Primary Caretakers Research Articles

Effectiveness of the Preschool Version of the First Step to Success Early Intervention Program for Preventing Antisocial Behaviors

Problem behaviors are defined as negative/harming/aggressive behaviors that can be consistently demonstrated in various environments such as at school, home, or in the community (Walker, Colvin, & Ramsey, 1995). A wide range of problem behaviors are discussed in the literature under the titles antisocial behaviors, difficult behaviors, unwanted behaviors, aggressive behaviors, and adjustment and behavior disorder. Physical and verbal attacks, over irritability, reacting to friends with hostility, constant objection to the directions of adults, ignoring the warnings of adults, harming public property intentionally, harming and teasing others, and hyperactivity can be stated as examples of antisocial behaviors (Giannopulu, Escolano, Cusin, Citeau, & Dellatolas, 2008; Tremblay, 2000).Academic skills are one of the main areas where children with antisocial behaviors experience severe difficulties. Studies have shown that these children have lower rates of participation in academic activities and lower academic success compared to their peers (Coie & Jacobs, 1993; Hendawi, 2012; Lane, 1999). They are often expelled from school or drop out and encounter the risks of committing crime or becoming addicted to drugs (Tremblay, 2000; Walker et al., 1995). Children with antisocial behaviors also have some problems with social skills, and this has a strong relationship with their academic skills. Studies have revealed that these children have problems with their peers in social interactions; have difficulties in understanding social clues or behaviors of their peers; frequently prefer aggressive problem solving strategies in their relationships; and were often rejected by their peers (Parker & Asher, 1987; Pepler, Craig, & Roberts, 1998; Walker, Ramsey, & Gresham, 2004). Children with antisocial behaviors affect both the house that they live in and the school that they are educated in, and teachers and families usually spend most of their time trying to cope with those behaviors instead of focusing on academic activities (Finn & Pannozzo, 2004).The roots of antisocial behaviors go back to the early years of life (Arseneault et al., 2003; Campbell, 2002; Fox, Dunlap, & Powell, 2002; Wakschlag & Danis, 2004; Waliski & Carslon, 2008). Studies indicate that the behaviors of arguing, disobedience, and not sharing that appear in early childhood turn into fighting, lying, and stealing in the primary school years. These then turn into more serious and complex behaviors that are difficult to overcome such as interpersonal violence, committing crimes, harming the property of others, starting gangs and racketeering during and after puberty (Loeber, 1990; Patterson, DeBaryshe, & Ramsey, 1989; Robins, 1978; Tremblay, Phil, Vitaro, & Dobkin, 1994; Walker & Cheng, 2007; Wicks- Nelson & Israel, 1997). In particular, half of the children who display externalized problem behaviors (such as hitting and swearing) during preschool continue these behaviors during and after their school years (Campbell, 1995). The amelioration of antisocial behaviors that could not be controlled with effective interventions in earlier periods costs more effort, time and money in the long term (Elliot, Prior, Merrigan, & Ballinger, 2002). In addition to this, primary caretakers and the immediate environment (such as teachers and classmates) play a significant role in a child's social and emotional development (Dunlap et al., 2006; Robins, 1978; Walker et al., 2004). Early intervention programs that start at early ages and implemented in various mediums (individual, family, and school) have gradually become important in this context (Elliot et al., 2002; Kazdin, 1987). One such program is the First Step to Success (FSS) Early Intervention Program that was developed by Walker et al. (1997) for preschool and primary school first/second grade students at risk of displaying antisocial behaviors. The program was later applied to nursery school students by Walker et al. …

Prevalence of Diarrhoea and Associated Factors among Under-Five Children in Jigjiga District, Somali Region, Eastern Ethiopia

Background: Diarrheal disease is a major cause of morbidity and mortality among children in many developing countries, including Ethiopia and is a leading cause of morbidity in Pastoralist Ethiopian-Somali region. Diarrheal disease is not purely medical, but huge part of this should be traced back to the social, economic, environmental and behavioural aspects of the family. Determining these interactions is relevant to prevent and control diarrhoea. Objective: The objective of this study was to measure the prevalence of diarrhoea and describe associated factors relating to diarrheal disease among under-five children in Jigjiga district. Methods: A cross-sectional study was conducted in Jigjiga district from June 12 to 26 in 2014 using a structured and pretested questionnaire. A total of 1807 primary care takers were interviewed. Proportionate to size allocation was done and simple random selection was used to select sample units. Diarrheal morbidity occurred in the under-five children in the past 14 days were registered to determine prevalence. Data were entered using Epi Info version 3.5.3 and analysed in SPSS version 20. Odds ratio with 95% CI in a multivariate logistic regression was employed to control confounding factors. Results: The findings of this study showed that the overall two-week period prevalence of diarrhoea in under-five children was 27.3%: 95% CI (26.9%, 27.4%). Education of the primary caretaker, occupation of the father, birth order of the child, maternal diarrhoea, and hand washing during critical times, water source, type of water storage container, latrine availability, frequency of household solid waste water disposal, availability of liquid waste water drainage system and the type of the kitchen floor material showed as independent predictors of under-five child hood diarrhoea. Conclusion: This study revealed that diarrhoea morbidity was relatively high among children under-five years of age residing in Somali region. Efforts to reduce childhood diarrhoea should focus mainly on water, sanitation and hygiene interventions including health education.

Medicine and Morality in the Ho Family in Lijiang

I travelled to the Lijiang basin area of Yunnan province in the spring of 2014 to record and explore the ‘traditional’ knowledge and practice of Chinese medicine among the Ho family. The Ho family includes three generations of herbalists who combine Naxi medicinal plants, Chinese medicine diagnostics, and knowledge of Western medicine in their clinical practice. They have also created their own herbarium of over 1000 local plants, which they organise based on modern botanical nomenclature. In the 1930s and 1940s, the Austrian-American botanist and explorer Joseph Rock introduced Latin botanical names to the father of Ho Shixiu, currently the oldest living Ho family member. The son of Ho Shixiu, Ho Shulong, who is now its primary caretaker, however, informed us that he was influenced by books as much as by his father’s oral teachings about medicinal plants. The youngest member of this lineage is a graduate of Yunnan Chinese Medicine University and acknowledges that his knowledge base in local ecology and medicinal plants must increase if he is to carry on the lineage. My aim is to describe both the unique aspects of the Ho family’s knowledge and its transmission, and the cultural and medical elements that have influenced and enriched them. From my perspective, these different types knowledge seem to sustain and give meaning to their family-based practice lineage. I argue that we need to carry out more ethnographic work in order to understand the relationship between medical knowledge and practice, and its social, historical, and cultural context. I hope this field note is a step in that direction.

Early Parental Support, Relationships With God, and Self-Rated Health in Advanced Old Age

Object relations theory specifies that the nature of the relationship that individuals form with their primary caretaker serves as a prototype for the social relationships they develop in adulthood. Some investigators extend this perspective by arguing that social ties with caretakers also shape relationships with God. The purpose of this study is to empirically evaluate this extension. Data from a nationwide survey of older adults (N = 1,277) are used to evaluate a model that contains the following core relationships: (1) people who receive support from their primary caretakers will be more likely to attend worship services; (2) individuals who attend church frequently will be likely to develop a close relationship with God; (3) those who have a close relationship with God will be more hopeful about the future; and (4) people who are more hopeful will enjoy better health. The data provide support for each of these relationships.

Mothers in Cameroonian Prisons: Pregnancy, Childbearing and Caring for Young Children

According to the Cameroonian Penal Code, pregnant women, nursing mothers and children may not be admitted to prison and, by implication, there are no facilities to cater for these vulnerable categories of prisoners. Yet pregnant women are arrested occasionally and they deliver children in prison and some women are sentenced as nursing mothers. There is an implicit belief and practice that women are the primary caretakers of children – hence their imprisonment impacts on children both inside and outside of prison. This article first discusses the discrepancies between policy and practice regarding female inmates and their children in the Cameroonian penitentiary system. It then goes on to show how pregnancies, deliveries and being a mother are dealt with by female prisoners, given the constraints under which they are living. The research is based on observations and interviews at six out of 73 prisons in Cameroon. The data for this article is based on qualitative analysis of the narratives of 13 female inmates, who have experienced motherhood in prison, interviews with five prison staff members and two NGO representatives working in close collaboration with these inmates. The study was approached with standpoint feminist theory as a point of departure.

Impact de l’influence culturelle et de la topographie urbaine dans les actes d’agressions sexuelles sérielles

ObjectivesThis article deals about an aspect not taken into consideration often when considering violent sexual offenses. The term “crime scene”, which got widespread into common language, depicts all the elements collected at the place where a crime occurred and which could later become pieces of evidence. However, the place by itself, the link between the offender and the place, the influence of the urban environment and the cultural aspect of it do not receive that much attention in the literature. This paper originates from a comparison of the work of two psychologists specialized within the field of geoprofiling, D. Canter and K. Rossmo, the latter being a Canadian citizen and the former an Englishman. If their postulates were similar, their findings however diverged. If primary caretakers and early interactions are not to be underestimated regarding their roles into the personality development, we will in these pages consider the urban environment by itself in serial sexual offenses. MethodsDue to a restricted access to this type of patients, we mainly focused our hypothesis on a literature review and a few patients of ours, met during previous research works. Concepts used in this paper overlap various fields such as psychodynamic, criminology, criminalistics, psycho-sociology and even urbanism. We focused in this paper onto the importance of the culture and the urban concrete environment as probable variables explaining these discrepancies observed into the behavioral patterns and distances covered by Serial Sex Offenders between the two shores of the Atlantic. The underlying question being how their space conception, their “mental maps”, depends of the culture they were bred in and how it could have an incident onto their offense zones? ResultsThe findings highlight an inherently cultural variation of the spatial conception, but also how the space is built up and integrated between the USA (and all the large and historically “recents” territories) and Europe. American sexual serial offenders are more likely to cover larger distances, almost twice as much than their European counterparts. It seems that our hypothesis is relevant; a cultural distinction may exist on the way spatial environment is perceived and could thus have incidences into the offense patterns. ConclusionsWith the development of the E.U., our spatial conceptions as European citizens evolve. Thanks to mass transportation, and the Erasmus programs, it is not uncommon for an Italian individual to study in Scotland or Finland for instance. This is of some importance into how the spatial mobility is becoming more thinkable, and somehow how it induces a shrinkage of the distance into the mental mapping process.

Eating Disorder Treatment as a Process of Mind–Body Integration: Special Challenges for Women

The concept of body image remains too focused on internal representation and not enough on internal experiencing. Body image is but one expression of the more foundational body self. When an eating disorder is conceptualized as an attempt to manage an impaired sense of body self (and associated disregulation), the ultimate goal of treatment becomes embodiment. The eating disordered body must be worked with as an actual as well as symbolic body and understood within its own developmental trajectory. The gender-specificity of eating disorders is explored by focusing on three particular bodily challenges for females in our society: (1) Women are more likely than men to unconsciously use their bodies as repositories for their dissociated need and desire, (2) girls’ bodies are mirrored in a more distorted and overstimulating manner than boys’ and (3) because girls are the same biological sex as their usual primary caretakers, they are more likely to be used as narcissistic extensions. A clinical example is presented, illustrating the influence of these female bodily challenges on the development of body self and eating disorders and how these issues play out in treatment. An intensive clinical focus on the patient’s and therapist’s body states allows for the desomatization and integration of dissociated affect, resulting in a more integrated body–mind self and a decreased need for an eating disorder.

Models for violence by Turkish police officers toward romantic partners and police partners

Social learning theory suggests that displays of violence in close relationships would be increased for individuals exposed to family models of violence, especially from parents. Because police officers may regard their departments as a second ‘family,’ violence shown by the ‘father figure’ police supervisor may be a significant model for violence, as recent research has found for American police officers. The police supervisor might also be expected to be a powerful model for violence because Turkish police officers serve in a male-dominated workplace in a largely male-dominated society. This study examined how violence reported by Turkish police officers in their close relationships (toward romantic partners, toward police partners) was explained by parental models from the ‘home family’ (father-to-mother, mother-to-father, father-to-participant, mother-to-participant) and from the ‘police family’ (supervisor-to-participant). Study participants included 233 Turkish police officers (96% male; 66% under 30 years of age; 6.9 mean years of service) who completed anonymous questionnaires to report violence in each relationship using the six-item subscale of the Revised Conflict Tactics Scale. Multiple regression analyses revealed that the set of ‘home family’ and ‘police family’ parental models explained 42% of variance in romantic partner violence and 74% of variance in police partner aggression. Violence from the police supervisor was the most consistent and significant model, perhaps because the police supervisor was a new and powerful ‘father figure’ for the relatively young officers of the present study. Violence received from the mother was also associated with increased risk of police partner violence, perhaps because mothers were the officers’ primary caretakers during childhood, making their style of conflict resolution the most prevalent parental model. Employee assistance programs to encourage ‘Peace in the Family’ for Turkish police officers may require participation by police supervisors, who must model non-violent conflict resolution in their departments.

Household Animal and Human Medicine Use and Animal Husbandry Practices in Rural Bangladesh: Risk Factors for Emerging Zoonotic Disease and Antibiotic Resistance.

SummaryAnimal antimicrobial use and husbandry practices increase risk of emerging zoonotic disease and antibiotic resistance. We surveyed 700 households to elicit information on human and animal medicine use and husbandry practices. Households that owned livestock (n = 265/459, 57.7%) reported using animal treatments 630 times during the previous 6 months; 57.6% obtained medicines, including antibiotics, from drug sellers. Government animal healthcare providers were rarely visited (9.7%), and respondents more often sought animal health care from pharmacies and village doctors (70.6% and 11.9%, respectively), citing the latter two as less costly and more successful based on past performance. Animal husbandry practices that could promote the transmission of microbes from animals to humans included the following: the proximity of chickens to humans (50.1% of households reported that the chickens slept in the bedroom); the shared use of natural bodies of water for human and animal bathing (78.3%); the use of livestock waste as fertilizer (60.9%); and gender roles that dictate that females are the primary caretakers of poultry and children (62.8%). In the absence of an effective animal healthcare system, villagers must depend on informal healthcare providers for treatment of their animals. Suboptimal use of antimicrobials coupled with unhygienic animal husbandry practices is an important risk factor for emerging zoonotic disease and resistant pathogens.

Can poverty reduction investments translate into more healthcare workers?

Structure/Method/Design: This was a qualitative study of 100 patient care attendants in the Medicine Department at Mulago National Referral Hospital. Participants were recruited via simple random sampling in August 2014. Only one attendant per patient was included. Data was collected using an interviewer-administered questionnaire. Results were analyzed qualitatively to identify recurring themes. Written informed consent was sought from every participant and IRB approvals were obtained. Outcomes & Evaluation: Most of the participants were female, married, farmers and of youthful age. The services they provided focused on self-care deficits such as feeding, cleaning, and administering of drugs. Furthermore, most participants reported the attendants to be an imperative and suitable method to respond to patient needs. While serving as an attendant, each participant spends at least 120,000 Ugandan Shillings on transport, food and communication. Patients’ relatives generally provided funding. Almost all participants slept on the floor when serving as attendants and consumed food served by the hospital to the patients. The greatest challengesmentioned included the poor bedding and sanitation of the hospital. Most attendants were their family’s primary home caretaker and breadwinner, leaving the needs of family back home neglected. Going Forward: Interpretation: The need for a patient care attendant imposes a financial strain on patient families by providing an additional cost and often disposing a primary income earner. Limitations: There is no standardized instrument available to assess the lives of patient care attendants. However, existing literature and the study objectives were used to design a data collection instrument that was comprehensive and detailed. Strength: The study findings are a true representation of the participants’ views since data collection was exhaustively done until no new themes were generated. Funding: Western Connecticut Health Network. Danbury, Conecticut, USA. Abstract #: 02GMHE0010

“How can Life be still?”: Teaching Janet Frame’s <em>A State of Siege</em> and Virginia Woolf’s <em>To the Lighthouse</em>

Janet Frame's A State of Siege was published in 1966. In both style and theme, the novel was ahead of its time. Its style remains a challenge to today's students, and the feminist overtones of Frame's tale, dealing as it does with a middle-aged woman-Malfred Signal-breaking free of family and job to pursue her art, might at first glance seem dated to a generation in which have seemingly made such gains in opportunities in education and career. Yet so often remain primary caretakers when family members need help, like Malfred, and so many careers, like the teaching job from which Malfred retires in A State of Siege, remain female-identified. mysterious way in which Malfred dies allows speculation as to what finally defeats her. novel, rooted in so many realistic details, at the same time contains allegorical elements that allow students to speculate about the persistence of expectations for dictated by gender, as well as reasons for violence against women. novel would work in many classes from Women in Literature, to the Female Gothic, Zealand Literature, and Modernism (or the Lyrical Novel). Even paired with such novels as Charlotte Bronte's Jane Eyre (1847) and Virginia Woolf's To the Lighthouse (1927), Frame's novel holds its own. Because of limitations of space, will concentrate on a comparison between A State of Siege and To the Lighthouse, though will mention other works, including films, to provide resources that may prove helpful in teaching a range of classes.There are many similarities between Woolf's novel and Frame's. Each novel features a middle-aged female painter who is looked down upon by other characters, and each novel can be viewed as a tribute to the author's mother-until she wrote To the Lighthouse Woolf said her mother's memory obsessed her (Sketch 80); Frame's mother died before she wrote her novel, but her mentor Frank Sargeson forbade her to speak of the death, according to biographer Michael King (135-36). Each novel employs stylistic experimentation and is divided into three parts. In A State of Siege the parts are The Knocking, Darkness, and The Stone. In To the Lighthouse the parts are The Window, Time Passes, and The Lighthouse. In Woolf's novel, World War intervenes in the action and scars the characters; in Frame's, it is World War II that alters Malfred's life. Ironically, in some ways the earlier novel, To the Lighthouse, could be seen as presenting the most successfully liberated female artist in that Lily Briscoe finishes her painting at the end of the novel, declaring, I have had my vision (310), whereas the deadly assault on Malfred Signal begins the night of the day she finishes her painting, and her painting is not even of her sought-after New View. Both Woolf and Frame were also institutionalized numerous times in their lives. Frame may never have suffered from any mental illness beyond anxiety and depression (though she received both insulin shock treatments and electroshock). Woolf was diagnosed as schizophrenic, but Frame was found by one doctor not to be suffering schizophrenia at all (King 197). More than once, Frame's linguistic flights of fancy were misinterpreted as madness for which she was institutionalized and treated.In fact, part of the difficulty of both A State of Siege and To the Lighthouse comes from the fact that both novels are stylistic tours de force that show that relate to in a different way than men do. As Annette Kolodny points out, women writers, coming into a tradition of literary and conventional forms already appropriated, for centuries, to the purposes of male expression, will be forced virtually to 'wrestle' with that language (6) in order 'to remake it as a adequate to our conceptual processes' (Stanley and Robbins, qtd. in Kolodny 6). By the end of Frame's work, a piece of nonsense verse has pride of place, demonstrating the break from based on the Name of the Father, as Jacques Lacan would say. …

Prevalence of Anxiety Disorders in Hong Kong Chinese Children With ADHD

Objective: This study examined the prevalence and correlates of anxiety disorders in Chinese children with ADHD. Method: Overall, 120 children with ADHD aged 6 to 12 years were recruited, and the parent version of computerized Diagnostic Interview Schedule for Children–Version 4 was administrated to their primary caretakers. Results: The prevalence rate of anxiety disorders was 27.5%, which is consistent with the reports of previous Asian and Western studies. Among the children with ADHD and anxiety disorders, more than 50% of them also had comorbid oppositional defiant disorder or conduct disorder (ODD/CD), which yielded an adjusted odds ratio of 3.0 in multivariable analysis for anxiety disorder, with comorbid ODD/CD. In addition, anxiety disorders were positively associated with inattention symptoms in children with both disorders. Conclusion: Clinicians should perform screening and careful assessment for anxiety symptoms in children with ADHD, particularly those suffering from comorbid ODD/CD.

The Role of Parental ADHD in Sustaining the Effects of a Family-School Intervention for ADHD

This study investigated the extent to which parental Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms impact child and parent outcomes following a multimodal family–school intervention, the Family School Success (FSS) program, when compared to an active-control condition (CARE). Participants were 139 children with ADHD (67% male; 91% non-Hispanic; 77% Caucasian; Grades 2–6) and their primary caretaker (91% female; ages 26–59) who participated in a randomized clinical trial evaluating the efficacy of FSS. Associations were examined between parent-reported ADHD symptoms at baseline and intervention outcomes reported by parents and teachers after treatment and at a 3-month follow-up, including child homework and classroom impairments, child ADHD and oppositional defiant disorder symptoms, parenting behaviors, and parent–teacher relationship quality. Across both treatment conditions, parental ADHD was not associated with parent or child outcomes at postassessment. However, differences emerged between the two treatment groups at follow-up for parents with ADHD, particularly when an empirically supported symptom cutoff was used to identify parents at risk for having ADHD. In FSS, but not in CARE, parental ADHD was associated with declines in treatment gains in the quality of the parent–teacher relationship and the child's homework performance. Parents at risk for ADHD had difficulty maintaining treatment effects for themselves and their child in the FSS intervention but not in CARE. The supportive and educational components central to the CARE intervention may be helpful in promoting the sustainability of psychosocial interventions for children with ADHD who have parents with elevated ADHD symptoms.

High Failure Rate with Brigance Developmental Screening in 3 Year-Old Children with Sickle Cell Disease

Background: Central nervous system complications of sickle cell disease (SCD) include stroke, silent cerebral infarct, and neurocognitive deficits, but few studies have examined developmental delays in preschool-age children. Using the Brigance developmental screen in 3 year-old children with SCD we found a high frequency of scores below the “normal” cutoff for age, but control data were lacking (Ped. Blood Cancer 2011;56:620). We hypothesized that children with SCD would be more likely to “fail” this screening test than age-matched children from a similar ethnic/socio-economic background.Methods: This prospective study was approved by the St. Jude Children’s Research Hospital (SJCRH) IRB and informed consent obtained for each subject. 3.0-3.9 year-old SCD subjects were tested in the SJCRH Sickle Cell Clinic. Patients receiving chronic transfusion therapy were excluded. Age-matched and race-matched control subjects with similar socio-economic backgrounds were recruited from 8 Memphis daycare centers. The Brigance Preschool Screen was administered by trained examiners in the clinic or the daycare and required about 15 minutes to complete; the primary caretaker simultaneously completed the demographic form. None of the participants had previous exposure to the test. The proportions of subjects who failed the Brigance test (scoring below the age-related “cutoff”) and test raw scores (higher scores indicating better performance) were compared between SCD and control subjects using the exact Chi-square test and the two-sample t-test, respectively; logistic regression was used to model the associations between the Brigance failure proportions and other covariates for the groups. P-values <0.05 were considered significant.Results: Testing was performed on 103 SCD subjects not on treatment, an additional 20 HbSS subjects receiving hydroxyurea (HU), and 109 daycare subjects. Seventy-four percent of children with SCD (not on HU) failed the Brigance screen, compared to 61% of controls (p = 0.04). Mean (SD) Brigance raw scores for the non-HU SCD patients and controls were 45.9 (20.8) and 56.1 (22.5), respectively (p < 0.001). In the non-HU SCD group the pass/fail rate was not significantly different in those with more severe (SS, Sβ0thal) and milder (SC, Sβ+thal) genotypes. Medical factors, including absolute neutrophil count, hemoglobin concentration, %HbF level and O2saturation by pulse oximetry, were not associated with Brigance results. In contrast, socio-economic/demographic factors had a significant effect on the scores: lower income level, more household children under age 18, and more household residents were associated with increased failure (p </= 0.03). Lower caretaker education level showed a similar trend (p = 0.065). None of the socio-economic/demographic factors were associated with failure in the control group, although there was a trend toward failure with more household children under age 18 (p = 0.07). HU-treated SCD children were not significantly different from untreated patients in the failure rate (p = 0.4) and had no significant associations with medical or socio-economic factors.Conclusions: Among 3-year-olds tested with the Brigance Developmental Screen, a higher proportion of children with SCD failed compared to matched controls, but both groups showed a surprisingly high rate. Medical factors, such as hemoglobin level and sickle cell genotype, were not associated with the failure rate, nor was treatment with HU in a limited number of subjects. Socio-demographic factors (income level and numbers of household members) were associated with the failure rate in the SCD group, but not in the control group. These data indicate that preschool children with SCD are at very high risk for developmental delay, and underlying environmental factors seem to contribute more than medical factors. More detailed neurocognitive evaluation of preschool children with SCD and effective ways to enhance their development are needed. DisclosuresOff Label Use: Hydroxyurea for children with sickle cell disease.

Women's Burdens: Exploratory Analysis on Matrifocality, (re)Production and Social Protection in Douro Region, Portugal

Drawing from the concepts of matrifocality, kinship and gender inequality, this paper develops a brief discussion around the overloading of duties faced by socially and economically vulnerable women. The accumulation of such duties burdens women with social and parental responsibilities, reinforcing their role as income providers, household custodians and primary caretakers of dependent children and elders. These duties, often culturally and socially informed, are especially overwhelming for women belonging to less affluent social strata. Manifestly exploratory, the analysis is based on three case studies of women, all of them in their fifties, living in the Douro vineyards region. They all assume the headship of their households and benefit or were beneficiaries of the Social Insertion Income (SII), a state social protection device intended to alleviate economic hardships and promote active labor insertion.

Family Dynamics of the Stay-at-Home Father and Working Mother Relationship.

A phenomenological qualitative study was utilized to explore family dynamics in stay-at-home father and working mother households. A total of 20 working mothers were asked to describe family interactions and daily routines with regard to their stay-at-home father and working mother dynamic. All participants were married, heterosexual women with biological children ages 1 to 4 and who worked outside the home and the father stayed home as primary caretaker and did not contribute financially. The study indicated that the family dynamic of a working mother and stay-at-home father provided a positive parent-child relationship, enhanced parenting cohesion, and enhanced quality time.

Caretaker mental health and family environment factors are associated with adolescent psychiatric problems in a Vietnamese sample

Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam.

Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level

Background Diarrhoea is the second leading cause of child mortality worldwide. Low- and middle-income countries are particularly burdened with this both preventable and treatable condition. Targeted interventions include the provision of safe water, the use of sanitation facilities and hygiene education, but are implemented with varying local success. Objective To determine the prevalence of and factors associated with diarrhoea in children under five years of age in rural Burundi. Design A cross-sectional survey was conducted among 551 rural households in northwestern Burundi. Areas of inquiry included 1) socio-demographic information, 2) diarrhoea period prevalence and treatment, 3) behaviour and knowledge, 4) socio-economic indicators, 5) access to water and water chain as well as 6) sanitation and personal/children's hygiene. Results A total of 903 children were enrolled. The overall diarrhoea prevalence was 32.6%. Forty-six per cent (n=255) of households collected drinking water from improved water sources and only 3% (n=17) had access to improved sanitation. We found a lower prevalence of diarrhoea in children whose primary caretakers received hygiene education (17.9%), boiled water prior to its utilisation (19.4%) and were aged 40 or older (17.9%). Diarrhoea was associated with factors such as the mother's age being less than 25 and the conviction that diarrhoea could not be prevented. No gender differences were detected regarding diarrhoea prevalence or the caretaker's decision to treat. Conclusions Diarrhoea prevalence can be reduced through hygiene education and point-of use household water treatment such as boiling. In order to maximise the impact on children's health in the given rural setting, future interventions must assure systematic and regular hygiene education at the household and community level.

Mealtime Disruption and Caregiver Stress in Referrals to an Outpatient Feeding Clinic.

This investigation explores the feeding behaviors, comorbidities, and parenting stress in young children referred to an outpatient feeding clinic. Eligible participants (n =72) were primary caretakers of children ages 2-6 years referred to an interdisciplinary outpatient feeding disorder clinic, subcategorized according to the absence (n = 18) or presence (n = 54) of caretaker-reported medical or developmental comorbidities. This group was compared with an equivalent control sample of caretakers of age-matched children (n = 72). Measures included the Children's Eating Behavior Inventory (CEBI) and the Parenting Stress Index-Short Form (PSI-SF). The CEBI and PSI scores were higher in the feeding disorder group than in the control group. PSI total was incrementally increased for control vs feeding disorder without comorbidity vs feeding disorder with comorbidity. Increased maladaptive behaviors and parenting stress were evident in children with feeding disorder regardless of the presence of comorbidity. Parenting stress was exacerbated by the presence of comorbidity.

Dietary Intake of Key Food and Beverage Groups Among a Diverse Sample of Low-Income and Food-Insecure Mothers

To describe baseline food insecurity and dietary intake for a diverse sample of low-income mothers in North Carolina. Baseline data came from participants in the Voices into Action (VIA) project, who were primary caretaker of at least one child (2-8 years). This analysis included mothers with complete data for sociodemographics, food security status, and dietary recalls (n=101). Participants had household incomes <200% of the federal poverty line, and were racially and ethnically diverse (41% black, 34% white, 25% Latina). Within-person means of dietary variables (servings/day) were calculated across individual recalls (3 recalls per participant). We examined differences in dietary variables by sociodemographics and food insecurity status. More than half of mothers were food insecure; 19% were very food insecure. Average intake of healthful foods—whole fruits, whole grains, seafood and plant proteins—were somewhat low (0.5, 1.0, and 0.8 servings/day, respectively). Yet, average intake of less healthful foods—salty snacks and sweets—were also fairly low (0.4 and 0.8 servings/day, respectively). Calorically sweetened, non-dairy beverages were somewhat high (2.5 servings/day). There were differences by food insecurity status. Low-income and food-insecure populations are often described as relying on low-cost, energy-dense foods for nutritional needs. However, few studies have examined comprehensive dietary intake data for this population. These findings question the assumption that low-income, food-insecure mothers are relying heavily on nutritionally poor, energy dense foods, and suggest that mothers' higher intake of sweetened beverages might be a compensatory behavior related to food insecurity.