Self-Esteem, Teasing and Quality of Life: African American Adolescent Girls Participating in a Family-Based Pediatric Overweight Intervention

Two studies investigated overweight in African American girls. First, African American adolescent girls (BMI was ≥ 85th percentile) and their mothers participated in focus groups addressing weight and eating. Although mothers and daughters shared some similar views on these issues, there were important discrepancies, with mothers expressing greater doubt about the potential success of a healthy weight program. The second study evaluated baseline data from 39 African American girls participating in a weight management program; mothers' reports were also analyzed. In both studies, adolescents reported significant teasing, and in the second study, teasing was inversely associated with social quality of life (β=.55, t=3.01, p=.007). Motivation to participate was positively associated with teasing (r=.50, p < .01). Self-esteem was inversely related to positive health habits (all p < .05). Mothers who viewed their daughters as having higher self-esteem were less concerned about their daughters' weight. Differences in mothers' and daughters' perceptions highlight the importance of a family approach in pediatric overweight interventions. Results provide evidence that overweight African American girls face significant weight stigmatization and suggest areas to target regarding intervention implementation.

The clinical aspects of newborn screening: importance of newborn screening follow-up

The aim of newborn screening is to identify presymptomatic healthy infants that will develop significant metabolic or endocrine derangements if left undiagnosed and untreated. The goal of ultimately reducing or eliminating irreversible sequelae is reached by maximizing test sensitivity of the primary newborn screening that measures specific analytes by a number of methodologies. Differentiation of true from false negatives is accomplished by the test specificity. This review discusses disorders for which, in general, there are available therapies and that are detected by routine and expanded newborn screening. Recommendations are presented for evaluation by a primary care physician, with confirmation by a metabolic or endocrinology specialist. Disorders are organized in tabular format by class of pathway or analyte, with attention to typical clinical presentations, confirmatory biochemical and molecular tests, and therapies. There are numerous challenges in clinical follow-up, including diagnosis and appropriate understanding of the consequences of the disorders. The data required to meet these challenges can be acquired only by large scale longitudinal comprehensive studies of outcome in children identified by newborn screening. Only with such data can newborn screening fully serve families.     

Family Ritual and Routine: Comparison of Clinical and Non-Clinical Families

Research demonstrates that the constructive use of family rituals is reliably linked to family health and to psychosocial adjustment. This study explores the relationship between family rituals and child well-being. Two samples participated: 21 families whose adolescent was receiving psychiatric treatment and 21 families in which the adolescent was a public school student. A parent and the adolescent were individually interviewed regarding family rituals and completed standardized measures of adolescent and family functioning. Analyses demonstrated that, in addition to significant sample differences in the expected direction on measures of functioning, the non-clinical families scored significantly higher on the index of family rituality than did the treatment families; this is additional evidence that family rituals are a correlate of child well-being. Further analysis of the data pointed to “people resources” as a robust dimension in its association to adolescent functioning. The role family ritual and routine plays in defining family relationships, both within the nuclear family and with other important adults, was significantly related to clinical status. This work may point to an important, yet overlooked, dimension of family ritual life, the relational qualities of rituals and routines.     

Programmatic staff care in an outpatient setting

Traditionally, chaplains have provided care for staff through consultation, informal conversation, grief work, and more formal counsel and ritual. This article discusses four programmatic approaches to staff care created in response to particular assessed needs: "Finding Soul" addresses staff care needs to find meaning and joy in their work and to contribute to the "soul" of the institution. "Existential Expedition" helps staff both deal with their accumulated grief and provide better direct care around existential issues being faced by their patients. "After Book" provides a way for staff to have closure with parents/families and to provide holistic care to families after discharge from the system. "The Labyrinth Program" provides staff with an opportunity to de-stress and to attend to their emotional and spiritual well-being. Focused upon staff care, these programs also secondarily benefit both patients/families and the vision and mission of the institution.     

A Model of Contagion Through Competition in the Aggressive Behaviors of Elementary School Students

This article extends the work of Kellam, Ling, Merisca, Brown and Ialongo (1998) by applying a mathematical model of competition between children to peer contagion in the aggressive behaviors of elementary school students. Nonlinearity in the relationship between group aggression and individual aggression at 2-year follow-up is present. Consistent with the findings of Kellam et al. (1998), hierarchical linear modeling indicates that the relationship is statistically significant for those students whose initial parental ratings of aggressive behavior were above the sample median. In the context of competition between students, the behavior of initially aggressive students may be negatively reinforced. Lowering aggression in the school environment may therefore be the most effective way to lower the level of these students aggressive behavior.     

Amputees by choice: body integrity identity disorder and the ethics of amputation

ABSTRACT Should surgeons be permitted to amputate healthy limbs if patients request such operations? We argue that if such patients are experiencing significant distress as a consequence of the rare psychological disorder named Body Integrity Identity Disorder (BIID), such operations might be permissible. We examine rival accounts of the origins of the desire for healthy limb amputations and argue that none are as plausible as the BIID hypothesis. We then turn to the moral arguments against such operations, and argue that on the evidence available, none is compelling. BIID sufferers meet reasonable standards for rationality and autonomy: so as long as no other effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests.     

Spatial and object working memory impairments in schizophrenia patients: a Bayesian item-response theory analysis

This study reports evidence that schizophrenia patients are significantly impaired in both spatial and object (shape) working memory. A 3-s delay between exposure and recall of targets was used and Bayesian item-response theory was applied to compensate for the tasks' differential difficulty while simultaneously taking account of missing data from participant attrition. Weaker evidence was found that in schizophrenia both domains are equally impaired on average, that spatial and object working memory appear to be more highly correlated with each other in the schizophrenia population than in the normal population, and that schizophrenia patients show greater variability in spatial than object working memory performance.     

Relations among musical skills,phonological processing,and early reading ability in preschool children

We examined the relations among phonological awareness, music perception skills, and early reading skills in a population of 100 4- and 5-year-old children. Music skills were found to correlate significantly with both phonological awareness and reading development. Regression analyses indicated that music perception skills contributed unique variance in predicting reading ability, even when variance due to phonological awareness and other cognitive abilities (math, digit span, and vocabulary) had been accounted for. Thus, music perception appears to tap auditory mechanisms related to reading that only partially overlap with those related to phonological awareness, suggesting that both linguistic and nonlinguistic general auditory mechanisms are involved in reading.