, acculturation, degree of school involvement and related demographic characteristics. Multiple regression analysis was performed to determine the degree of relationships existing between the predictor variables of self-efficacy and level of acculturation, and level of school involvement. The data was subjected to a path analysis to test the validity of the causal model advanced in this study specifying a positive relationship between the constructs of acculturation, parental self-efficacy and level of school involvement.^ A total of 109 Hispanic parents of students enrolled in five elementary public schools in Dade County, Florida, were selected for participation in the study. Results revealed a significant positive correlation r =.23, p $<$.05 between level of parental self-efficacy and number of hours parents spent helping their children with homework. A statistically significant positive correlation was found between acculturation and level of self-efficacy r =.21, p $<$.05. Statistically significant positive correlations were also found between acculturation and such indicators of parental school involvement as participation in parent-teacher conferences r =.20, p $<$.05, volunteering at school, r =.22, p $<$.05, attendance at school sponsored sports activities r =.26, p $<$.01, and volunteering in field-trips r =.28, p $<$.01.^ The multiple regression analysis equation predicting level of homework assistance provided by parents and self-efficacy was statistically significant, F(2,106) = 3.59, p $<$.03. The beta weights revealed that self-efficacy contributed the most to the prediction of homework assistance by parents, B =.258, p $<$.009. In turn, the variable of acculturation was the most significant predictor of number of school based parent involvement activities, B =.281, p $<$.05 level. The path analysis confirmed the results obtained in the multiple regression analyses, establishing self-efficacy as having a direct effect on the level of homework assistance provided by parents. Conversely, the variable of acculturation had a direct effect on the number of school based parent involvement activities. ^

The influence of weak parental and peer attachment on academic achievement among late adolescent college students

The current study examined the influence of weak parental and peer attachment on academic achievement among late adolescent college students. In previous research, weak attachment to parents and/or peers had been found to have an adverse influence on the academic success of college students. This study also examined the potential moderating influence of several cognitive and non-cognitive psychosocial variables that might act as protective factors for weakly attached students and, therefore, enhance their academic competence. Data regarding attachment, cognitive variables, and non-cognitive variables were collected using several self-report measures. The multi-ethnic sample of students in this study (n = 357) attended an urban university. Students were classified into one of nine parental-peer attachment groups (e.g., Low-Low, Medium-Medium, High-High). Attachment groups were compared in terms of cognitive and non-cognitive variables. Contrary to the hypothesis, no statistically significant academic achievement differences were revealed for the group of college students who perceived themselves to be weakly attached to both parents and peers. Analysis of variance (ANOVA) identified the High-High group to be significantly different in terms of academic outcome variables from the other eight groups while the Low-Low group had significantly lower levels of non-cognitive variables than several of the other attachment groups. Hierarchical multiple regression analyses revealed that cognitive variables accounted for significant amounts of variance in academic outcomes and that several non-cognitive variables were significant predictors of scholastic competence. Correlational analyses revealed that parental and peer attachment were positively correlated with several cognitive and non-cognitive variables but neither was significantly correlated with self-reported college GPA. In general, the findings do not provide support for a main effect of weak attachment to parents and peers upon academic adversity among college students. Results suggest that both cognitive variables and non-cognitive variables may moderate academic risk due to weak attachment to parents and peers. Descriptive within group analyses of the Low-Low group revealed a heterogeneous group of students with regards to academic outcomes and scores on non-cognitive measures. Gender and ethnic differences were found for attachment status but not for cognitive or non-cognitive variables. Implications for interventions and suggestions for future research are presented. ^

An examination of parental opinions regarding the inclusion of disabled students in regular education classes

This study investigated the opinions regarding inclusion of parents of both disabled and nondisabled elementary children from a large suburban county. An opinion survey combining Wilczenski's Attitudes Toward Inclusive Education Scale with additional questions was distributed to 1170 children from 24 schools. Three research questions focused on differences between mean parental responses as they related to the inclusion and disability status of the parent's child. Results from the 270 respondents indicated that parents with disabled children had more favorable opinions about inclusion than did those with nondisabled children. Parents with included children were more favorable toward inclusion than were parents whose children were not included. Parents with included disabled children were more accepting of inclusion than were those with nondisabled children in inclusive settings. Parents' answers differed depending on the type of disability being included. Regardless of their child's disability or inclusion status, the ranking for disability types from most acceptable for inclusion to least acceptable were: social, sensory, motor, academic and behavioral. Results across types of questions, including questions relating to acceptance and general inclusion issues, indicated consistently more favorable opinions of parents with disabled children, included children and disabled children in inclusive classes. Two additional research questions examined parental responses as they related to demographic characteristics of the parents and of the schools their children attended. Analysis of Variance found only one significant main effect for any parental demographic variable. This difference was for the number of parents' elementary children when comparing parents with and without disabled children. The only significant main effects of demographics of schools the parents' children attended were for the area of the county and for schools with differing percentages of severely disabled students when comparing responses of parents with disabled and nondisabled children. For all research questions, tests indicated low effect sizes and moderate to high power levels. These results, and the fact that means for all groups were in the middle range of response choices, indicate that there may be little practical significance to the overall results. Further studies should investigate the trends found in this study. ^