Revisiting the relationship between marriage and wellbeing : does marriage quality matter?

This paper revisits the marriage and wellbeing relationship using variables reflecting marriage quality and data from the US, the UK and Germany. People in self-assessed poor marriages are fairly miserable and much less happy than unmarried people, even in the first year of marriages. However, people in self-assessed good marriages are even happier than the literature suggests. Women show greater range of responses to marriage quality than men. The effect of employment status and subjective health on happiness and the marriage effects on interpersonal trust and mental health change dramatically when marriage quality is controlled for. A strong link from happiness to marriage does not exist. However, happier people are more likely to stay single instead of being unhappily married, but less likely to stay single compared to being very happily married and happiness cannot predict staying single versus being pretty happily married.

Iron intakes of Australian infants and toddlers: findings from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program

Fe deficiency remains the most common nutritional deficiency worldwide and young children are at particular risk. Preventative food-based strategies require knowledge of current intakes, sources of Fe, and factors associated with low Fe intakes; yet few data are available for Australian children under 2 years. This study’s objectives were to determine intakes and food sources of Fe for Australian infants and toddlers and identify non-dietary factors associated with Fe intake. Dietary, anthropometric and socio-demographic data from the Melbourne Infant Feeding, Activity and Nutrition Trial Program were analysed for 485 infants (mean age: 9·1 (sd 1·2) months) and 423 toddlers (mean age: 19·6 (sd 2·6) months) and their mothers. Dietary intakes were assessed via 24-h recalls over 3 non-consecutive days. Prevalence of inadequate Fe intake was estimated using the full probability approach. Associations between potential non-dietary predictors (sex, breast-feeding status, age when introduced to solid foods, maternal age, maternal education, maternal employment status and mother’s country of birth) and Fe intakes were assessed using linear regression. Mean Fe intakes were 9·1 (sd 4·3) mg/d for infants and 6·6 (sd 2·4) mg/d for toddlers. Our results showed that 32·6 % of infants and 18·6 % of toddlers had inadequate Fe intake. Main food sources of Fe were Fe-fortified infant formula and cereals for infants and toddlers, respectively. Female sex and current breast-feeding were negatively associated with infant Fe intakes. Introduction to solid foods at or later than 6 months was negatively associated with Fe intake in toddlers. These data may facilitate food-based interventions to improve Australian children’s Fe intake levels.

Maternal depressive and anxiety symptoms, self-esteem, body dissatisfaction and preschooler obesity: a cross-sectional study

The primary aim of the present study was to cross-sectionally examine the associations between maternal psychosocial variables, child feeding practices, and preschooler body mass index z-score (BMI-z) in children (aged 2–4 years). A secondary aim was to examine differences in child weight outcomes between mothers scoring above and below specified cut-offs on the psychosocial measures. Two hundred and ninety mother–child dyads were recruited from Melbourne, Australia, and completed questionnaires examining demographic information, mothers’ depressive and anxiety symptoms, self-esteem and body dissatisfaction, restrictive and pressure child feeding practices, and preschoolers’ BMI-z scores. Independent t-tests and hierarchical multiple regression were employed to analyse the data. In the final regression model, none of the maternal psychosocial measures or feeding practices predicted child BMI-z scores; maternal body mass index and employment status were the only predictors of preschooler BMI-z. However, independent t-tests revealed that children of mothers with elevated body dissatisfaction scores had significantly higher BMI-z scores than children of mothers without elevated scores. The results suggest that psychosocial variables are not related, cross-sectionally, to preschooler weight outcomes; however, further research is needed to replicate the group differences noted between mothers with and without body dissatisfaction, and to track these relationships longitudinally.

Parent and family factors associated with service use by young people with mental health problems: a systematic review

AIM: To conduct a systematic review of parent and family factors associated with service use for young people with mental health problems, to inform early intervention efforts aimed at increasing service use by young people. METHODS: A systematic search of academic databases was performed. Articles were included in the review if they had: a sample of young people aged between 5 and 18 years; service use as the outcome measure; one or more parental or family variables as a predictor; and a comparison group of non-service using young people with mental health problems. In order to focus on factors additional to need, the mental health symptoms of the young person also had to be controlled for. Stouffer's method of combining P-values was used to draw conclusions as to whether or not associations between variables were reliable. RESULTS: Twenty-eight articles were identified investigating 15 parental or family factors, 7 of which were found to be associated with service use for a young person with mental health needs: parental burden, parent problem perception, parent perception of need, parent psychopathology, single-parent household, change in family structure and being from the dominant ethnic group for the United States specifically. Factors not found to be related to service use were: family history of service use, parent-child relationship quality, family functioning, number of children, parent education level, parent employment status, household income and non-urban location of residence. CONCLUSIONS: A number of family-related factors were identified that can inform effective interventions aimed at early intervention for mental health problems. Areas requiring further research were also identified.

Visual impairment and socioeconomic factors

BACKGROUND: Information about socioeconomic factors associated with visual impairment can assist in the design of intervention programmes. Such information was collected by the Melbourne Visual Impairment Project (Melbourne VIP). METHODS: The Melbourne VIP was a population based study of non-institutionalised permanent residents in nine suburbs of the Melbourne metropolitan area aged 40 years of age and older. A standardised eye examination was provided to eligible residents which included a structured interview. Variables of interest for this analysis were age, sex, country of birth, language spoken at home, education level, use of private health insurance, employment status, and living arrangements. Visual impairment was defined as a best corrected visual acuity < 6/18 and/or visual field constriction to within 20 degrees of fixation. RESULTS: A total of 3271 (83%) residents participated. Participants ranged in age from 40 to 98 years; 54% were female. Forty four (1.34%) were classified as visually impaired due to visual acuity and/or visual field loss. To evaluate the independent association of the significant sociodemographic variables with visual impairment, a regression model was constructed that included age, retirement status, use of private health insurance, and household arrangement. The results showed that age was the significant predictor of visual impairment (OR: 3.19; CI: 2.29-4.43), with the mean age of people with visual impairment significantly older (75.0 years) compared with people without visual impairment (58.2 years) (t test = 9.71; p = 0.0001). Of the 44 visually impaired people, 39 (87%) were aged 60 years of age and older. CONCLUSION: The results indicate that age is the most significant factor associated with visual impairment. Of some importance was the finding that people with visual impairment were less likely to have private health insurance. With the aging of the population, the number of people affected by visual impairment will increase significantly. Intervention programmes need to be established before the onset of middle age to offset the escalation of visual impairment in the older population.

Incidência de acidentes do trabalho não-fatais em localidade do Sudeste do Brasil

Estimou-se a proporção de incidência de acidentes do trabalho na Cidade de Botucatu, São Paulo, Brasil, segundo sexo, idade, existência de contrato de trabalho e ocupações. Para tanto, foi realizado inquérito domiciliar em amostra aleatória sistemática por conglomerados (195 setores censitários). Coletaram-se informações de todos os moradores dos domicílios amostrados com idade maior que nove anos. Para aqueles que trabalhavam nos últimos noventa dias que precederam a entrevista, foram obtidas informações sobre ocupação, posição na ocupação, contrato de trabalho e ocorrência de acidentes. Foram estudados 9.626 domicílios residenciais (fração amostral de 0,26). A proporção de acidentes não-fatais no município foi de 3,3% (IC95%: 2,7-3,9), sendo maior em homens 4,5% (IC95%: 3,6-5,5), variando com o tipo de contrato de trabalho e grande grupo de ocupação. Comparando-se esses resultados com períodos anteriores, observa-se diminuição significativa do risco de acidentes na cidade.

Women's contribution to equality in Latin America and the Caribbean

Includes bibliography

Dimensional correlates of poor insight in obsessive-compulsive disorder

Background: Cross-sectional studies have associated poor insight in patients with obsessive-compulsive disorder (OCD) with increased OCD symptom severity, earlier age of onset, comorbid depression, and treatment response. The goal of this current study was to examine the relationship between dimensions of OCD symptomatology and insight in a large clinical cohort of Brazilian patients with OCD. We hypothesized that poor insight would be associated with total symptom severity as well as with hoarding symptoms severity, specifically. Methods: 824 outpatients underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Brown Assessment of Beliefs Scale (BABS), a socio-demographic questionnaire, and the Structured Clinical Interview for axis I DSM-IV disorders (SCID-P). Tobit regression models were used to examine the association between level of insight and clinical variables of interest. Results: Increased severity of current and worst-ever hoarding symptoms and higher rate of unemployment were associated with poor insight in OCD after controlling for current OCD severity, age and gender. Poor insight was also correlated with increased severity of current OCD symptoms. Conclusion: Hoarding and overall OCD severity were significantly but weakly associated with level of insight in OCD patients. Further studies should examine insight as a moderator and mediator of treatment response in OCD in both behavioral therapy and pharmacological trials. Behavioral techniques aimed at enhancing insight may be potentially beneficial in OCD, especially among patients with hoarding. © 2011.

Childcare and parental leave

This issue of Challenges examines the progress made thus far on childcare leave for parents —mothers and fathers— and turns a spotlight on pending debts in this regard. Few legislative or practical measures exist for satisfying the many types of early childhood care needs, and inequalities of origin are still rife. In order to meet those needs, the policy response must be aimed at ensuring universal satisfaction of children's right to care regardless of the formal employment status (or otherwise) of their parents, and the existing models of care from birth must be thoroughly reviewed.

From the classroom to the workplace: Three decades of evidence for Latin America

Includes bibliography.

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social. Objective: Investigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study. Material and Methods: This research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (chi 2) and by discriminant analysis. Results: The final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001). Conclusions: The results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.

The Impact of Teaching Presence in Intensive Online Courses on Perceived Learning and Sense of Community: A Mixed Methods Study

This mixed methods concurrent triangulation design study was predicated upon two models that advocated a connection between teaching presence and perceived learning: the Community of Inquiry Model of Online Learning developed by Garrison, Anderson, and Archer (2000); and the Online Interaction Learning Model by Benbunan-Fich, Hiltz, and Harasim (2005). The objective was to learn how teaching presence impacted students’ perceptions of learning and sense of community in intensive online distance education courses developed and taught by instructors at a regional comprehensive university. In the quantitative phase online surveys collected relevant data from participating students (N = 397) and selected instructional faculty (N = 32) during the second week of a three-week Winter Term. Student information included: demographics such as age, gender, employment status, and distance from campus; perceptions of teaching presence; sense of community; perceived learning; course length; and course type. The students claimed having positive relationships between teaching presence, perceived learning, and sense of community. The instructors showed similar positive relationships with no significant differences when the student and instructor data were compared. The qualitative phase consisted of interviews with 12 instructors who had completed the online survey and replied to all of the open-response questions. The two phases were integrated using a matrix generation, and the analysis allowed for conclusions regarding teaching presence, perceived learning, and sense of community. The findings were equivocal with regard to satisfaction with course length and the relative importance of the teaching presence components. A model was provided depicting relationships between and among teaching presence components, perceived learning, and sense of community in intensive online courses.

The association between low alcohol use and traffic risk behaviors among Brazilian college students

Although there are a large number of studies focused on binge drinking and traffic risk behaviors (TRB), little is known regarding low levels of alcohol consumption and its association to TRB. The aim of this cross-sectional study is to examine the association of low to moderate alcohol intake pattern and TRB in college students in Brazil. 7037 students from a National representative sample were selected under rigorous inclusion criteria. All study participants voluntarily fulfilled a structured, anonymous, and self-questionnaire regarding alcohol and drug use, social-demographic data, and TRB. Alcohol was assessed according to the average number of alcoholic units consumed on standard occasions over the past 12 months. The associations between alcohol intake and TRB were summarized with odds ratio and their confidence interval obtained from logistic regression. Compared with abstainers students who consumed only one alcohol unit had the risk of being a passenger in a car driven by a drunk driver increased by almost four times, students who reported using five or more units were increased by almost five times the risk of being involved in a car crash. Compared with students who consumed one alcohol unit, the risk of driving under the influence of alcohol increased four times in students using three alcohol units. Age group, use of illicit drugs, employment status, gender, and marital status significantly influenced occurrence of TRB among college students. Our study highlights the potential detrimental effects of low and moderate pattern of alcohol consumption and its relation to riding with an intoxicated driver and other TRB. These data suggest that targeted interventions should be implemented in order to prevent negative consequences due to alcohol use in this population. (C) 2012 Elsevier Inc. All rights reserved,

THE ASSOCIATION BETWEEN CHILDHOOD ADVERSITY AND COMPONENTS OF METABOLIC SYNDROME IN ADULTS WITH MOOD DISORDERS: RESULTS FROM THE INTERNATIONAL MOOD DISORDERS COLLABORATIVE PROJECT

Objective: We sought to determine whether a reported history of childhood adversity is associated with components of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III)-defined metabolic syndrome in adults with mood disorders. Method: This was a cross-sectional analysis of adult outpatients (N = 373; n = 230 female, n = 143 male; mean age [SD] = 42.86 [14.43]) from the International Mood Disorders Collaborative Project (University of Toronto and Cleveland Clinic) with DSM-IV-defined major depressive disorder and bipolar I/II disorder. Childhood adversity was measured with the Klein Trauma & Abuse-Neglect self-report scale. The groups with and without childhood adversity were compared to determine possible differences in the rates of metabolic syndrome and its components. Logistic and linear regressions adjusted for age, sex, education, employment status, and smoking were used to evaluate the association between childhood adversity and components of metabolic syndrome. Results: For the full sample, 83 subjects (22.25%) met criteria for metabolic syndrome. Individuals reporting a history of any childhood adversity had higher systolic and diastolic blood pressure (systolic: p = 0.040; diastolic: p = 0.038). Among subjects with a history of sexual abuse, a significant proportion met criteria for obesity (45.28% vs. 32.88%; p = 0.010); a trend toward overweight was found for subjects with a history of physical abuse (76.32% vs. 63.33%; p = 0.074), although this relationship did not remain significant after adjusting for potential confounders. There was no statistically significant difference in the overall rate of dyslipidemia and/or metabolic syndrome between subjects with and without childhood adversity. Conclusion: The results herein provide preliminary evidence suggesting that childhood adversity is associated with metabolic syndrome components in individuals with mood disorders. Int'l. J. Psychiatry in Medicine 2012;43:165-177)

Adesão ao seguimento nutricional ambulatorial pós-cirurgia bariátrica e fatores associados

OBJETIVO: Estimar a prevalência da adesão ao seguimento nutricional ambulatorial pós-cirúrgico e avaliar sua associação com fatores selecionados em indivíduos submetidos à cirurgia bariátrica. MÉTODOS: Estudo de coorte retrospectiva com base na revisão de dados pós-operatórios de 241 prontuários de adultos submetidos à gastroplastia redutora com derivação em Y de Roux entre 2006 e 2008. Considerou-se aderente o indivíduo que compareceu a quatro ou mais consultas nutricionais nos 12 primeiros meses após a cirurgia. Para investigar a associação entre adesão ao seguimento nutricional e idade, sexo, estado conjugal, escolaridade, situação empregatícia, distância entre a residência e o hospital, estratégias para perda de peso no período pré-operatório, índice de massa corporal no pré-cirúrgico imediato, presença de comorbidades e duração da internação pós-operatória, foram calculadas razões de prevalência e utilizou-se regressão múltipla de Poisson. RESULTADOS: A prevalência de adesão foi de 56% (IC95%=49,7-62,3) nessa população predominantemente feminina (80,9%), com média de idade de 44,4 anos (DP=11,6) e de IMC pré-operatório de 47,2kg/m² (DP=6,2). Dos fatores estudados, somente a duração da internação pós-operatória igual ou superior a 6 dias mostrou-se significativamente associada à adesão após análise ajustada por sexo e idade (RP=1,46; IC95%=1,15-1,86). CONCLUSÃO: A prevalência de adesão encontrada foi semelhante às de estudos internacionais, mas baixa considerando-se 75% como referência. A maior adesão observada nos indivíduos com internação pós-operatória prolongada pode sugerir que o maior contato com a equipe multiprofissional aumente a percepção da necessidade de cuidados com a saúde em longo prazo.