Unlocking the Black Box: A Multilevel Analysis of Preadolescent Children’s Coping

This random assignment experimental study examined the intersection of children’s coping and physiologic stress reactivity and recovery patterns in a sample of preadolescent boys and girls. A sample of 82 fourth-grade and fifth-grade (M_age = 10.59 years old) child–parent dyads participated in the present study. Children participated in the Trier Social Stress Test and were randomly assigned to one of two post–Trier Social Stress Test experimental coping conditions—behavioral distraction or cognitive avoidance. Children’s characteristic ways of coping were examined as moderators of the effect of experimental coping condition on cortisol reactivity and recovery patterns. Multilevel modeling analyses indicated that children’s characteristic coping and experimental coping condition interacted to predict differential cortisol recovery patterns. Children who characteristically engaged in primary control engagement coping strategies were able to more quickly down-regulate salivary cortisol when primed to distract themselves than when primed to avoid, and vice versa. The opposite pattern was true for characteristic disengagement coping in the context of coping condition, suggesting that regulatory fit between children’s characteristic ways of coping and cues from their coping environment may lead to more and less adaptive physiologic recovery profiles. This study provides some of the first evidence that coping “gets under the skin” and that children’s characteristic ways of coping may constrain or enhance a child’s ability to make use of environmental coping resources.     

Parent’s with incurable cancer: ‘Nuts and bolts’ of how professionals can support parents to communicate with their dependent children

ObjectiveParents with incurable cancer are often uncertain how, what and when is best to tell their children about their poor prognosis and prepare them for the actual death. Despite parents' desire and need for support from health and social care professionals (HSCPs), this is often lacking. HSCPs feel ill-equipped, identifying a need for an evidence-based communication framework for professionals to use in practice, promoting parent-child communication at end of life.MethodsA systematic process, involving a systematic review and data from 76 semi-structured, face-to-face qualitative interviews from three participant populations, including HSCPs (n = 32), bereaved parents (n = 21) and funeral directors (n = 23) were triangulated. This informed the development of the ‘Talking, Telling and Sharing’: End of life framework (6 W Grid), guided by an expert group.ResultsAn evidence-based, theory-driven communication framework has been developed. This provides a mechanism for HSCPs to proactively and directly engage with patients, addressing their parent-child communication concerns.ConclusionClear, evidence-based communication frameworks can enhance patient-provider communication in practice, particularly around sensitive and complex issue.Practice implicationsThere is a need for HSCPs to encourage parents to start these difficult conversations soon after receiving the poor prognosis, to avoid crisis management when the ill-parent is actively dying or throughout the immediate bereavement period.     

Friendship with a robot: Children’s perception of similarity between a robot’s physical and virtual embodiment that supports diabetes self-management

Objective

The PAL project develops a conversational agent with a physical (robot) and virtual (avatar) embodiment to support diabetes self-management of children ubiquitously. This paper assesses 1) the effect of perceived similarity between robot and avatar on children’s’ friendship towards the avatar, and 2) the effect of this friendship on usability of a self-management application containing the avatar (a) and children’s motivation to play with it (b).

Children’s perceptions of emotion regulation strategy effectiveness: links with attachment security

Six- and nine-year-old children (N = 97) heard illustrated stories evoking anger in a story character and provided evaluations of the effectiveness of eight anger regulation strategies. Half the stories involved the child’s mother as social partner and the other half involved a peer. Attachment security was assessed via the Security Scale. Children reported greater effectiveness for seeking support from adults and peers in the peer context than the mother context, but perceived venting as more effective with mothers. Children with higher security scores were more likely to endorse problem solving and less likely to endorse aggression in both social contexts than those with lower security scores. Early evidence for gender differences was found in that boys endorsed the effectiveness of distraction while girls endorsed venting their emotion.     

Caregivers’ Advice and Children’s Bystander Behaviors During Bullying Incidents

Many bullying prevention programs take a bystander approach, which encourages children to intervene when they are bystanders to bullying incidents. Little is known about how caregivers’ advice to children might promote or undermine the positive bystander behaviors targeted by these programs. Accordingly, the aim of the current study was to investigate relations between caregivers’ advice and children’s bystander behavior during bullying situations. Participants were 106 racially/ethnically diverse 4th- and 5th-grade students (M age = 10.5 years, SD = .71 years), their classmates, and their caregivers. During classroom visits, peers reported on children’s bystander behaviors. During home visits, caregivers and children completed a coded interaction task in which caregivers advised children about how to respond to bullying situations at school. Results suggested that (a) bystander intervention was positively predicted by caregivers’ advice to help/comfort the victim, (b) bystander passivity was positively predicted by caregivers’ advice to not intervene and negatively predicted by caregivers’ advice to help/comfort the victim, and (c) bystander reinforcement/assistance of the bully was positively predicted by caregivers’ advice not to intervene and not to tell adults. Results support a link between caregivers’ advice at home and children’s corresponding behavior when they are bystanders to bullying situations at school. These results emphasize the importance of collaboration between families and schools to reduce school bullying. Implications and directions for future research are discussed.     

Foster children’s attachment security and behavior problems in the first six months of placement: associations with foster parents’ stress and sensitivity

Both traumatic experiences in their birth families and multiple placement histories lead to increased mental health problems in foster children. The formation of secure attachments to new caregivers could be a protective factor for foster children. The current study focused on the associations between foster parents’ sensitivity, parenting stress and foster children’s attachment behavior as well as behavior problems. The sample consists of 48 children (aged from 1 to 6 years) and their foster caregivers. Attachment behavior and sensitivity were observed during home visits. Furthermore, caregiver reports were used to assess parenting stress and children’s behavior problems. Compared to normative data, foster children showed lower levels of attachment security and more behavior problems. Foster children’s attachment security and behavior problems were predicted significantly or marginally by foster parents’ stress and supportive presence.     

Mothers’ Intentions to Support Children’s Physical Activity Related to Attention and Implicit Agreement with Advertisements

Background

ParticipACTION’s Think Again campaign targeted mothers who think their children are sufficiently active, yet whose children do not achieve recommended amounts of physical activity.

Purpose

This research examined the relationship of mothers’ intentions to support children’s physical activity with explicit believability and implicit agreement with the Think Again campaign message, attention paid to the advertisement, involvement with the issue, concern regarding children’s inactivity, and attitudes.

Method

Participants were mothers from Edmonton, Canada (N?=?102) who viewed one Think Again advertisement then completed a measure of implicit agreement with the campaign message and questionnaires.

Results

The mothers who paid attention to the message and were concerned for their own children were more likely to intend to act on campaign messages. The majority of participants implicitly agreed that children’s physical inactivity was a problem, but there was less agreement that physical inactivity was a problem for their own children.

Conclusion

Participants automatically tended to agree with campaign messages when the focus was on children in general, but there was greater disagreement when asked about participant’s own children. Why most mothers were not in agreement with the reality of how much physical activity their children needs remains to be determined.     

A Longitudinal Study of Fathers’ and Young Children’s Depressive Symptoms

Considerable research has examined the effects of maternal depression on children, but few studies have focused on the relation between paternal and child depressive symptoms, particularly during early childhood. Even fewer studies have been longitudinal, leaving open questions about how paternal and child depression covary over time. The present study sought to address this gap by examining the relation between fathers’ and children’s depressive symptoms over a 3-year period. Participants were 153 preschool children with behavior problems and their parents. Three longitudinal analytic approaches were used to examine how father and child depression change together and predict one another over time. Additional analyses examined whether externalizing problems or maternal depression might account for the associations between fathers’ and children’s depressive symptoms. Changes in paternal depression significantly predicted changes in father-reported and mother-reported child depressive symptoms. These effects were evident both in year-to-year fluctuations and in linear trajectories across the 3-year period. Cross-lagged analyses suggested that these relations may have been driven by father-effects; paternal depression at one time point predicted child depression at the next time point, but child depression did not significantly predict later paternal depression. We found little evidence that externalizing problems or maternal depression accounted for the relations between fathers’ and children’s depressive symptoms. Results provide convergent evidence that fathers’ depression may play an important role in the development of depressive symptoms in young children and underscore the importance of including fathers in studies of depression in families.     

Children’s,parents’, and other stakeholders’ perspectives on the factors influencing the initiation of early dietary change in the management of childhood chronic disease: a mixed studies systematic review using a narrative synthesis

BackgroundEarly dietary change can provide vital medical benefits supporting childhood chronic disease self-management.ObjectiveTo explore factors influencing the initiation of early dietary change in the management of childhood chronic disease, as described by children, parents’, and other stakeholders, to inform practice change in early paediatric service delivery.MethodsThis systematic review crossed seven databases from 2000-2018 to identify empirical research (qualitative, quantitative, and mixed-method designs), including grey literature. Methodological quality was appraised using validated scoring systems.ResultsSix studies met our criteria for inclusion in the review. Four themes of early dietary change emerged from these studies: (1) the role of education; (2) parents/caregivers’ roles; (3) the role of self-management, and the (4) identification of enablers and barriers to dietary change.ConclusionObtaining the perspectives of children, parents’ and other stakeholders’ on factors influencing early dietary change is key to the self-management of childhood chronic disease.Practice implicationsEarly dietary change provides an essential resource in the self-management of many chronic diseases. In collaboration, children, parents’ and healthcare professionals recognise the value of regular, engaging education, supported by workshops to empower and upskill, enabling change in everyday dietary habits, while using enablers and recognising challenges.     

Comparing movement patterns associated with Huntington’s chorea and Parkinson’s dyskinesia

Involuntary movements such as levodopa-induced dyskinesia in Parkinson’s disease (PD) and chorea in Huntington’s disease (HD) are the consequence of two distinct basal ganglia dysfunctions. Yet, their clinical manifestations seem to resemble each other. We seek to determine how to detect PD dyskinesia and HD chorea during quiet stance using healthy control subjects’ postural sway as a base measure and identify means to distinguish mathematically HD chorea from PD dyskinesia. Movements were recorded using a magnetic tracker system with fifteen sensors placed strategically to capture whole-body displacement. Choreic and dyskinetic patients as well as healthy controls were asked to stand with arms stretched horizontally in front of them for 60 s. We examined amplitude, frequency dispersion, proportional energy, sample entropy, kurtosis, skewness, amplitude fluctuation, maximum coherency between 44 pairs of body segments. The choreic and dyskinetic movements revealed similar patterns of sample entropy, amplitude fluctuation, and coherencies between body segments. However, skewness and kurtosis for velocity of movements were found to be higher in HD chorea than in PD dyskinesia, reflecting rapid movements in HD patients. There was also a tendency for the frequency composition of PD dyskinesia to be more concentrated in the 1.0–1.5 Hz range. Our results show that despite their similarities in apparent randomness and lack of coordination, dyskinesia associated with treatment of PD and chorea in HD each have their own distinctive characteristics which may be related to their specific pathophysiology.     

Bidirectional Relations Between Temperament and Parenting Predicting Preschool-Age Children’s Adjustment

Bidirectional associations between child temperament (fear, frustration, positive affect, effortful control) and parenting behaviors (warmth, negativity, limit setting, scaffolding, responsiveness) were examined as predictors of preschool-age children’s adjustment problems and social competence. Participants were a community sample of children (N = 306; 50% female, 64% European American) and their mothers. Observational measures of child temperament and parenting were obtained using laboratory tasks at two time points (children’s ages 36 and 54 months). Teacher-reported adjustment measures were collected at the first and third time points (children’s ages 36 and 63 months). Cross-lagged analyses were performed to examine whether child temperament and parenting predict changes in one another, whether they each contribute independently to children’s adjustment, and whether these transactional relations account for adjustment outcomes. Maternal negativity at 36 months predicted increases in child frustration at 54 months. Maternal negativity and child effortful control predicted decreases in each other from 36 to 54 months. Maternal warmth predicted increases in child effortful control over time. Child frustration, child effortful control, maternal warmth, and maternal negativity at 54 months each independently predicted child adjustment problems at 63 months, controlling for problems at 36 months. Child executive control at 54 months predicted increases in child social competence at 63 months. The findings suggest that temperament and parenting have independent and additive effects on preschool-age child adjustment, with some support for a bidirectional relation.     

Patients’ perspectives about doctor-patient communication regarding transvaginal mesh implant surgery

ObjectivesMany women experience pelvic floor disorders which may require medical intervention such as transvaginal mesh implant surgeries (TVM; the abdominal or vaginal insertion of woven netting to support pelvic tissue). We examined women’s perceptions of communication with their health professionals concerning TVM.DesignWe analysed 153 women’s written submissions to an Australian Government Inquiry regarding their experiences of transvaginal mesh surgery to explore their perceptions of TVM-related doctor-patient communication. Data were analysed using deductive and inductive reflexive thematic analysis.ResultsWomen expressed several challenges in their communication with their health professionals. Three themes regarding communication were generated: Insufficient information was abundant; Normalisation and minimisation of the procedure and risks; and, Desired communication interactions.ConclusionsAccording to women’s accounts, doctor-patient communication was poor. Health professionals must be knowledgeable about medical procedures and their potential complications and provide their patients with adequate, accurate information to make informed choices about their health. Health professionals should also document informed consent.Practice implicationsHealth professionals should be well-informed about TVM, including best-practice treatments for pelvic floor disorders, indications for TVM, the risks, outcomes and potential complications from various forms of TVM, and ways to adequately communicate sufficient information to women.     

The Association Between Anxiety Symptoms and Sleep in School-Aged Children: A Combined Insight From the Children’s Sleep Habits Questionnaire and Actigraphy

The current study assessed the association between anxiety symptoms and sleep in 90 school-aged children, aged 6–12 years (M_age = 108 months, 52.2% male). The Children’s Sleep Habits Questionnaire (CSHQ) and 14 nights of actigraphy were used to assess sleep. Anxiety was assessed using the Spence Children’s Anxiety Scale (SCAS). A significant association was found between parent-reported anxiety symptoms and current sleep problems (i.e., CSHQ total scores ≥ 41). An examination of SCAS subscales identified a specific association between generalized anxiety disorder (GAD) symptoms and increased parental sleep concerns, including sleep onset delay, sleep duration, and daytime sleepiness. Regarding actigraphy, whilst anxiety was not associated with average sleep variables, a relationship was identified between anxiety and the night-to-night variability of actigraphy-derived sleep schedules.     

Treatment of psoriatic arthritis with traditional DMARD’s and novel therapies: approaches and recommendations

Introduction: Recent advances in the therapeutics of psoriatic arthritis (PsA) have provided more options to clinicians managing PsA. The purpose of this review is to update the reader on treatment options for PsA using conventional synthetic disease modifying agents (csDMARDs) and novel therapies including tumour necrosis factor alpha inhibitors, interleukin 12/23 inhibitor (ustekinumab), the interleukin 17 antagonists including secukinumab, brodalumab, ixekizumab, and the phosphodiesterase-4 inhibitor, apremilast.

Areas covered: We reviewed published articles on the treatment of PsA. Our main sources of data included treatment recommendations, registry studies, systematic literature reviews, major randomised controlled trials for more recently approved drugs, and abstracts from the American College of Rheumatology and EULAR meetings.

Expert commentary: An overview of the evidence for the use of various pharmacotherapeutic agents for treatment of this heterogeneous disease was compiled. Treatment options for the various domains of PsA are also discussed.     

Shared perturbations in the metallome and metabolome of Alzheimer’s,Parkinson’s,Huntington’s,and dementia with Lewy bodies: A systematic review

Despite differences in presentation, age-related dementing diseases such as Alzheimer’s (AD), Parkinson’s (PD), and Huntington’s diseases (HD), and dementia with Lewy bodies (DLB) may share pathogenic processes. This review aims to systematically assemble and compare findings in various biochemical pathways across these four dementias.PubMed and Google Scholar were screened for articles reporting on brain and biofluid measurements of metals and/or metabolites in AD, PD, HD, or DLB. Articles were assessed using specific a priori-defined inclusion and exclusion criteria. Of 284 papers identified, 198 met criteria for inclusion.Although varying coverage levels of metals and metabolites across diseases and tissues made comparison of many analytes impossible, several common findings were identified: elevated glucose in both brain tissue and biofluids of AD, PD, and HD cases; increased iron and decreased copper in AD, PD and HD brain tissue; and decreased uric acid in biofluids of AD and PD cases. Other analytes were found to differ between diseases or were otherwise not covered across all conditions.These findings indicate that disturbances in glucose and purine pathways may be common to AD, PD, and HD. However, standardisation of methodologies and better coverage in some areas – notably of DLB – are necessary to validate and extend these findings.