Looking at childhood obesity through the lens of Baumrind's parenting typologies

Obesity is becoming the leading negative health outcome for the current generation of children to a greater degree than for any previous generation. Pediatric orthopaedic nurses encounter many patients and families with concerns about obesity and need the ability to promote parenting capacity in order to detect, prevent, or treat childhood obesity. Parenting is a complex process with numerous two-way interactions between the parent and child. Pediatric orthopaedic nurses affect parenting capacity daily as they care for families in all care settings. Many family researchers use Baumrind's parenting typologies (styles) and their correlations to child health outcomes in research. Understanding Baumrind's theories can help pediatric orthopaedic nurses understand the mechanisms parents use to affect the health outcomes related to the obesity of their children. Baumrind's is one parenting theory that can help demonstrate how parental behaviors and practices affect a child's self-concept and self-care development and ultimately a child's health promotion beliefs and practices related to obesity prevention and care that continue into adulthood. Nurses can use reviews of literature and application to practice of parenting styles to expand their repertoire of parent guidance and anticipatory teaching directed to the prevention and care of childhood obesity.     

1型糖尿病患儿父母亲职压力影响因素及干预措施的研究进展

阐述亲职压力的概念,综述1型糖尿病患儿父母亲职压力的现状、影响因素及干预措施。指出临床医护工作者可借鉴国外研究成果,从疾病管理、自我效能及应对方式等可控性因素入手,通过评估父母照顾问题及需求,为其提供疾病管理支持与协调服务,通过心理干预加强父母疾病管理自我效能和积极应对方式。同时探讨1型糖尿病患儿父母亲职压力的根源,制定针对性的干预措施。     

Weight status,diet quality,perceived stress,and functional health of caregivers of children with autism spectrum disorder

1 Purpose

Caring for children with autism spectrum disorder (ASD) can be highly demanding and can put significant strain on caregivers. To date, little is known about the extent to which caregivers of children with ASD experience increased levels of stress which may adversely affect health outcomes. The purpose of this secondary analysis was to compare caregivers of children with ASD and caregivers of typically developing children (TDC) in weight status, diet quality, perceived stress related to the parenting role, and functional health and well‐being.

2 Design and methods

Caregivers of 25 children with ASD and 30 TDC completed the 2005 Block Food Frequency Questionnaire, the 36‐item Short Form of the Parenting Stress Index (PSI/SF), and the Short Form Health Survey (SF‐36) and had their heights and weights measured during an onsite visit. Diet quality was assessed using the Healthy Eating Index (HEI)‐2010 and its dietary components and conformance to the 2010 Dietary Guidelines for Americans.

3 Results

ASD caregivers did not differ significantly from TDC caregivers in body mass index or overweight/obesity prevalence (p ≥ .28), even when controlling for covariates. In univariate analyses, ASD caregivers consumed significantly fewer empty calories from solid fats, alcohol, and added sugars than TDC caregivers (p = .03), but they did not differ significantly in any other dietary outcomes including nutrient adequacy (p ≥ .10) and mean total HEI scores (p = .20). ASD caregivers, when compared to TDC caregivers, reported significantly greater parenting stress for the subscales difficult child and parent–child dysfunctional interaction as well as total stress (p < .001). In addition, 56% of ASD caregivers compared with 6.7% of TDC caregivers showed clinically significant levels of stress (p < .0001); a finding which remained statistically significant when controlling for covariates. ASD and TDC caregivers did not differ significantly in any SF‐36 health domains related to functional health and well‐being (p ≥ .10).

4 Practice implications

Despite higher reported levels of stress, ASD caregivers did not differ significantly from TDC caregivers in diet‐ and health‐related outcomes. Nurses and other health professionals should use comprehensive screening tools to assess overall caregiver stress and levels of resilience.     

抽动障碍儿童主要照顾者家庭坚韧力及影响因素研究

目的 探讨抽动障碍儿童主要照顾者家庭坚韧力现状及其影响因素.方法 采用一般资料调查表、 耶鲁抽动程度综合量表、家庭坚韧力量表以及亲职压力简表对167名抽动障碍患儿主要照顾者进行问卷调查.结果 抽动障碍患儿照顾者家庭坚韧力总分为(40.14±5.89)分.家庭坚韧力得分与亲职压力得分呈负相关(P<0.01);多元线性回归...     

A worksite parenting program

With more and more companies offering wellness programs for their employees, it seems reasonable to offer parent training classes to employees as an educational tool and a means of coping with stress. A series of parenting classes was developed using the STAR Parenting Model. The STAR Model teaches parents to stop, think, ask, and respond to their children based on tenets of cognitive behavior management. Classes taught to faculty and staff of the university were well attended and participants indicated that the method positively altered their parenting practices. Parents are challenged by their young children and by their jobs and careers. Parenting education at work may help to ease some employee stress and improve their parenting practices.     

Positive Experiences of Mothers and Fathers of Children with Autism

Background The present study examined the positive experiences of parents raising school‐aged children with autism within the context of parenting stress. Materials and Methods Participants included 23 mother/father pairs raising children with autism (ages 5 to 11 years, M = 7.39). Parents completed measures of parenting stress and positive experiences of raising their children. Results Consistent with previous research in a pre‐school aged population of children with autism, mothers reported significantly more positive experiences than did fathers. Mothers’ and fathers’ reports of their positive experiences were negatively related to their reports of parenting stress. Fathers’, but not mothers’, positive experiences were negatively related to their partners’ reports of parenting stress. Conclusion Findings are discussed within a positive psychology framework suggesting that a focus on positive experiences may buffer against negative well‐being.     

An Examination of Parenting Variables and Child Self-Care Behavior Across Disease Groups

The present study examined the relationship of three parent-related variables, namely, perceived child vulnerability, parental overprotection, and parenting stress to child self-care behaviors among 200 children with Type 1 diabetes, asthma, or cystic fibrosis. A related goal of the study was to examine for illness- and age-related differences among the same variables of interest. Results indicated that higher levels of parenting stress were associated with lower parent ratings of their child’s self-care behaviors. Additional analyses of individual illness groups demonstrated that age was significantly related to both child and parent ratings of self-care only for the diabetes group, with older children engaging in lower levels of self-care. Such results support continued investigation of parent behaviors and beliefs as they relate to child self-care outcomes at different ages in pediatric chronic illness populations.     

Types, availability, and perception of social support among parents of young children with cognitive delays in Vietnam

Parents of young children with disabilities experience increased parenting stress owing to the caregiving demands the children place on them and concern over how they will raise and care for their children in the future. Support or understanding from others can be helpful in relieving the psychological and physical strain that caregivers experience. The project examined the types and availability of social support for Vietnamese parents of young children with cognitive delays, and their perceived social support and parenting stress. Fourteen types of informal support (spouse, wife's father, wife's mother, husband's father, husband's mother, wife's siblings, husband's siblings, sons, daughters, other relatives, friends, neighbors, and parents of other children with disabilities and social helpers) and eight types of professional support (teachers, therapists, doctors, private therapists, home helpers, social agencies, babysitters, and doctors in community health clinics) were available. When the level of intellectual functioning among children was lower, both mothers and fathers reported less availability of support from most types of informal support and teachers. For both mothers and fathers, a larger network of informal and professional support reduced the amount of stress they experienced. Specifically, however, when immediate family members were not available, mothers were more likely to experience parenting stress whereas the unavailability of friends and neighbors increased fathers' parenting stress. While addressing the stigma in society that affects the lives of the families of the children with disabilities in gaining informal support, the need for developing professional services in developing countries is discussed.     

老年女性2型糖尿病患者颈动脉内膜中层厚度的相关因素分析

目的研究老年女性2型糖尿病患者颈动脉内膜中层厚度（IMT）的相关因素。方法将205例2型糖尿病患者分为老年女性组,非老年女性组、老年男性组和非老年男性组,比较各组颈动脉IMT差异;将老年女性组分为内膜正常组、内膜增厚组、斑块形成组、管腔狭窄组,比较各组间尿白蛋白排泄率（UAER）、血糖、血脂等。对颈动脉IMT异常的老年女性患者,采用多元逐步回归分析颈总动脉IMT和UAER、血糖、血脂等之间的关系。结果（1）老年女性组和非老年女性组比较IMT显著增厚;（2）非老年男性组和非老年女性组比较IMT显著增厚;老年女性组和老年男性组比较无显著性差异;（3）老年女性患者中斑块形成组和管腔狭窄组与内膜正常组比较,UAER显著增加。（4）相关分析发现老年女性2型糖尿病患者平均IMT值与UAER、收缩压呈正相关,与高密度脂蛋白胆固醇呈负相关。结论2型糖尿病患者颈动脉硬化程度存在性别、年龄差异,老年女性2型糖尿病患者平均IMT值与收缩压、UAER呈正相关。     

The relationship between maternal chronic pain and child adjustment: the role of parenting as a mediator.

The role of parenting in the relationship between maternal chronic pain and negative child outcomes, including internalizing, externalizing, and social and health problems, was investigated. Parenting strategies used by mothers with chronic pain were compared to parenting strategies used by a control group of mothers without pain. Thirty-nine mothers experiencing chronic pain, their 55 children, 35 pain-free mothers, and their 48 children participated in the study. The results showed that for mothers with chronic pain, dysfunctional parenting strategies and the quality of the mother-child relationship were related to negative child outcomes. Mothers with chronic pain were more likely to engage in lax parenting and report reduced relationship quality with children than were control mothers. For the chronic pain group, over-reactive parenting was found to mediate the relationship between maternal physical functioning and child adjustment. Dysfunctional parenting strategies may constitute part of the risk that maternal chronic pain poses for children. The similarities between the impact of maternal chronic pain on child adjustment and that of other maternal stressors, such as depression, are discussed. PERSPECTIVE: In mothers with chronic pain, poor maternal physical functioning was associated with increased maternal over-reactive behavior that was in turn related to poor child adjustment. Maternal over-reactive behavior did not, however, differ in chronic pain and control mothers.     

Are there sex differences in emotional and biological responses in spousal caregivers of patients with Alzheimer's disease?

The purpose of this study was to compare emotional and biological responses of men and women who are spousal caregivers of patients with Alzheimer's disease (AD). Quality-of-life measurements, bioinstrumentation data, and immunophenotype assessments were obtained from female and male spousal caregivers of patients with AD. Spousal caregivers (women, n = 45 with average age 69.7; men, n = 16 with average age 71.4 years) completed questionnaires that assessed psychosocial variables. Blood was drawn and lymphocyte subsets (including natural killer [NK] cell number) were determined using flow cytometry. The degree of relaxation was determined measuring muscle tension (EMG) in the frontalis and trapezius muscles, skin conductance, skin temperature, and heart rate. Male spousal caregivers, as compared to female spousal caregivers, had significantly lower levels of stress, depression, caregiver burden (subjective), anxiety, anger-hostility, and somatic symptoms and higher levels of mental health, sense of coherence, NK cell number, and social and physical functioning. There were no statistically significant differences between the 2 groups in social support, coping resources, or T, T suppressor, or activated T cells. Women had more T helper cells and fewer NK cells than men. Men had fewer manifestations of a physiological stress response, as indicated by bioinstrumentation parameters. Unique sex-specific issues need to be considered when strategies are implemented to assist the increasing number of caregivers as our society ages.     

儿童自我报告及其主要照顾者报告结局一致性研究

目的研究儿童自我报告结局及其主要照顾者报告的儿童相关结局的差异程度.方法2019年4-6月,便利抽取某专科医院门诊儿童及其主要照顾者197对进行调查,应用自行设计的一般资料问卷和儿童患者报告结局测量信息系统(pe-diatric patient-reported outcome information system,Pediatric PROMIS)负性情绪简表儿童报告版和父母报告版进行调查,通过t检验比较儿童及父母报告的差异性,通过Pearson相关性分析检验两者的相关性.结果儿童自我报告及其主要照顾者报告结局的一致性较低,相关系数为0.083~0.386之间.结论主要照顾者报告和儿童自我报告的负性情绪呈显著弱相关,且主要照顾者容易高估儿童的负性情绪水平.建议临床医护人员多关注儿童自我报告的症状,从而促进儿童参与临床决策制度和治疗效果评价.     

Dominant Western health care: type 2 diabetes mellitus.

Diabetes is a major public health problem with serious complications. In 2002, the Centers for Disease Control estimated that 18.2 million people in the United States had diabetes. One in every 400 to 500 adolescents is diagnosed with type 1 diabetes mellitus (T1DM), and pediatric type 2 diabetes mellitus (T2DM) represents an emerging public health concern. The Children's Hospital of Philadelphia (CHOP) identified 337 children with T2DM through 2004. These children were mostly female and obese with a strong family history of T2DM. One patient's course of treatment for 1.5 years after initial presentation is described. Nineteen percent of the patients at CHOP were diagnosed with a neuropsychiatric illness before T2DM onset, further complicating their treatment. There is an imperative need for large-scale studies investigating the pathophysiology, treatment, and complications of T2DM in adolescents and youth.     

Utilization of parenting groups and consultation services as parenting support services by Japanese mothers of 18 month old children

Aim: To clarify the factors related to the utilization of parenting groups and consultation services by mothers with children aged 18 months. Methods: This was a cross‐sectional study using a self‐report questionnaire survey at health examinations in five health centers of an urban city in Tokyo, Japan, from July to September 2003. The final study population was comprised of the 371 mothers who provided information on both demographics and the utilization of services. Results: Of these 371 mothers, 166 participated in parenting groups since the birth of their 18 month old child. Logistic regression analyses indicated the following factors related to such participation: past experience in the use of services provided by the local government, trust in the specific group, and worries about their children. Participation in the parenting groups was not related to child‐rearing anxiety or mental health status. The participants indicated that the groups provided friends and child‐rearing information and alleviated stress. Worries about children and past experience in the use of public services would enhance the utilization of services. Conclusion: It is essential for service‐providers to offer services specific to the situation or desires of mothers. Mothers might need both consultation services and support groups to reinforce the mother–child relationship, for social support, and to freely discuss worries with both professionals and peers.     

1型糖尿病小鼠模型的构建

目的构建1型糖尿病小鼠模型,为进一步研究1型糖尿病发病机制及治疗方法提供依据。方法模型的诱导采用多次小剂量链脲佐菌素(STZ)给药法(MLDSTZ),雄性BALB/c小鼠64只,随机分为3组:模型组、阴性对照组、正常对照组。模型组小鼠连续5 d腹腔注射STZ溶液,阴性对照组腹腔注射柠檬酸缓冲液,正常对照组不注射。给药后观察小鼠一般状况,检测血糖、尿糖,同时以石蜡切片观察小鼠的胰腺组织病理变化。结果 STZ诱导的糖尿病模型鼠与对照相比存在明显的多饮、多食、多尿和体质量减轻等典型的糖尿病表现。在末次注射STZ 3周后,模型组小鼠尿糖均为阳性,对照组均为阴性。在4周后,模型组小鼠空腹血糖水平明显高于对照组,差异有统计学意义(P<0.01)。模型鼠均有不同程度的胰岛萎缩、胰岛β细胞空泡变性、数目减少及不同程度的胰岛炎改变。结论采用MLDSTZ构建的1型糖尿病小鼠模型稳定,方法可靠。     

不同性别2型糖尿病患者甲状腺功能与血脂关系分析

目的探讨2型糖尿病患者不同性别及甲状腺功能状态下血脂的特点。方法收集279例2型糖尿病患者,依据性别、促甲状腺激素(TSH)水平分组后,比较各组血脂的差别,应用相关分析研究TSH与血脂的关系。结果 (1)女性TSH、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白A1(apoA1)高于男性(P0.05)。(2)亚临床甲状腺功能减退患者的血脂高于甲状腺功能正常者(P0.05)。(3)甲状腺功能正常的2型糖尿病患者,与TSH2.5 mU/L组相比,TSH为2.5~4.0 mU/L组男性HDL-C降低,女性TC升高(P0.01)。(4)2型糖尿病患者无论男女TSH均与TC、三酰甘油(TG)呈正相关(P0.05)。结论 2型糖尿病患者甲状腺功能与血脂水平密切相关,对血脂异常应注意甲状腺功能监测。     

Cancer caregivers' quality of life: effects of gender, relationship, and appraisal

The objective of this study was to examine caregivers' gender and relationship to the cancer survivor as plausible predictors of their appraisals of providing care, and to further examine the association of the caregivers' appraisal with their own quality of life. Of the 739 caregivers who participated in the American Cancer Society's Quality of Life Survey for Caregivers, 627 were either the spouse or the offspring of a cancer survivor. Of those, 448 who provided complete information on study variables were included in this study. Multivariate analyses revealed that male caregivers were more likely to appraise the caregiving experience as boosting their self-esteem (positive) than female caregivers, whereas adult daughters appraised the experience as stressful (negative), and sons appraised the experience as the least stressful. More importantly, caregivers' esteem and caregiving stress were strong predictors of the caregivers' quality of life. These effects were significant after controlling for potentially confounding variables. The findings suggest that cancer caregivers may benefit from programs designed to assist them in viewing their involvement in cancer care as meaningful and as a personal growth experience, as well as helping them to seek support to minimize their caregiving stress.