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Prevention starts from the crib: the pediatric point of view on detection of families at high cardiovascular risk.
Capra, ME, Pederiva, C, Banderali, G, Biasucci, G
Italian journal of pediatrics. 2021;(1):51
Abstract
BACKGROUND Cardiovascular disease (CVD) is one of the main causes of mortality and morbidity in Italy. Hypercholesterolemia is a modifiable CVD risk factor. The detection and treatment of hypercholesterolemia can modify the natural history of CVD, making CVD risk for affected patients comparable to that of unaffected ones. In this scenario, the detection of families at high cardiovascular risk is the first step of CVD prevention. This multicenter, observational study is aimed at finding an effective and non-invasive screening strategy to detect families at high risk for CVD. METHODS A survey investigating the knowledge of lipid and CVD issues was distributed to the parents of all infants born at the Neonatology Unit of Piacenza City Hospital and San Paolo Hospital in Milan over a 6 months period. Overall, 554 surveys have been collected. RESULTS 26.8% newborns had parents who knew their own lipid profile, 40.2% had parents who knew the correct normal blood values of total cholesterol, 37.1% had parents who declared to have first or second degree relatives with lipid disorders, 33.7% had parents who declared to have first or second degree relatives with premature CVD CONCLUSION Collecting a problem-tailored and accurate family history seems to be a good strategy to detect high risk families. Our data suggest that the percentage of adults who are unaware of their lipid profile, with a positive family history for CVD and/or lipid disorders is higher than expected. As a result, even the number of undetected paediatric patients at high cardiovascular risk might be greater than expected.
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2.
Parental Perception of Children's Weight Status: Love Overpasses Scientific Evidence! A Cross-Sectional Observational Study.
Sirico, F, Fernando, F, Bianco, A, Loiacono, C, Nuccio, F, Gambardella, F, Palermi, S, Montagnani, S, Biffi, A
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension. 2020;(1):29-34
Abstract
INTRODUCTION Age, gender, body mass index percentiles and the adherence to Mediterranean diet were investigated as potential predictor factors in this assessment. AIM: To assess the parental perception of children's weight status. METHODS This cross-sectional observational study was carried out during a corporate wellness program (Ferrari Formula Benessere) implemented by Ferrari S.p.A. and managed by Med-Ex s.r.l. The children's real weight status was assessed through Body Mass Index percentiles (ArthroPlus software-WHO). RESULTS 328 children (66.4%) were normal-weight, 10 were underweight (2%), 66 were overweight (13.4%) and 90 were obese (18.2%). 289 children (59%) were classified correctly by parents, while 205 children (41%) were not. 64 of 66 overweight children and 90 of 90 children with obesity have been completely underestimated (53 of 90 children with obesity were judged normal weight). The parents' probability to estimate children's weight status correctly decreased increasing body mass index percentiles paradoxically [OR = 0.96 (0.95-0.97)] and was lower in boys [OR = 0.65 (0.44-0.98)]. Although not statistically significant, children with higher adherence to Mediterranean diet seems to have higher probability to be correctly estimated [low adherence: reference, medium adherence: OR = 1.06 (0.61-1.85), high adherence: OR = 1.48 (0.81-2.75)]. CONCLUSIONS A high percentage of children is overweight or obese and almost half of parents classified their weight status incorrectly. Increasing children's body mass index percentiles decreases the probability to be correctly classified.
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Life events, coping styles, and psychological well-being in children living with parents who harmfully consume alcohol.
Iacopetti, C, Londi, I, Patussi, V, Sirigatti, S, Cosci, F
Clinical psychology & psychotherapy. 2019;(2):157-166
Abstract
INTRODUCTION Children living with parents who harmfully consume alcohol might experience more life events, in particular negative, than children living with parents who do not harmfully consume alcohol. They also primarily use less adaptive coping styles and often demonstrate lower resilience. No studies evaluated whether coping styles or psychological well-being might influence the risk of life events occurrence in children living with parents who harmfully consume alcohol. METHODS Forty-five children living with parents who harmfully consume alcohol and 45 children living with parents who do not harmfully consume alcohol, matched for sex and age, were assessed via the Appendix Life Events of the Minnesota Multiphasic Personality Inventory-Adolescent, the Coping Inventory for Stressful Situations, and the Psychological Well-Being scales. RESULTS Children living with parents who harmfully consume alcohol had more life events in the 6-month period before the assessment, mostly negative and neutral, and lower levels of psychological well-being than children living with parents who do not harmfully consume alcohol. The risk of having experienced at least one negative or neutral life event was higher in children living with parents who harmfully consume alcohol than in their peers and in those with lower psychological well-being. The risk of having had a positive life event was not related to parents' consumption of alcohol but to avoidant coping and low self-acceptance behaviours. CONCLUSIONS Children living with parents who harmfully consume alcohol need interventions aimed at improving psychological well-being to protect them from life events, especially from negative ones.
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Body weight, body composition and energy balance related behaviour during the transition to parenthood: study protocol of a multi-centre observational follow-up study (TRANSPARENTS).
Deliens, T, Versele, V, Vanden Eynde, H, Clarys, P, Devlieger, R, Bogaerts, A, Gucciardo, L, Schreurs, A, Van Holsbeke, C, Aerenhouts, D
BMC public health. 2019;(1):516
Abstract
BACKGROUND The transition to parenthood is a cornerstone event for both parents, potentially leading to relevant changes in lifestyle and behaviour. In women, the metabolic changes during and after pregnancy and the deleterious effects of excessive gestational weight gain and postpartum weight retention have been extensively described. However, there is no full understanding about which specific energy balance related behaviours (EBRB) contribute to unfavourable weight gain and weight retention. Furthermore, information on how transition to parenthood affects men is lacking. Therefore, this study aims to investigate changes in body weight, body composition and EBRB in couples transitioning to parenthood. METHODS TRANSPARENTS is a multi-centre observational follow-up study that focuses on body weight, body composition and EBRB during the transition to parenthood. Couples (women and men) will be recruited during the first trimester of their first pregnancy. Study visits will occur at four occasions (12 weeks of pregnancy, 6 weeks postpartum, 6 months postpartum and 12 months postpartum). Anthropometrics of the parents and new-borns will be assessed including body weight, height/length, body composition (using bio-electrical impedance analysis and measurement of four skinfold thicknesses (biceps, triceps, subscapular and supraspinal/suprailiac)) and waist and hip circumference. Dietary intake, physical activity, sedentary behaviour, smoking habits, sleeping pattern, fatigue, diet and exercise related partner support, mental health, breastfeeding, contraception use, and socio-demographics will be assessed using a questionnaire. In addition, accelerometry will be used to assess physical activity and sedentary behaviour objectively. Also data from women's medical record, such as pre-pregnancy weight and pregnancy outcomes, will be included. Multilevel modelling will be used to evaluate maternal and paternal changes in body weight, body composition and EBRB during and after pregnancy (primary outcomes). Multiple linear regression analyses will be performed to identify predictors of changes in body weight, body composition and EBRB. All analyses will be adjusted for possible confounders. DISCUSSION TRANSPARENTS is a unique project identifying vulnerable parents and (un)favourable changes in EBRB throughout this potentially critical life period. Provided insights will facilitate the development of effective intervention strategies to help couples towards a healthy transition to parenthood. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03454958. Registered March 2018.
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Parental feeding behavior in relation to children's tasting behavior: An observational study.
Moens, E, Goossens, L, Verbeken, S, Vandeweghe, L, Braet, C
Appetite. 2018;:205-211
Abstract
Children's eating habits are shaped in part by parental feeding practices. While maladaptive practices have already received a lot of research attention, the effects of adaptive strategies, especially in elementary school aged children of different weight status, are less examined. This study examines how parents (1) model and (2) encourage their child to taste an unknown food. Thereby, attention is paid to the distinction between encouraging what (i.e. adaptive type of encouragement) and the amount (i.e. maladaptive type of encouragement) children eat/drink. Twenty-five families with a child with overweight and 30 families with a child of healthy weight (7-13 years) participated in a taste task. Both the child's tasting behavior and the parents' modelling and encouragement behavior were observed and related to the child's age and weight status. As 94.3% of the children tasted the unknown food, weight status differences between tasters and non-tasters could not be investigated. Only 26.9% of the parents used modelling to enhance tasting behavior; this was unrelated to age and weight status. 77.4% of the parents encouraged their children to taste (encouragement of what children eat/drink), and this was significantly more prevalent in parents of younger children and of healthy-weight children. 21.1% of the parents also encouraged their children to finish the juice (encouragement of amount children eat/drink) and this was also more prevalent in parents of the healthy-weight group. These results evidenced that parental modelling is not often used to enhance tasting behavior in children. In contrast, parental encouragement was frequently observed, especially in parents of younger children and of healthy-weight children. Encouragement, however, seems difficult to measure and more research on adaptive parental encouragement is needed.
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Altered perception of the nutritional status of preschoolers by their parents: A risk factor for overweight and obesity.
Chávez Caraza, KL, Rodríguez de Ita, J, Santos Guzmán, J, Segovia Aguirre, JG, Altamirano Montealvo, DC, Matías Barrios, VM
Archivos argentinos de pediatria. 2016;(3):237-142
Abstract
INTRODUCTION Many parents have a misperception of their children's body size; in general, they underestimate overweight and obesity. OBJECTIVE To identify the difference between parents' perception of their children's nutritional status and measured body mass index. POPULATION AND METHODS To identify the difference between parents' perception of their children's nutritional status and measured body mass index. RESULTS A total of 605 children and their parents were assessed. Seventy-four (12.2%) were overweight and 87 were obese (14.3%). There were 161 overweight or obese children, but 98.8% (159) of parents underestimated their children's nutritional status. Parents' underperception of their children's body size accounted for an OR= 2.1 ± 0.5, p= 0.002 (95% confidence interval [CI]: 1.32-3.32) for obesity and an OR = 4.42 ± 1.2, p < 0.001 (95% CI: 2.631-7.439) for overweight. CONCLUSIONS Among parents of overweight and obese children, 98.8% (159) underestimated their children's weight status. Such underestimation by parents may be a significant risk factor for the development and/or persistence of overweight and obesity in their children.
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Breaking down barriers to communicating complex retinoblastoma information: can graphics be the solution?
Chiu, HH, Dimaras, H, Downie, R, Gallie, B
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie. 2015;(3):230-5
Abstract
OBJECTIVE To investigate the impact of a graphical timeline summarizing bilateral retinoblastoma disease and treatment outcomes on parents' understanding of complex medical information. DESIGN Cross-sectional survey. PARTICIPANTS Parents of children with retinoblastoma who were being actively managed at The Hospital for Sick Children were recruited. Forty-five parents from 42 families participated. METHODS After a standardized presentation on retinoblastoma and visual tool named Disease-Specific electronic Patient Illustrated Clinical Timeline (DePICT), parents completed a 19-item questionnaire designed to assess their understanding of treatment choices for 2 eyes in bilateral retinoblastoma as communicated using DePICT. SPSS was used to perform statistical analysis. RESULTS Forty-five parents from 42 families participated (65% female). Median age of participants was 34 years. Median level of participant education was completion of college/trade school. The median level of annual income was $40,000 to $70,000 CDN. Median time since diagnosis of retinoblastoma in their child was 13.5 months. Twenty-three (51%) participants were parents of children with unilateral retinoblastoma, and 22 (49%) were parents of children with bilateral retinoblastoma. Median number of correct answers was 15 of 19, and mean score was 77%. Normal distribution of scores was noted. English as a first language was significantly associated with score (p = 0.01). No significant association was observed between other variables and score in all analyses. CONCLUSIONS This study builds on the validation of DePICT by demonstrating that parents can achieve good comprehension even when considering choices for treatment for 2 eyes with bilateral retinoblastoma. Clinical application of this tool can enhance the consent process.
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Assessing parental self-efficacy for obesity prevention related behaviors.
Wright, JA, Adams, WG, Laforge, RG, Berry, D, Friedman, RH
The international journal of behavioral nutrition and physical activity. 2014;:53
Abstract
BACKGROUND Reliable, valid and theoretically consistent measures that assess a parent's self-efficacy for helping a child with obesity prevention behaviors are lacking. OBJECTIVES To develop measures of parental self-efficacy for four behaviors: 1) helping their child get at least 60 minutes of moderate intensity physical activity every day, 2) helping one's child consume five servings of fruits and vegetables each day, 3) limiting sugary drinks to once a week, and 4) limiting consumption of fruit juice to 6 ounces every day. METHODS Sequential methods of scale development were used. An item pool was generated based on theory and qualitative interviews, and reviewed by content experts. Scales were administered to parents or legal guardians of children 4-10 years old. The item pool was reduced using principal component analysis. Confirmatory factor analysis tested the resulting models in a separate sample. SUBJECTS 304 parents, majority were women (88%), low-income (61%) and single parents (61%). Ethnic distribution was 40% Black and 37% white. RESULTS All scales had excellent fit indices: Comparative fit index> .98 and chi-squares (Pediatrics 120 Suppl 4:S229-253, 2007) = .85 - 7.82. Alphas and one-week test-retest ICC's were ≥.80. Significant correlations between self-efficacy scale scores and their corresponding behaviors ranged from .13-.29 (all p < 0.03). CONCLUSIONS We developed four, four-item self-efficacy scales with excellent psychometric properties and construct validity using diverse samples of parents. CLINICAL TRIAL REGISTRATION NCT01768533.