Background Factors (background + factor)

Distribution by Scientific Domains

Selected Abstracts

Predictors of academic attainments of young people with Down's syndrome

S. Turner
Abstract Background Earlier studies of young people with Down's syndrome have investigated a relatively limited range of variables which may influence their academic attainment. The relative strength of such influences and how they may vary during the school career, has also been under-researched. Aims The aim of the paper is to identify the contemporary and antecedent predictors of the level of academic attainment achieved by a representative sample of young people with Down's syndrome. Sample The paper reports data from three studies of 71 young people with Down's syndrome and their families. Mean IQ at the time of the first study (t1) was 40.4. Mean chronological age was 9 years at t1, 14 at t2, and 21 at t3, when all the young people had left school. Methods The outcome measure was the 58-item Academic Attainments Index (AAI), comprising three sub-scales covering reading, writing and numeracy. Predictors of the outcome were derived from questionnaires and interviews from tutors, mothers and fathers. A path analysis approach was used to investigate the pattern of predictors of the outcome over the three studies. Results Factors predicting greater progress in this measure between t2 and t3 were lower chronological age and attendance at mainstream school. Progress from t1 to t2 was also associated with attendance at mainstream school, as well as with higher t1 mental age, mother's practical coping style and higher child attentiveness. Background factors predicting higher t1 AAI scores were higher mental age, attendance at mainstream school and father's internal locus of control. The path analysis model predicted 48% of the variance in t3 outcome scores. Severity of intellectual impairment was by far the most significant predictor. Conclusion Limitations to the study include evidence of attrition bias towards more able children, and the need to obtain the t3 outcome measure from tutors for some young people and parents for others. Parents may have over-estimated abilities. Results are broadly in agreement with other studies, and confirm the pattern reported earlier with this group. Mainstream school attendance had a modest beneficial effect on AAI scores throughout the school career of the children, independently of level of intellectual disability. Identification of predictors of attainment levels and of improvement over time may help parents, teachers and other professionals involved with families of children and young people with Down's syndrome optimise the attainment of such skills. [source]

The enigma of the welfare state: excellent child health prerequisites , poor subjective health

C Lindgren
Abstract The rate of subjective health complaints among Swedish children is increasing by age and over time, and more so than among children in other Scandinavian countries. In contrast, the somatic health and prerequisites for wellbeing are excellent. This paradoxical situation, The Enigma of the Welfare State, is the focus of this viewpoint. We argue that one important background factor may be late adverse effects of the welfare society itself and some of its inherent values. We have identified several possible pathways. We have given them names of diseases , on the society level , like health obsession, stress panic, welfare apathy and hyper-individualism. Together with other factors such as a dysfunctional school and an unsatisfactory labour market for youth, these diseases are involved in an interplay that is constantly inducing anxiety and low self-esteem. Conclusion:, The gradually deteriorating self-reported health among Swedish youth may, to some degree, be explained as a late adverse effect of the welfare society itself and its inherent values. [source]

The impact of newborn bathing on the prevalence of neonatal hypothermia in Uganda: A randomized, controlled trial

Anna Bergström
Abstract Aim: To elucidate the impact of bathing on the prevalence of hypothermia among newborn babies exposed to the skin-to-skin (STS) care technique before and after bathing. Methods: Non-asphyxiated newborns after vaginal delivery (n=249) in a Ugandan referral hospital were consecutively enrolled and randomized either to bathing at 60 min postpartum (n=126) or no bathing (n=123). All mothers practised skin-to-skin care of their newborns. Four rectal and tympanic registrations of newborn temperatures were carried out in both groups directly after drying at birth, and at 60, 70 and 90 min postpartum. Results: Bathing of newborns in the first hour after delivery resulted in a significantly increased prevalence of hypothermia, defined as temperature <36.5°C, at 70 and at 90 min postpartum despite the use of warmed water and the application of the STS method. There was no neonatal mortality. Aside from the bathing procedure, no background factor potentially predisposing the newborns to hypothermia was identified. Conclusion: Bathing newborn babies shortly after birth increased the risk of hypothermia despite the use of warm water and STS care for thermal protection of the newborn. [source]

Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study,, 1993,1999

S Berra
The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at-risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24,48 h after birth and a follow-up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer-Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26,2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58,6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79,4.21), the first mother-child contact occurring after 90min of life (OR =1.88; 95% CI 1.22,2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05,2.15). The calibration of the model was acceptable in the CLACYD I sample (p= 0.54), as well as in the CLACYD II sample (p= 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning. [source]


CRIMINOLOGY, Issue 2 2006
This study extends recent inquiries of contextual effects in sentencing by jointly examining the influence of judge and courtroom social contexts. It combines two recent years of individual sentencing data from the Pennsylvania Commission on Sentencing (PCS) with data on judicial background characteristics and county court social contexts. Three-level hierarchical models are estimated to investigate the influence of judge and county contexts on individual variations in sentencing. Results indicate that nontrivial sentencing variations are associated with both individual judge characteristics and county court contexts. Judicial background factors also condition the influence of individual offender characteristics in important ways. These and other findings are discussed in relation to contemporary theoretical perspectives on courtroom decision making that highlight the importance of both judge and court contexts in sentencing. The study concludes with suggestions for future research on contextual disparities in criminal sentencing. [source]

Outcome after prolonged convulsive seizures in 186 children: low morbidity, no mortality

Piia Metsäranta BM
Prolonged convulsive seizures are a common neurological emergency and a potential cause of neuronal damage and functional sequelae. We explored the role of seizure duration and various background factors for neurological sequelae in children with prolonged convulsive seizures. The population-base of this study was all children (age < 16 years) who had been admitted to the Tampere University Hospital, Finland between 1993 and 1999 with convulsive seizures lasting more than 5 minutes. Patients were followed up individually (mean length of follow-up 2 years 1 month, range 0 to 7 years 8 months). All available data on the prolonged seizure episodes and clinical follow-up were analyzed retrospectively by a detailed review of all medical charts and records. In 186 children (94 males, 92 females; mean age 4 years 5 months, SD 3 years 10 months, range 1 month to 15 years 4 months) there were 279 separate convulsive seizure episodes lasting over 5 minutes, yielding an annual incidence of 47.5 out of every 100000 episodes. Seizure aetiology was idiopathic in 26.2% of episodes, febrile in 41.9%, remote symptomatic in 28%, and acute symptomatic in 3.9% of episodes. Mean duration of all seizure episodes was 42.5 minutes (SD 46.1 minutes) and was significantly correlated with the aetiology: shortest in the febrile group (mean 35.4 minutes) and longest in the acute symptomatic group (mean 88.6 minutes; p < 0.001). There was no mortality related directly to these acute seizure episodes. The most common sequela was an onset of epilepsy in 40 children (22%). Permanent neurological sequelae were noted in only four patients (2.2%; mean seizure duration 16 minutes) and non-permanent sequelae in six patients (3.2%; mean seizure duration 38 minutes). Neurological sequelae of prolonged convulsive seizures in children are rare and are related to aetiological factors rather than the duration of a single seizure. The role of acute seizures in the evolution of epilepsy in children remains obscure. [source]

Psychiatric epidemiology of old age: the H70 study , the NAPE Lecture 2003

I. Skoog
Objective: To describe methodological issues and possibilities in the epidemiology of old age psychiatry using data from the H70 study in Göteborg, Sweden. Method: A representative sample born during 1901,02 was examined at 70, 75, 79, 81, 83, 85, 87, 90, 92, 95, 97, 99 and 100 years of age, another during 1906,07 was examined at 70 and 79 years of age, and samples born between 1922 and 1930 were examined at 70 years of age. The study includes psychiatric examinations and key informant interviews performed by psychiatrists, physical examinations performed by geriatricians, psychometric testings, blood sampling, computerized tomographies of the brain, cerebrospinal fluid analyses, anthropometric measurements, and psychosocial background factors. Results: Mental disorders are found in approximately 30% of the elderly, but is seldom detected or properly treated. Incidence of depression and dementia increases with age. The relationship between blood pressure and Alzheimer's disease is an example of how cross-sectional and longitudinal studies yield completely different results. Brain imaging is an important tool in epidemiologic studies of the elderly to detect silent cerebrovascular disease and other structural brain changes. The high prevalence of psychotic symptoms is an example of the importance to use several sources of information to detect these symptoms. Dementia should be diagnosed in all types of studies in the elderly, as it influences several outcomes such as mortality, blood pressure, and rates of depression. Suicidal feelings are rare in the elderly and are strongly related to mental disorders. Conclusion: Modern epidemiologic studies in population samples should be longitudinal and include assessments of psychosocial risk factors as well as comprehensive sets of biologic markers, such as brain imaging, neurochemical analyses, and genetic information to maximize the contribution that epidemiology can provide to increase our knowledge about the etiology of mental disorders. [source]

Adults with self-reported learning disabilities in Slovenia: Findings from the international adult literacy survey on the incidence and correlates of learning disabilities in Slovenia

DYSLEXIA, Issue 4 2003
Lidija Magajna
This study of adults with self-reported learning disabilities (SRLD) in Slovenia is part of a larger secondary analysis of the data from the International Literacy Survey project (IALS). The purpose of the study was to examine the characteristics of 79 (2.68%) individuals who reported experiencing learning disabilities and compare them to the general population on a variety of indicators of educational background, employment status, and reading and writing activities at work and at home. The proficiency scores of the SRLD individuals were lower in all three literacy domains (prose, document and quantitative literacy). In prose literacy 77.9% of SRLD adults performed at Level 1 and only 7.8% reached the level necessary for a modern technological society. Experiencing learning disabilities was not related to gender or age, however, results showed significant differences between the levels achieved by older and younger people with SRLD. In SRLD groups aged 40 years and above, no one achieved more than the second level of literacy in any domain. Learning disabilities were reported more frequently in rural areas. SRLD groups achieve significantly lower educational attainment, and lower employment status, with a preference for manual labour or craft. These findings are of critical importance. SRLD people report that poorer literacy skills are an obstacle to their progression in employment. In the Slovene sample, the SRLD group stands out for low scores in quantitative literacy. Results show that they are less active, pick up information only auditorily or in short written form. They need more frequent help from relatives in literacy activities. Interpretation of the IALS data on SRLD presents many problems. These include amongst others, problems in terminology, different background factors, and the validity of self-report measures. However, the study also raises many interesting challenges for future research and policy. Increasing the availability of support, assistance and counselling for adolescents and adults with learning disabilities remains a very important goal for dyslexia and LD policies in Slovenia. Copyright © 2003 John Wiley & Sons, Ltd. [source]

An Extended Analytical Approach to Credit Risk Management

ECONOMIC NOTES, Issue 2 2002
Alexandre Kurth
Among the ,reduced form models' for measuring the credit risk of a bank's portfolio is CreditRisk+, which provides a closed,form solution for calculating the portfolio loss distribution based on an actuarial approach. The limitations of this model are well known, but they are often misinterpreted as being deeply embedded within the model. Dismantling the mathematical components of the model allows one to modify and extend it in several ways while remaining within an analytical approach. One of the most unattractive features is the orthogonality of the background factors or sectors as it hinders any resemblance to real,world macroeconomic indexes or industrial sectors and geographical areas. Among other extensions, which we mention briefly, we present in more detail how the original model can be amended to consider correlations among default risk sectors and among severity risk segments. These extensions are applied to real,life data, based on mortality rate data produced by the Italian Central Bank. (J.E.L.: C00, C51). [source]

Self-reported functional ability predicts three-year mobility and mortality in community-dwelling older persons

Ryuichi Kawamoto
Background:, A comprehensive evaluation of the functions of community-dwelling older persons was conducted in 1988. Three years after the 1988 study commenced, the relationship between these background factors and changes during the subsequent 3 years were examined. Methods: ,The study was a comprehensive evaluation of the daily functions of community-dwelling elderly people, and encompassed age, gender, mode of living, marital status, financial status, family relationships, basic activities of daily living, visual and hearing impairment, a history of disease, self-related feeling, social role, social support, habits and physical exercise and the relationship between independence and survival for 3 years after the basic study. The subjects were 2274 community-dwelling elderly people who participated in the first survey in July 1998 and who were aged 65 years and over at that time. Unassisted questionnaire sheets were used for the first survey and changes since the first survey. Results:, Thirty men and 60 women died during the 3 year period. Data were also gathered about the daily activity levels of 1709 persons (75.2%) with 1499 (87.7%) ranking J for independence and 210 persons (12.3%) ranking A to C for dependence. Age, gender, basic activities of daily living (BADL), history of falls, self-related happiness, participation in community events and physical-exercise habits were found to be explanatory variables for independence after three years; as were age, gender, and BADL for survival. Conclusion: , The explanatory variables relating to independence and prognosis of life of the elderly obtained in this study will be important in future considerations of the issue of care-taking and measures to enable it. [source]

Relationship between symptoms of temporomandibular disorders and dental status, general health and psychosomatic factors in two cohorts of 70-year-old subjects

Tor Österberg
Objective:, To study the prevalence of symptoms of temporomandibular disorders (TMD) in two cohorts of 70-year-old subjects examined 8 years apart and analyse the relationship between such symptoms and dental status, general health and various background factors. Materials and methods:, Two cohorts of 70-year-old subjects, born in 1922 (n = 422) and 1930 (n = 491) respectively, were examined with an interval of 8 years. A TMD symptom index (0,5) was established on answers to five questions related to TMD symptoms. Results:, There were no statistically significant differences between the two cohorts for prevalence of TMD symptoms and TMD index, neither for headache, neck ache, bruxism and chewing ability. TMJ sounds was the most prevalent symptom, 14%, whereas other TMD symptoms had low prevalence. The distribution of the TMD symptom index showed that 81% reported no symptoms, 15% one symptom, 3% two symptoms and 1% three to five symptoms. Single TMD symptoms and the TMD index exhibited significant associations (p < 0.001) with bruxism, headache, neck pain and several general health and psychosomatic factors, but with dental status only in women. Logistic regression showed that bruxism, neck pain, mouth dryness and a number of psychosomatic factors were associated with the TMD index. Conclusions:, Besides TMJ sounds (14%), other TMD symptoms were rarely reported by the 70-year-old subjects. The TMD index was significantly associated with bruxism and several general health and psychosomatic complaints but with dental status only in women. [source]

Predictors of gambling problems among male adolescents

Arne Gerdner
The study concerns prediction of gambling problems in 178 male adolescents (aged 16 and 18 years) who completed a questionnaire, which included the South Oaks Gambling Screen (SOGS), a version of the Temperament and Character Inventory and a number of questions concerning social background, emotional and life-style factors. About 27% of the boys gamble at least weekly. As many as 16% qualify as probable pathological gamblers according to the SOGS. Another 7% are at risk. None of the social background factors are related to severity of gambling problems. The only significant family factor is parental substance misuse. The optimal multivariate model predicts about 30% of the variance in gambling problems. The strongest factor is frequency of alcohol drinking. Several factors indicate a personality with problems in relations to others. Another factor indicates a dreamy personality. Unexpectedly, impulsiveness is not related to gambling. In conclusion, problem gambling among male adolescents is related to life-style and personality, especially in relation to others, but not to usual social background factors. Gamblers are asocial rather than impulsive. The nature of this finding should be further explored, since an asocial personality may point at genetics as well as to early social influences, as may the finding on the relation between gambling and parental drinking. [source]

,To Whom Much Has Been Given...': Religious Capital and Community Voluntarism Among Churchgoing Protestants

Jerry Z. Park
Research on volunteering behavior has consistently found a positive relationship between religion and volunteering. Using a sample of churchgoing Protestants (N=1,738)from the Religious Identity and Influence Survey we examine the specific influences of religiosity, religious identity, religious socialization, and religious social networks on local volunteer activity in church programs and non-church organizations, as well as general volunteering tendencies. These influences are presented within the theoretical framework of religious capital. Logistic regression techniques were applied to determine the strength of the contribution of these influences while accounting for basic background factors. Findings suggest that churchgoing Protestants are influenced by all measures to some degree, but religiosity (specifically participation in church activities) remains the strongest influence. Significant religious influences overall are most pronounced within the context of church-related volunteering which suggests that churchgoing Protestants exhibit a strong sense of community identity through their local churches. A discussion of these results and their implications for volunteering follows. [source]

Diabetic foot ulcer burden may be modified by high-dose atorvastatin: A 6-month randomized controlled pilot trial

Abstract Background:, Diabetic foot ulcers (DFUs) are common complications of diabetes mellitus (DM), with a complex pathogenesis. Treatment is difficult and no single treatment with measurable clinical impact is available. In the present clinical pilot trial, we investigated whether statins could be of use against some of the pathogenic factors in DFUs. Methods:, Thirteen diabetic patients (10 men; 11 with Type 2 DM; mean age 64 years; mean duration of DM 18 years) with neuropathic DFUs <4 months were randomized to treatment with either 10 mg (six patients; six ulcers) or 80 mg (seven patients; nine ulcers) atorvastatin for 6 months in addition to conventional DFU care (i.e. prompt debridement, DFU pressure relief, and management of any underlying infection). Results:, There were no significant differences in background factors (i.e. HbA1c 8.9%, micro- and macrovascular complications, concomitant medications) or DFU characteristics (duration, surface area, grading) between the two groups. All ulcers in the group receiving 10 mg atorvastatin healed, compared with six of nine ulcers in the group receiving 80 mg atorvastatin (NS). However, two previously healed DFUs recurred and six new DFUs developed in the low-dose group compared with none and one, respectively, in the high-dose group (P = 0.048). There was a significant decrease in C-reactive protein (,1.5 mg/L; P = 0.044) and a non-significant trend towards beneficial effects on lipids and the ankle,arm blood pressure index in the high-dose compared with the low-dose group. Conclusions:, We observed a possible beneficial effect of 6-months high-dose atorvastatin on DFUs, which should be tested in appropriately sized prospective studies. [source]

The Well-Being of Children Born to Teen Mothers

Judith A. Levine
Children born to early child bearers are more likely than other children to display problem behaviors or poor academic performance, but it is unclear whether early childbearing plays a causal role in these outcomes. Using multiple techniques to control for background factors, we analyze 2,908 young children and 1,736 adolescents and young adults in the National Longitudinal Survey of Youth (NLSY79) and the NLSY79 Children and Young Adults (CNLSY79) data sets to examine whether early childbearing causes children's outcomes. We find evidence that teen childbearing plays no causal role in children's test scores and in some behavioral outcomes of adolescents. For other behavioral outcomes, we find that different methodologies produce differing results. We thus suggest caution in drawing conclusions about early parenthood's overarching effect. [source]

Long-Term Effects of Minimum Drinking Age Laws on Past-Year Alcohol and Drug Use Disorders

ALCOHOLISM, Issue 12 2009
Karen E. Norberg
Background:, Many studies have found that earlier drinking initiation predicts higher risk of later alcohol and substance use problems, but the causal relationship between age of initiation and later risk of substance use disorder remains unknown. Method:, We use a "natural experiment" study design to compare the 12-month prevalence of Diagnostic and Statistical Manual, Fourth Edition, alcohol and substance use disorders among adult subjects exposed to different minimum legal drinking age laws minimum legal drinking age in the 1970s and 1980s. The sample pools 33,869 respondents born in the United States 1948 to 1970, drawn from 2 nationally representative cross-sectional surveys: the 1991 National Longitudinal Alcohol Epidemiological Survey (NLAES) and the 2001 National Epidemiological Study of Alcohol and Related Conditions. Analyses control for state and birth year fixed effects, age at assessment, alcohol taxes, and other demographic and social background factors. Results:, Adults who had been legally allowed to purchase alcohol before age 21 were more likely to meet criteria for an alcohol use disorder [odds ratio (OR) 1.31, 95% confidence intervals (95% CI) 1.15 to 1.46, p < 0.0001] or another drug use disorder (OR 1.70, 95% CI 1.19 to 2.44, p = 0.003) within the past-year, even among subjects in their 40s and 50s. There were no significant differences in effect estimates by respondent gender, black or Hispanic ethnicity, age, birth cohort, or self-reported age of initiation of regular drinking; furthermore, the effect estimates were little changed by inclusion of age of initiation as a potential mediating variable in the multiple regression models. Conclusion:, Exposure to a lower minimum legal purchase age was associated with a significantly higher risk of a past-year alcohol or other substance use disorder, even among respondents in their 40s or 50s. However, this association does not seem to be explained by age of initiation of drinking, per se. Instead, it seems plausible that frequency or intensity of drinking in late adolescence may have long-term effects on adult substance use patterns. [source]

Leadership in education: Effective U.K. college principals

Fabio Sala
College leaders face increasing challenges to manage complex responsibilities. They must possess a wide variety of managerial and leadership skills to be successful in academic environments, which are beginning to resemble more traditional organizational frameworks. The study examined in this article explored the relationships among managerial style, organizational climate, and several measures of college-student performance with a sample of British further education college principals (similar to U.S. community college presidents). While considering the influence of various background factors, such as the size of the college, student funding, and years of experience, several significant relationships emerged demonstrating a significant association between principals' managerial behaviors and measures of college and student performance. [source]

Annotation: Pathways to care for children with mental health problems

Kapil Sayal
Background:, Although many children with mental health problems are in contact with primary health care services, few receive appropriate help. Methods:, Using a pathways to care model, this paper systematically reviews the literature relating to access to services. It separates out the various stages of help-seeking: parental perception of problems, use of primary care services, recognition within primary care, and referral to or use of specialist health services. Results:, Following parental awareness of child symptoms, parental perception of problems is the key initial step in the help-seeking process. Although children with mental health problems or disorders are regular attenders within primary care and most parents acknowledge that it is appropriate to discuss concerns about psychosocial issues in this setting, few children are presented with mental health symptoms even if their parents have such concerns. Subsequently, less than half of children with disorders are recognised in primary care. Amongst recognised children, about half are referred to specialist services. Overall, up to one-third of children with disorders receive services for mental health problems. Factors such as the type and severity of disorder, parental perceptions, child age and gender, and family and social background factors determine which affected children access services. Conclusions:, As there are inequities in patterns of service use, a greater emphasis on developing resources at population and primary care levels is required. Barriers involving parental perceptions and expression of concerns within consultations should be minimised at these levels. This requires both public education approaches and improved training and specialist support for primary care services to enhance their ability to provide for these children. [source]

Increased prevalence of burnout symptoms in parents of chronically ill children

C Lindström
Abstract Aim:, To examine the prevalence of burnout symptoms in the context of parenting a chronically ill child. Methods:, A total of 252 parents of children with Type 1 Diabetes Mellitus and 38 parents of children with Inflammatory Bowel Diseases participated in a population-based study. A control group consisted of 124 randomly selected parents of healthy children. We used self-report questionnaires to assess symptoms of burnout. Results:, The main finding was that significantly more parents of children with chronic diseases (36%) scored for clinical burnout, compared with parents of healthy children (20%). Burnout symptoms were most prominent among mothers of children with diabetes, although fathers of children with diabetes and mothers and fathers of children with inflammatory bowel diseases also reported higher levels of various burnout symptoms. Conclusion:, Burnout may be a useful model for understanding long-term parental responses and should be acknowledged among the different types of psychological consequences of the multi-faceted experience of parenting a child with chronic illness. Gender seems to influence the risk of burnout symptoms. Continued research about other background factors, and how the parents' situation changes over time are warranted. In the clinic, we need to draw attention to the group of parents who may suffer from burnout. [source]

Factors influencing the acceptance of volunteer home-visiting support offered to families with new babies

Jacqueline Barnes
ABSTRACT This study investigated the characteristics of families with a new baby, screened to identify families with vulnerability, who did not take up the offer of home-visiting support from a community volunteer. Using logistic regression, background factors were compared with those families receiving support. Those not receiving support, 59.1% of those referred, were more socially, educationally and economically disadvantaged, living in more disadvantaged neighbourhoods. Those who received support were more likely to have larger families, no local support network, or had family members with health or mental health problems. One in nine families referred had not been reached by the support service. In brief qualitative telephone interviews, mothers who did not take up the offer of support reported changing their mind, wanting to cope without help and in some cases feeling that the support offered did not meet their specific needs. Policy implications are suggested, in particular offering support to new parents thought to be vulnerable within a statutory framework, with sufficient infrastructure and resources to conduct outreach work. Research implications include making a concerted effort to find out about families who decide not to take part in service evaluation studies, or who drop out after initial agreement. [source]

Does Amount of Time Spent in Child Care Predict Socioemotional Adjustment During the Transition to Kindergarten?

Early Child Care Research Network, Human Development, National Institute of Child Health
To examine relations between time in nonmaternal care through the first 4.5 years of life and children's socioemotional adjustment, data on social competence and problem behavior were examined when children participating in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care were 4.5 years of age and when in kindergarten. The more time children spent in any of a variety of nonmaternal care arrangements across the first 4.5 years of life, the more externalizing problems and conflict with adults they manifested at 54 months of age and in kindergarten, as reported by mothers, caregivers, and teachers. These effects remained, for the most part, even when quality, type, and instability of child care were controlled, and when maternal sensitivity and other family background factors were taken into account. The magnitude of quantity of care effects were modest and smaller than those of maternal sensitivity and indicators of family socioeconomic status, though typically greater than those of other features of child care, maternal depression, and infant temperament. There was no apparent threshold for quantity effects. More time in care not only predicted problem behavior measured on a continuous scale in a dose-response pattern but also predicted at-risk (though not clinical) levels of problem behavior, as well as assertiveness, disobedience, and aggression. [source]

School,Based Early Intervention and Later Child Maltreatment in the Chicago Longitudinal Study

Arthur J. Reynolds
Investigated were the effects of participation in the Title I Child,Parent Centers (CPC) on substantiated reports of child maltreatment for 1,408 children (93% of whom are African American) in the Chicago Longitudinal Study. The CPCs provide child education and family support services in high,poverty areas. After adjusting for preprogram maltreatment and background factors, 913 preschool participants had significantly lower rates of court petitions of maltreatment by age 17 than 495 children of the same age who participated in alternative kindergarten interventions (5.0% vs. 10.5%, a 52% reduction). Participation for 4 to 6 years was significantly associated with lower rates of maltreatment (3.6% vs. 6.9%, a 33% reduction). Findings based on child protective service records (as well as combined protective service and court records) were similar. Preschool length, family risk, and school poverty were associated with lower rates of maltreatment. Parental involvement in school and school mobility were significant mediators of intervention effects. [source]

Effects of fully established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study

Richard Reading
Effects of fully established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study . MelhuishE., BelskyJ., LeylandA. H., BarnesJ. & the National Evaluation of Sure Start Research Team ( 2008 ) The Lancet , 372 , 1641 , 1647 . DOI: 10.1016/S0140-6736(08)61687-6 . Background Sure Start Local Programmes (SSLPs) are area-based interventions to improve services for young children and their families in deprived communities, promote health and development, and reduce inequalities. We therefore investigated whether SSLPs affect the well-being of 3-year-old children and their families. Methods In a quasi-experimental observational study, we compared 5883 3-year-old children and their families from 93 disadvantaged SSLP areas with 1879 3-year-old children and their families from 72 similarly deprived areas in England who took part in the Millennium Cohort Study. We studied 14 outcomes , children's immunizations, accidents, language development, positive and negative social behaviours and independence; parenting risk; home-learning environment; father's involvement; maternal smoking, body-mass index and life satisfaction; family's service use; and mother's rating of area. Findings After we controlled for background factors, we noted beneficial effects associated with the programmes for five of 14 outcomes. Children in the SSLP areas showed better social development than those in the non-SSLP areas, with more positive social behaviour (mean difference 0.45, 95% CI 0.09 to 0.80, P = 0.01) and greater independence (0.32, 0.18 to 0.47, P < 0.0001). Families in SSLP areas showed less negative parenting (,0.90, ,1.11 to ,0.69, P < 0.0001) and provided a better home-learning environment (1.30, 0.75 to 1.86, P < 0.0001). These families used more services for supporting child and family development than those not living in SSLP areas (0.98, 0.86 to 1.09, P < 0.0001). Effects of SSLPs seemed to apply to all subpopulations and SSLP areas. Interpretation Children and their families benefited from living in SSLP areas. The contrast between these and previous findings on the effect of SSLPs might indicate increased exposure to programmes that have become more effective. Early interventions can improve the life chances of young children living in deprived areas. [source]

Illness and exposure to negative life experiences in adolescence: two sides of the same coin?

A study of 15-year-olds in Oslo, Norway
Aim: To investigate associations between negative life experiences and common illnesses among adolescents. Methods: Cross-sectional questionnaire study carried out at all lower secondary schools (10 grade) in Oslo, Norway, during 2000 and 2001 (n= 8316 pupils). Different negative life experiences and illnesses were addressed. Results: The participation rate was 88%. Among reported negative life experiences last year were a pressure felt to succeed (62%), death of a close person (26%), exposure to physical violence (22%), bullying at school (15%) and sexual violation (4%). A large number of the pupils had some chronic illness: hay fever (38%), eczema (29%) and asthma (13%). Reported illnesses the previous 12 month were: headache (56%), painful neck or shoulders (35%), sore throat at least three times (15%), lower respiratory tract infection (9%) and mental problems for which help was sought (7%). During the week prior to the survey, 26% of all girls had symptoms of a depressive disorder, while this applied to 10% of all boys. Fifty-three percent of the boys (29% of the girls) who had depressive symptoms had been exposed to physical violence. Sexually violated boys had a high probability for seeking help for mental problems (OR = 4.9) and for frequent episodes of sore throat (OR = 2.5). Corresponding odds ratios for girls were 1.7 and 2.5, respectively. Conclusion: Common illnesses in adolescence are significantly associated with negative life experiences. In clinical encounters with adolescents not only should the presenting complaints be addressed, but also other common illnesses and relevant background factors such as negative life events. [source]