Child behaviour problems and childhood illness: development of the Eczema Behaviour Checklist.

BACKGROUND/OBJECTIVES: Children with atopic dermatitis are at increased risk of both general behaviour problems, and those specific to the condition and its treatment. This can hamper the ability of parents to carry out treatment and manage the condition effectively. To date, there is no published instrument available to assess child behaviour difficulties in the context of atopic dermatitis management. Our aim was to develop a reliable and valid instrument to assess atopic dermatitis-specific child behaviour problems, and parents' self-efficacy (confidence) for managing these behaviours. METHODS: The Eczema Behaviour Checklist (EBC) was developed as a 25-item questionnaire to measure (i) extent of behaviour problems (EBC Extent scale), and (ii) parents' self-efficacy for managing behaviour problems (EBC Confidence scale), in the context of child atopic dermatitis management. A community-based sample of 292 parents completed the EBC, measures of general behaviour difficulties, self-efficacy with atopic dermatitis management and use of dysfunctional parenting strategies. RESULTS: There was satisfactory internal consistency and construct validity for EBC Extent and Confidence scales. There was a negative correlation between atopic dermatitis-specific behaviour problems and parents' self-efficacy for dealing with behaviours (r = -.53, p < .001). Factor analyses revealed a three-factor structure for both scales: (i) treatment-related behaviours; (ii) symptom-related behaviours; and (iii) behaviours related to impact of the illness. Variation in parents' self-efficacy for managing their child's atopic dermatitis was explained by intensity of illness-specific child behaviour problems and parents' self-efficacy for dealing with the behaviours. CONCLUSIONS: The new measure of atopic dermatitis-specific child behaviour problems was a stronger predictor of parents' self-efficacy for managing their child's condition than was the measure of general child behaviour difficulties. Results provide preliminary evidence of reliability and validity of the EBC, which has potential for use in clinical and research settings, and warrant further psychometric evaluation.

A systematic review of parenting interventions for parents of children with type 1 diabetes.

OBJECTIVE: To summarize the parenting intervention literature for parents of children aged 2-10 years (mean age <10 years) with type 1 diabetes and to evaluate intervention efficacy in improving a range of parent, family and child outcomes. The present review de-emphasizes the traditional medical approach to illness management summarized in previous reviews and focuses on parenting factors identified in the literature as important to diabetes management. This review article is important as it outlines the present state of parenting intervention literature for this population. METHODS: Electronic searches were conducted for seven databases (Cumulative index to nursing and allied health literature, MEDLINE, PsycINFO, PubMed, Scopus, The Cochrane library and Web of Science) from their start dates until April 2014. Reference lists of all included papers were also searched for potentially relevant articles. RESULTS: Seven papers, representing six studies, met the inclusion criteria. Three studies primarily focused on improving parenting practices. The intervention programmes described in the remaining studies comprised multiple components; thus, it is difficult to establish the contribution of the parenting components to improving outcomes. CONCLUSIONS: Parenting interventions may help to improve responsibility sharing and cooperation in diabetes management, child behaviour difficulties, parental behaviour, parents' psychological distress and child health outcomes. This review suggests the need for further well-designed trials of parenting interventions to determine their specific contribution to improving outcomes for this population.

Developing web-based Triple P 'Positive Parenting Programme' for families of children with asthma.

BACKGROUND: We examined the feasibility of self-directed Triple P 'Positive Parenting Programme' for optimizing parents' management of childhood asthma and behaviour. METHODS: Eligible families were invited to access asthma-specific web-based Triple P as part of a preliminary randomized controlled study. RESULTS: Initial study information and introductory website pages received considerable interest but intervention uptake was poor with high rates of attrition. CONCLUSIONS: Although parents of children with asthma show willingness to access web-based parenting support, further work is necessary to develop engaging websites and determine barriers to uptake, and adherence to online parenting interventions with this population.

The Lifestyle Behaviour Checklist: evaluation of the factor structure.

OBJECTIVE: Childhood overweight and obesity have been identified as a significant global health problem, and have multiple health and socio-emotional sequelae. The family context and parenting behaviours in particular play an important role in childhood overweight and obesity; however, limited research has explored the relationship between parenting and child obesity. The aim of this research was to refine the content of a tool designed to assess child lifestyle behaviour problems and parents' confidence in managing these behaviours. DESIGN: Content revisions of the Lifestyle Behaviour Checklist (LBC) were undertaken, and the psychometric properties were examined. SUBJECTS: One hundred and fifty-six parents of an overweight or obese child completed the LBC, as well as questionnaires regarding child behaviour in general and parenting practices. RESULTS: The results of this study support the validity of the revised LBC as a measure of parental concerns about weight-related problem behaviour, and provide evidence for a four-factor structure and strong internal consistency.

Case-control study of early childhood caries in Australia.

The aim of this case-control study of 617 children was to investigate early childhood caries (ECC) risk indicators in a non-fluoridated region in Australia. ECC cases were recruited from childcare facilities, public hospitals and private specialist clinics to source children from different socioeconomic backgrounds. Non-ECC controls were recruited from the same childcare facilities. A multinomial logistic modelling approach was used for statistical analysis. The results showed that a large percentage of children tested positive for Streptococcus mutans if their mothers also tested positive. A common risk indicator found in ECC children from childcare facilities and public hospitals was visible plaque (OR 4.1, 95% CI 1.0-15.9, and OR 8.7, 95% CI 2.3-32.9, respectively). Compared to ECC-free controls, the risk indicators specific to childcare cases were enamel hypoplasia (OR 4.2, 95% CI 1.0-18.3), difficulty in cleaning child's teeth (OR 6.6, 95% CI 2.2-19.8), presence of S. mutans (OR 4.8, 95% CI 0.7-32.6), sweetened drinks (OR 4.0, 95% CI 1.2-13.6) and maternal anxiety (OR 5.1, 95% CI 1.1-25.0). Risk indicators specific to public hospital cases were S. mutans presence in child (OR 7.7, 95% CI 1.3-44.6) or mother (OR 8.1, 95% CI 0.9-72.4), ethnicity (OR 5.6, 95% CI 1.4-22.1), and access of mother to pension or health care card (OR 20.5, 95% CI 3.5-119.9). By contrast, a history of chronic ear infections was found to be protective for ECC in childcare children (OR 0.28, 95% CI 0.09-0.82). The biological, socioeconomic and maternal risk indicators demonstrated in the present study can be employed in models of ECC that can be usefully applied for future longitudinal studies.

Parenting knowledge and its role in the prediction of dysfunctional parenting and disruptive child behaviour.

BACKGROUND: There is a paucity of research on the relationship between parental knowledge, parenting and parenting self-efficacy, and some inconsistencies have been reported in the literature. METHOD: Parent knowledge of effective parenting strategies was assessed among 68 parents from a non-clinic sample, who also completed questionnaires relating to parenting confidence, quality of parenting and child behaviour. RESULTS: Parents with greater knowledge tended to be less dysfunctional, and reported significantly higher education and income levels. Parenting confidence explained a significant proportion of the variance in reported frequency of disruptive child behaviour while knowledge did not independently contribute to the prediction. However, the relationship between parenting confidence and dysfunctional parenting was moderated by the level of knowledge. There was a stronger negative relationship between confidence and dysfunctional parenting when knowledge level was low than when it was high. Post hoc analyses indicated that the relationship between parenting knowledge and disruptive child behaviour was moderated by the level of parenting dysfunction. Parenting knowledge and reported frequency of disruptive behaviour were positively related when the level of dysfunction was low, but were unrelated when it was high. CONCLUSIONS: Parents with low levels of knowledge and confidence in their parenting may be at greater risk of dysfunctional parenting and might benefit from interventions designed to enhance both knowledge and confidence. Results are interpreted in relation to inconsistencies with previous research and implications for future methodologies.

Concurrent predictors of dysfunctional parenting and maternal confidence: implications for parenting interventions.

BACKGROUND: The often intense nature of the conflict between parents and their toddlers requires better understanding of what happens during this stage of development and how difficulties can be prevented from escalating in the future. Clarification of the nature of family and parenting factors related to toddler behaviour allows better capacity for intervention development and tailoring to individual families. METHODS: A total of 126 mothers of toddlers completed a self-report assessment battery, examining child behaviour, parenting style and confidence, as well as broader family adjustment measures. RESULTS: The study found that maternal confidence and dysfunctional parenting were interrelated and were also predicted best by parenting variables, in contrast to socio-demographic and child variables. Maternal confidence also mediated the relationships between family income and toddler behaviour. CONCLUSIONS: Parenting style and confidence are important modifiable factors to target in parenting interventions. The implications for the development, implementation and delivery of parenting interventions are discussed.

Binge drinking in university students: A test of the cognitive model.

The aim of this study was to test the cognitive model [Addict. Behav. 29 (2004) 159] of binge drinking in university students. In Study 1, 202 participants completed the Drinking Expectancy Questionnaire (DEQ), the Drinking Refusal Self-Efficacy Questionnaire (DRSEQ), and the Khavari Alcohol Test (KAT). The results showed that both alcohol expectancies (AEs) and drinking refusal self-efficacy (DRSE) are needed to discriminate between binge, social, and heavy drinkers. In general, binge drinkers tend to have higher AEs than social drinkers, and have slightly lower DRSE. However, young social and binge drinkers can only be discriminated on the basis of their AEs. One hundred and fourteen students were recruited for the second study, to predict which individuals would engage in binge drinking during a 4-week self-monitoring period. Over 80% of predicted binge drinkers binged at least once during the monitoring period. These two studies confirmed the cognitive model of binge drinking, and thus, hold implications for the prevention of binge drinking among adolescents and young adults.

A cognitive model of binge drinking: the influence of alcohol expectancies and drinking refusal self-efficacy.

While binge drinking-episodic or irregular consumption of excessive amounts of alcohol-is recognised as a serious problem affecting our youth, to date there has been a lack of psychological theory and thus theoretically driven research into this problem. The current paper develops a cognitive model using the key constructs of alcohol expectancies (AEs) and drinking refusal self-efficacy (DRSE) to explain the acquisition and maintenance of binge drinking. It is suggested that the four combinations of the AE and DRSE can explain the four drinking styles. These are normal/social drinkers, binge drinkers, regular heavy drinkers, and problem drinkers or alcoholics. Since AE and DRSE are cognitive constructs and therefore modifiable, the cognitive model can thus facilitate the design of intervention and prevention strategies for binge drinking.

[The use of the latissimus dorsi myocutaneous island flap for the reconstruction of the oral cavity floor and of the pharynx]. / Zastosowanie wyspowego plata skórno-miesniowego z m. najszerszego grzbietu w rekonstrukcji dna jamy ustnej i gardla.

The use of myocutaneous island flaps for the reconstruction of the extensive postoperative defects, enlarged possibilities of surgery treatment of malignant tumors. The report presented a case of recurrence of the tongue cancer after radiotherapy. There was performed an extensive surgery in result of which the tongue, the oral cavity floor, the pharynx and the larynx were excised. The defect was reconstructed with the latissimus dorsi myocutaneous island flap. The authors present the vascularization of the flap and the technique of its formation. The latissimus dorsi myocutaneous island flap is often used in the reconstruction of the oral cavity and the pharynx due to its long pedicle and rich vascularization.

[Surgical treatment of advanced cancers of the oral cavity, pharynx and mandible]. / Leczenie chirurgiczne zaawansowanego raka jamy ustnej, gardla i zuchwy.

There was presented a case of advanced recurrence of the oral cavity and mandible cancer after partial glossectomy. The authors stress the possibility of extensive surgery and next postoperative defect reconstruction. The Pectoralis Mayor osteomyocutaneous island flap of rib was used to reconstruction of the fundi oral cavity, the mandible and the pharynx.

[Difficulties with diagnosing Wegener's granulomatosis]. / Trudnosci w rozpoznawaniu ziarniniakowatosci Wegenera.

The authors presents 14 cases Wegener's granulomatosis diagnosed in ORL Clinic in Warsaw. Localisation of the disease, clinical manifestation and difficulties of histopathological examination was described, emphasizing the role of ANCA test (antineutrophil-cytoplasm antibodies).