Understanding How Family Socioeconomic Status Mediates the Maternal Intelligence–Child Cognitive Outcomes Relationship: A Moderated Mediation Analysis

In a model of moderated mediation using matched data from the 1979 National Longitudinal Survey of Youth and the 1979 National Longitudinal Survey of Youth, Children and Young Adults, I test (1) whether family socioeconomic status (SES) mediates the maternal intelligence-child cognitive outcomes relationship and (2) the extent to which this mediating impact is dependent on the level of maternal intelligence. Results reveal that the mediating impact of SES on the maternal intelligence–child cognitive outcomes relationship varies as a function of the level of maternal intelligence. The positive effect of higher SES on children's academic ability decreases as the cognitive ability of mothers increases, such that children in low IQ households benefit most from higher SES, while children in high IQ households benefit somewhat less.     

Family Health Climate and Adolescents’ Physical Activity and Healthy Eating: A Cross-Sectional Study with Mother-Father-Adolescent Triads

Introduction

The importance of the family environment for children’s and adolescents’ health behavior has been demonstrated, the underlying mechanisms of this influence remain unclear. Therefore, the aim of the study was to investigate the relationship between family environmental and individual determinants. It was hypothesized that the Family Health Climate (FHC) is associated with adolescents’ physical activity and dietary behavior and that intrinsic motivation mediates this association.

Methods

Cross-sectional data were collected from 198 families (mother, father, and child) using questionnaires. Perceptions of FHC of mothers, fathers, and their children were assessed using the FHC-scales for physical activity (FHC-PA) and nutrition (FHC-NU). The adolescents also rated their intrinsic motivation for exercise and healthy eating, their physical activity and consumption of healthful food. A structural equation model was analyzed and a bootstrapping procedure was used to test direct and indirect effects.

Results

The FHC-PA was related to the amount of weekly physical activity and the FHC-NU to the consumption of fruit, vegetables and salad. These effects were mediated by adolescents’ intrinsic motivation; the indirect effects were significant for both behaviors.

Discussion

These results emphasize the importance of the FHC in shaping adolescents’ physical activity and dietary behavior. Individual motivational factors are potential mediators of family and parental influences. Considering family-level variables and their interaction with individual factors contributes to the understanding of adolescents’ health behavior.     

Can Ethnic Background Differences in Children’s Body Composition Be Explained by Differences in Energy Balance-Related Behaviors? A Mediation Analysis within the Energy-Project

Background

In affluent countries, children from non-native ethnicity have in general less favourable body composition indicators and energy balance-related behaviors (EBRBs) than children from native ethnicity. However, differences between countries have been reported.

Methodology/Principal Findings

A school-based survey among 10–12 years old children was conducted in seven European countries with a standardized protocol. Weight, height and waist circumference were measured; engagement in EBRBs was self-reported. For those countries with significant ethnic differences in body composition (Greece and the Netherlands), multilevel mediation analyses were conducted, to test the mediating effect of the EBRBs in the association between ethnic background and body composition indicators. Analyses were adjusted for gender and age, and for parental education in a later step. Partial mediation was found for sugared drinks intake and sleep duration in the Greek sample, and breakfast in the Dutch sample. A suppression effect was found for engagement in sports activites in the Greek sample.

Conclusions/Significance

Ethnic differences in children’s body composition were partially mediated by differences in breakfast skipping in the Netherlands and sugared drinks intake, sports participation and sleep duration in Greece.     

Sex-Related Online Behaviors,Perceived Peer Norms and Adolescents’ Experience with Sexual Behavior: Testing an Integrative Model

Research on the role of sex-related Internet use in adolescents’ sexual development has often isolated the Internet and online behaviors from other, offline influencing factors in adolescents’ lives, such as processes in the peer domain. The aim of this study was to test an integrative model explaining how receptive (i.e., use of sexually explicit Internet material [SEIM]) and interactive (i.e., use of social networking sites [SNS]) sex-related online behaviors interrelate with perceived peer norms in predicting adolescents’ experience with sexual behavior. Structural equation modeling on longitudinal data from 1,132 Dutch adolescents (M_age T₁ = 13.95; range 11-17; 52.7% boys) demonstrated concurrent, direct, and indirect effects between sex-related online behaviors, perceived peer norms, and experience with sexual behavior. SEIM use (among boys) and SNS use (among boys and girls) predicted increases in adolescents’ perceptions of peer approval of sexual behavior and/or in their estimates of the numbers of sexually active peers. These perceptions, in turn, predicted increases in adolescents’ level of experience with sexual behavior at the end of the study. Boys’ SNS use also directly predicted increased levels of experience with sexual behavior. These findings highlight the need for multisystemic research and intervention development to promote adolescents’ sexual health.     

Chinese Migrant Adolescents’ Perceived Discrimination and Psychological Well-Being: The Moderating Roles of Group Identity and the Type of School

Perceived discrimination can be harmful to migrant adolescents in China. However, little is known about the processes through which discrimination may be linked to decreased well-being in Chinese migrant adolescents. This study examined the relationship between perceived discrimination and three indices of psychological well-being (self-esteem, life satisfaction, collective self-esteem) in 798 Chinese migrant adolescents (49.4% from public schools). Group identity affirmation and belonging (GIAB) was examined as a protective factor that was expected to alleviate the negative effects of perceived discrimination on well-being, and the type of school was investigated as a potential moderator of the associations of interest. The results indicate that perceived discrimination was negatively linked to the three indices of psychological well-being and that the negative effects of perceived discrimination on psychological well-being were particularly salient for migrant adolescents attending public schools. Additionally, GIAB emerged as a protective buffer against perceived discrimination’s negative effects on collective well-being.     

Portuguese Family Physicians’ Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study

Background

Physicians’ ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests.

Methods

A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician’s level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician’s cost estimate was compared with the true cost and the absolute error was calculated.

Results

One-quarter (24%; 95% confidence interval: 23%–25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53–56) overestimating and 21% (95% IC: 20–22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain.

Conclusions

Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care.     

Overnutrition in Prenatal and Neonatal Life: A Problem?

In most areas of the world nutritional problems are related to quantitative and qualitative deficiencies. However, in North America the possible harmful effects of overnutrition deserve careful consideration.Little information is available concerning overnutrition during prenatal and neonatal life. The author draws attention to this possibility by outlining clinical and biochemical disorders occurring in the newborn which are related to excessive ingestion of calories, fat, protein, vitamins and minerals before and after birth. Particular reference is made to the ingestion of nutritional substances during pregnancy in amounts that are relatively innocuous to the mother but may be harmful to the infant in utero.Further research in this interesting field is needed in an attempt to assess the effect on the fetus of qualitative overnutrition during pregnancy.     

Adolescents’ sleep/wake patterns and school schedules: towards flexibility

In the literature, two main trends may be identified in the countermeasures associated to adolescents’ sleep restriction: sleep education and changes in the school start times (SSTs). However, school educational programmes have been able to increase knowledge about sleep, which did not necessarily result in behavioural changes. Later SSTs have been proposed as a strategy to reduce the adolescents’ sleep restriction, but there is no consensus about the change. Longitudinal studies in adolescent populations are urgently needed in order to determine the efficacy of interventions aiming at a change in SSTs. Academic, behavioural, health and well-being variables could be monitored for an extensive period before and after implementing the new school schedule options, thereby enabling a within-subject experimental design. It is no longer acceptable to impose the “one-size-fits-all” approach on the SSTs.     

Do Parents Meet Adolescents’ Monitoring Standards? Examination of the Impact on Teen Risk Disclosure and Behaviors if They Don’t

In this study, we examined how adolescents compare monitoring efforts by their parents to those of a "good parent" standard and assessed the impact of these comparisons on adolescent self-disclosure and risk behavior and their perceptions of their parents'' monitoring knowledge. Survey responses from 519 adolescents (12–17 years) at baseline of a larger, longitudinal study examining parental monitoring and adolescent risk were examined. Adolescents’ “good parent comparisons” differed greatly by monitoring areas (e.g., telephone use, health, money); however, between 5.5% and 25.8% of adolescents believed their parents needed to monitor their activities more than they currently were monitoring. Alternatively, between 8.5% and 23.8% of adolescents believed their parents needed to monitor their activities less often. These perceptions significantly distinguished adolescents in terms of their level of disclosure, perceived monitoring knowledge, and risk involvement. Adolescents who viewed their parents as needing to monitor more were less likely to disclose information to their parents (p<.001), less likely to perceive their parents as having greater monitoring knowledge (p<.001), and more likely to be involved in a risk behaviors (p<.001) than adolescents who perceived their parents needed no change. Adolescent disclosure to a parent is a powerful predictor of adolescent risk and poor health outcomes. These findings demonstrate that adolescents'' comparisons of their parents'' monitoring efforts can predict differences in adolescent disclosure and future risk. Obtaining adolescent "good parent" comparisons may successfully identify intervention opportunities with the adolescent and parent by noting the areas of need and direction of monitoring improvement.     

“I Don’t See That as a Medical Problem”: Clinicians’ Attitudes and Responses to Requests for Cosmetic Genital Surgery by Adolescents

Labiaplasty is a form of genital surgery to reduce large or protruding labia minora. Internationally, the rates of this surgery among women and girls is increasing and is viewed as a worrying trend. Currently, the main clinical strategy is to reassure adolescents that they are normal by talking about the variation of labia size and appearance and showing pictures demonstrating the wide range of normal female genital appearance. For the most part, policy documents recommend against labiaplasty in adolescents, claiming that it is medically non-essential surgery. In this paper, we contrast findings from our interviews with clinicians with the existing literature and policy documents and we point out areas needing more thought. This is qualitative research using semi-structured interviews. We set out to find out on what basis clinicians decide how to treat or manage adolescent patients seeking labiaplasty. We interviewed clinicians who are likely to be approached by under-eighteens requesting labiaplasty. We use interpretive content analysis and thematic analysis to analyse the data. Our findings support the emphasis on education and reassurance as the first step for all patients, but other issues that have not figured previously in the literature that would alter clinical strategies for managing patients emerge as well. Key findings are that reassurance does not always work and that the distinction between functional and appearance concerns is not a solid foundation in itself for deciding whether surgery is ethically appropriate. We conclude that the distinction between functional and appearance concerns is not ethically relevant. It is open to different interpretations and is not regarded by all clinicians as the definitive factor in relation to surgery. The focus of clinicians should be on relieving distress whatever the cause. Appearance reasons may sometimes justify surgery but, also, functional reasons may sometimes not be sufficient justification for surgery.     

Cushing Disease in Children and Adolescents: Twenty Years’ Experience in A Tertiary Care Center in India

ObjectiveTo analyze the clinical presentation, diagnostic evaluation, treatment modalities, and follow-up of pediatric patients with Cushing disease.MethodsIn this retrospective analysis, we reviewed records of children (younger than 20 years) with Cushing disease who had undergone transsphenoidal adenomectomy in a tertiary health care center in India during the period of 1988 to 2008. Endogenous hypercortisolism was identified by a serum cortisol value ≥ 1.8 μg/dL during a low-dose dexamethasone suppression test (LDDST) with or without elevated midnight serum cortisol (≥ 3.2 μg/dL). Corticotropin dependence was defined by a basal plasma corticotropin concentration ≥ 5 pg/mL. Patients with normal pituitary imaging underwent bilateral inferior petrosal sinus sampling (BIPSS). Those with persistent or recurrent disease after surgery were treated with second-line interventions on a case-by-case basis.ResultsTwenty-nine boys and 19 girls were included. Mean age was 14.85 (± 2.5) years. Weight gain (98%), round facies (98%), and growth arrest (83%) were the most common manifestations. LDDST and midnight cortisol had 100% sensitivity for detecting endogenous hypercortisolism, while midnight corticotropin measurement had 100% sensitivity for defining corticotropin dependence. Magnetic resonance imaging and unstimulated BIPSS had 71% and 89% sensitivity, respectively, for diagnosing Cushing disease. Twenty-seven patients (56%) achieved remission after the first transsphenoidal operation with higher remission rates in those with microadenoma (75%). Basal serum cortisol < 5 mg/dL on the fifth postoperative day predicted cure. Eight patients received postoperative radiotherapy, with 4 achieving remission.ConclusionsClinical presentation and diagnostic yield with various tests were similar to those previously reported in the literature. Remission rates were poor after first transsphenoidal operation in patients with macroadenoma and outcome was dismal with a second transsphenoidal operation. Serum cortisol concentration < 5 mg/dL on the fifth postoperative day predicted cure. (Endocr Pract. 2011;17:369-376)     

High Resolution Melting Analysis: A Rapid Screening and Typing Tool for Common β-Thalassemia Mutation in Chinese Population

β-thalassemia is a common inherited disorder worldwide including southern China, and at least 45 distinct β-thalassemia mutations have been identified in China. High-resolution melting (HRM) assay was recently introduced as a rapid, inexpensive and effective method for genotyping. However, there was no systemic study on the diagnostic capability of HRM to identify β-thalassemia. Here, we used an improved HRM method to screen and type 12 common β-thalassemia mutations in Chinese, and the rapidity and reliability of this method was investigated. The whole PCR and HRM procedure could be completed in 40 min. The heterozygous mutations and 4 kinds of homozygous mutations could be readily differentiated from the melting curve except c.-78A>G heterozygote and c.-79A>G heterozygote. The diagnostic reliability of this HRM assay was evaluated on 756 pre-typed genomic DNA samples and 50 cases of blood spots on filter paper, which were collected from seven high prevalent provinces in southern China. If c.-78A>G heterozygote and c.-79A>G heterozygote were classified into the same group (c.-78&79 A>G heterozygote), the HRM method was in complete concordance with the reference method (reverse dot blot/DNA-sequencing). In a conclusion, the HRM method appears to be an accurate and sensitive method for the rapid screening and identification of β-thalassemia mutations. In the future, we suggest this technology to be used in neonatal blood spot screening program. It could enlarge the coverage of β-thalassemia screening program in China. At the same time, its value should be confirmed in prospectively clinical and epidemiological studies.     

Family Life and Social Medicine: Discourses and Discontents Surrounding Puebla’s Psychiatric Care

Drawing on clinical data from 15 months of on-site participant observation in the only public psychiatric hospital in the state of Puebla, Mexico, this article advances our understanding of globalization in relation to psychiatry. I challenge the construction of psychiatry as only treating the individual patient and provide grounded doctor-patient-family member interaction in a Mexican psychiatric clinic in order to review what happens when doctors cannot interact with patients as atomized individuals even though in theory they are trained to think of patients that way. Challenged by severe structural constraints and bolstered by lessons from other nations’ efforts at deinstitutionalization, psychiatrists in Puebla push to keep patients out of the inpatient wards and in their respective communities. To this end, psychiatrists call upon co-present kin who are identified both as the customer and part of the caretaking system outside the clinic. This modification to the visit structure changes the dynamic and content of clinical visits while doctors seamlessly respond to unspoken beliefs and values that are central to local life, ultimately showing that efforts to define a “global psychiatry” informed by global policy will fail because it cannot exist in a uniform way—interpersonal interaction and personal experience matters.     

Adolescents’ Experience and Knowledge of,and Attitudes toward,Bees: Implications and Recommendations for Conservation

Invertebrates are generally regarded with apathy, distaste, and fear in Western society. These negative sentiments likely contribute to the disparity in wildlife conservation efforts, which largely favor vertebrate organisms. Bees represent one of the most ecologically and economically important invertebrate groups, yet bee diversity and abundance is declining worldwide, mirroring the general decline of invertebrate biodiversity. Developing and implementing successful conservation efforts requires interdisciplinary research that considers the ecological and social realities of today’s world. To better inform conservation efforts related to bees, we examined adolescents’ experiences and knowledge of, and attitudes toward, bees and investigated how these dimensions related to one another. A total of 794 eighth-grade science students from the suburbs of Chicago, USA completed a 48-item, paper questionnaire. The results indicated that adolescents were only somewhat knowledgeable about bee biology and services, and they confused bees with other flying insects, especially those with black-and-yellow coloration. Adolescents regarded bees with a generally neutral attitude; their knowledge and attitudes were correlated in a positive manner. Various bee-related experiences were linked to adolescents’ knowledge and attitudes and may have influenced bee-related behavior. In particular, students who engaged in gardening and lawn-care activities demonstrated higher levels of knowledge and more positive attitudes. This study provides insight into the relationships between experiences and knowledge of, and attitudes toward, invertebrates and suggests that engaging in certain outdoor activities may promote positive attitudes toward bees among adolescents.     

Niger’s Child Survival Success,Contributing Factors and Challenges to Sustainability: A Retrospective Analysis

BackgroundHousehold surveys undertaken in Niger since 1998 have revealed steady declines in under-5 mortality which have placed the country ‘on track’ to reach the fourth Millennium Development goal (MDG). This paper explores Niger’s mortality and health coverage data for children under-5 years of age up to 2012 to describe trends in high impact interventions and the resulting impact on childhood deaths averted. The sustainability of these trends are also considered.ConclusionIncreases in access and coverage of care for mothers and children have averted a considerable number of childhood deaths. The 2006 free health care policy and health post expansion were paramount in reducing barriers to care. However the sustainability of this policy and health service provision is precarious in light of persistently high fertility rates, unpredictable GDP growth, a high dependence on donor support and increasing pressures on government funding.     

A Feel for Genealogy: ‘Family Treeing’ in the North of England

Family history research is popular in England. As a social practice it straddles social class and is confined to neither the middle nor the working classes, but shows an enthusiastic and flourishing interest in the workings of social class and in micro-histories of the region. This article focuses on experts in family history research in a region of the north west of England where it is referred to colloquially as ‘family treeing’. Here family treeing is inflected by a post-industrial landscape and recent social and economic transformations with attendant threats to working-class life and dignity. Family treeing is about caring for the dead, but it is also, significantly, about caring for the living, and not only kin. It is an active practice of belonging both to people and places, and entails constant acts of reciprocity.     

Adolescents’ Use of Care for Behavioral and Emotional Problems: Types,Trends, and Determinants

Objective

While adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10–19 years.

Methods

We obtained longitudinal data on 2,230 adolescents during ages 10–19 from four measurements regarding use of general care and specialized care (youth social care and mental healthcare) in the preceding 6 months, the Child Behavior Checklist (CBCL) and Youth Self-Report, and child and family characteristics. We analyzed data by multilevel logistic regression.

Results

Overall rates of use increased from 20.1% at age 10/11 to 32.2% at age 19: general care was used most. At age 10/11 use was higher among boys, at age 19 among girls. Use of general care increased for both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change was associated with CBCL externalizing and internalizing problems, school problems, family socioeconomic status, and parental divorce. Preceding CBCL problems predicted more use: most for mental health care and least for general care. Moreover, general care was used more frequently by low and medium socioeconomic status families, with odds ratios (95%-confidence intervals): 1.52 (1.23;1.88) and 1.40 (1.17;1.67); youth social care in case of parental divorce, 2.07 (1.36;3.17); and of special education, 2.66 (1.78;3.95); and mental healthcare in case of special education, 2.66 (1.60;4.51).

Discussion

Adolescents with behavioral and emotional problems use general care most frequently. Overall use increases with age. Determinants of use vary per type.     

The Efficacy of Traditional Chinese Medical Exercise for Parkinson’s Disease: A Systematic Review and Meta-analysis

Background and Objective

Several studies assessed the efficacy of traditional Chinese medical exercise in the management of Parkinson’s disease (PD), but its role remained controversial. Therefore, the purpose of this systematic review is to evaluate the evidence on the effect of traditional Chinese medical exercise for PD.

Methods

Seven English and Chinese electronic databases, up to October 2014, were searched to identify relevant studies. The PEDro scale was employed to assess the methodological quality of eligible studies. Meta-analysis was performed by RevMan 5.1 software.

Results

Fifteen trials were included in the review. Tai Chi and Qigong were used as assisting pharmacological treatments of PD in the previous studies. Tai Chi plus medication showed greater improvements in motor function (standardized mean difference, SMD, -0.57; 95% confidence intervals, CI, -1.11 to -0.04), Berg balance scale (BBS, SMD, -1.22; 95% CI -1.65 to -0.80), and time up and go test (SMD, -1.06; 95% CI -1.44 to -0.68). Compared with other therapy plus medication, Tai Chi plus medication also showed greater gains in motor function (SMD, -0.78; 95% CI -1.46 to -0.10), BBS (SMD, -0.99; 95% CI -1.44 to -0.54), and functional reach test (SMD, -0.77; 95% CI -1.51 to -0.03). However, Tai Chi plus medication did not showed better improvements in gait or quality of life. There was not sufficient evidence to support or refute the effect of Qigong plus medication for PD.

Conclusions

In the previous studies, Tai Chi and Qigong were used as assisting pharmacological treatments of PD. The current systematic review showed positive evidence of Tai Chi plus medication for PD of mild-to-moderate severity. So Tai Chi plus medication should be recommended for PD management, especially in improving motor function and balance. Qigong plus medication also showed potential gains in the management of PD. However, more high quality studies with long follow-up are warrant to confirm the current findings.     

Fluoride and Children’s Intelligence: A Meta-analysis

This paper presents a systematic review of the literature concerning fluoride that was carried out to investigate whether fluoride exposure increases the risk of low intelligence quotient (IQ) in China over the past 20 years. MEDLINE, SCI, and CNKI search were organized for all documents published, in English and Chinese, between 1988 and 2008 using the following keywords: fluorosis, fluoride, intelligence, and IQ. Further search was undertaken in the website www.fluorideresearch.org because this is a professional website concerning research on fluoride. Sixteen case-control studies that assessed the development of low IQ in children who had been exposed to fluoride earlier in their life were included in this review. A qualitative review of the studies found a consistent and strong association between the exposure to fluoride and low IQ. The meta-analyses of the case-control studies estimated that the odds ratio of IQ in endemic fluoride areas compared with nonfluoride areas or slight fluoride areas. The summarized weighted mean difference is -4.97 (95%confidence interval [CI] = -5.58 to -4.36; p < 0.01) using a fixed-effect model and -5.03 (95%CI = -6.51 to 3.55; p < 0.01) using a random-effect model, which means that children who live in a fluorosis area have five times higher odds of developing low IQ than those who live in a nonfluorosis area or a slight fluorosis area.     

Anti Intellectualism and the ‘Aboriginal Problem: Colin Tatz and the ‘Self Determination’ Approach

Over the past two decades, writings generalizing about the place of Aborigines in Australia at the national level and proposing policies have been dominated by what I will call the ‘self-determination’ approach. This approach has made little theoretical or substantive contribution at the level at which moral judgement and policy have been directed because moral and political concerns have constrained and biased inquiry. This paper offers a critique of the self-determination approach by focusing on the works of Professor Tatz, who has been a major influence in its development and proselytization.