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1.
Int J Behav Nutr Phys Act ; 16(1): 100, 2019 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-31685028

RESUMO

BACKGROUND: Most research on parenting and childhood obesity and obesity-related behaviours has focused on mothers while fathers have been underrepresented. Yet, recent literature has suggested that fathers uniquely influence their children's lifestyle behaviours, and hence could also affect their weight status, but this has not yet been scientifically proven. Therefore, the present study aimed to determine whether the association between fathers' weight status and their children's weight status is mediated by fathers' and children's movement behaviours (i.e. physical activity (PA) and screen time (ST)). METHODS: Cross-sectional data of 899 European fathers and their children were analyzed. Fathers/male caregivers (mean age = 43.79 ± 5.92 years, mean BMI = 27.08 ± 3.95) completed a questionnaire assessing their own and their children's (mean age = 8.19 ± 0.99 years, 50.90% boys, mean BMIzscore = 0.44 ± 1.07) movement behaviours. Body Mass Index (BMI, in kg/m2) was calculated based on self-reported (fathers) and objectively measured (children) height and weight. For children, BMI z-scores (SD scores) were calculated to obtain an optimal measure for their weight status. Serial mediation analyses were performed using IBM SPSS 25.0 Statistics for Windows to test whether the association between fathers' BMI and children's BMI is mediated by fathers' PA and children's PA (model 1) and fathers' ST and children's ST (model 2), respectively. RESULTS: The present study showed a (partial) mediation effect of fathers' PA and children's PA (but not father's ST and children's ST) on the association between fathers' BMI and children's BMI (model for PA; coefficient: 0.001, 95% CI: [0.0001, 0.002]; model for ST; coefficient: 0.001, 95% CI: [0.000, 0.002]). Furthermore, fathers' movement behaviours (PA and ST) were positively associated with their children's movement behaviours (PA and ST) (model for PA, coefficient: 0.281, SE: 0.023, p < 0.001; model for ST, coefficient: 0.345, SE: 0.025, p < 0.001). CONCLUSIONS: These findings indicate that the influence of fathers on their children's weight status partially occurs through the association between fathers' PA and children's PA (but not their ST). As such, intervening by focusing on PA of fathers but preferably of both members of the father-child dyad (e.g. engaging fathers and their children in co-PA) might be a novel and potentially effective strategy for interventions aiming to prevent childhood overweight and obesity. Longitudinal studies or intervention studies confirming these findings are however warranted to make meaningful recommendations for health intervention and policy. TRIAL REGISTRATION: The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708 .


Assuntos
Peso Corporal/fisiologia , Exercício , Relações Pai-Filho , Pai/estatística & dados numéricos , Tempo de Tela , Adulto , Índice de Massa Corporal , Criança , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
Cien Saude Colet ; 24(9): 3563-3570, 2019 Sep 09.
Artigo em Português | MEDLINE | ID: mdl-31508773

RESUMO

There is evidence that parental support and behavior impact the healthy behavior of adolescents directly. The scope of this study is to identify the relationship between students' Lifestyle Profile (LP) and that of their parents. Two hundred and eight students aged between 11 and 15 and their respective parents participated in the study. An instrument that included five components was used to evaluate the parents' LP. These components included nutrition, physical activity, preventive behavior, relationships, and stress management. An instrument adapted for adolescents was used to evaluate the students' LP. Descriptive statistics and the Chi-square test were used for the data analysis. Students, mothers and fathers showed positive behavior (PB) for the LP, but when the different components of lifestyle were stratified, an average score of the nutritional responses of students and parents was bordering on negative behavior (NB). The average number of mothers' points in physical activity corresponded to NB. There were no significant relationships between parents' and students' LP, though in the physical activity component alone a significant relationship was found. The relationships established between the groups in the LP suggest that PB of the parents increases the chances of having children with PB.


Assuntos
Comportamentos Relacionados com a Saúde , Estilo de Vida , Relações Pais-Filho , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Criança , Exercício/fisiologia , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Mães/estatística & dados numéricos , Inquéritos e Questionários
3.
BMC Health Serv Res ; 19(1): 675, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533696

RESUMO

BACKGROUND: The Ghana Community-based Health Planning and Services (CHPS) initiative is a national strategy for improving access to primary health care services for underserved communities. Following a successful trial in the North Eastern part of the country, CHPS was adopted as Ghana's flagship programme for achieving the Universal Health Coverage. Recent empirical evidence suggests, however, that scale-up of CHPS has not necessarily replicated the successes of the pilot study. This study examines the community's perspective of the performance of CHPS and how the scale up could potentially align with the original experimental study. METHOD: Applying a qualitative research methodology, this study analysed transcripts from 20 focus group discussions (FGDs) in four functional CHPS zones in separate districts of the Northern and Volta Regions of Ghana to understand the community's assessment of CHPS. The study employed the thematic analysis to explore the content of the CHPS service provision, delivery and how community members feel about the service. In addition, ordinary least regression model was applied in interpreting 126 scores consigned to CHPS by the study respondents. RESULTS: Two broad areas of consensus were observed: general favourable and general unfavourable thematic areas. Favourable themes were informed by approval, appreciation, hard work and recognition of excellent services. The unfavourable thematic area was informed by rudeness, extortion, inappropriate and unprofessional behaviour, lack of basic equipment and disappointments. The findings show that mothers of children under the age of five, adolescent girls without children, and community leaders generally expressed favourable perceptions of CHPS while fathers of children under the age of five and adolescent boys without children had unfavourable expressions about the CHPS program. A narrow focus on maternal and child health explains the demographic divide on the perception of CHPS. The study revealed wide disparities in actual CHPS deliverables and community expectations. CONCLUSIONS: A communication gap between health care providers and community members explains the high and unrealistic expectations of CHPS. Efforts to improve program acceptability and impact should address the need for more general outreach to social networks and men rather than a sole focus on facility-based maternal and child health care.


Assuntos
Atenção Primária à Saúde/organização & administração , Serviços de Saúde Rural/organização & administração , Adolescente , Adulto , Criança , Pai/estatística & dados numéricos , Feminino , Gana , Pessoal de Saúde , Humanos , Masculino , Mães/estatística & dados numéricos , Projetos Piloto , Cobertura Universal do Seguro de Saúde/organização & administração
4.
BMC Public Health ; 19(1): 1219, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484566

RESUMO

BACKGROUND: Given the urban-rural structure and the increase in rural-to-urban migration, three types of children have emerged in contemporary China: rural, urban, and migrant children. Health disparities among these types of children have caused widespread concern, being the main contributor to health inequalities among children in China. The purpose of this study was to investigate health disparities among these children and the mechanisms underlining them. METHODS: This research applied multiple linear regression to data obtained from the Chinese Education Panel Survey (CEPS), a national representative survey of 7772 students from 2014 to 2015. Multiple linear regression with interactive terms was used to explore how gender and father's education moderate the degree of health inequalities among the children. 'Height for age Z-scores' (HAZ) was deployed as the indicator of the children's health status, with larger scores indicating better health status. RESULTS: The findings of the current study were threefold: First, this study found significant health disparities among the three types of children. Urban children are generally the healthiest (M = 1.064), followed by migrant children, (M = 0.779) and rural children (M = 0.612). Second, fathers' education significantly compensates for the heath disparities among the children. Fathers' education has a larger effect in compensating a rural-migrant difference (b = - 0.018, P < 0.05) than a rural-urban difference (b = - 0.016, P < 0.1). Third, the compensating effect of the fathers' education varies by gender. The compensating effect is larger for boys (b = 0.028, P < 0.001) than for girls (b = 0.025, P < 0.01). CONCLUSIONS: This study found significant health inequalities among urban, migrant, and rural children, which might be shaped by the distinction of urban-rural structure and the process of rural-to-urban migration in contemporary China. Fathers' education also plays an important role in narrowing-but not eliminating-the health inequality between urban and rural children. Furthermore, the compensating effect of fathers' education is higher for boys than for girls, reflecting the patriarchal tradition in China. The currents study suggests that to promote the healthy growth of children, it is necessary to consider the health inequalities among different types of children when developing health-related policies. Factors like family socioeconomic status and gender may likewise play an important role in the implementation of policies.


Assuntos
Disparidades nos Níveis de Saúde , População Rural/estatística & dados numéricos , Migrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Criança , China , Escolaridade , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários
5.
PLoS Med ; 16(8): e1002868, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31398184

RESUMO

BACKGROUND: High body mass index (BMI) is associated with mortality, but the pervasive problem of confounding and reverse causality in observational studies limits inference about the direction and magnitude of causal effects. We aimed to obtain estimates of the causal association of BMI with all-cause and cause-specific mortality. METHODS AND FINDINGS: In a record-linked, intergenerational prospective study from the general population of Sweden, we used two-sample instrumental variable (IV) analysis with data from 996,898 fathers (282,407 deaths) and 1,013,083 mothers (153,043 deaths) and their sons followed up from January 1, 1961, until December 31, 2004. Sons' BMI was used as the instrument for parents' BMI to compute hazard ratios (HRs) for risk of mortality per standard deviation (SD) higher parents' BMI. Using offspring exposure as an instrument for parents' exposure is unlikely to be affected by reverse causality (an important source of bias in this context) and reduces confounding. IV analyses supported causal associations between higher BMI and greater risk of all-cause mortality (HR [95% confidence interval (CI)] per SD higher fathers' BMI: 1.29 [1.26-1.31] and mothers' BMI: 1.39 [1.35-1.42]) and overall cancer mortality (HR per SD higher fathers' BMI: 1.20 [1.16-1.24] and mothers' BMI: 1.29 [1.24-1.34]), including 9 site-specific cancers in men (bladder, colorectum, gallbladder, kidney, liver, lung, lymphatic system, pancreas, and stomach) and 11 site-specific cancers in women (gallbladder, kidney, liver, lung, lymphatic system, ovaries, pancreas, stomach, uterus, cervix, and endometrium). There was evidence supporting causal associations between higher BMI in mothers and greater risk of mortality from kidney disease (HR: 2.17 [1.68-2.81]) and lower risk of mortality from suicide (HR: 0.77 [0.65-0.90]). In both sexes, there was evidence supporting causal associations between higher BMI and mortality from cardiovascular diseases (CVDs), stroke, diabetes, and respiratory diseases. We were unable to test the association between sons' and mothers' BMIs (as mothers' data were unavailable) or whether the instrument was independent of unmeasured or residual confounding; however, the associations between parents' mortality and sons' BMI were negligibly influenced by adjustment for available confounders. CONCLUSIONS: Consistent with previous large-scale meta-analyses and reviews, results supported the causal role of higher BMI in increasing the risk of several common causes of death, including cancers with increasing global incidence. We also found positive effects of BMI on mortality from respiratory disease, prostate cancer, and lung cancer, which has been inconsistently reported in the literature, suggesting that the causal role of higher BMI in mortality from these diseases may be underestimated. Furthermore, we expect different patterns of bias in the current observational and IV analyses; therefore, the similarities between our findings from both methods increases confidence in the results. These findings support efforts to understand the mechanisms underpinning these effects to inform targeted interventions and develop population-based strategies to reduce rising obesity levels for disease prevention.


Assuntos
Índice de Massa Corporal , Causas de Morte , Mortalidade , Adolescente , Adulto , Crianças Adultas/estatística & dados numéricos , Família , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Mães/estatística & dados numéricos , Modelos de Riscos Proporcionais , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
6.
Acta Med Port ; 32(7-8): 499-504, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31445529

RESUMO

INTRODUCTION: Children's exposure to secondhand smoke is a cause of serious health problems and infant morbidity. This is the first nationally representative study conducted in Portugal to describe the prevalence of children exposed to secondhand smoke at home and in the car. MATERIAL AND METHODS: This is a descriptive cross-sectional study with a representative sample of 2396 Portuguese children aged 0 to 9 years old, stratified by age and administrative region NUTS II. Questionnaires were administered between January and September 2016. RESULTS: Results showed that 6.1% of mothers and 11.2% of fathers reported smoking at home. It was found that 4.5% of mothers and 8.3% of fathers reported smoking in the car. Results also showed that 5.4% of children were double exposed to secondhand smoke at home and in the car. Children whose parents were smokers and had a lower level of education were more exposed to secondhand smoke at home. DISCUSSION: Children's exposure to secondhand smoke has been decreasing in Portugal. Parental smoking and a low educational level were risk factors for children's exposure to secondhand smoke at home. CONCLUSION: The main source of children's exposure to secondhand smoke is parental smoking. As such, it is crucial to implement effective measures to control parental smoking. It is necessary to promote smoking cessation among parents and to ban smoking inside the car.


Assuntos
Automóveis/estatística & dados numéricos , Habitação/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Escolaridade , Exposição Ambiental/estatística & dados numéricos , Pai/educação , Pai/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Mães/educação , Mães/estatística & dados numéricos , Portugal/epidemiologia , Prevalência , Fumar/epidemiologia , Abandono do Hábito de Fumar , Inquéritos e Questionários
7.
Nurs Res ; 68(5): E1-E9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31465306

RESUMO

BACKGROUND: Although perinatal deaths are still a common pregnancy outcome in developing countries, little is known about the effect perinatal death has on fathers. OBJECTIVE: The aim of the study was to understand and describe the meaning of perinatal death in a sample of fathers from northeastern Colombia. METHODS: Using purposive and snowball sampling approaches, we identified 15 participants from northeastern Colombia who agreed to participate. We used a descriptive phenomenological design. Data were collected through in-depth, semistructured interviews. RESULTS: Men suffer in solitude and hide their emotions as they feel the need to be the main supporters of their partners. Three major themes emerged: experience of loss, coming to terms with an irreparable loss, and overcoming the loss. DISCUSSION: While women are receiving care, health staff may neglect or forget men. Men suffer alone while seeking ways of attunement with their partners' emotions to support them during the grieving process. Fathers can overcome and adjust to the loss when they transcend it and find new meaning. Men felt neglected and marginalized at hospitals while their partners were receiving treatment. Health professionals should recognize and acknowledge the pain of fathers who face perinatal death and include them as much as possible in the standard of care. The results identify opportunities for healthcare providers in clinical and outpatient settings to acknowledge the importance of men within the context of pregnancy and to learn about their pain and suffering when they face a perinatal death.


Assuntos
Pai/psicologia , Morte Perinatal , Adolescente , Adulto , Colômbia , Emoções , Pai/estatística & dados numéricos , Pesar , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
8.
PLoS One ; 14(7): e0219544, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291369

RESUMO

The aim of this study was to analyse the relationship between parents' past experience as Physical Education (PE) students and the importance they give to PE within the school curriculum. Parents of 1834 teenagers from Spain and Portugal participated in the study (1834 fathers and 1834 mothers). An 11 item questionnaire was used for data collection. The measures studied were: socio-demographic characteristics, parent´s past experience as PE students, and importance that parents gave to PE in the school curriculum. The results suggest that parents' past experiences as PE student condition their evaluation of the importance that PE should have in the school curriculum. As the past experience as PE student deteriorated and as age increased, there was an increase in the probability that parents evaluate PE as deserving a less important status in their children's curriculum. These findings can contribute to understanding how the parents' past experiences as PE students seem to partially model the value judgements that they make later in life regarding the importance of the subject.


Assuntos
Currículo , Pai/estatística & dados numéricos , Mães/estatística & dados numéricos , Relações Pais-Filho , Educação Física e Treinamento , Adulto , Idoso , Pai/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães/psicologia , Portugal , Instituições Acadêmicas , Espanha , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
9.
Midwifery ; 77: 37-44, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31254962

RESUMO

AIM: To explore the experience of both the mothers and the fathers regarding the care received during delivery in cases of stillbirth. DESIGN: A hermeneutic phenomenological study based on semi-structured interviews with eleven mothers and fathers who experienced stillbirth. PARTICIPANTS: A purposive sample was recruited in Hospital XXX of XX and through a local pregnancy loss support organization. METHODS: Interviews were recorded and transcribed verbatim and analysed using inductive thematic analysis. FINDINGS: Four main categories identified: 1) denial of grief, 2) the life and death paradox, 3) guilt, and 4) go through and overcome the loss. The parents manifested a lack of recognition of their loss and their parenthood. Although the midwife was the highest valued professional, not all the experiences were positive and the parents would have appreciated being accompanied by trained people with good communication skills. They also referred to in-hospital logistic barriers that complicated the process, as well as the fact that these births occurred in the same place where healthy deliveries were attended. CONCLUSION: Findings highlight the importance of tailoring support systems according to mothers' and fathers' needs. Promoting social and institutional recognition of this kind of loss and training healthcare professionals in the accompaniment of this type of mourning is useful to plan comprehensive care to facilitate the initiation and subsequent evolution of healthy mourning.


Assuntos
Pai/psicologia , Mães/psicologia , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Natimorto/psicologia , Adaptação Psicológica , Adulto , Luto , Pai/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Mães/estatística & dados numéricos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/estatística & dados numéricos , Espanha/epidemiologia , Natimorto/epidemiologia
10.
J Fam Psychol ; 33(6): 704-710, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31169391

RESUMO

Many studies have indicated a relationship between parental and child religiosity, but the strength of the relationship has varied. Moreover, few studies have examined moderators of this relationship, and none have conducted a meta-analysis to determine a concise picture of the association between parent and child religiosity. The current study conducted a meta-analysis to clarify the relationship between parent and child religiosity as well as gender as a possible moderator. Analysis of 30 studies conducted over the past 27 years revealed that the strength of transmission of religiosity from parent to child is dependent on parent and child gender. Overall, effect sizes were strongest for sons, mothers, and the mother-daughter dyad. Thus, these results suggest that gender plays a major role in the connection between parent and child religiosity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Pai/psicologia , Mães/psicologia , Relações Pais-Filho , Religião , Adolescente , Adulto , Criança , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Mães/estatística & dados numéricos , Fatores Sexuais , Adulto Jovem
11.
Eur J Contracept Reprod Health Care ; 24(3): 216-221, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31055972

RESUMO

Objective: Our aim was to study the association between early-life factors and the development of endometriosis. Methods: This case-control study included 440 women with surgically confirmed endometriosis (cases) and 880 women without endometriosis (controls). Information on early-life factors was ascertained retrospectively by in-person interviews with participants and their mothers. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between endometriosis and maternal and paternal characteristics and foetal and infant exposures were estimated using unconditional logistic regression, adjusting for frequency matching and confounding variables. Results: We observed that women who were not breastfed as infants had twice the risk of endometriosis compared with women who were breastfed (adjusted OR 2.0; 95% CI 1.6, 4.5). Our data suggested an increased endometriosis risk with neonatal vaginal bleeding (adjusted OR 1.9; 95% CI 1.2, 4.3) and paternal smoking (adjusted OR 1.8; 95% CI 1.1, 4.9). Although the CIs included the null hypothesis value, caesarean section (adjusted OR 1.7; 95% CI 1.0, 3.5) and prematurity (adjusted OR 1.4; 95% CI 0.8, 3.7) were probably associated with the incidence of endometriosis. Conclusions: Some early-life factors including breastfeeding, neonatal vaginal bleeding and paternal smoking were associated with subsequent, surgically confirmed endometriosis in this cohort of Chinese women.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Endometriose/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Hemorragia Uterina/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Cesárea/estatística & dados numéricos , China/epidemiologia , Pai/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fumar/epidemiologia , Adulto Jovem
12.
J Fam Psychol ; 33(5): 565-574, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31021128

RESUMO

Widowed parents play a critical role in promoting family adaptation and facilitating their children's adjustment to the loss of a parent; yet the psychological wellbeing of these parents has received scant attention. In this study we examined depressive symptoms and grief intensity in 252 spousally bereaved men with dependent-age children. Participants learned of the study and completed initial surveys at variable time points during their first 2 years of bereavement. Depressive and grief symptoms remained persistently high, with 45% of the sample exceeding screening thresholds for clinically significant depressive symptoms two years after the death of their spouses. In linear regression models, higher intensity or frequency of depression and grief symptoms were associated with poorer psychological adaptation, lower parenting self-efficacy, and lower parenting satisfaction scores. Relationships between fathers' distress and potentially modifiable end-of-life variables regarding their spouses were examined. Notably, those who reported that their wives were at peace with dying had lower depressive and grief scores at various intervals. Overall, the magnitude and duration of the depressive and grief symptoms suggests that widowed fathers' psychological distress does not quickly abate over the first 2 years of bereavement, which may be attributable to the unique set of bereavement challenges facing widowed parents such as facilitating their children's grief, assuming sole parenting responsibilities, and managing a household on their own. The findings underscore the need to further examine emotional distress in widowed parents and how their wellbeing impacts family functioning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Luto , Transtorno Depressivo/psicologia , Pai/psicologia , Poder Familiar/psicologia , Autoeficácia , Viuvez/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Pai/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Inquéritos e Questionários , Viuvez/estatística & dados numéricos , Adulto Jovem
13.
Int J Pediatr Otorhinolaryngol ; 122: 18-26, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30928866

RESUMO

OBJECTIVE: Anotia and microtia are congenital malformations of the external ear with few known risk factors. We conducted a comprehensive assessment of a wide range of potential risk factors using data from the National Birth Defects Prevention Study (NBDPS), a population-based case-control study of non-chromosomal structural birth defects in the United States. METHODS: Mothers of 699 infants with anotia or microtia (cases) and 11,797 non-malformed infants (controls) delivered between 1997 and 2011 were interviewed to obtain information about sociodemographic, health behavioral, and clinical characteristics. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated with logistic regression. RESULTS: Infants with anotia/microtia were more likely to be male (aOR, 1.29; 95% CI, 1.10-1.50) and from a multifetal pregnancy (aOR, 1.68; 95% CI, 1.16-2.42). Cases were also more likely to have parents of Hispanic ethnicity (maternal aOR, 3.19; 95% CI, 2.61-3.91; paternal aOR, 2.11; 95% CI, 1.54-2.88), and parents born outside the United States (maternal aOR, 1.29; 95% CI, 1.06-1.57; paternal aOR, 1.92; 95% CI, 1.53-2.41). Maternal health conditions associated with increased odds of anotia/microtia included obesity (aOR, 1.31; 95% CI, 1.06-1.61) and pre-pregnancy diabetes (type I aOR, 9.89; 95% CI, 5.46-17.92; type II aOR, 4.70; 95% CI, 2.56-8.63). Reduced odds were observed for black mothers (aOR, 0.57; 95% CI, 0.38-0.85) and mothers reporting daily intake of folic acid-containing supplements (aOR, 0.59; 95% CI, 0.46-0.76). CONCLUSION: We identified several risk factors for anotia/microtia, some which have been previously reported (e.g., diabetes) and others which we investigate for perhaps the first time (e.g., binge drinking) that warrant further investigation. Our findings point to some potentially modifiable risk factors and provide further leads toward understanding the etiology of anotia/microtia.


Assuntos
Microtia Congênita/epidemiologia , Diabetes Mellitus/epidemiologia , Adulto , Afro-Americanos/estatística & dados numéricos , Estudos de Casos e Controles , Microtia Congênita/etnologia , Suplementos Nutricionais , Orelha Externa/anormalidades , Pai/estatística & dados numéricos , Feminino , Ácido Fólico/uso terapêutico , Comportamentos Relacionados com a Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Obesidade/epidemiologia , Gravidez , Gravidez Múltipla , Fatores de Proteção , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia
14.
MCN Am J Matern Child Nurs ; 44(4): 186-194, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31008721

RESUMO

BACKGROUND: Although teen fathers are a vulnerable group of parents, they have received far less attention than teen mothers. PURPOSE: We conducted a systematic search of qualitative studies that examined their prenatal and postpartum experience to better understand teen fathers' concerns, strengths, and vulnerabilities. METHODS: We searched nine electronic databases through September 2017; 29 studies represented in 30 articles met study criteria. All authors independently extracted data from each article. Coding decisions were reviewed weekly and differences were settled by consensus. RESULTS: From pooling the results of 29 primary studies, we describe how a tenuous ground contributes to teen paternity and imperils young fathers' involvement with their children. In the best of circumstances, the ground begins to stabilize for teens who become involved parents despite significant challenges and hardships. CLINICAL IMPLICATIONS: Our results contribute to the visibility of teen fathers and the social disparities that imperil fathering. We provide clinical guidance for strengthening the ground for teen fathers and their families, recognizing that clinicians often encounter challenges such as interpersonal factors and sociocultural conditions that systematically erode fathers' ties to their children, partners, professional caregivers, and institutions.


Assuntos
Pai/psicologia , Pesquisa Qualitativa , Adolescente , Pai/estatística & dados numéricos , Humanos , Masculino , Poder Familiar/psicologia
15.
Arch Psychiatr Nurs ; 33(2): 155-163, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30927985

RESUMO

Little information is available on parental self-care while in recovery from addictive substances, and its relationship to parenting and recovery outcomes. We evaluated the feasibility of obtaining self-care and parenting outcomes for adults in long-term recovery from addictive substances, and explored potential contributing factors. Nineteen mothers and fathers who self-reported at least two years of sobriety participated in this study. Feasibility challenges included recruitment and scheduling interviews, given multiple work and personal demands on participants' schedules. Possible associations of self-care to parental efficacy (PE), parenting behaviors, resilience, and total recovery years were examined as indicators to parental functioning. The exploratory analyses showed a significant moderate correlation between PE and parenting behaviors (r = 0.45, p < 0.05) as well as total years in recovery and age (r = 0.43, p < 0.05); total years in recovery differed significantly when compared by race (χ2 (1) = 5.63; p = 0.018) and education (χ2 (1) = 3.94; p = 0.048). There was also a significant inverse relationship between total years in recovery and PE (r = -0.43, p < 0.05) and parental self-care (r = -0.59, p < 0.01). Recruiting parents (especially minorities) in long-term recovery was very challenging indicating that recruitment through community organizations was not feasible without a site champion. Preliminary findings showed statistically significant correlations among self-care, parental efficacy, age, and total years in recovery. As researchers and clinicians, it is necessary to determine the role and impact of self-care for future intervention development, however, recruitment strategies need to be modified to ensure sufficiently large study samples.


Assuntos
Poder Familiar/psicologia , Autocuidado , Autoeficácia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adolescente , Adulto , Criança , Educação não Profissionalizante , Pai/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Mães/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários
16.
Eur J Epidemiol ; 34(7): 651-660, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30868347

RESUMO

Recent studies have shown that certain pharmacological agents used by fathers before conception may increase the risk of adverse neonatal outcomes in offspring. However, little is known about the effect of paternal use of antiepileptic drugs (AEDs) on congenital anomalies in children. Based on Danish national registers, we conducted a cohort study of 733, 282 singletons born from 1997 to 2008, with follow-up throughout 2013. The children whose fathers used AEDs during the 3 months before conception were categorized as the exposed. Logistic regression model was used to examine association between paternal AEDs use before conception and the risk of congenital anomalies in offspring. Compared with unexposed children, the exposed had a 23% increased risk of congenital anomalies (odds ratios (OR) 1.23, 95% confidence interval [CI] 1.10-1.37) after adjusting for potential confounders. When extending the exposure window to 1 year before conception to the end of pregnancy, except for those using AEDs during 3 months before conception (the susceptible period of exposure), the increased risks were also observed in children whose fathers were former users (i.e., those using AEDs only from 1 year to 3 months before conception) (OR 1.29, 95%CI 1.03-1.61) and later users (i.e., those using AEDs only during pregnancy) (OR 1.35, 95%CI 1.12-1.65). This study suggested that the mildly increased risk of congenital anomalies in the offspring associated with paternal AEDs use before conception may be attributable to the underlying indications related to AEDs use.


Assuntos
Anticonvulsivantes/efeitos adversos , Epilepsia/tratamento farmacológico , Pai/psicologia , Exposição Paterna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca/epidemiologia , Epilepsia/epidemiologia , Pai/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Vigilância da População , Cuidado Pré-Concepcional , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
17.
PLoS One ; 14(3): e0213897, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30893380

RESUMO

METHODS: A cross-sectional survey of men attending antenatal care with their partners at three London Maternity Units. We assessed level of pregnancy planning using the partner version of the London Measure of Unplanned Pregnancy (LMUP), preconception health behaviours, and whether they had sought information and health professional advice before conception. MAIN RESULTS: We recruited 573 men (91% response rate). Mean age was 34 years, 86% were in employment or full time education and 66% had a degree. Half were overweight or obese, 16% were still smoking and 79% had consumed alcohol in the three months before conception. Of 250 men answering questions about medication, a third were taking medication with potentially adverse effects on male reproductive health, while 23% reported taking pre-pregnancy vitamins. 46.9% had looked at information about pregnancy from a variety of sources, including online, before their partner became pregnant. Assessed by the LMUP, 74% of pregnancies were planned. Male 'planners' were more likely than other men to reduce smoking, reduce alcohol consumption and to eat more healthily in preparation for pregnancy. However, 57% took no action to improve their health. SIGNIFICANCE OF THE FINDINGS: In a sample of relatively educated men accompanying their partners on an antenatal visit, nearly half had made at least one positive health behaviour change before pregnancy, but half were overweight or obese and a third were on medication that could impair male reproductive health. These findings, together with a high prevalence of alcohol consumption and smoking, indicate the need for greater paternal preconception health awareness and care. Innovative ways to promote positive messages about fatherhood, including medication review as part of preconception care, should be evaluated for impact on improving paternal reproductive health and pregnancy and neonatal outcomes.


Assuntos
Pai/estatística & dados numéricos , Cuidado Pré-Concepcional/estatística & dados numéricos , Saúde Reprodutiva/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos Transversais , Inglaterra , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde/fisiologia , Humanos , Homens , Pessoa de Meia-Idade , Cuidado Pré-Natal/estatística & dados numéricos , Fumar/efeitos adversos , Inquéritos e Questionários , Adulto Jovem
18.
PLoS One ; 14(2): e0212667, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30817752

RESUMO

BACKGROUND: The present study conducted secondary analyses of a randomized controlled trial to examine the transgenerational relationship between cognitive-behavioral therapy for child Separation Anxiety Disorder (SepAD) and the mental health of parents. Symptoms of anxiety and depression were compared before and after child treatment between parents of children treated for SepAD and parents of healthy children, who did not receive any treatment. METHODS: One hundred and seven children aged 4-14 years with SepAD received one of two cognitive behavioral treatment programs for SepAD (TAFF; TrennungsAngstprogramm Für Familien; English: Separation Anxiety Family Therapy or CC; Coping Cat). Their parents (N = 189; 101 mothers and 88 fathers) were assessed at baseline and post-treatment for symptoms of separation anxiety, general anxiety, and depression. A comparison group of parents (N = 74; 42 mothers and 32 fathers) of 45 children without SepAD, who did not receive any treatment, were also assessed. RESULTS: Results indicated a significant interaction effect between group and time on mothers' depression and separation anxiety, indicating that maternal symptoms of depression and separation anxiety improved in the child treatment condition in comparison to mothers of healthy children. There was no significant improvement in parental pathology levels among fathers of children treated for SepAD. CONCLUSIONS: Treatment for child SepAD may have subsequent positive effects on mothers' own levels of separation anxiety and depression, though the mechanisms are yet unknown. Future studies are needed that test the transgenerational effect of child SepAD treatment on parental mental health as the primary research question.


Assuntos
Ansiedade de Separação/terapia , Transtornos do Comportamento Infantil/terapia , Terapia Cognitivo-Comportamental , Depressão/diagnóstico , Pai/psicologia , Mães/psicologia , Adolescente , Adulto , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Depressão/psicologia , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento
19.
Obesity (Silver Spring) ; 27(4): 523-524, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30900414

RESUMO

On September 22, 2017, "Engaging the Forgotten Parent: Conference of Experts on Fathers' Role in Children's Weight-Related Behaviours and Outcomes" brought researchers, students, health professionals, community stakeholders, and knowledge users from Canada, Australia, and the United States together to Toronto, Ontario, for a 1-day gathering focused on furthering scientific understanding of effective strategies to recruit, engage, and retain fathers in family-based obesity research. Furthermore this conference focused on identifying key knowledge gaps and opportunities for collaborative research to further our understanding of fathers' roles in the development of their children's behaviors and weight outcomes. The following four themes emerged from the conference: (1) underrepresentation of fathers in family-based obesity research, (2) fathers' engagement in children's weight-related behaviors and desire to participate in research, (3) best practices in recruiting, engaging, and retaining fathers in research, and (4) key lessons learned from fatherhood research in developmental science.


Assuntos
Peso Corporal/fisiologia , Comportamento Infantil/fisiologia , Relações Pai-Filho , Pai , Adulto , Austrália/epidemiologia , Canadá/epidemiologia , Criança , Congressos como Assunto , Relações Familiares , Pai/psicologia , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Poder Familiar , Seleção de Pacientes , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/etiologia , Estados Unidos/epidemiologia
20.
BMC Public Health ; 19(1): 102, 2019 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-30670034

RESUMO

BACKGROUND: To improve prerequisites for better health development among children growing up in multicultural suburbs in Stockholm County, where poorer health is displayed in several aspects including child health, early support was initiated for first-time parents in one of the suburbs. An extended postnatal home visiting program during the child's first 15 months was offered to families with first-time mothers during 2013-2014 and consisted of six home visits by a child health care nurse and a parental advisor from social services. Almost all invited families (94%) participated in the program and the program evaluation. Fathers' participation in two or more home visits within the program was 53%. The aim of this study was to explore the experiences of fathers participating in the program, with respect to their role as a first-time parent from a resilience perspective. METHODS: In-depth interviews were conducted with nine fathers. Constructivist grounded theory (GT) was applied in the analysis. RESULTS: The fathers' experiences formed the core category of the study, 'striving for stability in living conditions', as well as three categories: 'everyday life conditions', 'adjustment to fatherhood in Sweden' and 'channels of support'. The fathers perceived that the home visiting program strengthened their parental confidence and increased their knowledge of societal services and local resources for their family. CONCLUSIONS: In terms of resilience, the extended postnatal home visiting program benefitted the interviewed migrant fathers on an individual level by meeting part of their need for support regarding knowledge and parental confidence; on a structural level the program helped fathers gain information about available societal services and resources in their local area. TRIAL REGISTRATION: The study was retrospectively registered (11 August 2016) in the ISRCTN registry (ISRCTN11832097 DOI: https://doi.org/10.1186/ISRCTN11832097 ).


Assuntos
Pai/psicologia , Visita Domiciliar , Cuidado Pós-Natal , Resiliência Psicológica , Adulto , Diversidade Cultural , Pai/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , População Suburbana/estatística & dados numéricos , Suécia
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