Prevention Messages in Parent-Infant Bed-Sharing: Message Source, Credibility, and Effectiveness

Objective. Despite educational outreach, bed-sharing prevalence is rising. Mothers’ and fathers’ bed-sharing practices, prevention message source, perceived source credibility, and the effectiveness of the prevention message were evaluated. Methods. Data were collected from 678 community parents via an online survey. Results were analyzed using descriptive statistics and phi tests. Results. Bed-sharing reasons focused on comfort and ease. Mothers were more likely to receive prevention messages from individual professionals or organizations, whereas fathers were more likely to hear prevention messages from spouses/coparents and grandfathers. Physicians were the most common source, and physicians and grandmothers were rated as the most credible and effective. Conclusions. Prevention message source varies between mothers and fathers, highlighting the need for continued research with fathers. Grandmothers and physicians are effective and credible sources of prevention messages. Although less frequent, prevention messages from grandmothers were most effective. There was no evidence of effective messages from educational campaigns

“It’s just another added layer of difficulty”: Language access equity and inclusion in pediatric interpreted medical encounters — Provider and interpreter perspectives

Limited English proficient or language-diverse patients and families in pediatric interpreted medical encounters (IME) are susceptible to health disparities and inequities in the US compared to English proficient patients and families in language-concordant medical encounters. Policies to improve access to language services intend to bridge this gap, yet evidence suggests that significant inequities still exist. This study explores perspectives of interpreters and pediatric critical care medical providers to better understand the complexities of IME in pediatric settings. Qualitative data were analyzed from two interview studies with medical interpreters and providers using thematic coding and inductive analysis. Several factors were identified by both interpreters and medical providers that negatively affected communication, equity, and inclusion. These included systems-level factors (e.g., time constraints and language variety), interpersonal factors (e.g., difficulties with communication and mistrust), and intrapersonal factors (e.g., implicit biases and judgements). These results highlight multiple layers of potential inequities which adversely affect patients and families in pediatric IME.; En los encuentros médicos interpretados (EMI) en pediatría en los EE.UU., las personas y familiares que acuden a una consulta médica con un dominio limitado del inglés o con otras lenguas están expuestas a perjuicios y desigualdades en materia de salud, en comparación con aquellas que dominan el inglés y que asisten a las consultas en su idioma. Las políticas para mejorar el acceso a los servicios lingüísticos pretenden salvar esta brecha, pero los datos indican que siguen dándose desigualdades significativas. Este estudio explora las perspectivas de intérpretes y de proveedores de atención sanitaria crítica pediátrica para comprender mejor las complejidades de los EMI en contextos pediátricos. Se analizan los datos cualitativos procedentes de dos estudios con entrevistas a intérpretes y proveedores de atención sanitaria utilizando codificación temática y análisis inductivo. Los resultados muestran que ambos grupos detectan varios factores que afectan negativamente a la comunicación, la equidad y la inclusión. Estos factores se localizan a nivel sistémico (como son las limitaciones de tiempo y la variedad lingüística), interpersonal (por ejemplo, las dificultades de comunicación y la desconfianza) y a nivel intrapersonal (como son los sesgos implícitos y los prejuicios). Estos resultados ponen de manifiesto las múltiples capas de desigualdades potenciales que perjudican a pacientes y familiares en los EMI en pediatría.; En les trobades mèdiques interpretades (EMI) en pediatria als EUA, les persones i familiars que acudeixen a una consulta mèdica amb un domini limitat de l'anglés o amb llengües diferents a aquesta s’exposen a perjudicis i desigualtats en matèria de salut, en comparació amb les que dominen l'anglès i que assisteixen a les consultes en el seu idioma. Les polítiques per millorar l'accés als serveis lingüístics pretenen salvar aquesta escletxa, però les dades indiquen que continuen donant-se desigualtats significatives. Aquest estudi explora les perspectives d’intèrprets i de proveïdors d’atenció sanitària crítica en pediatria per comprendre millor les complexitats de les EMI en contextos pediàtrics. S’analitzen les dades qualitatives procedents de dos estudis amb entrevistes a intèrprets i proveïdors d’atenció sanitària utilitzant una codificació temàtica i una anàlisi inductiva. Els resultats mostren que tots dos grups detecten diversos factors que afecten negativament la comunicació, l'equitat i la inclusió. Aquests factors es localitzen a nivell sistèmic (com són les limitacions de temps i la varietat lingüística), interpersonal (per exemple, les dificultats de comunicació i la desconfiança) i a nivell intrapersonal (com ara els biaixos implícits i els prejudicis). Aquests resultats palesen les múltiples capes de desigualtats potencials que perjudiquen pacients i familiars als EMI en pediatria

Adolescent Experiences with Self-Asphyxial Behaviors and Problematic Drinking in Emerging Adulthood

Self-asphyxial behavior to achieve a euphoric high (The Choking Game; TCG), occurs most often during early adolescence. Participants in TCG often engage in other risky behaviors. This study investigated the relationship between prior experience with TCG and problematic drinking behaviors in emerging adulthood. Emerging adults, 18 to 25 years old (N = 1248), 56% female, and 78% Caucasian completed an online survey regarding knowledge of and prior engagement in TCG and current drinking behaviors. Participants who personally engaged in TCG during childhood/adolescence or were familiar with TCG reported significantly more problematic drinking behaviors during emerging adulthood. Those present when others engaged in TCG but resisted participation themselves reported significantly less current problematic drinking behaviors than those who participated, but significantly more current problematic drinking behaviors than those never present. Emerging adults with increased social familiarity with TCG during adolescence endorsed greater problematic drinking behaviors. Results suggest resistance skills may generalize across time/activities

What Does Weight Have to Do with It? Parent Perceptions of Weight and Pain in a Pediatric Chronic Pain Population

Tailored pain management strategies are urgently needed for youth with co-occurring chronic pain and obesity; however, prior to developing such strategies, we need to understand parent perspectives on weight in the context of pediatric chronic pain. Participants in this study included 233 parents of patients presenting to a multidisciplinary pediatric chronic pain clinic. Parents completed a brief survey prior to their child\u27s initial appointment; questions addressed parents\u27 perceptions of their child\u27s weight, and their perceptions of multiple aspects of the relationship between their child\u27s weight and chronic pain. The majority (64%) of parents of youth with obesity accurately rated their child\u27s weight; this group of parents was also more concerned (p \u3c 0.05) about their child\u27s weight than parents of youth with a healthy weight. However, the majority of parents of youth with obesity did not think their child\u27s weight contributed to his/her pain, or that weight was relevant to their child\u27s pain or pain treatment. Overall, only half of all parents saw discussions of weight, nutrition, and physical activity as important to treating their child\u27s pain. Results support the need for addressing parents\u27 perceptions of their child\u27s weight status, and educating parents about the relationship between excessive weight and chronic pain

Clinical correlates of grey matter pathology in multiple sclerosis

Traditionally, multiple sclerosis has been viewed as a disease predominantly affecting white matter. However, this view has lately been subject to numerous changes, as new evidence of anatomical and histological changes as well as of molecular targets within the grey matter has arisen. This advance was driven mainly by novel imaging techniques, however, these have not yet been implemented in routine clinical practice. The changes in the grey matter are related to physical and cognitive disability seen in individuals with multiple sclerosis. Furthermore, damage to several grey matter structures can be associated with impairment of specific functions. Therefore, we conclude that grey matter damage - global and regional - has the potential to become a marker of disease activity, complementary to the currently used magnetic resonance markers (global brain atrophy and T2 hyperintense lesions). Furthermore, it may improve the prediction of the future disease course and response to therapy in individual patients and may also become a reliable additional surrogate marker of treatment effect

Prevention of the Choking Game: Parent Perspectives

BACKGROUND: Many preadolescents and adolescents have been reported to take part in forced asphyxiation as a means of creating a feeling of being high without taking drugs. This activity goes by different names, including the Choking Game, Blackout, and Space Monkey. The limited epidemiological data suggest that about 6-11% of adolescents report having engaged in this behavior. METHODS: This study surveyed a predominantly Caucasian cohort of parents regarding their knowledge of the choking game and its associated risks, as well as their attitudes toward possible prevention efforts. RESULTS: Three quarters of parents responding reported being familiar with the choking game but considerably fewer (20%) reported having talked to their children about this activity. Ninety-six percent of parents reported knowing that unintentional death was a potential risk and ninety percent believe information about this activity should be included in school health curricula. CONCLUSIONS: Parents of adolescents in the United States appear to be quite knowledgeable about the Choking Game and its potential risks and are overwhelmingly supportive of prevention measures. The parents surveyed understood the importance of preventing children from engaging in the Choking Game, but may need specific help in how to talk to their children about it. Further work is needed to confirm that the proportion of parents identified as aware of this risk taking behavior is consistent across other populations and to urgently identify effective prevention efforts that can be integrated into existing health curricula

Utility of the PedsQLTM family impact module: Assessing the psychometric properties in a community sample

Purpose Research on families coping with pediatric chronic illnesses has established that children and parents are affected by the illness. Therefore, optimal assessment of parent and family functioning is clinically important. The PedsQLTM family impact module (FIM) assesses parents\u27 health-related quality of life (HRQOL) and family functioning. While the FIM has been shown to be reliable and valid in multiple chronic illness groups, there is little data on its use in non-clinical groups. The study\u27s objective was to assess the reliability, validity, and factor structure of the FIM in a community sample. Methods Nine hundred and twenty-nine community parents of children 2-17 years old completed an anonymous online survey. The mean age of the participants was 37.6 years (SD = 8.6), and the majority were mothers (63.6 %), white (82.9 %), and married (74.8 %). The mean age of the children being reported on was 8.8 years (SD = 3.9), and the majority were female (52.3 %) and 41.2 % were reported as having at least one chronic condition. Results All of the FIM\u27s scales demonstrated excellent internal consistency reliability. Confirmatory factor analysis of the measure supported the current structure. The measure correlated in the expected direction with validated measures of anxiety, depression, child HRQOL, and number of chronic conditions endorsed. Independent t tests indicated that the measure has discriminant validity between parents who reported having a child with a chronic condition to those who did not. Conclusion The results of this study suggest the FIM is a reliable and valid measure of parent HRQOL and family functioning within a community sample, and facilitate its use in comparative studies. © Springer Science+Business Media Dordrecht 2013

Impact of Tourette Syndrome: A preliminary investigation of the effects of disclosure on peer perceptions and social functioning

Individuals with Tourette Syndrome (TS) often experience social difficulties, which may be caused or compounded by others\u27 negative perceptions of persons with the disorder. As a result, researchers and clinicians have called for the development of attitude change strategies. One such strategy is preventative disclosure, in which one informs others about his or her condition. To date, no known research exists exploring the effects of this type of disclosure with TS. In an attempt to examine the effects of TS disclosure, adults (N =369) read vignettes that varied in a 2 (male vs. female character) x 2 (preventative disclosure of disorder vs. nondisclosure) design. Respondents answered several questions regarding the character presented in the vignette, which when factor-analyzed, resulted in four factors (social rejection, attributions of a drug/alcohol problem, perceptions of psychological/medical problems, and general concern). The results of this preliminary study are promising, in that the data suggest that preventative disclosure of TS may reduce social rejection, minimize concern, and decrease perceptions of drug and alcohol problems. No effect of character gender was found. Implications of these findings, limitations to the current study, and directions for future research are discussed

Development and Validation of 18-Item Short Form for the Parents as Social Context Questionnaire

Parenting styles have been shown to have direct and indirect influences on child, adolescent, and adult psychosocial outcomes. The Parents as Social Context Questionnaire assesses how well an individual’s parenting style provides for their child’s psychological needs on six unipolar subscales: warmth, rejection, structure, chaos, autonomy, support, and coercion. The aim of the present study was to increase the clinical and research utility of the Parents as Social Context Questionnaire by: (1) establishing a short form; (2) evaluating the fit of the established short form with the unipolar, six dimensional and the bipolar, three-dimensional frameworks of parenting styles; and (3) assessing the reliability and validity of the established short form. Three-hundred and fifty-one parents of a child between the ages of 1 and 12 years were recruited by university students in the United States and completed the current study as part of a larger online survey. First, the number of items per latent factor in the 30-item Parents as Social Context Questionnaire was reduced. A unipolar, six-dimensional structure with positive and negative higher-order factors demonstrated good fit, while a bipolar, three-dimensional structure did not. Results demonstrated adequate to good internal consistency, convergent validity, and criterion validity. The current study produced preliminary support for an 18-item, unipolar, six-dimensional short form of the Parents as Social Context Questionnaire (i.e., PASCQ-18), which has the potential to allow for more widespread assessment of parenting styles in clinical and research settings by decreasing patient and participant burden and promoting a higher response rate