Sociodemographic and motivational characteristics of parents who volunteer their children for clinical research: a controlled study.

OBJECTIVE--To determine the sociodemographic and motivational characteristics of parents who volunteer their children for clinical research. DESIGN--A questionnaire was administered to parents who volunteered their children for a randomised, double blind, placebo controlled trial of a drug to treat asthma and to a control group of parents whose children were eligible for the trial but had refused the invitation. SETTING--A children''s hospital in Australia. SUBJECTS--68 Parents who had volunteered their children and 42 who had not; a response rate of 94% and 70%, respectively. MAIN OUTCOME MEASURES--Responses of parents to questionnaire designed to assess their perceptions, attitudes, and health seeking behaviour as well as sociodemographic data. RESULTS--Volunteering parents were less well educated with only 15% (10/68) of mothers and 16% (11/68) and of fathers having had a tertiary or university education compared with 26% (11/42) of mothers and 45% (19/42) in the non-volunteering group. Fewer volunteering parents had professional or administrative jobs than did non-volunteering parents (mothers 6% (4/68); fathers 9% (6/68) v mothers 14% (6/42); fathers 31% (13/42)). Volunteering parents had less social support, and they displayed greater health seeking behaviour and consumed more habit forming substances. They were motivated by a desire to help others and to contribute to medical research, but they were also searching for more information and better ways to help their own children. CONCLUSION--Parents who volunteer their children for medical research are significantly more socially disadvantaged and emotionally vulnerable.     

Children and the nuclear threat: a child psychiatrist's personal reflections

From the very first stages of life, parents have provided their children with love and protection against harm from within or without, especially from life-threatening situations. Children's perception of death as a unique phenomena develops around age ten and later on, when they begin to grasp the meaning of mortality. This often occurs when they themselves suffer from terminal illness. Children have been the object of destruction, as witnessed by The Holocaust and Hiroshima. The threat of nuclear war poses a new problem for parents, since threatening others is no longer a viable solution to the conflict. In addition, adults manifest a massive denial that the destruction of mankind can take place at any time. This denial, like a family secret, prevents children from asking questions and expressing to their parents their fears about their own and mankind's destruction. Examples are given of how children do express their concerns and fears about the nuclear threat when they are allowed to express themselves. Unless this denial is replaced by open communication about the seriousness of the situation, children and adolescents will view the adults' denial as numbness and folly and as responsible for the world's destruction. A meaningful dialogue between parents and children about the threat is given as the solution to the family conflict.     

The pediatric walk-in clinic: competition for the private practitioner.

In an affluent city with many pediatricians a 20% increase in patients seen in a hospital-based walk-in clinic in 1982 prompted a study to determine the characteristics of clinic users and their reasons for using the clinic. It was found that users of the clinic were middle-class, that they had a higher employment rate than the average for the region, and that in 54% of the families both parents worked outside the home. The children of 85% of the families were patients of pediatricians in private practice; most of the others were patients of a family physician in private practice. Most of the children seen at the clinic had had symptoms for more than 24 hours, but few parents had attempted to contact their own physicians. In the previous 12 months 95% of the children had been seen at the clinic, 43% in the month preceding the study. They came to the clinic for two main reasons: the broad range of services offered --laboratory, radiology and pharmacy as well as medical--and the convenient hours, with 71% coming outside of their physicians'' office hours. Given the reality of social trends pediatricians will either have to share their patients with facilities that offer services outside of regular office hours or devise another system for the treatment of their patients.     

Grandparental investment and reproductive decisions in the longitudinal 1970 British cohort study

There has been a recent increase in interest among evolutionary researchers in the hypothesis that humans evolved as cooperative breeders, using extended family support to help decrease offspring mortality and increase the number of children that can be successfully reared. In this study, data drawn from the 1970 longitudinal British cohort study were analysed to determine whether extended family support encourages fertility in contemporary Britain. The results showed that at age 30, reported frequency that participants saw their own parents (but not in-laws) and the closeness of the bond between the participant and their own parents were associated with an increased likelihood of having a child between ages 30 and 34. Financial help and reported grandparental childcare were not significantly positively associated with births from age 30 to 34. Men's income was positively associated with likelihood of birth, whereas women's income increased likelihood of birth only for working women with at least one child. While it was predicted that grandparental financial and childcare help would increase the likelihood of reproduction by lowering the cost to the parent of having a child, it appears that the mere physical presence of supportive parents rather than their financial or childcare help encouraged reproduction in the 1970 British birth cohort sample.     

Implications of caring for an aging parent.

The burden of care for the aged often falls on their adult children, who are themselves stressed by the developmental tasks of middle age. These people are frequently unprepared for the role of caregiver, in which they become parents to their own parents. The author describes the potentially turbulent effect of this role and discusses the origin of the stresses that the caregiver may experience. Doctors need to recognize and deal with the negative feelings, such as resentment, anger, frustration, ambivalence, guilt and demoralization, that may arise in adult children who care for their parents. These emotions must be put into proper context if the mental and physical health of the caregivers as well as the vital support they provide for their elderly parents are to be maintained.     

Food-sharing in cotton-top tamarins (Saguinus oedipus)

Food-sharing behaviour was observed in 9 captive families of cotton-top tamarins (range 4-14 individuals per group), during meals of fresh fruit. Food was transferred to infants by their parents and older sibs in response to begging, and was also offered to them without prior solicitation. Older, mature, reproductively suppressed individuals shared more than young immature monkeys. Infants in larger families received more food than those in smaller ones, though individuals in smaller families shared more. Transfer to infants increased to a maximum at 12 weeks of age and then declined gradually. At one year of age they no longer received food from others. Food sharing by older siblings is a form of helping behaviour which may increase their inclusive fitness, and benefit parents, both directly, by reducing the costs they incur in rearing young, and indirectly, by increasing the amount of food available to infants.     

Email submissions from outside the United Kingdom

ObjectivesTo identify whether psychiatric disturbance in parentally bereaved children and surviving parents is related to service provision.DesignProspective case-control study.SettingTwo adjacent outer London health authorities. Participants45 bereaved families with children aged 2 to 16 years.ResultsParentally bereaved children and surviving parents showed higher than expected levels of psychiatric difficulties. Boys were more affected than girls, and bereaved mothers had more mental health difficulties than bereaved fathers. Levels of psychiatric disturbance in children were higher when parents showed probable psychiatric disorder. Service provision related to the age of the children and the manner of parental death. Children under 5 years of age were less likely to be offered services than older children even though their parents desired it. Children were significantly more likely to be offered services when the parent had committed suicide or when the death was expected. Children least likely to receive service support were those who were not in touch with services before parental death.ConclusionsService provision was not significantly related to parental wishes or to level of psychiatric disturbance in parents or children. There is a role for general practitioners and primary care workers in identifying psychologically distressed surviving parents whose children may be psychiatrically disturbed, and referring them to appropriate services.

Key messages

• Parentally bereaved children show high levels of psychological disturbance, with boys being more vulnerable than girls
• Surviving mothers show more psychiatric morbidity than surviving fathers
• Psychological distress in bereaved parents is associated with psychological difficulties in their children
• Service provision for bereaved children is not determined by mental health difficulties in either parents or children, or by parental wishes; it is influenced only by the manner of parental death and the age of the child
• The mismatch between need and service provision indicates a role for general practitioners and primary care workers in identifying distressed or disturbed families in need of public or voluntary service help

     

Cultural values and other perceived benefits of organized activities: A qualitative analysis of Mexican-origin parents’ perspectives in Arizona

The limited understanding on why Latino parents endorse organized activities is problematic given that these beliefs can help elucidate why they overcome barriers to support their children’s participation. In this study, we analyzed interviews from a diverse group of 34 Mexican-origin parents who resided in Arizona. Results of the study indicate that although organized activities were perceived as contexts that can help youth gain skills reflecting mainstream American values (e.g., school engagement, interpersonal skills), parents also thought that activities promoted positive behaviors associated with their ethnic culture based on traditional values related to respeto, familism, and religiosity. The implications of this study suggest that understanding Mexican-origin parents’ perspectives can help organized activity leaders design programs that fully address the benefits that families seek from organized activities.     

American individualism and the social incorporation of unaccompanied Guatemalan Maya young adults in Los Angeles

This study prompts a re-examination of segmented assimilation by investigating the social incorporation of unauthorized Guatemalan Maya young adults who arrive to the USA as unaccompanied minors to work while their families remain abroad. Unaccompanied Guatemalan Maya young adult participants of a Los Angeles support group show that Americanization and the adoption of American individualism equips youth growing up without parents or supportive social institutions with the rhetoric and behaviours of self-responsibility necessary for emotional, psychological and financial stability. As youth become expressive individuals, their social commitments move from the transnational family to the local community, which bolsters social incorporation and shapes aspirations for socio-economic mobility.     

Plasticity,political economy,and physical growth status of Guatemala Maya children living in the United States

Migration of Maya refugees to the United States since the late 1970s affords the opportunity to study the consequences of life in a new environment on the growth of Maya children. The children of this study live in Indiantown, Florida, and Los Angeles, California. Maya children between 4 and 14 years old (n = 240) were measured for height, weight, fatness, and muscularity. Overall, compared with reference data for the United States, the Maya children are, on average, healthy and well nourished. They are taller and heavier and carry more fat and muscle mass than Maya children living in a village in Guatemala. However, they are shorter, on average, than children of black, Mexican-American, and white ethnicity living in Indiantown. Children of Maya immigrants born in the United States tend to be taller than immigrant children born in Guatemala or Mexico. Families that invest economic and social resources in their children tend to have taller children. More economically successful families have taller children. Migration theory and political economy theory from the social sciences are combined with plasticity theory and life history theory (parental investment) from biology to interpret these data. Am J Phys Anthropol 102:17–32, 1997. © 1997 Wiley-Liss, Inc.     

Historical perspectives on parental investment and childbearing

This article provides some historical perspectives on parental investment and childbearing. Scholars are debating whether parents always loved and nurtured their children. The historical record provides some support for both sides. Parents who abandoned their children often did so with the hope that someone else would be able to raise them. But others, like the ancient Carthagians, sacrificed their own children to appease the gods. Colonial Americans appear to have been particularly solicitous of the well-being of their children. The paper then traces the changes in the role of women in facilitating the process of childbirth in America. Scholars are cautioned not to idealize the childbirth experiences of women in the past as they experienced considerable pain and fear.     

Parents, ADHD and the internet

The objective of this study is to examine the potential impact of using the internet on medical consultations by analysing the attitudes, attributions, and emotional responses of parents who have been informed by specialists that their child does not have attention-deficit hyperactivity disorder (ADHD) and to examine the nature of the feedback they obtained from members of online internet support groups. Over 40,000 messages from the five most popular international internet forums discussing children with ADHD were analysed. Messages from parents who reported that they had seen at least one specialist (e.g. paediatrician, psychiatrist or psychologist) because of their concerns that their child had ADHD were identified. The children included boys and girls with an age range from 2 to 16?years. Of these, we analysed messages where the parents additionally reported that the specialist had excluded a diagnosis of ADHD. Using these criteria, 91 messages from parents who had consulted over 200 different specialists and 398 replies to these messages were identified for content analysis. The replies to concerned parents were analysed to determine whether they were offered impartial advice. A majority of the parents reported that they did not believe the specialist and were unhappy about their child not being diagnosed with ADHD. They expressed dissatisfaction with the professional's opinions and the implication that their child's conduct was caused by their poor parenting skills. Importantly, 87.6?% of the responses that these parents received, from other members of online forums, reinforced the parent's negative attitude towards the professional's judgement. It was generally suggested that the parents should not believe the expert and should seek a further opinion. The use of the internet may encourage "doctor shopping" and mistrust in health services. Medical professionals and others may need to be aware of this, and parents may need more support than is generally offered to be able to accept alternative explanations for their child's behaviour.     

Continuing psychological care

This article draws together thoughts derived from an experienced clinical psychologist's practice, with parents of ill and premature infants in the context of a psychological service for children and parents in a paediatric and maternity teaching hospital. Parents were those referred by attendant neonatologists in intensive neonatal care who observed acute distress. Referral was usually some weeks after birth and help continued until after discharge, in some instances after the death of the infant. The particular approach adopted was that of offering parents a therapeutic contact which, allowed them talk over these thoughts and feelings for which they had little other skilled listening environment. Parents chose the opportunity of a safe, calm and confidential contact to explore deep feelings and draw on their own strengths and an understanding of their own vulnerabilities. The novel insights derived and the clinical material presented were used to develop an understanding of the issues a support service should address. Key aims are described and should be incorporated to restore and enhance personal strengths and the mother child relationship hence contributing to positive outcome in infant development. Reference is made to the importance of understanding how women achieve soothed states and restoration of empowerment when birth presents extra challenge.     

Parents' difficulties and information needs in coping with acute illness in preschool children: a qualitative study.

OBJECTIVES: To identify and explore difficulties parents experience with acute illness in young children and the information they seek to help them. DESIGN: Qualitative study using semi-structured one t one and group interviews with parents of preschool children. SETTING: Disadvantaged inner city community. SUBJECTS: 95 parents of preschool children. RESULTS: Parents felt disempowered when dealing with acute illness in their children because of difficulties making sense of the illness. Central to parents'' difficulties were their experiences of inadequate information sharing by their general practitioners and variations in their doctors'' decisions and behaviour. Disparity between parents'' beliefs and expectations about illness and treatment and professionals'' behaviour further frustrated parents'' attempts to understand illness. Parents expressed a need for a range of accessible and specific information to support them through their negotiation of children''s illness. CONCLUSIONS: Communication with parents requires greater recognition of parents'' difficulties. Professionals have considerable potential to empower parents by sharing more information and skills. Such information should be consistent and address parents'' concerns, beliefs, and expressed needs if this potential is to be realised.     

Pediatric obesity attitudes, services, and information among rural parents: a qualitative study

The objective of this study was to learn more about the attitudes concerning pediatric obesity among rural parents, the barriers these parents face in trying to help their children attain a healthy weight status, and the pediatric weight loss services currently available in small rural communities. A series of eight qualitative focus groups were conducted with 21 parents of overweight rural children in third through fifth grade. Eight saturated themes resulted indicating that parents (i) believe overweight children are lazy, (ii) are concerned about the weight of their children, (iii) believe that some individuals will be overweight no matter what they do, and (iv) have tried a variety of techniques to help their children lose weight. Barriers to helping their children lose weight unique to their rural status included lack of weight loss resources in their community, lack of exercise facilities, and lack of low-fat or low-calorie options in grocery stores. Rural families of overweight children encounter many barriers to healthier living, some of which are unique to their rural status.     

The General Factor of Personality (GFP) and parental support: testing a prediction from Life History Theory

In the present study, we tested whether the General Factor of Personality (GFP) is related to the level of parental support. The GFP is assumed to occupy the apex of the hierarchy of human personality structure and is believed to reflect a socially and sexually selected aggregate of behavioral characteristics that are generally valued as “desirable” in interpersonal relationships. The relationship between the GFP and parental support tested in this study is predicted by Life History Theory, a midlevel evolutionary account of systematic differences in evolved reproductive strategies. A total of 428 families with mother, father, and two children (range 14–16 years) participated. Parents filled out personality questionnaires (Big Five) and their level of parental support. The children also independently rated the amount of support they perceived from their parents. In the present sample, parents' GFPs were found to explain 33% of the variance in the Big Five. Moreover, the parents' GFPs showed significant relationships with the parents' self-rated parental support, but also with the child-rated parental support. The monoinformant (parents ratings) and multi-informant (parent and child ratings) data support the notion of a substantive GFP that is related to the investment of parents into their offspring.     

Professional and personal attitudes about access and confidentiality in the genetic testing of children: a pilot study

The ability to perform predictive genetic testing of children raises ethical concerns regarding whether and when to test and the disclosure of results. Semi-structured interviews with a convenience sample of pediatricians (12) and geneticists (13) were conducted to see how they would react to parental requests for predictive genetic testing of their children, and their attitudes about testing their own children. We also asked about disclosure attitudes and practices for their patients' relatives and within their own families. Respondents would provide predictive genetic testing for most conditions, yet were less likely to seek this information about their own children. Respondents believed it was very important for patients to share some types of genetic information with relatives, and were directive in their counseling about intrafamilial disclosure, especially within their own families. Although respondents would almost never breach patient confidentiality, many would breach confidentiality within their own families. Health care professionals distinguish between their professional and personal roles with regard to issues of access and confidentiality in predictive testing of children. They are willing to provide greater access and more confidentiality for their patients than within their own families.     

Development of Social Variation in Reproductive Schedules: A Study from an English Urban Area

Background

There is striking social variation in the timing of the onset of childbearing in contemporary England, with the mean age at first motherhood about 8 years earlier in the most deprived compared to the least deprived neighbourhoods. However, relatively little is known about how these social differences in reproductive schedule develop in childhood.

Methodology/Principal Findings

We studied the development of differences in reproductive schedules, using a cross-sectional survey over 1000 school students aged 9–15 in the metropolitan borough of North Tyneside. Students from more deprived neighbourhoods had earlier ideal ages for parenthood than those from more affluent ones, and these differences were fully apparent by age 11. We found evidence consistent with three mechanisms playing a role in maintaining the socioeconomic gradient. These were: vertical intergenerational transmission (students whose own parents were younger at their birth wanted children younger); oblique intergenerational transmission (students in neighbourhoods where parents were younger in general wanted children earlier); and low parental investment (students who did not feel emotionally supported by their own parents wanted children at a younger age).

Conclusions/Significance

Our results shed some light on the proximate factors which may be involved in maintaining early childbearing in disadvantaged communities. They help understand why educational initiatives aimed at adolescents tend to have no effect, whereas improving the well-being of poor families with young children may do so. Our results also suggest that there will be considerable intergenerational inertia in the response of reproductive schedules to changing socioecological conditions.     

Counselling the parents of handicapped children.

The parents of handicapped children have to adjust to a wide variety of emotional and psychological problems when first confronted with the failure of their reproductive expectations. Counselling is a formal procedure or transaction in which both counsellor and parents aim to find a mutually acceptable plan of adjustment. Parents may need support to cope with their own personal inadequacies as well as with their own personal inadequacies as well as with the needs of the child. Counselling should be a continuous process, in which the parents can learn to accept the child as a different rather than a lesser person.     

Differential parental investment in families with both adopted and genetic children

Stepchildren are abused, neglected and murdered at higher rates than those who live with two genetically related parents. Daly and Wilson used kin selection theory to explain this finding and labeled the phenomenon “discriminative parental solicitude.” I examined discriminative parental solicitude in American households composed of both genetic and unrelated adopted children. In these families, kin selection predicts parents should favor their genetic children over adoptees. Rather than looking at cases of abuse, neglect, homicide and other antisocial behavior, I focused on the positive investments parents made in their children as well as the outcomes of each child. The results show that parents invested more in adopted children than in genetically related ones, especially in educational and personal areas. At the same time, adoptees experienced more negative outcomes. They were more likely to have been arrested, to have been on public assistance and to require treatment for drug, alcohol or mental health issues. They also completed fewer years of schooling and were more likely to divorce. In adoptive families, it appears that “the squeaky wheel gets the grease.” Parents invest more in adoptees not because they favor them, but because they are more likely than genetic children to need the help. I conclude that discriminative parental solicitude differs in adoptive and step households because adoptive families generally result from prolonged parenting effort, not mating effort like stepfamilies.