ABSTRACT
The 1998 El Niño significantly reduced garden productivity in the Upper Orinoco region in Venezuela. Consequently, parents were forced to allocate food carefully to their children. Nutrition data collected from village children combined with genealogical data allowed the determination of which children suffered most, and whether the patterns of food distribution accorded with predictions from parental investment theory. For boys, three social variables accounted for over 70% of the variance in subcutaneous fat after controlling for age: number of siblings, age of the mother's youngest child, and whether the mother was the senior or junior co-wife, or was married monogamously. These results accord well with parental investment theory. Parents experiencing food stress faced a trade-off between quantity and quality, and between investing in younger versus older offspring. In addition, boys with access to more paternal investment (i.e. no stepmother) were better nourished. These variables did not account for any of the variance in female nutrition. Girls' nutrition was associated with the size of their patrilineage and the number of non-relatives in the village, suggesting that lineage politics may have played a role. An apparent lack of relationship between orphan status and nutrition is also interesting, given that orphans suffered high rates of skin flea infections. The large number of orphans being cared for by only two grandparents suggests that grooming time may have been the resource in short supply.
Subject(s)
Child Welfare/statistics & numerical data , Food Supply/statistics & numerical data , Parenting/psychology , Adolescent , Age Factors , Child , Child, Preschool , Ectoparasitic Infestations , Family Characteristics , Female , Health Status , Hierarchy, Social , Humans , Male , Marital Status , Multivariate Analysis , Nutrition Disorders/epidemiology , Paternal Behavior , Regression Analysis , Sex Factors , Skinfold Thickness , Venezuela/epidemiologyABSTRACT
A model is presented for providing home care services for children dying from cancer and for their families. Forty-two families whose children were patients at the Midwest Children's Cancer Center received home care during the first two years of this program. Variations in patient age, diagnosis, or family structure did not preclude successful participation in home care. In all families, the medical and nonmedical financial burdens of inpatient and outpatient hospital care were reduced when the child died at home. Since this program was initiated, terminal care has shifted from hospital-based medical management to nursing support in the home for the majority of children at our cancer center.