Cancer Patient Ethnicity and Associations with Emotional Distress—the 6th Vital Sign: A New Look at Defining Patient Ethnicity in a Multicultural Context

Variations in access to care, utilization of available resources and treatment outcomes in the context of ethnicity have been recognized, but very little research of this nature exists in the oncology context. The present paper is an in-depth analysis of data on a large representative sample of Canadian cancer patients with a focus on the role of ‘ethnicity’, its association to psychological distress, and its impact on the cancer experience. Because of a heterogeneous representation of ethnic self-identifications which were not easily grouped or classified, English as a second language was considered as a surrogate marker to ethnicity. People who self-reported to be from an English-speaking country were grouped together and compared to those hailing from countries which do not have English as a primary language. In a hierarchical logistic regression model (n = 2,402) the demographic and cancer-related variables associated with significant clinical distress in the first block were gender (male, except those with prostate cancer), age less that 68 years, less than a year since diagnosis, diagnosis of lung cancer, and recurrent disease. In the second block, after controlling for the influence of these factors, patient-reported ethnicity (being originally from a non-English speaking country) added significantly to the prediction of patient distress. Though compelling, there is a need to understand the relationship between the ethnic features and language (English versus non-English language). A hypothesis is presented as an attempt to understand an individual’s ‘ethnicity’ within the framework of a multicultural society.     

Are All Program Elements Created Equal? Relations Between Specific Social and Emotional Learning Components and Teacher–Student Classroom Interaction Quality

School-based social and emotional learning (SEL) programs are presented to educators with little understanding of the program components that have the greatest leverage for improving targeted outcomes. Conducted in the context of a randomized controlled trial, the present study used variation in treatment teachers’ (N?=?143) implementation of four core components of the Responsive Classroom approach to examine relations between each component and the quality of teachers’ emotional, organizational, and instructional interactions in third, fourth, and fifth grade classrooms (controlling for pre-intervention interaction quality and other covariates). We also examined the extent to which these relations varied as a function of teachers’ baseline levels of interaction quality. Indices of teachers’ implementation of Morning Meeting, Rule Creation, Interactive Modeling, and Academic Choice were derived from a combination of teacher-reported surveys and classroom observations. Ratings of teacher–student classroom interactions were aggregated across five observations conducted throughout the school year. Structural path models indicated that teachers’ use of Morning Meeting and Academic Choice related to higher levels of emotionally supportive interactions; Academic Choice also related to higher levels of instructional interactions. In addition, teachers’ baseline interaction quality moderated several associations such that the strongest relations between RC component use and interaction quality emerged for teachers with the lowest baseline interaction quality. Results highlight the value of examining individual program components toward the identification of program active ingredients that can inform intervention optimization and teacher professional development.     

A Fresh Look at Sinusitis and ‘Bronchitis’

The hospitalization of a chronically ill child requires meticulous orchestration. Treatment recommendations must be transmitted to the family in a coherent and supportive fashion. Patient comfort and nutrition must be maintained, and psychological support provided. Discharge planning is often extensive. To promote continuity of care, appointment of a case manager is recommended.     

Relationships between health and culture in Polynesia – A review

This review of journal articles and book chapters discusses the health beliefs characteristic of Polynesia and reveals several themes. These are: commonality in health conceptualisations across the cultures of the region which differ from the conceptualisations of biomedicine; the role of the relational self, traditional living and communalism in understanding health; the place of spirituality and religion in health and illness causation; and pluralism and pragmatism in health-seeking behaviour. Suggestions are made as to how awareness of key ideas might contribute to effective planning of health promotion and intervention activities.     

Mother–Child Interactions and the Associations with Child Healthcare Utilization in Low-Income Urban Families

Studies have demonstrated that low-income families often have disproportionately high utilization of emergency department (ED) and hospital services, and low utilization of preventive visits. A possible contributing factor is that some mothers may not respond optimally to their infants’ health needs, either due to their own responsiveness or due to the child’s ability to send cues. These mother–child interactions are measurable and amenable to change. We examined the associations between mother–child interactions and child healthcare utilization among low-income families. We analyzed data from the Nurse-Family Partnership trial in Memphis, TN control group (n = 432). Data were collected from child medical records (birth to 24 months), mother interviews (12 and 24 months postpartum), and observations of mother–child interactions (12 months postpartum). We used logistic and ordered logistic regression to assess independent associations between mother–child interactions and child healthcare utilization measures: hospitalizations, ED visits, sick-child visits to primary care, and well-child visits. Better mother–child interactions, as measured by mother’s responsiveness to her child, were associated with decreased hospitalizations (OR: 0.51; 95% CI: 0.32, 0.81), decreased ambulatory-care-sensitive ED visits (OR: 0.65, 95% CI: 0.44, 0.96), and increased well-child visits (OR: 1.55, 95% CI: 1.06, 2.28). Mother’s responsiveness to her child was associated with child healthcare utilization. Interventions to improve mother–child interactions may be appropriate for mother–child dyads in which child healthcare utilization appears unbalanced with inadequate primary care and excess urgent care. Recognition of these interactions may also improve the care clinicians provide for families.     

Use of Praise and Reprimands as Critical Ingredients of Teacher Behavior Management: Effects on Children’s Development in the Context of a Teacher-Mediated Classroom Intervention

This intervention study examined teachers’ use of verbal praise and reprimands as specific components of teacher behavior management that can promote children’s development in schools. The impact of teacher praise and reprimands on children’s development was examined in the context of a teacher-mediated, classroom intervention. The sample involved 570 children and 30 teachers from second grade classrooms in 15 primary schools. The Good Behavior Game was implemented in half of the classrooms based on random assignment within schools. Teacher behavior management (praise for appropriate behavior and reprimands for inappropriate behavior) was observed during regular classroom lessons. Hyperactive, disruptive, and withdrawn child behavior were assessed using teacher and peer reports, global self-concept and emotional engagement were assessed using child self-reports. All variables were assessed at the beginning (pre-test) and at the end (post-test) of the school year. Multilevel regression models accounted for the nested structure of the data. The results suggested positive effects of fewer reprimands and more praise on child outcomes (except emotional school engagement), although the results differed by informant. We also found indirect effects of the Good Behavior Game (GBG) on child outcomes via teacher praise and reprimands. Overall, the study suggests that teachers’ use of praise and reprimands is a malleable classroom factor that influences children’s behavioral and socio-emotional development.     

Influences on Parents’ Child Care Choices: A Comparative Analysis of Preschool and Long Day Care Users

Background

This paper investigates Australian parents’ child care decision-making, including the motivational and influential factors that they attribute to their choice. Research demonstrates that child care decision making is multifaceted, involving a combination of child-related, personal, familial and contextual considerations. Existing research has tended to compare centre-based child care users with those using family-based options, and has not examined differences in the decision-making of parents who using different centre-based options.

Objective

This study compared the characteristics and child care choices of parents using long day care (LDC) with those using preschool services to determine (1) whether they differ demographically and (2) if their reported child care decision-making motivations and influences diverge.

Method

Participants were 1418 parents who completed a nationally-distributed survey in which they provided demographic information, specified their reasons for choosing to use child care, and rated the importance of factors that influenced their child care choice.

Results

LDC parents had, on average, younger children, worked longer hours and resided in areas with lower socioeconomic resources than preschool parents. When compared with preschool parents, those using LDC were more likely to nominate pragmatic factors as influencing their child care decision making. External pressures, mainly related to educational outcomes, were more salient for preschool than LDC parents. However, both groups of parents similarly rated child-centred factors as the most important overall influence.

Conclusion

Our findings add complexity to current understandings of parents’ child care decision making by showing that parents should not be treated as a homogenous group by policy makers, providers, and researchers.

     

Maternal and Child Health in Mongolia at 3 Years After Childbirth: A Population-Based Cross-Sectional Descriptive Study

Objectives In recent years Mongolia has made great advances towards Millennium Development Goals to reduce maternal and child mortality, however few studies have investigated maternal and child health status several years after childbirth. Our study aims to describe priority health issues in maternal and child health in Mongolia 3 years after childbirth, and key areas requiring further health policy development. Methods We conducted a population-based cross-sectional study in Bulgan province, Mongolia. Participants were women who gave birth in 2010 and lived in Bulgan in 2013, and their children who were almost 3 years of age. Data was collected using structured interviews, self-administered questionnaires, transcribed records from the Maternal and Child Health Handbook, anthropometric measurements, and a developmental assessment tool. Results Data was obtained from 1,019 women and 1,013 children (recovery rate: 94.1 %). Among women, 171 (17.2 %) were obese and had an average body mass index (BMI) of 25.7, 40 (4.4 %) experienced intimate partner violence (IPV) and 356 (36.2 %) reported urinary incontinence in the past month. Among children, 110 (10.8 %) were assessed as at risk of developmental delay, 131 (13.1 %) were overweight or obese, burns accounted for the highest number of serious accidents at 173 (17.0 %) while lower respiratory tract infections (LRTIs) were the most frequent cause of pediatric hospitalization. Conclusions for Practice Further development in health policy is required in Mongolia to target the significant health challenges of obesity, IPV, and urinary incontinence in women, and obesity, development delay, burns, and LRTIs in children.     

Relationships between sugar‐foods and the DMFT in 1968–1970

As shown in a sample of 2514 adolescent participants in the Ten‐State Nutrition Survey of The United States, there is a systematic relation between sugar‐food intakes and dental caries as shown by the DMFT index. Analyzed with respect to the DMFT, adolescents with high values of the DMFT reported sugar‐food ingestion ten times greater than did comparable adolescents with low DMFT values. Conversely, boys and girls and blacks and whites deemed high in sugar‐containing food intakes showed DMFT values approximately twice as high as in adolescents with low reported sugar‐food intakes. These findings attest to the practicability of investigating relationship between dietary habits and dental disease in mass‐data nutrition surveys.     

Improving Young Children’s Social and Emotional Competence: A Randomized Trial of the Preschool “PATHS” Curriculum

This paper reports the results from a randomized clinical trial evaluating an adaptation of the Promoting Alternative Thinking Strategies curriculum (PATHS) for preschool-age children in Head Start. PATHS is a universal, teacher-taught social-emotional curriculum that is designed to improve children's social competence and reduce problem behavior. Twenty classrooms in two Pennsylvania communities participated in the study. Teachers in the 10 intervention classrooms implemented weekly lessons and extension activities across a 9-month period. Child assessments and teacher and parent reports of child behavior assessments were collected at the beginning and end of the school year. Analysis of covariance was used to control for baseline differences between the groups and pretest scores on each of the outcome measures. The results suggest that after exposure to PATHS, intervention children had higher emotion knowledge skills and were rated by parents and teachers as more socially competent compared to peers. Further, teachers rated intervention children as less socially withdrawn at the end of the school year compared to controls.     

Emerging Adults’ Expectations for Pornography Use in the Context of Future Committed Romantic Relationships: A Qualitative Study

Using qualitative content analysis from the written comments of 404 primarily heterosexual college students, we examined (1) their expectations for pornography use while married or in a committed long-term relationship and (2) variations by gender. Four prominent groups emerged. A majority of men (70.8 %) and almost half of women (45.5 %) reported circumstances (alone or with their partners) wherein pornography use was acceptable in a relationship and several conditions for, and consequences associated with, such use also emerged. Another group (22.3 % men; 26.2 % women) viewed pornography use as unacceptable because of being in a committed relationship whereas a third group (5.4 % men; 12.9 % women) reported that pornography use was unacceptable in any context or circumstance. A final group emerged of a few women (10.4 %) who stated that a partner’s use of pornography was acceptable, but they did not expect to use it personally. Implications for relationship education among emerging adults and future research on pornography use within the context of romantic relationships are discussed.     

Predictors and Correlates of Homework Completion and Treatment Outcomes in Parent–Child Interaction Therapy

Background

Behavioral parent training has been demonstrated to be an effective treatment for child behavior problems; however, lack of parent engagement can limit the effectiveness of treatment. Understanding more about predictors and correlates of a specific measure of parent engagement—homework completion—in parent training can help to improve treatment effectiveness and treatment outcomes.

Objective

We examined predictors of homework completion, as well as the relationship between homework completion, treatment correlates, and treatment outcomes in an open trial of parent–child interaction therapy (PCIT), a behavioral parent training program.

Methods

Participants included 53 families (mean child age = 4.40 years, SD = 1.43) who received PCIT in a community mental health center serving demographically (i.e., SES, ethnicity) diverse families.

Results

Homework completion varied significantly between mothers and fathers but did not vary with other demographic family characteristics. Parents who completed treatment showed a somewhat greater likelihood of completing homework throughout treatment and a significantly greater likelihood of completing homework during the first phase of treatment. Additionally, parents who completed more homework were more likely to report higher levels of treatment satisfaction and showed a trend toward completing treatment in fewer sessions.

Conclusions

Our findings suggest that homework has some benefits for treatment outcomes. Despite the benefits of homework, rates of adherence to homework were variable and below optimal levels. Study findings have implications for further understanding the role of homework in behavioral parent training programs.

     

A Qualitative Study of Heterosexual Women’s Attempts to Renegotiate Sexual Relationships in the Context of Severe Sexual Problems

Previous qualitative research on women's sexual problems has documented the ways in which they can impact psychological well-being as well as women's close interpersonal relationships. However, little attention has been paid to the ways that women with sexual problems negotiate sexual contact in the context of a relationship where sexual activity has a central role. This article draws on qualitative data from in-depth interviews with 23 heterosexual women who experienced sexual desire loss or vulvar pain. The data were analyzed within a material-discursive framework and this identified the centrality of relational and broader social factors in women's sexual negotiation. Key findings included: avoiding potentially intimate situations; engaging in intercourse when it was painful or the women had no desire to; and mentally planning and preparing themselves for sex. Other sexual activities were almost always regarded as a prelude to intercourse, yet around half of the sample had adapted their sexual repertoire to compensate for an absence of intercourse. The implications for future research and treatment in the area of women's sexual problems are discussed.