Relationship between juvenile obesity, dietary energy and fat intake and physical activity.

OBJECTIVE: To determine the relationship of juvenile obesity to dietary fat, particularly saturated fat, and with dietary energy (controlling for activity patterns). DESIGN: Cross-sectional, evaluation of diet and activity patterns of obese and non-obese children and adolescents. SUBJECTS: A total of 181 children, aged 4-16 y. Subjects were divided into two groups: obese (body mass index, BMI, > 95th percentile for age and sex), 40 males and 51 females; and non-obese (BMI < 75th percentile for age and sex), 35 males and 55 females. MEASUREMENTS: Dietary intake was analyzed with a dietary history interview; activity patterns were analyzed with an activity interview and body fat was measured with bioelectrical impedance analysis. RESULTS: The obese subjects consumed significantly more total calories, total fat in grams and saturated fatty acids (SFA) in grams than did the non-obese subjects. Based on step-wise multiple regression, the total energy consumed, not total fat or SFA, had the strongest relationship to the subject's percentage body fat, controlling for activity levels. CONCLUSION: We suggest that, although obese children and adolescents consume more dietary energy and fat than non-obese children and adolescents, there is a stronger relationship between total energy consumed and juvenile adiposity than with dietary fat or type of dietary fat consumed.

The COPE program: a strategy to improve outcomes of critically ill young children and their parents.

Critically ill young children and their parents are subjected to multiple stressors during hospitalization, which may predispose them to short- and long-term negative outcomes. Nurses who care for children who are critically ill and their families during and following their intensive care unit stay must be knowledgeable of the impact of a child's critical illness on the family and factors influencing adjustment to the stressful experience. Knowledge of these issues is essential in planning effective intervention strategies to enhance coping outcomes in this population. This article (a) discusses how young children and their parents are affected by critical illness; (b) outlines major sources of stress for families; (c) identifies factors influencing coping outcomes; and (d) describes the COPE program, a newly devised early intervention program for critically ill young children and their parents.

Coping with marital separation: smoothing the transition for parents and children.

Divorce is a stressful multistage process that can have long-lasting negative outcomes for parents and children. Pediatric nurse practitioners are often the first health care professionals to be informed of family transitions. Therefore they must be knowledgeable of the impact of divorce on parents and children to implement appropriate interventions to enhance coping outcomes in this population. This article discusses the effects of divorce on parents and children and identifies intervention strategies that can be used by nurse practitioners when dealing with separated families. Description of the COPE Program, an intervention program recently implemented with parents and young children experiencing marital separation, is also highlighted.

Helping mothers cope with a critically ill child: a pilot test of the COPE intervention.

The purpose of this study was to pilot test the effects of a theoretically driven intervention program (COPE = Creating Opportunities for Parent Empowerment) on the coping outcomes of critically ill children and their mothers. Thirty mothers of 1- to 6-year-old children in a pediatric intensive care unit (PICU) were randomly assigned to receive COPE or a comparison program. Mothers who received the COPE program: (a) provided more support to their children during intrusive procedures; (b) provided more emotional support to their children; (c) reported less negative mood state and less parental stress related to their children's emotions and behaviors; and (d) reported fewer post-traumatic stress symptoms and less parental role change four weeks following hospitalization. Results indicate the need to educate parents regarding their children's responses as they recover from critical illness and how they can assist their children in coping with the stressful experience.

An evaluation of the efficacy of a preventive intervention for 4th-6th grade urban children of divorce.

This study evaluates the efficacy of the Children of Divorce Intervention Program (CODIP), a preventive intervention based on social support and coping skills, for 4th-6th grade urban children of divorce. Structure and content of the 14 group sessions were tailored to the developmental level and sociocultural make-up of the target sample. Pre-post comparisons of demographically matched groups of 57 CODIP participants, 38 non-program divorce controls and 93 children from non-divorced families revealed improvements on parent, child and group leader measures of adjustment. Limitations of the study and directions for future research are discussed.

Relationships between support and adjustment among children of divorce.

In a sample of 102 4th-6th grade urban children of divorce, low to moderate relationships were found between perceived support and child adjustment. This relationship held for several sources of support and across several types of adjustment measures. It was strongest when adjustment was assessed through child self-ratings. Thus, children of divorce who perceived themselves as having more overall support had lower scores on measures of post-divorce difficulties, anxiety, and worry, and higher scores on measures of openness about the divorce and positive resources. The relationships found between support and adjustment among children of divorce suggest a potentially useful role for support in developing preventive interventions for such youngsters.

Gender and sex-role influences on children's self-esteem.

This study examined direct and moderating influences of gender and sex-role orientations on children's general self-esteem. Moderating influences of these variables on the prediction of self-esteem were examined with respect to two sets of competence beliefs regarding school achievement: perceived capacities and perceived strategies for doing well in school. One hundred nineteen fourth-, fifth-, and sixth-grade children were assessed using the Perceived Competence Scale for Children (Harter, 1982), the Multidimensional Measure of Children's Perceptions of Control (Connell, 1985), and the Children's Personal Attributes Questionnaire (Hall & Halberstadt, 1980). Correlational and hierarchical multiple regression analyses indicated that upper elementary schoolchildren's general self-esteem is (a) marginally related to biological gender, with boys showing a slight advantage; (b) significantly related to masculinity and androgyny; and (c) predicted more strongly by perceived capacities to do schoolwork in girls than in boys, and by perceived (lack of) strategies for academic success in nontraditionally sex-typed children than in traditionally sex-typed children. Of the two nontraditionally sex-typed groups, androgynous children were found to have more positive school competence beliefs than were undifferentiated children.