Parental strategies for influencing the diet of their children - A qualitative study from disadvantaged areas.

BACKGROUND: A social gradient is evident in the prevalence of childhood overweight and obesity, to the disadvantage of children with low socioeconomic status (SES). Parents have a substantial influence on their children's dietary behaviours and weight development through the way they interact with the children around food. This study aims to explore the variation of how parents with low SES influence their child's dietary behaviours. METHODS: A phenomenographic design and analysis was used on 29 sessions of motivational interviewing with mothers and fathers participating in the Healthy School Start intervention study in 2012. The parents had a maximum of 12 years of education and resided in areas targeted for socioeconomic development. In the sessions, parents explored changes that they wanted to make in the home environment regarding their child's dietary behaviours. RESULTS: Five categories of guidance of children's dietary habits were found ranging from silently guiding to enforcement. The categories of guidance were structurally related to each other through positive to negative impact of parental recognition of responsibility for the child's behaviours, level of trust in the child's satiety response, and level of parental emotional distress. CONCLUSION: The results suggest that parents use situation-specific guidance with both negative and positive impacts on child behaviours. Depending on the type of guidance used, parents are in need of different supporting strategies to enhance positive parent-child interplay. Suggestions for intervention strategies are provided where specific focus on parental responsibility recognition, emotional self-regulation, increased responsiveness, and cooperation between parents are highlighted.

How can medical schools contribute to bringing about health equity?

The role of medical schools is in a process of change. The World Health Organization has declared that they can no longer be ivory towers whose primary focus is the production of specialist physicians and cutting edge laboratory research. They must also be socially accountable and direct their activities towards meeting the priority health concerns of the areas they serve. The agenda must be set in partnership with stakeholders including governments, health care organisations and the public. The concept of social accountability has particular resonance for the Bar Ilan Faculty of Medicine in the Galilee, Israel's newest medical school, which was established with a purpose of reducing health inequities in the Region. As a way of exploring and understanding the issues, discussions were held with international experts in the field who visited the Galilee. A symposium involving representatives from other medical schools in Israel was also held to extend the discourse. Deliberations that took place are reported here. The meaning of social accountability was discussed, and how it could be achieved. Three forms of action were the principal foci - augmentation of the medical curriculum, direct action through community engagement and political advocacy. A platform was set for taking the social accountability agenda forward, with the hope that it will impact on health inequalities in Israel and contribute to discussions elsewhere.

Cultural competence among Swedish child health nurses after specific training: A randomized trial.

An urgent need to improve Swedish primary child health-care nurses' cultural competence was revealed by previous research among nurses working in, and immigrant parents visiting, primary child health-care services. The aim of this study was to evaluate the extent to which specific training affected how nurses rated their own cultural competence, difficulties, and concerns and to study how the nurses evaluated the training. Conducted as a randomized controlled trial, the effects on a study sample of 51 nurses were assessed by questionnaires in a pre- and post-study design. The findings indicated that the 3 days of training were appreciated by the nurses and had some effects on their cultural competence, difficulties, and concerns. The training might have had positive effects on the nurses' working conditions as they rated it to have an impact on their ability to cope with the demands of their work activities in the health services. These effects are presumed to contribute to an improved quality of the health services, with a reduction in the risk for health-care disparities among children of immigrant parents.

Primary Child Health Care Nurses' assessment of health risks in children of foreign origin and their parents--a theoretical model.

BACKGROUND: According to recent studies, intercultural interaction in health care between clients and care-givers seems to be problematic. A recent Swedish study revealed that a majority of Primary Child Health Care Nurses (PCHNurses) experienced difficulties in their interaction with children and parents of foreign origin. As every third child in the Primary Child Heath Care (PCHC) services is of foreign origin it seem to be of utmost importance to examine in depth how these difficulties could be understood and explained. AIM: The present study aimed at a theoretical explanation of the core problem concerning PCHNurses' interaction with children and parents of foreign origin, as experienced by the PCHNurses. METHODS: Fifteen PCHNurses working in the PCHC services were interviewed. Grounded Theory was used as research methodology because focus is on social interactions and the aim is to theoretically explain unarticulated social processes. RESULTS: Anxiety about missing children, exposed to risks of ill-health, due to various conditions in the child's home environment, turned out to be the PCHNurses' main concern. An assessment of health risks was initiated, when PCHNurses thought that psychosocial conditions in the child's environment might cause ill health. Some of the psychosocial conditions were difficult to assess, as they were unfamiliar and not understood by the PCHNurses. In such difficult-to-assess cases, when the PCHNurses considered the possibility of undefined risk to the child's health they held on to the assessment of the cases and worked out strategies to learn and understand more about the child and the child's home environment. A theoretical model grounded in data was created accounting for the variation in the assessment process and the different strategies used. Implications are discussed and recommendations for improvements are given.

The impact of a student learning journal: a two-stage evaluation using the Nominal Group Technique.

Reflection offers a strategy that can help learners connect what they learn with their everyday practice. It can also assist them in taking control of their learning and in developing insight into the way that they learn. This study used the Nominal Group Technique to evaluate a reflective learning journal on a one-year course for GPs and pharmaceutical advisers. Changes were introduced in answer to the students' responses in the first year, and the evaluation at the end of the second year showed a significant reduction in students' levels of confusion and anxiety related to keeping the diary. They also said that keeping the diary benefited their learning styles but they reported that keeping a learning diary was time-consuming.