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1.
Curr Sports Med Rep ; 20(7): 374-383, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34234093

RESUMO

ABSTRACT: Children with obesity experience musculoskeletal pain and reduced physical function and well-being, which collectively impact their fitness, strength, motor skills, and even their ability to undertake simple tasks, like walking and climbing stairs. Disrupting obesity-related disability may be critical to increasing children's physical activity. Thus, barriers to movement should be considered by health practitioners to improve the efficacy of prescribed physical activity. This applied clinical review highlights key subjective and objective findings from a hypothetical case scenario, linking those findings to the research evidence, before exploring strategies to enhance movement and increase physical activity.


Assuntos
Exercício Físico , Obesidade Pediátrica/reabilitação , Aptidão Física , Actigrafia/estatística & dados numéricos , Ciclismo , Criança , Teste de Esforço , Feminino , Pé Chato/diagnóstico , Análise da Marcha , Geno Valgo/diagnóstico , Letramento em Saúde , Humanos , Atividade Motora , Destreza Motora , Movimento , Força Muscular , Dor Musculoesquelética/diagnóstico , Obesidade Pediátrica/complicações , Exame Físico , Família de Pais Solteiros , Natação
2.
J Fam Psychol ; 35(6): 767-779, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33734762

RESUMO

This study explores the effects of family structure (single mother by choice/partnered mother), pathway to motherhood (adoption/assisted reproduction techniques or ART), and parenting style on children's psychological adjustment and social competence. Ninety-eight families participated: 45 single mothers by choice (29 adoptive, 16 by ART); and 53 partnered mothers (27 adoptive, 26 by ART). Ninety-eight children were evaluated (Age = 5.36) by their teachers. As regards family structure, children of single mothers by choice (both adopted and conceived by ART) showed good psychological adjustment and good social competence. No significant differences were observed between them and those living with two parents when all were conceived by ART. However, children adopted by single mothers had higher hyperactivity and lower self-control than those living with two adoptive parents. No differences were observed in terms of nurturing parenting style, either between single and partnered mothers, or between adoptive and ART mothers. The nurturing parenting style significantly predicted better psychological adjustment and social competence among children. The results are discussed in connection with the debate regarding the effect of structure versus family processes on children's psychosocial adjustment. The implications for interventions with single mothers by choice are also explored. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Mães , Poder Familiar , Criança , Pré-Escolar , Feminino , Humanos , Relações Mãe-Filho , Família de Pais Solteiros , Espanha
3.
JAMA Netw Open ; 4(2): e2036809, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33544146

RESUMO

Importance: Studying long-term changes in neighborhood socioeconomic status (SES) may help to better understand the associations between neighborhood exposure and weight outcomes and provide evidence supporting neighborhood interventions. Little previous research has been done to examine associations between neighborhood SES and weight loss, a risk factor associated with poor health outcomes in the older population. Objective: To determine whether improvements in neighborhood SES are associated with reduced likelihoods of excessive weight gain and excessive weight loss and whether declines are associated with increased likelihoods of these weight outcomes. Design, Study, and Participants: This cohort study was conducted using data from the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health study (1995-2006). The analysis included a cohort of 126 179 adults (aged 50-71 years) whose neighborhoods at baseline (1995-1996) were the same as at follow-up (2004-2006). All analyses were performed from December 2018 through December 2020. Exposures: Living in a neighborhood that experienced 1 of 8 neighborhood SES trajectories defined based on a national neighborhood SES index created using data from the US Census and American Community Survey. The 8 trajectory groups, in which high, or H, indicated rankings at or above the sample median of a specific year and low, or L, indicated rankings below the median, were HHH (ie, high in 1990 to high in 2000 to high in 2010), or stable high; HLL, or early decline; HHL, or late decline; HLH, or transient decline; LLL, or stable low; LHH, or early improvement; LLH, or late improvement; and LHL, or transient improvement. Main Outcomes and Measures: Excessive weight gain and loss were defined as gaining or losing 10% or more of baseline weight. Results: Among 126 179 adults, 76 225 (60.4%) were men and the mean (SD) age was 62.1 (5.3) years. Improvements in neighborhood SES were associated with lower likelihoods of excessive weight gain and weight loss over follow-up, while declines in neighborhood SES were associated with higher likelihoods of excessive weight gain and weight loss. Compared with the stable low group, the risk was significantly reduced for excessive weight gain in the early improvement group (odds ratio [OR], 0.87; 95% CI, 0.79-0.95) and for excessive weight loss in the late improvement group (OR, 0.89; 95% CI, 0.80-1.00). Compared with the stable high group, the risk of excessive weight gain was significantly increased for the early decline group (OR, 1.19; 95% CI, 1.08-1.31) and late decline group (OR, 1.13; 95% CI, 1.04-1.24) and for excessive weight loss in the early decline group (OR, 1.15; 95% CI, 1.02-1.28). The increases in likelihood were greater when the improvement or decline in neighborhood SES occurred early in the study period (ie, 1990-2000) and was substantiated throughout the follow-up (ie, the early decline and early improvement groups). Overall, we found a linear association between changes in neighborhood SES and weight outcomes, in which every 5 percentile decline in neighborhood SES was associated with a 1.2% to 2.4% increase in the risk of excessive weight gain or loss (excessive weight gain: OR, 1.01; 95% CI, 1.00-1.02 for women; OR, 1.02; 95% CI, 1.01-1.03 for men; excessive weight loss: OR, 1.02; 95% CI, 1.01-1.03 for women; OR, 1.02; 95% CI, 1.01-1.03 for men; P for- trend < .0001). Conclusions and Relevance: These findings suggest that changing neighborhood environment was associated with changes in weight status in older adults.


Assuntos
Trajetória do Peso do Corpo , Características de Residência/estatística & dados numéricos , Classe Social , Idoso , Escolaridade , Grupos Étnicos , Feminino , Habitação/tendências , Humanos , Renda/tendências , Masculino , Pessoa de Meia-Idade , Assistência Pública/tendências , Família de Pais Solteiros , Fatores Socioeconômicos , Desemprego/tendências , Estados Unidos , Ganho de Peso , Perda de Peso
4.
Pediatr Int ; 63(5): 581-588, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32996283

RESUMO

BACKGROUND: Single-parent families with disabled children are obliged to take special care of children and shoulder excessive burdens. This study aimed to clarify the family functioning of child-rearing single-parent families with children attending special needs schools in Japan. METHODS: Semi-structured interviews were conducted with qualitative content analysis utilized for data analysis. RESULTS: The results of the data analysis clarified nine categories: excessive concentration of family functioning on mothers, and adjustments in the family functioning they perform; creation of a family environment friendly to disabled children and their families; satisfaction with family needs by gaining support from the neighborhood and social resources; anxieties related to children's disabilities; promotion of a better understanding of disability; unavoidable reduction in the amount of time shared by the family; efforts to maintain an infrastructure for health care; selection and effective use of a special needs school; and strengthened bonds between families with disabled children. CONCLUSIONS: Receiving adequate support from the school is of great assistance in enabling families to maintain their family functioning. This demonstrates that, through the use of the time while the child attends a special needs school, the family can accomplish family functioning, contributing to a fulfilling family life.


Assuntos
Crianças com Deficiência , Família de Pais Solteiros , Família , Feminino , Humanos , Japão , Mães , Instituições Acadêmicas
5.
J Fam Psychol ; 35(2): 192-202, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32940489

RESUMO

Findings are presented of the second phase of a longitudinal study of families created by single mothers by choice. Forty-four single heterosexual mothers were compared with 37 partnered heterosexual mothers, all with a donor-conceived child aged around 8-10 years. Standardized interview, observational, and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children, and teachers. There were no differences in maternal mental health, the quality of mother-child relationships or children's emotional and behavioral problems between family types. However, higher levels of parenting stress and higher levels of children's prior adjustment difficulties were each associated with children's adjustment difficulties in middle childhood irrespective of family type. The findings suggest that the presence of two parents-or of a male parent-is not essential for children to flourish, and add to the growing body of evidence that family structure is less influential in children's adjustment than the quality of family relationships. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Comportamento Infantil/psicologia , Ajustamento Emocional , Relações Mãe-Filho , Poder Familiar/psicologia , Comportamento Problema/psicologia , Família de Pais Solteiros/psicologia , Adulto , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino
7.
Artigo em Inglês | MEDLINE | ID: mdl-32899489

RESUMO

The family is of exceptional and lifelong importance to the health of adolescents. Family structure has been linked to children's and adolescents' health and well-being; a nuclear family has been shown to be indicative of better health outcomes as compared with a single-parent family or a step-family. Family climate is rarely included in studies on children's and adolescents' health and well-being, albeit findings have indicated it is importance. Using data from n = 6838 students aged 12-13 years from the German National Educational Panel Study, this study shows that stronger familial cohesion and better a parent-child relationship are associated with better self-rated health, higher life satisfaction, more prosocial behavior, and less problematic conduct, and that these associations are stronger than those for family structure. Surveys on young people's health are encouraged to include family climate above and beyond family structure alone.


Assuntos
Saúde do Adolescente , Relações Familiares , Família , Relações Pais-Filho , Adolescente , Criança , Feminino , Alemanha , Humanos , Masculino , Família de Pais Solteiros
8.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32747472

RESUMO

BACKGROUND AND OBJECTIVES: Little is known about the 2% of US children being raised by their grandparents. We sought to characterize and compare grandparent- and parent-headed households with respect to adverse childhood experiences (ACEs), child temperament, attention-deficit/hyperactivity disorder (ADHD), and caregiver aggravation and coping. METHODS: Using a combined data set of children ages 3 to 17 from the 2016, 2017, and 2018 National Survey of Children's Health, we applied survey regression procedures, adjusted for sociodemographic confounders, to compare grandparent- and parent-headed households on composite and single-item outcome measures of ACEs; ADHD; preschool inattention and restlessness; child temperament; and caregiver aggravation, coping, support, and interactions with children. RESULTS: Among 80 646 households (2407 grandparent-headed, 78 239 parent-headed), children in grandparent-headed households experienced more ACEs (ß = 1.22, 95% confidence interval [CI]: 1.07 to 1.38). Preschool-aged and school-aged children in grandparent-headed households were more likely to have ADHD (adjusted odds ratio = 4.29, 95% CI: 2.22 to 8.28; adjusted odds ratio = 1.72, 95% CI: 1.34 to 2.20). School-aged children in these households had poorer temperament (ßadj = .25, 95% CI: -0.63 to 1.14), and their caregivers experienced greater aggravation (ßadj = .29, 95% CI: 0.08 to 0.49). However, these differences were not detected after excluding children with ADHD from the sample. No differences were noted between grandparent- and parent-headed households for caregiver coping, emotional support, or interactions with children. CONCLUSIONS: Despite caring for children with greater developmental problems and poorer temperaments, grandparent caregivers seem to cope with parenting about as well as parents.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Saúde da Família , Avós/psicologia , Poder Familiar/psicologia , Pais/psicologia , Adaptação Psicológica , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Pré-Escolar , Intervalos de Confiança , Estudos Transversais , Escolaridade , Feminino , Avós/educação , Nível de Saúde , Humanos , Masculino , Razão de Chances , Avaliação de Resultados em Cuidados de Saúde , Relações Pais-Filho , Pais/educação , Agitação Psicomotora/epidemiologia , Família de Pais Solteiros/psicologia , Família de Pais Solteiros/estatística & dados numéricos , Apoio Social , Temperamento
9.
J Nutr Educ Behav ; 52(9): 840-849, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32595083

RESUMO

OBJECTIVE: To investigate the association of adolescent self-report of family mealtime communication on obesity-related behaviors in single- and dual-parent households and by sex in a sample of overweight and obese Hispanic adolescents. DESIGN: Cross-sectional analysis of a randomized control trial SETTING: Eighteen middle schools in Miami-Dade County, Florida. PARTICIPANTS: Two-hundred and eighty Hispanic seventh- and eighth-grade students MAIN OUTCOME MEASURES: Physical activity, fruit and vegetable intake, and added sugar intake. ANALYSIS: Structural equation modeling. RESULTS: The findings indicate that mealtime communication was associated with fruit and vegetable consumption in boys (ß = .30; P = .001; 95% confidence interval [CI], 0.52-2.68) and physical activity in girls (ß = .26; P = .010; 95% CI, 0.16-1.30). Moreover, a single-parent household was associated with dietary consumption in boys (fruit and vegetable intake [ß= .18; P = .039; 95% CI, 0.02-2.60] but had a moderating effect on fruit and vegetable consumption in girls (ß = .21; P = .015; 95% CI, 0.14-2.19). CONCLUSIONS AND IMPLICATIONS: Family mealtime communication may impact dietary and physical activity outcomes in Hispanic adolescents with overweight and obesity, but differentially across gender and household parent makeup. These findings, together with the prevalence of single parents, point to the importance of targeting Hispanic single parents as agents of change to promote healthy lifestyle behaviors in their children via positive mealtime interactions.


Assuntos
Dieta/estatística & dados numéricos , Família , Hispano-Americanos/estatística & dados numéricos , Refeições , Obesidade Pediátrica/epidemiologia , Adolescente , Adulto , Comunicação , Estudos Transversais , Exercício Físico/fisiologia , Feminino , Frutas , Humanos , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Família de Pais Solteiros , Estudantes , Verduras
10.
Cien Saude Colet ; 25(4): 1529-1538, 2020 Mar.
Artigo em Português | MEDLINE | ID: mdl-32267453

RESUMO

Gender inequality is revealed in the issues of education, income and access to Food and Nutrition Security. In Brazil, the National Women Thousand Program aims to intensify the process of regional and institutional development by improving the access of women in situations of social vulnerability to education and the world of work. The objective is to analyze the contribution of the Programa Nacional Mulheres Mil's to reduce vulnerability to food insecurity of households headed by woman. A semi-structured questionnaire was applied to 384 participants, which contained the demographic and socioeconomic variables as well as the Brazilian Food Insecurity Scale. It was observed that, although there was no change in the Food Security situation, there were significant differences in relation to income, especially among women in situation of food insecurity, varying from 20.5% to 46% the number of participants with an income range higher than one minimum wage. The advance in the identified income was not enough to intervene in Food Insecurity. Further research should be carried out in order to deepen the understanding of the relationships between income, education and food and nutritional security, especially from the point of view of actions directed at the female gender.


Assuntos
Insegurança Alimentar , Segurança Alimentar , Avaliação de Programas e Projetos de Saúde , Fatores Sexuais , Adulto , Brasil , Fatores Econômicos , Escolaridade , Feminino , Insegurança Alimentar/economia , Humanos , Renda , Estudos Prospectivos , Família de Pais Solteiros , Populações Vulneráveis
11.
Ciênc. Saúde Colet ; 25(4): 1529-1538, abr. 2020. tab
Artigo em Português | LILACS | ID: biblio-1089515

RESUMO

Resumo A desigualdade de gênero se revela nas questões de educação, renda e acesso a Segurança Alimentar e Nutricional. No Brasil, o Programa Nacional Mulheres Mil tem como objetivo intensificar o processo de desenvolvimento regional e institucional, pela melhoria do acesso de mulheres em situação de vulnerabilidade social à educação e ao mundo do trabalho. O objetivo é analisar a contribuição do Programa para redução da vulnerabilidade à insegurança alimentar dos domicílios chefiado por mulheres. Aplicou-se um questionário semiestruturado para 384 participantes contendo as variáveis demográficas e socioeconômicas e a Escala Brasileira de Insegurança Alimentar. Constataram-se diferenças significativas em relação à renda, especialmente, entre aquelas em situação de insegurança alimentar, variando o número de participantes da faixa de renda superior a um salário mínimo. O avanço na renda não foi suficiente para intervir na Insegurança Alimentar. Mais pesquisas devem ser realizadas com objetivo de aprofundar a compreensão das relações entre renda, educação e Segurança Alimentar e Nutricional, sobretudo sob a ótica das ações direcionadas ao gênero feminino.


Abstract Gender inequality is revealed in the issues of education, income and access to Food and Nutrition Security. In Brazil, the National Women Thousand Program aims to intensify the process of regional and institutional development by improving the access of women in situations of social vulnerability to education and the world of work. The objective is to analyze the contribution of the Programa Nacional Mulheres Mil's to reduce vulnerability to food insecurity of households headed by woman. A semi-structured questionnaire was applied to 384 participants, which contained the demographic and socioeconomic variables as well as the Brazilian Food Insecurity Scale. It was observed that, although there was no change in the Food Security situation, there were significant differences in relation to income, especially among women in situation of food insecurity, varying from 20.5% to 46% the number of participants with an income range higher than one minimum wage. The advance in the identified income was not enough to intervene in Food Insecurity. Further research should be carried out in order to deepen the understanding of the relationships between income, education and food and nutritional security, especially from the point of view of actions directed at the female gender.


Assuntos
Humanos , Feminino , Adulto , Avaliação de Programas e Projetos de Saúde , Fatores Sexuais , Abastecimento de Alimentos , Abastecimento de Alimentos/economia , Brasil , Estudos Prospectivos , Família de Pais Solteiros , Populações Vulneráveis , Economia , Escolaridade , Renda
12.
Fam Process ; 59(2): 597-617, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30865293

RESUMO

The United States is in the midst of a childhood obesity epidemic that disproportionately impacts underserved and diverse populations. In this study, in-depth qualitative interviews were conducted with 16 low-income, single, female, parent/guardians of an overweight or obese 3- to 8-year-old from socioeconomically disadvantaged backgrounds. Following the tenets of the thematic analysis approach, interviews focused on identifying risk and protective factors influencing parental and child health behaviors associated with child weight status. Results from the interviews are organized according to the Socioecological Framework to help identify risk and protective factors at various system levels. Findings from this investigation have relevance for family therapists as they can inform clinical and advocacy-focused interventions with disadvantaged families affected by childhood obesity.


Assuntos
Comportamentos Relacionados com a Saúde , Obesidade Pediátrica/psicologia , Pobreza/psicologia , Família de Pais Solteiros/psicologia , Populações Vulneráveis/psicologia , Peso Corporal , Criança , Pré-Escolar , Características da Família , Terapia Familiar , Feminino , Humanos , Relações Pais-Filho , Pais/psicologia , Fatores de Proteção , Estados Unidos
13.
Child Dev ; 91(5): 1762-1785, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31745985

RESUMO

This article assessed changes in the association between single motherhood and children's verbal cognitive ability at age-11 using data from three cohorts of British children, born in 1958 (n = 10,675), 1970 (n = 8,933) and 2000 (n = 9,989), and mediation analysis. Consistent with previous studies, direct effects were small and insignificant. For those born in 1958 and 1970 indirect effects, operating through reduced economic and parental resources, were associated with -.107-SD to -.156-SD lower attainment. Differences between the two cohorts, and by children's age when parents separated, were insignificant. For the 2000 cohort, effect sizes for children born to single mothers did not change significantly (-.112-SD) but attenuated for children whose parents separated in early childhood (-.076-SD) or while of school age (-.054-SD).


Assuntos
Desenvolvimento Infantil , Mães/estatística & dados numéricos , Família de Pais Solteiros/estatística & dados numéricos , Adulto , Criança , Cognição , Estudos de Coortes , Feminino , Humanos , Masculino , Reino Unido
14.
Psicol. Estud. (Online) ; 25: e44926, 2020. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1135779

RESUMO

RESUMO. O presente artigo é parte de pesquisa mais ampla sobre o vínculo parento-filial nas adoções tardias. O objetivo deste estudo foi investigar as motivações para adoção tardia, buscando analisar o papel do trabalho dos Grupos de Apoio à Adoção no momento da escolha do perfil. Foram entrevistados dez sujeitos independentes, três homens e sete mulheres, que adotaram crianças maiores de dois anos e as entrevistas analisadas pelo método de análise de conteúdo. O desejo por vivenciar a parentalidade se apresentou como motivação imperativa no momento da escolha por uma adoção. De modo geral, as motivações para adoção tardia se apresentaram permeadas por mitos que se constituem como crenças, produzindo efeitos impeditivos ou impulsionadores. O altruísmo como motivação para adoção tardia emergiu no presente estudo como um complicador na medida em que prevalece o desejo de ser o salvador e não o de salvar. Destaca-se o trabalho realizado nos Grupos de Apoio à Adoção como fator fundamental na desconstrução de mitos e fantasias dos pretendentes, na conscientização sobre o real perfil das crianças abrigadas e sobre a adoção tardia como possibilidade.


RESUMEN. El presente artículo forma parte de una investigación más amplia sobre el vínculo pariente-hijo en las adopciones tardías. El objetivo de este estudio fue investigar las motivaciones para las adopciones tardías, buscando analizar el rol del trabajo de los Grupos de Apoyo a la Adopción en el momento de la selección del perfil. Se entrevistaron 10 sujetos independientes, 3 hombres y 7 mujeres, que adoptaron niños mayores de dos años y las entrevistas analizadas por el método de análisis de contenido. El deseo de vivir la parentalidad se presentó como motivación imperativa en el momento de optar por una adopción. De modo general, las motivaciones para la adopción tardía se presentaron permeadas por mitos que se constituyen como creencias, produciendo efectos impeditivos o impulsores. El altruismo como motivación para adopción tardía emergió en el presente estudio como un factor que complica, en la medida en que prevalece el deseo de ser el salvador y no el de salvar. Se destaca el trabajo realizado en los Grupos de Apoyo a la Adopción como factor fundamental en la deconstrucción de mitos y fantasías de los pretendientes, generando conciencia sobre el real perfil de los niños albergados y sobre la adopción tardía como posibilidad.


ABSTRACT The present article is part of a broader research on the parent-child bond in late adoptions. This study aimed to investigate the motivations for late adoption, seeking to analyze the role of the work done by the Adoption Support Groups in the moment of choosing the profile. The authors interviewed ten independent subjects, three men and seven women, who adopted children older than two years, and they analyzed the interviews using the content analysis method. The desire to experience parenthood proved to be the imperative motivation in the moment of seeking for an adoption. In general, the motivations for late adoption presented themselves permeated by myths that are established as beliefs, producing impeditive or driving effects. Altruism as motivation for late adoption emerged in the present study as a complicating factor since what prevails is the desire to be the savior and not the desire to save. The authors highlight the work done by the Adoption Support Groups as a fundamental factor in the deconstruction of the myths and fantasies of the applicants, in raising awareness both on the true profile of the sheltered children and late adoption as a possibility.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adoção/psicologia , Criança Adotada/psicologia , Grupos de Autoajuda , Conscientização , Família/psicologia , Defesa da Criança e do Adolescente/psicologia , Poder Familiar/psicologia , Família de Pais Solteiros , Acolhimento , Relações Familiares/psicologia
15.
Nutrients ; 11(12)2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31861207

RESUMO

The rapid economic and social development in the past decades has greatly increased the societal acceptance of divorce and non-marital pregnancies in China, which leads to a soaring number of single-parent children. This paper aimed to investigate the impact of having one parent absent on children' food consumption and nutrition status. We extracted 1114 children from a longitudinal household survey data in China, all of which were observed twice. Using the Propensity Score Matching and Difference-in-Difference methods, we found that being raised by one parent does not have a negative effect on children's food consumption and nutrition intake. On the contrary, single-parent families tend to provide more food to their children as a compensation for the absence of one parent and this compensation effect offsets the negative impact caused by declined family income. Particularly, urban, rich families had stronger compensation effect than other families with low and middle incomes.


Assuntos
Comportamento Infantil/psicologia , Dieta/psicologia , Comportamento Alimentar/psicologia , Poder Familiar/psicologia , Família de Pais Solteiros/psicologia , Adaptação Psicológica , Adolescente , Adulto , Criança , Pré-Escolar , China , Ingestão de Alimentos , Feminino , Humanos , Renda , Estudos Longitudinais , Masculino , Inquéritos Nutricionais , Estado Nutricional , Pontuação de Propensão
16.
J Trauma Stress ; 32(6): 890-898, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31800141

RESUMO

Adolescent gang members are at high risk for polytraumatization (i.e., experiencing two or more types of trauma), which may contribute to behavioral problems, such as delinquency or drug distribution, and mental health symptoms, such as posttraumatic stress disorder (PTSD) and depression. The present study examined the associations between polytraumatization and these behavioral and mental health outcomes. We hypothesized that increased polytraumatization would lead to increased (b) mental health symptoms, (b) delinquency, and (c) drug distribution. Participants included 441 adolescent gang members (57.8% male; age range: 14-19 years) from a midsized city in the Midwestern United States. A path model was used to test hypotheses. A total of 88.0% of participants experienced polytraumatization, such as physical and sexual assault, involvement in accidents, or witnessing a death or injury. Polytraumatization was uniquely and positively associated with depressive and PTSD symptoms, delinquency, and drug distribution, ßs = .25-.50, ps < .001, explaining an additional 5.9%-22.5% of the variance in these outcomes beyond covariates. Untreated traumatic exposure among adolescent gang members may subsequently lead to poor behavioral and mental health outcomes. These results may inform prevention and intervention efforts focused on mental health and social justice among a high-risk adolescent population.


Assuntos
Exposição à Violência/estatística & dados numéricos , Delinquência Juvenil/estatística & dados numéricos , Grupo Associado , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Afro-Americanos/estatística & dados numéricos , Depressão/diagnóstico , Depressão/epidemiologia , Tráfico de Drogas/estatística & dados numéricos , Exposição à Violência/psicologia , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Família de Pais Solteiros/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
17.
JAMA Netw Open ; 2(10): e1912727, 2019 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-31596488

RESUMO

Importance: Since the transition to the American Community Survey, data uncertainty has complicated its use for policy making and research, despite the ongoing need to identify disparities in health care outcomes. The US Centers for Medicare & Medicaid Services' new, stratified payment adjustment method for its Hospital Readmissions Reduction Program may be able to reduce the reliance on data linkages to socioeconomic survey estimates. Objective: To determine whether there are differences in the reliability of socioeconomically risk-adjusted hospital readmission rates among hospitals that serve a disproportionate share of low-income populations after stratifying hospitals into peer group-based classification groups. Design, Setting, and Participants: This cross-sectional study uses data from the 2014 New York State Health Cost and Utilization Project State Inpatient Database for 96 278 hospital admissions for acute myocardial infarction, pneumonia, and congestive heart failure. The analysis included patients aged 18 years and older who were not transferred to another hospital, who were discharged alive, who did not leave the hospital against medical advice, and who were discharged before December 2014. Main Outcomes and Measures: The main outcomes were 30-day hospital readmissions after acute myocardial infarction, pneumonia, and congestive heart failure assessed using hierarchical logistic regression. Results: The mean (SD) age of the patients was 69.6 (16.0) years for the safety-net hospitals and 74.9 (14.7) years for the non-safety-net hospitals; 9382 (48.8%) and 7003 (48.5%) patients, respectively, were female. For safety net designations, 20% (3 of 15) of all evaluations concealed and distorted differences in risk, with factors such as poverty failing to identify similar risk of acute myocardial infarction readmission until unreliable estimates were excluded from the analysis (OR, 1.23 [95% CI, 1.00-1.52], P = .02; vs OR, 1.17 [95% CI, 0.94-1.46], P = .15). By comparison, 2 of the 60 models (3%) for the peer group-based classification altered the association between socioeconomic status and readmission risk, concealing similarities in congestive heart failure readmission when adjusted using high school completion rates (OR, 1.27 [95% CI 1.02-1.58], P = .04; vs OR, 1.23 [95% CI, 0.98-1.53], P = .06) and distorting similarities in pneumonia readmissions when accounting for the proportion of lone-parent families (OR, 1.27 [95% CI, 0.98-1.66], P = .07; vs OR, 1.35 [95% CI, 1.02-1.80], P = .04) between the lowest and highest socioeconomic status hospitals in quartile 1. Conclusions and Relevance: There was greater precision in socioeconomic adjusted readmission estimates when hospitals were stratified into the new payment adjustment criteria compared with safety net designations. A contributing factor for improved reliability of American Community Survey estimates under the new payment criteria was the merging of patients from low-income neighborhoods with greater homogeneity in survey estimates into groupings similar to those for higher-income patients, whose neighborhoods often exhibit greater estimate variability. Additional efforts are needed to explore the effect of measurement error on American Community Survey-adjusted readmissions using the new peer group-based classification methods.


Assuntos
Hospitais/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Provedores de Redes de Segurança/estatística & dados numéricos , Inquéritos e Questionários/normas , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Escolaridade , Feminino , Insuficiência Cardíaca/epidemiologia , Hospitais/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , New York/epidemiologia , Pneumonia/epidemiologia , Pobreza , Reprodutibilidade dos Testes , Risco Ajustado , Fatores de Risco , Família de Pais Solteiros , Desemprego
18.
Dev Psychopathol ; 31(5): 1801-1811, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31489831

RESUMO

Dishion and Patterson's work on the unique role of fathers in the coercive family process showed that fathers' coercion explained twice the variance of mothers' in predicting children's antisocial behavior and how treatment and prevention of coercion and promotion of prosocial parenting can mitigate children's problem behaviors. Using these ideas, we employed a sample of 426 divorced or separated fathers randomly assigned to Fathering Through Change (FTC), an interactive online behavioral parent training program or to a waitlist control. Participating fathers had been separated or divorced within the past 24 months with children ages 4 to 12 years. We tested an intent to treat (ITT) mediation hypothesis positing that intervention-induced changes in child problem behaviors would be mediated by changes in fathers' coercive parenting. We also tested complier average causal effects (CACE) models to estimate intervention effects, accounting for compliers and noncompliers in the treatment group and would-be compliers in the controls. Mediation was supported. ITT analyses showed the FTC obtained a small direct effect on father-reported pre-post changes in child adjustment problems (d = .20), a medium effect on pre-post changes in fathers' coercive parenting (d = .61), and a moderate indirect effect to changes in child adjustment (d = .30). Larger effects were observed in CACE analyses.


Assuntos
Coerção , Relações Pai-Filho , Pai/psicologia , Poder Familiar/psicologia , Comportamento Problema/psicologia , Família de Pais Solteiros/psicologia , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Divórcio , Feminino , Humanos , Masculino , Modelos Teóricos , Negociação
19.
Child Abuse Negl ; 97: 104123, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31473384

RESUMO

BACKGROUND: Previous research has demonstrated the association between child maltreatment and household composition, with increased maltreatment risk generally present in single mother households. However, existing research does not fully examine the complexity and configuration of single mother households. In particular, less is known about important variants of single parent family structures, such as grandparents residing in the home, and the extent to which household compositions change across time. OBJECTIVE: The present study examines rates of maltreatment allegations across various household compositions in a sample of single biological mother households. PARTICIPANTS AND SETTING: Youth participants (N = 417) were part of the larger multi-site Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) study. METHODS: Participants completed longitudinal assessments of household composition and maltreatment allegations from ages 4 to 10. RESULTS: The present study illustrates substantial variability in the rate of maltreatment allegations across different types of single mother household compositions. In particular, the presence of non-relatives, especially unrelated males, demonstrated an increased risk for maltreatment allegations in the home. Conversely, single mother homes with two or more adult relatives, especially grandmothers, were at reduced risk for child maltreatment allegations. CONCLUSIONS: This study highlights variability in maltreatment allegations among single mother homes, including how maltreatment allegations vary across different household configurations, across child age periods and across different risk levels.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Características da Família , Mães/estatística & dados numéricos , Família de Pais Solteiros/estatística & dados numéricos , Adolescente , Adulto , Criança , Serviços de Proteção Infantil/estatística & dados numéricos , Pré-Escolar , Pai/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
20.
J Fam Psychol ; 33(6): 649-660, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31282693

RESUMO

This study examined family processes on the adjustment of adolescents from single-mother households using a dyadic approach. Participants included 107 noncohabiting Black parental dyads of adolescents aged 12 to 18 years. Each parent completed measures of positive parenting, parent-child relationship quality, parental depressive symptoms, coparenting relationship quality, and adolescent adjustment. Data were analyzed using the actor-partner interdependence model (APIM) and extended mediational model (APIMeM) within a structural equation modeling framework. APIM demonstrated significant actor effects from parent-child relationship quality and parental depressive symptoms to both adolescent externalizing and internalizing problems as well as significant partner effects from parent-child relationship quality to adolescent externalizing problems for both mothers and fathers. Additionally, APIMeM revealed significant indirect actor and partner effects from parent-child relationship quality to externalizing behavior through one's own and one's coparent's coparenting relationship quality for both parents. Indirect actor effects were also observed from positive parenting to externalizing behavior through one's own perception of coparenting relationship quality for both parents. Both APIM and APIMeM models found a significant gender difference for the direct effect from positive parenting to externalizing problems. Specifically, the association was negative for mothers in both models; whereas it was nonsignificant (APIM) and positive (APIMeM) for fathers. This study highlights the unique contributions of mother's and father's parent and coparent factors on one's own, and one's coparent's, perception of adolescent adjustment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Comportamento do Adolescente/psicologia , Afro-Americanos/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Família de Pais Solteiros/psicologia , Adolescente , Afro-Americanos/estatística & dados numéricos , Criança , Feminino , Humanos , Masculino , Fatores Sexuais , Família de Pais Solteiros/estatística & dados numéricos , Sudeste dos Estados Unidos
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