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1.

Background

Preschoolers’ emotional competence is of prime importance in their concurrent and later social and academic success. Parents are primary socializers of these abilities, but more and more early childhood educators are also important in their development. However, their means of socializing emotional competence are understudied, and could be influenced by aspects of their professional and personal lives.

Objectives

The current study illustrates how components of job stress and intrapersonal attributes of ethnicity and education/experience can contribute to early childhood teachers’ reports of their socialization of children’s emotion.

Methods

Teachers completed self-reports on demographics, stress, and endorsement of socialization of emotion techniques.

Results

Greater feelings of job resources and job control significantly related to positive emotional expressiveness, contingent reactions, and attitudes toward teaching children about emotions, as endorsed by teachers in early childhood settings; in contrast, greater feelings of job demands significantly related to teachers’ negative emotional expressiveness. Subsequent to these zero-order correlations, a well-fitting full model of these relations was found, in which teachers’ endorsements of specific emotion socialization behaviors were captured by positive and negative latent variables that are parallel to parental socialization of emotion. These coherent latent variables for positive and negative socialization of emotion were predicted by teachers’ feelings of job resources, African American ethnicity, and education/experience (via the proxy variable program type).

Conclusions

Discussion centers on importance of supporting teachers’ well-being, because teachers who enjoy working in early childhood education will have a positive impact of young children’s emotional development.
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2.

Aim

Stressful life events and individual stress experience are important risk factors for the development of physical and mental disorders. One of the modulating factors determining interindividual differences in stress experience is the person’s gender. In the current study, we investigated sex-related differences in the frequency and perception of stressful life events during adolescence, a period characterized by particularly high stress levels.

Subject and methods

We examined 1,657 14-year-old adolescents who were recruited as part of the IMAGEN study, a European multicenter research project on mental well-being of young people. For the detection of stressful life events, we used the Life Events Questionnaire, a highly valid instrument for testing common stressful events during adolescence.

Results

Although boys and girls did not differ significantly regarding the total amount of stressful life events, girls reported more stressful events in the familial and body-related areas, whereas boys experienced more conflicts with superiors and independence-marking events. As regards valence, girls reported greater psychological distress compared to boys; however, in all significant results, the effect sizes were only small to moderate.

Conclusion

While previous research highlighted severe stressors in adult samples, we investigated for the first time adolescents with a broader scope of stressful events. The observed differences in the stress experience may contribute to explain the sex-dependent variations in the incidence of stress-related disorders.
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3.

Background

Providing enriched learning environments is important to stimulating children’s development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children’s school readiness.

Objective

The purpose of this study was to examine associations between QRIS, a statewide government-funded early childhood care and education policy which integrates structural quality of child-care, and children’s cognitive skills.

Methods

A sample of randomly selected 313 children (mean age = 54.9 months, SD = 6.7) from 36 QRIS-participating early child-care programs was included in this study.

Results

Multilevel analysis with a latent variable (i.e., observed cognitive skills consisting of vocabulary, phonological awareness, and mathematical skills) revealed that children in the highest level of QRIS programs demonstrated better cognitive skills after controlling for child demographics, and home and neighborhood environments. In addition, QRIS moderated a negative association between family socioeconomic risk and children’s cognitive skills.

Conclusions

The results suggest that policymakers may expect positive returns on QRIS investments in terms of children’s early cognitive achievements that support their school readiness in later life.
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4.

Background

Early childhood teachers represent important socializers of children’s emotions providing professional practices, such as communication about children’s emotions, influencing children’s development. According to an ecological framework, early childhood teachers’ emotional practices are guided by both their personal and professional emotional abilities.

Objective

In this study, we addictively took into account both teachers’ personal (i.e., level of education, years of experience, parenthood status, personal emotional self-efficacy) and professional emotional characteristics (i.e., self-efficacy as emotional socializers, and coaching style) in their contribution to teacher–parent/colleague communication about children’s emotions.

Methods

382 early childhood teachers from Center and South of Italy took part to this study (mean years of professional experience = 15.07, SD 10.29 years).

Results

Results showed a positive association between proneness to communicate with parents about children’s emotions and having one’s own children, self-efficacy as emotional socializer, and coaching style. As for communication with colleagues about children’s emotions, we found positive associations with years of experience, personal emotional self-efficacy, and coaching style.

Conclusions

These findings reinforce the need for preservice and in-service programs to promote a reflective orientation to professional practice focusing on early childhood teachers’ personal and professional emotional competence.
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5.

Background

Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear.

Objective

The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother–child agreement for anxiety subtypes, and by exploring mother–child discrepancies in relation to independent observer ratings of behavioral anxiety.

Method

The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7–13 years. Mother–child dyads were observed during an anxiety-provoking task and independent observers rated children’s observed anxiety.

Results

The findings indicated a high level of mother–child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother–child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children’s observed anxious voice was negatively associated with child-reported panic disorder.

Conclusions

The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components.
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6.

Objective

This study used a two-wave longitudinal research design to explore the role of individual strengths, including interpersonal strength, intellectual strength, and temperance strength, in affecting the mental health of stressed college students.

Participants

A total of 404 stressed Chinese college students were screened to participate in this 12-month longitudinal study.

Methods

At the beginning of the study (Time 1), students who had not experienced stressful events within the last 12 months were invited to assess their strengths, psychological well-being, and psychological symptoms. After 12 months (Time 2), 404 students who reported stressful experiences completed the scales again and were retained for the final analyses.

Results

Academics-related stressors were the most endorsed life events among college students, whose states of mental health showed downward trends from Time 1 to Time 2. Three strengths had weak to modest correlations to mental health at both Time 1 and Time 2. Although the additional variances of mental health explained by the three strengths were very modest, the mediational roles of the strengths were identified. The perceived stress completely mediated the relationship between the strengths and the psychological symptoms and partly mediated the relationship between the strengths and psychological well-being.

Conclusions

Individual strengths may function as a defense against perceived stress and are protective factors of mental health. These strengths maintain mental health by enhancing the psychological well-being and reducing the psychological symptoms of individuals.
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7.

Background

Temperament has been associated with child anxiety in a number of studies; however, research examining possible mechanisms of effect using longitudinal designs is scarce.

Objective

This study tested a theoretically-derived model of anxiety development spanning infancy (6 months) to early childhood (approximately 72 months) that includes temperamental reactivity (i.e., behavioral inhibition), temperamental self-regulation (i.e., effortful control), and gender.

Methods

Data used in this study were collected in phase I and phase II from 1226 children and their caregivers by the National Institute of Child Health and Human Development for their prospective, longitudinal Study of Early Child Care and Youth Development. Structural equation modeling procedures were used to test whether effortful control mediated the relation between behavioral inhibition and anxiety and whether such mediation varied by gender.

Results

Results provided support for the model, suggesting that one mechanism linking the modest association between behavioral inhibition in infancy to anxiety symptoms in early childhood is through diminished effortful control. Further, moderated mediation analyses indicated that this mechanism was apparent only for girls.

Conclusions

Modulation of temperamental reactivity via effortful control may be a protective factor in the translation of early behavioral inhibition to childhood anxiety for girls.
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8.
9.

Objectives

The aim of the current study was to examine the influence of socioeconomic status (SES) on physiological (lipid profile, obesity indices) and behavioral (dietary habits, physical activity) cardiovascular disease (CVD) risk factors among primary schoolchildren in Istanbul.

Design

Cross sectional study.

Setting

One private school and two public schools from different SES districts in Istanbul.

Participants

510 randomly selected children aged 12 and 13 years old (257 boys, 253 girls).

Results

The prevalence of overweight (15.2%) and the energy intake (p < 0.001 and p < 0.05 for boys and girls respectively) were found to be higher for the middle/ high SES group for both genders. Regarding biochemical indices, middle/ high SES children had higher values of High Density Lipoprotein-cholesterol (HDL-C) (p < 0.001 and p < 0.05 for boys and girls respectively) and lower values of TC/HDL-C ratio and LDL-C/HDL-C ratio (p < 0.05 and p < 0.001 for boys and girls respectively). This could be attributed to the higher physical activity levels observed for middle/ high SES children (p < 0.001).

Conclusion

The findings of the current study revealed a coexistence of both overweight and higher energy intake in middle/ high SES children, as well as a coexistence of underweight and lower physical activity levels in low SES children. These observations should guide the public health policy in developing appropriate intervention strategies to efficiently tackle these health and social issues early in life.
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10.

Background

Previous studies about inequality in children’s health focused more on physical health than the neurodevelopment. In this study, we aimed to evaluate the inequality in early childhood neurodevelopment in poor rural China and explore the contributions of socioeconomic factors to the inequality.

Method

Information of 2120 children aged 0 to 35 months and their households in six poor rural counties of China was collected during July – September, 2013. Age and Stages Questionnaire-Chinese version, concentration index and decomposition analysis were used to assess the neurodevelopment of early childhood, measure its inequality and evaluate the contributions of socioeconomic factors to the inequality, respectively.

Result

The prevalence of suspected developmental delay in children under 35 months of age in six poor rural counties of China was nearly 40%, with the concentration index of ?0.0877. Household economic status, caregivers’ depressive symptoms, learning material and family support for learning were significantly associated with children’s suspected developmental delay, and explained 34.1, 14.1, 8.9 and 7.0% of the inequality in early childhood neurodevelopment, respectively.

Conclusion

The early childhood neurodevelopment in the surveyed area is poor and unfair. Factors including household economic status, caregivers’ depressive symptoms, learning material and family support for learning are significantly associated with children’s suspected developmental delay and early developmental inequality. The results highlight the urgent need of monitoring child neurodevelopment in poor rural areas. Interventions targeting the caregivers’ depressive symptoms, providing learning material and developmental appropriate stimulating activities may help improve early childhood neurodevelopment and reduce its inequality.
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11.

Background

Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites.

Methods

We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites.

Results

Average age of study children was 41 months. Mean food access insecurity score (range: 0–27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p?=?0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p?=?0.17).

Conclusions

Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.
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12.

Aim

This study aims to examine the association between the Haemophilus influenza type B (Hib) vaccination and child anthropometric outcomes in India.

Subject and methods

The study used prospective cohort data from the Young Lives Study (YLS) conducted in Andhra Pradesh, India. The participants were 1,824 children (aged 54–76 months). Stunting and underweight were used to measure the child anthropometric outcomes. The study used the multivariate logistic regression model to examine the association between Hib vaccination and childhood stunting and underweight.

Results

The result shows that stunting was lower among children who were vaccinated against Hib as compared to those who were not vaccinated (30.8% versus 39.5%). Similarly, the prevalence of underweight was also lower among the vaccinated children than the non-vaccinated ones (39.1% versus 48.0%). The results of the multivariate logistic regression analysis also suggest that children vaccinated against Hib were significantly less likely to be stunted (AOR: 0.76, 95% CI: 0.61–0.95) and underweight (AOR: 0.79, 95% CI: 0.64–0.98) than children who were not vaccinated against Hib, after controlling potentially confounding variables.

Conclusions

The study concludes that vaccination against Hib, in addition to being a major intervention for reducing childhood infectious diseases and mortality, may be considered as a potential tool for reducing the burden of undernutrition in India. Therefore, the inclusion of the Hib vaccine into the Universal Immunization Programme will be helpful in reducing the burden of child malnutrition in India.
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13.
14.

Objective

Breakfast skipping is reported to be associated with obesity in children and younger populations; however, few studies report the association among elderly. The purpose of this study was to investigate the relationships between breakfast skipping and obesity prevalence among elderly.

Design

Cross-sectional study.

Setting

Community-dwelling elderly in Nara, Japan.

Participants

1052 elderly participants (mean age: 71.6 years).

Measurements

Obesity and breakfast skipping were defined as body mass index of ≥25 kg/m2 and skipping breakfast one or more times per week, respectively.

Results

Two hundred and seventy-two participants (25.9%) were classified as obese and forty-one (3.9%) were as breakfast skippers. Obesity prevalence was significantly higher in breakfast skippers than in breakfast eaters (43.9% vs. 25.1%, P = 0.007). In multivariable logistic regression analysis adjusted for potential confounders (age, sex and alcohol consumption), breakfast skippers showed significantly higher odds ratio (OR) for obesity than breakfast eaters (OR, 2.23; 95% confidence interval, 1.17–4.27; P = 0.015), which continued to be significant after further adjustment for socioeconomic status. In addition, breakfast skippers showed significantly lower daily potassium (P <0.001) and dietary fibre intakes (P = 0.001) and lower subjective physical activity (P = 0.035) than breakfast eaters.

Conclusions

Breakfast skipping was significantly associated with obesity among elderly. Poor diet quality and physical inactivity may be potential intermediators underlying the association between breakfast skipping and obesity.
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15.

Background

Several observational studies have shown association between diet quality and depression, but few studies have explored the interrelationship between these variables.

Objective

The aim of this study was to assess the interrelationship between diet quality and depressive symptoms in elderly.

Design

Cross-sectional study.

Setting

Population based.

Participants

1,378 elderly in the city of Pelotas, Brazil.

Measurements

The diet quality was assessed by a short food frequency questionnaire and the prevalence of depressive symptoms was estimated by the abbreviated Brazilian version of the Geriatric Depression Scale (GDS). The association between diet quality and depressive symptoms was assessed using logistic regression.

Results

The prevalence of depressive symptoms was 15.3%. Elderly with low-quality diet were more likely to experience depressive symptoms, and the association was almost twice higher in males than in females (men OR = 3.8, 95% CI 1.4, 10.6; women OR = 2.1, 95% CI: 1.4, 3.3). On the other hand, depressive elderly had higher odds of consuming a low-quality diet (OR 2.4, 95% CI: 1.7, 3.8). Limitations: Self-reported data and crosssectional design limit our conclusions.

Conclusions

The choice of a low-quality diet was associated to a higher risk of depressive symptoms in elderly, and vice-versa. These results highlight the importance of encouraging the choice of healthy food habits, especially in depressed elderly, in order to promote healthy aging.
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16.
17.

Background

Characterization of the main features of pre-frailty may contribute to better understanding the mechanisms involved in the development of frailty.

Objective

To characterize the pre-frail population consulting in primary care centres in Mataró (Catalonia, Spain), to describe the Fried’s frailty criteria for this population and to identify the main associated factors.

Design

Cross-sectional study.

Setting

Three primary care centres in Catalonia.

Participants

Pre-frail subjects recruited from among persons aged 70 years and older consulting primary care centres and screened for frailty according to Fried’s criteria.

Measurements

Clinical, nutritional and functional data.

Results

Frailty prevalence of 31.0% and pre-frailty prevalence of 49.0% were observed. Comorbidity was not especially frequent among elderly individuals classified as pre-frail (except for diabetes with 35.8% prevalence). Functional status and nutritional status were both reasonably satisfactory in pre-frail subjects with mean Barthel score of 98 points and 91% classified as well nourished. Among pre-frail subjects, 35% were obese (body mass index>30); 75% reported pain; 12% had an accidental fall in the previous three months; and the mean number of medications ingested was 6.2. Weakness was the most prevalent frailty criterion (70%), followed by slowness (30%). Weakness was associated with age in men and with pain in women. Poor physical activity was associated with pain.

Conclusions

Pre-frailty is very common among elderly subjects consulting primary care centres. Weakness, slowness, diabetes, pain and polypharmacy should alert healthcare professionals to the onset of a frailty process.
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18.

Background

Exposure to multiple stressors and lack of access to resources place rural children at high risk for adverse consequences. Family Stress Model guided this study to examine relations between two stressors- food insecurity and maternal depressive symptoms, and behavior problems among younger and older rural children.

Objective

To test associations between food insecurity, maternal depressive symptoms, and behavior problems among younger and older rural low-income children.

Methods

Cross-sectional data from 370 low-income rural families across 13 states was analyzed using structural equation modeling and multiple group analyses. Mothers’ education level, household income, marital/partner status, and participation in SNAP served as covariates.

Results

Among younger children, maternal depressive symptoms partially mediated the relation between food insecurity and child externalizing behaviors, while among older children, maternal depressive symptoms completely mediated the relation between food insecurity and child internalizing and externalizing behaviors.

Conclusions

Stress manifested directly from, or indirectly through, maternal depressive symptoms and from food insecurity was related to behavior problems among younger and older rural children; however, the relations varied by age of children. Programs and policies that prevent or lessen both food insecurity and maternal depression may help to lessen problem behaviors among on rural children. Longitudinal studies are needed to rigorously examine causation and directionality among food insecurity, maternal depression and rural child behavior problems, while accounting for influences of child, caregiver and family characteristics.
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19.

Objective

Prior to 2007, forced sex with male children in South Africa did not count as rape but as "indecent assault", a much less serious offence. This study sought to document prevalence of male sexual violence among school-going youth.

Design

A facilitated self-administered questionnaire in nine of the 11 official languages in a stratified (province/metro/urban/rural) last stage random national sample.

Setting

Teams visited 5162 classes in 1191 schools, in October and November 2002.

Participants

A total of 269,705 learners aged 10–19 years in grades 6–11. Of these, 126,696 were male.

Main outcome measures

Schoolchildren answered questions about exposure in the last year to insults, beating, unwanted touching and forced sex. They indicated the sex of the perpetrator, and whether this was a family member, a fellow schoolchild, a teacher or another adult. Respondents also gave the age when they first suffered forced sex and when they first had consensual sex.

Results

Some 9% (weighted value based on 13915/127097) of male respondents aged 11–19 years reported forced sex in the last year. Of those aged 18 years at the time of the survey, 44% (weighted value of 5385/11450) said they had been forced to have sex in their lives and 50% reported consensual sex. Perpetrators were most frequently an adult not from their own family, followed closely in frequency by other schoolchildren. Some 32% said the perpetrator was male, 41% said she was female and 27% said they had been forced to have sex by both male and female perpetrators. Male abuse of schoolboys was more common in rural areas while female perpetration was more an urban phenomenon.

Conclusion

This study uncovers endemic sexual abuse of male children that was suspected but hitherto only poorly documented. Legal recognition of the criminality of rape of male children is a first step. The next steps include serious investment in supporting male victims of abuse, and in prevention of all childhood sexual abuse.
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20.

Background

The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings.

Objective

To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents.

Methods

A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE.

Results

Studies of non-atopic asthma/wheeze used a wide diversity of definitions of asthma/wheeze, comparison groups and methods to assess atopy. Among 30 risk factors evaluated in the 43 studies only 3 (family history of asthma/rhinitis/eczema, dampness/mold in the household, and lower respiratory tract infections in childhood) showed consistent associations with non-atopic asthma/wheeze. No or limited period of breastfeeding was less consistently associated with non-atopic asthma/wheeze. The few studies examining the effects of overweight/obesity and psychological/social factors showed consistent associations. We used a novel graphical presentation of different risk factors for non-atopic asthma/wheeze, allowing a more complete perception of the complex pattern of effects.

Conclusions

More research using standardized methodology is needed on the causes of non-atopic asthma.
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