Parental perspectives of a 4-week family-based lifestyle intervention for children with obesity

OBJECTIVES

The childhood obesity epidemic is now recognized as one of the most serious public health challenges of the 21st century. Community-based behaviour modification treatment programs involving both children and their families are warranted. The purpose of this study was to explore the experiences of parents whose children participated in the Children's Health and Activity Modification Program (C.H.A.M.P.): a 4-week lifestyle program delivered as a day-camp for obese children at risk for type II diabetes and their families. Parents were required to attend four half-day education sessions during the intervention period.

METHODS

Seven focus groups were conducted immediately following the 4-week interventions offered in August 2008 and 2009. The perspectives of 38 parents representing 32 children aged 8-14 with obesity (i.e., body mass index > the 95th percentile) were shared.

RESULTS

Overall, parents were pleased with the impact of the program and proud of their children's accomplishments (e.g., increased physical activity levels, enhanced self-esteem, weight loss). Several facilitators to success (e.g., social support; a positive environment) and barriers to its maintenance (e.g., time management; unsupportive family members) were identified, and recommendations were made for future programs. Although parents found the half-day sessions valuable, post-programmatic bi-monthly booster session adherence declined over the one-year follow-up period.

CONCLUSION

Delivered as a 4-week day-camp, C.H.A.M.P. represents a unique approach to the treatment of childhood obesity. Future family-based interventions should consider avenues for intensifying the parental program component whilst employing strategies to promote parental adherence in service of enhancing long-term sustainability of health behaviour changes.

The Children's Health and Activity Modification Program (C.H.A.M.P.): participants' perspectives of a four-week lifestyle intervention for children with obesity

To date, there is a paucity of qualitative research examining the influence of community-based interventions for childhood obesity on the participants themselves. This study explored the experiences of children who participated in the Children's Health and Activity Modification Program (C.H.A.M.P.), a four-week day camp for children with obesity aged 8-14, in order to uncover key program elements for positive behavior change. Following the intervention, children (n = 36) participated in focus groups where they were asked about their experiences pertaining to physical activity and nutrition, what it was like to be part of a team, and how they felt about themselves. Findings revealed that participants perceived C.H.A.M.P. as helpful (e.g. in making healthier food choices, being more active, and feeling more confident and self-aware). This pilot study offers unique insights into the perspectives of children with obesity. Results are discussed with respect to future program development and research for childhood obesity treatment.

Climbing towards recovery: investigating physically injured combat veterans' psychosocial response to scaling Mt. Kilimanjaro

PURPOSE

To explore physically injured combat veterans' psychosocial response to scaling Mt. Kilimanjaro.

METHOD

Participants (n = 4) were male and ranged in age from 22 to 44 years. They had all been wounded as a result of active duty in Afghanistan between 15 and 42 months (M = 27.25) before the study. Data were collected throughout a 9-day climb on Mt. Kilimanjaro using multiple sources of ethnographic data collection techniques including semi-structured interviews and detailed observations. Data were analyzed using cross case analysis.

RESULTS

The findings are divided into themes that were drawn out of the data to illustrate the participants' psychosocial response to their experience of climbing on Mt. Kilimanjaro. Key themes of self-determination, active coping and social support were identified from the data.

CONCLUSION

Support for those in recovery from trauma should foster psychosocial resources needed for healthy functioning. Future research should explore the role of meaningful and challenging activities as a way of improving the experience of recovery following serious injury.

The influence of parents and the home environment on preschoolers' physical activity behaviours: a qualitative investigation of childcare providers' perspectives

Background

Physical activity offers numerous physiological and psychological benefits for young children; however, many preschool-aged children are not engaging in sufficient activity. The home environment, inclusive of parent role modeling, has been identified as influencing preschoolers' physical activity. This study sought to examine childcare providers' perspectives of the importance of parents and the home environment for supporting the physical activity behaviours of preschool-aged children (aged 2.5-5 years) attending childcare.

Methods

A heterogeneous sample of childcare providers (n = 84; response rate 39%) working at childcare facilities in London, Ontario participated. Thirteen semi-structured focus groups were conducted in London centres between February 2009 and February 2010. Focus groups were audio recorded and transcribed verbatim and inductive content analysis was used to code and classify themes. A number of strategies were used to verify the trustworthiness of the data.

Results

Childcare providers acknowledged their reliance on parents/guardians to create a home environment that complements the positive physical activity messaging children may receive in childcare. Moreover, childcare staff highlighted the need for positive parent role modeling and parent support to encourage active healthy lifestyles among young children.

Conclusion

This study's findings highlight the need for increased parent-caregiver partnering in terms of communication and cooperation in service of promoting appropriate amounts of physical activity among London preschoolers.

Serotonin and dopamine transporters in relation to neuropsychological functioning, personality traits and mood in young adult healthy subjects

BACKGROUND

Serotonin and dopamine neurotransmitter systems are implicated in the regulation of mood, cognition and personality traits and their dysfunction is thought to be implicated in diverse psychopathologies. However, in healthy subjects the relationship between the serotonin and dopamine systems and neuropsychological functioning and personality traits is not clearly established. In the present study we investigated whether neuropsychological functioning, personality traits and mood states of a group of healthy subjects are associated with in vivo measures of serotonin transporters (SERTs) and dopamine transporters (DATs).

METHOD

A total of 188 young healthy subjects underwent neuropsychological and subjective measurements of memory function, depression and impulsivity. Participants' SERT and DAT availability in predefined regions of interest were assessed using single photon emission computed tomography (SPECT) with the radiotracer [123I]β-CIT. Individual magnetic resonance imaging (MRI) scans served as anatomic reference.

RESULTS

We did not find any significant association between SERT or DAT availability and neuropsychological test performance or self-reported impulsivity and mood. There were no significant sex differences in SERT or DAT availability, but men performed significantly better on some tests of visuospatial functioning than women.

CONCLUSIONS

Robust negative findings for striatal DAT availability seriously question earlier findings of positive associations between DAT availability and cognitive functions in healthy subjects. Our results also suggest that subcortical SERT availability is not associated with the neuropsychological functions and personality traits assessed. In summary, the present study suggests that neuropsychological and personality measurements in young healthy people are not associated with subcortical SERT or striatal DAT availabilities in the brain.

The use of group dynamics strategies to enhance cohesion in a lifestyle intervention program for obese children

Background

Most research pertaining to childhood obesity has assessed the effectiveness of preventative interventions, while relatively little has been done to advance knowledge in the treatment of obesity. Thus, a 4-week family- and group-based intervention utilizing group dynamics strategies designed to increase cohesion was implemented to influence the lifestyles and physical activity levels of obese children.

Methods/Design

This paper provides an overview of the rationale for and implementation of the intervention for obese children and their families. Objectives of the intervention included the modification of health behaviors and cohesion levels through the use of group dynamics strategies. To date, a total of 15 children (7 boys and 8 girls, mean age = 10.5) and their families have completed the intervention (during the month of August 2008). Physiological and psychological outcomes were assessed throughout the 4-week intervention and at 3-, 6-, and 12-month follow-up periods.

Discussion

It is believed that the information provided will help researchers and health professionals develop similar obesity treatment interventions through the use of evidence-based group dynamics strategies. There is also a need for continued research in this area, and it is our hope that the Children's Health and Activity Modification Program (C.H.A.M.P.) will provide a strong base from which others may build.

Physical activity context and university student's propensity to meet the guidelines Centers for Disease Control and Prevention/American College of Sports Medicine

BACKGROUND

Previous research shows that exercise context is important for exercise adherence--exercising alone is associated with reduced adherence whereas exercising with others is associated with increased adherence. The purpose of the study was to examine whether exercising in one or a combination of four contexts for physical activity (in a structured class, with others outside of a structured class, alone but in an exercise setting, and completely alone) is related to the degree to which university students meet prescribed (i.e., CDC/ACSM) guidelines for aerobic activity.

MATERIAL/METHODS

Males (n=196) and females (n=398) completed a self-reported physical activity questionnaire pertaining to the frequency, intensity and duration of their activity in the four contexts outlined above.

RESULTS

A positive relationship was found between the percentage of students meeting CDC/ACSM Guidelines and the number of contexts in which physical activity was undertaken. That is, a small percentage (9.9%) were active in a single context (i.e., only one context out of a possible four), with the majority of those (5.9%) engaging in physical activity with others outside of a structured setting. A larger percentage (28.9%) were active in two contexts, while 61.2% were active in three or more contexts.

CONCLUSIONS

Health care professionals interested in motivating the physically inactive to become more active and the physically active to maintain activity at a frequency, intensity, and duration sufficient to meet the CDC/ACSM guidelines ought to promote opportunities for physical activity in a variety of social contexts.

DNA microarray analysis of functionally discrete human brain regions reveals divergent transcriptional profiles

Transcriptional profiles within discrete human brain regions are likely to reflect structural and functional specialization. Using DNA microarray technology, this study investigates differences in transcriptional profiles of highly divergent brain regions (the cerebellar cortex and the cerebral cortex) as well as differences between two closely related brain structures (the anterior cingulate cortex and the dorsolateral prefrontal cortex). Replication of this study across three independent laboratories, to address false-positive and false-negative results using microarray technology, is also discussed. We find greater than a thousand transcripts to be differentially expressed between cerebellum and cerebral cortex and very few transcripts to be differentially expressed between the two neocortical regions. We further characterized transcripts that were found to be specifically expressed within brain regions being compared and found that ontological classes representing signal transduction machinery, neurogenesis, synaptic transmission, and transcription factors were most highly represented.

The clinical teacher. A critical link in competence development

Regardless of market conditions, staff development personnel are responsible for helping to meet the organization's need for competent staff. Collaboration between the organization's education and clinical staff is essential to effect a successful transfer from having knowledge to performing effectively. One organization's response to the challenge of competence development, and how a successful transfer of learning can be achieved by collaboration between clinical educators and clinical staff is reported.

The influence of black English on diagnosis of reading in learning disabled and normal readers

This study investigated the removal of black English dialect features from the error scores of three oral reading tests—the Gray Oral Reading Test, the Gilmore Oral Reading Test, and the Spache Diagnostic Reading Scales. The 40 children in the sample population (20 control children matched by age and sex with 20 children identified by the school as learning disabled) were given all three tests. Each test was scored first using test manual criteria and then rescored using those criteria but eliminating from the error count any dialect miscue. On all three tests, LD children scored lower than control children. Also, the effect of removing dialect miscues as errors caused an overall increase in reading scores on all three tests. On the Gray and Spache tests, but not on the Gilmore test, control children benefited more from the removal of dialect responses as errors than LD children. Additionally, the results indicated that dialect had a greater impact on the scores of the Gilmore than it did on the Gray and Spache tests.