Parenting a Chronically Ill Child: Social Support, Coping, Family Hardiness, and Maternal Stress

Parents of children with cancer experience higher stress than parents of children with other medical conditions or with no developmental concerns (Canam, 1993; Cohen, 1999). Researchers are beginning to explore a number of protective factors that may influence parental stress in parents of children with cancer. Social support (Abidin, 1992), problem-focused coping (Judge, 1998), and family hardiness (Maddi et al., 2006) have been related to lower levels of stress and more positive outcomes in parents of healthy children, but have not been fully explored in the pediatric cancer population. The current study was designed to assess the relationship between parental stress, social support, coping strategies, and family hardiness in mothers of children in active cancer treatment. It was hypothesized that: (a) problem-focused coping and social support would be inversely related to parenting stress and positively correlated with family hardiness, (b) emotion-focused and avoidance-based coping would be positively correlated with parenting stress and inversely related to family hardiness, (c) coping and family hardiness would emerge as significant predictors of parental stress when controlling for symptom severity and social support, and (d) hardiness would moderate the relationship between symptom severity and stress when controlling for social support. Results indicated that problem-focused coping and family hardiness did not emerge as unique predictors of parenting stress, and hardiness was not found to moderate the relationship between symptom severity and parenting stress. Future research for this population focusing on fathers, differing prognosis of the child, family hardiness of the current population, and limiting the research to specific types of cancer, treatment, or prognosis may be beneficial. Doctoral dissertation: http://aquila.usm.edu/masters_theses/232

Coping, Hardiness, and Parental Stress in Parents of Children Diagnosed with Cancer

Previous research has demonstrated a significant increase in stress for parents with a child in active cancer treatment. As the number of children diagnosed with cancer continues to rise, there has been a call to identify factors that may contribute to positive outcomes in these families (e.g., Sloper, 2000; Streisand, Kazak, & Tercyak, 2003). Certain effective coping strategies, particularly related to more problem-focused forms of coping and hardiness, appear to be negatively related to parental stress. However, little is known about how these strategies may impact parental stress in families of children in active cancer treatment. The current study assessed the influence of coping and family hardiness on parental stress among parents of children in active cancer treatment. The study hypothesized that: higher levels of effective coping and hardiness will predict a significant amount of variance in parental stress after accounting for symptom severity; the effect of hardiness on parental stress will be attenuated after the addition of Coping I, Coping II, and Coping III in three separate regression models; and the parallel mediation model will partially mediate the relationship between hardiness and parental stress. Results did not support the hypothesis that family hardiness and coping would emerge as significant predictors of parental stress over and above symptom severity. Effective coping was not observed as a partial mediator in the relationship between family hardiness and parental stress. However, communication with other parents and consultation with the medical staff, was found to have a significant indirect relationship between family hardiness and parental stress. The current study provides further information on the enduring impact of symptom severity and the potential relationship between family hardiness, parental stress, and coping through communication with other parents and the medical staff. Masters thesis: http://aquila.usm.edu/masters_theses/232

Examining Two Sides of Food System Challenges: A Case Study of the Potential Impacts of the Food Safety Modernization Act on U.S. Produce Growers and a Descriptive Analysis of the International Food Certification Industry

The Food Safety Modernization Act (FSMA) represents a major change to U.S. food policy. Because several FSMA rules require that covered businesses comply with standards by 2019 at the latest, the legislation is expected to have considerable effects on the U.S. food system in the near future. This research examines potential challenges associated with two different FSMA rules. The first essay uses farm-level data from the 2012 Census of Agriculture to estimate the number of farms and acres covered by the FSMA Final Rule on Produce Safety in the California, the Northeast, and the entire U.S. Industry information and interviews with stakeholders are assessed in conjunction with the Census data to hypothesize how farms in two distinct U.S. production regions, California and the Northeast, will fare under the rule. For the second essay, we developed unique datasets containing information on 425 food certification standards and 581 certification bodies. The certification data is used to develop a descriptive analysis of patterns in the international food certification industry. We show how offices of certification bodies that offer food safety certification services are distributed geographically, which serves as a basis for assessing international auditing capacity under the FSMA Final Rule on Accredited Third-Party Certification

Blood Sugar, Your Pancreas, and Unicorns: The Development of Health Education Materials for Youth With Prediabetes

Background. The obesity epidemic has led to an increase in prediabetes in youth, causing a serious public health concern. Education on diabetes risk and initiation of lifestyle change are the primary treatment modalities. There are few existing age-appropriate health education tools to address diabetes prevention for high-risk youth. Aim. To develop an age-appropriate health education tool(s) to help youth better understand type 2 diabetes risk factors and the reversibility of risk. Method. Health education tool development took place in five phases: exploration, design, analysis, refinement, and process evaluation. Results. The project resulted in (1) booklet designed to increase knowledge of risk, (2) meme generator that mirrors the booklet graphics and allows youth to create their own meme based on their pancreas’ current mood, (3) environmental posters for clinic, and (4) brief self-assessment that acts as a conversation starter for the health educators. Conclusion. Patients reported high likability and satisfaction with the health education tools, with the majority of patients giving the materials an “A” rating. The process evaluation indicated a high level of fidelity and related measures regarding how the health education tools were intended to be used and how they were actually used in the clinic setting

The Rorschach inkblot test as an aid in the psychoeducational diagnoses of learning disabled latency-aged males

The present study was intended to determine if three Rorschach indices (F%, A%, and ep) differentiated between matched pairs of LD and Non-LD latency-age males. The chief purpose of this research was to examine the efficacy of employing the Rorschach Inkblot Test as a supplement to the material currently used in the diagnosis of potentially LD children. An examination was made of the case histories of 1D boys who had received services from the Educational Clinic, University of Northern Iowa. Cumulative file data for Non-LD boys were gathered for comparative purposes. Subjects were matched according to age, IQ, and social-economic status. Rorschachs were administered to the Non-LD group and protocols scored. Data were analyzed using the Wilcoxon Matched-Pairs Signed-Ranks Test. No significant differences were obtained. Protocols were also examined qualitatively. The major conclusions were as follows: 1) It is necessary to consider the entire protocol to understand both the quantitative and qualitative implications of the data. 2) A large Rorschach sample pool is important; larger numbers of available subjects may provide more closely matched pairs. 3) It is advisable for researchers to have access to extensive home and school backgrounds of subjects in any study of this nature

Drug Court Versus Incarceration: Which Is More Effective?

Aim: This study explores the affect drug court treatment programs have on the sobriety and employment status of the participants. Background: Drug addiction has been an ongoing issue nationwide, and with addiction comes drug related crimes. Currently the preferred solution to this epidemic is to impose longer and longer lengths of incarceration for every incurred infraction. Methods: A descriptive correlational design will be used for this research study to evaluate the effectiveness of drug court compared to incarceration. The participants will be chosen by a random sampling of 100 residents of the Hampton Roads area of Virginia--50 who have graduated drug court and 50 who were incarcerated for drug-related offenses. Each participant must be a legal resident of Virginia for at least 3 years. The participants will be given a close-ended, 18-question questionnaire, titled “One Year Evaluation Post Drug Court.” The questionnaire will be designed to determine the participants’ life one year after graduating from a drug court program or one year after incarceration for a drug-related offense, possible drug and alcohol relapse, and questions on their demographics. Analysis: An analysis will be conducted using descriptive and inferential statistics. A demographic profile will be constructed of the population’s gender, age, ethnicity, level of education, and marital status. The data will be organized using frequency distribution to compare employment status and sobriety of each group. It will be a ratio measurement, and a dependent t-test will be used to verify the means of each group are statistically different. Expected Findings: It is expected that findings will show participation in drug court reduces the rate of recidivism and increases the rate of sobriety maintenance more than incarceration in drug-addicted individuals. Limitations: This study is limited due to the self-reporting nature of questionnaires and small sample size

Gut microbiota in HIV-pneumonia patients is related to peripheral CD4 counts, lung microbiota, and in vitro macrophage dysfunction.

Pneumonia is common and frequently fatal in HIV-infected patients, due to rampant, systemic inflammation and failure to control microbial infection. While airway microbiota composition is related to local inflammatory response, gut microbiota has been shown to correlate with the degree of peripheral immune activation (IL6 and IP10 expression) in HIV-infected patients. We thus hypothesized that both airway and gut microbiota are perturbed in HIV-infected pneumonia patients, that the gut microbiota is related to peripheral CD4+ cell counts, and that its associated products differentially program immune cell populations necessary for controlling microbial infection in CD4-high and CD4-low patients. To assess these relationships, paired bronchoalveolar lavage and stool microbiota (bacterial and fungal) from a large cohort of Ugandan, HIV-infected patients with pneumonia were examined, and in vitro tests of the effect of gut microbiome products on macrophage effector phenotypes performed. While lower airway microbiota stratified into three compositionally distinct microbiota as previously described, these were not related to peripheral CD4 cell count. In contrast, variation in gut microbiota composition significantly related to CD4 cell count, lung microbiota composition, and patient mortality. Compared with patients with high CD4+ cell counts, those with low counts possessed more compositionally similar airway and gut microbiota, evidence of microbial translocation, and their associated gut microbiome products reduced macrophage activation and IL-10 expression and increased IL-1β expression in vitro. These findings suggest that the gut microbiome is related to CD4 status and plays a key role in modulating macrophage function, critical to microbial control in HIV-infected patients with pneumonia