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Journal of Translational Medicine Oct 2015A great deal of attention has been focused on adverse effects of tobacco smoking on conception, pregnancy, fetal, and child health. The aim of this paper is to discuss... (Review)
Review
A great deal of attention has been focused on adverse effects of tobacco smoking on conception, pregnancy, fetal, and child health. The aim of this paper is to discuss the current evidence regarding short and long-term health effects on child health of parental smoking during pregnancy and lactation and the potential underlying mechanisms. Studies were searched on MEDLINE(®) and Cochrane database inserting, individually and using the Boolean ANDs and ORs, 'pregnancy', 'human lactation', 'fetal growth', 'metabolic outcomes', 'obesity', 'cardiovascular outcomes', 'blood pressure', 'brain development', 'respiratory outcomes', 'maternal or paternal or parental tobacco smoking', 'nicotine'. Publications coming from the reference list of studies were also considered from MEDLINE. All sources were retrieved between 2015-01-03 and 2015-31-05. There is overall consistency in literature about negative effects of fetal and postnatal exposure to parental tobacco smoking on several outcomes: preterm birth, fetal growth restriction, low birth weight, sudden infant death syndrome, neurodevelopmental and behavioral problems, obesity, hypertension, type 2 diabetes, impaired lung function, asthma and wheezing. While maternal smoking during pregnancy plays a major role on adverse postnatal outcomes, it may also cumulate negatively with smoking during lactation and with second-hand smoking exposure. Although this review was not strictly designed as a systematic review and the PRISMA Statement was not fully applied it may benefit the reader with a promptly and friendly readable update of the matter. This review strengthens the need to plan population health policies aimed to implement educational programs to hopefully minimize tobacco smoke exposure during pregnancy and lactation.
Topics: Adolescent; Asthma; Brain; Cardiovascular Diseases; Child; Child Behavior Disorders; Child, Preschool; Diabetes Mellitus, Type 2; Fathers; Female; Fetal Development; Fetal Growth Retardation; Humans; Infant; Infant, Newborn; Lactation; Male; Maternal Exposure; Mothers; Obesity; Paternal Exposure; Pregnancy; Prenatal Exposure Delayed Effects; Respiration Disorders; Smoking; Tobacco Smoke Pollution
PubMed: 26472248
DOI: 10.1186/s12967-015-0690-y -
The Cochrane Database of Systematic... May 2014Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing.
OBJECTIVES
To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence).
SEARCH METHODS
We searched the following databases on 5 December 2011: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005.
SELECTION CRITERIA
We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo.
DATA COLLECTION AND ANALYSIS
At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation.
MAIN RESULTS
We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction.
AUTHORS' CONCLUSIONS
The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.
Topics: Anxiety; Depression; Female; Humans; Maternal Behavior; Maternal Welfare; Mother-Child Relations; Parenting; Parents; Paternal Behavior; Program Evaluation; Randomized Controlled Trials as Topic; Self Concept
PubMed: 24838729
DOI: 10.1002/14651858.CD002020.pub4 -
The Cochrane Database of Systematic... Jun 2012Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Parental psychosocial health can have a significant effect on the parent-child relationship, with consequences for the later psychological health of the child. Parenting programmes have been shown to have an impact on the emotional and behavioural adjustment of children, but there have been no reviews to date of their impact on parental psychosocial wellbeing.
OBJECTIVES
To address whether group-based parenting programmes are effective in improving parental psychosocial wellbeing (for example, anxiety, depression, guilt, confidence).
SEARCH METHODS
We searched the following databases on 5 December 2012: CENTRAL (2011, Issue 4), MEDLINE (1950 to November 2011), EMBASE (1980 to week 48, 2011), BIOSIS (1970 to 2 December 2011), CINAHL (1982 to November 2011), PsycINFO (1970 to November week 5, 2011), ERIC (1966 to November 2011), Sociological Abstracts (1952 to November 2011), Social Science Citation Index (1970 to 2 December 2011), metaRegister of Controlled Trials (5 December 2011), NSPCC Library (5 December 2011). We searched ASSIA (1980 to current) on 10 November 2012 and the National Research Register was last searched in 2005.
SELECTION CRITERIA
We included randomised controlled trials that compared a group-based parenting programme with a control condition and used at least one standardised measure of parental psychosocial health. Control conditions could be waiting-list, no treatment, treatment as usual or a placebo.
DATA COLLECTION AND ANALYSIS
At least two review authors extracted data independently and assessed the risk of bias in each study. We examined the studies for any information on adverse effects. We contacted authors where information was missing from trial reports. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation.
MAIN RESULTS
We included 48 studies that involved 4937 participants and covered three types of programme: behavioural, cognitive-behavioural and multimodal. Overall, we found that group-based parenting programmes led to statistically significant short-term improvements in depression (standardised mean difference (SMD) -0.17, 95% confidence interval (CI) -0.28 to -0.07), anxiety (SMD -0.22, 95% CI -0.43 to -0.01), stress (SMD -0.29, 95% CI -0.42 to -0.15), anger (SMD -0.60, 95% CI -1.00 to -0.20), guilt (SMD -0.79, 95% CI -1.18 to -0.41), confidence (SMD -0.34, 95% CI -0.51 to -0.17) and satisfaction with the partner relationship (SMD -0.28, 95% CI -0.47 to -0.09). However, only stress and confidence continued to be statistically significant at six month follow-up, and none were significant at one year. There was no evidence of any effect on self-esteem (SMD -0.01, 95% CI -0.45 to 0.42). None of the trials reported on aggression or adverse effects.The limited data that explicitly focused on outcomes for fathers showed a statistically significant short-term improvement in paternal stress (SMD -0.43, 95% CI -0.79 to -0.06). We were unable to combine data for other outcomes and individual study results were inconclusive in terms of any effect on depressive symptoms, confidence or partner satisfaction.
AUTHORS' CONCLUSIONS
The findings of this review support the use of parenting programmes to improve the short-term psychosocial wellbeing of parents. Further input may be required to ensure that these results are maintained. More research is needed that explicitly addresses the benefits for fathers, and that examines the comparative effectiveness of different types of programme along with the mechanisms by which such programmes bring about improvements in parental psychosocial functioning.
Topics: Anxiety; Depression; Emotions; Female; Humans; Maternal Behavior; Maternal Welfare; Mother-Child Relations; Parenting; Parents; Paternal Behavior; Program Evaluation; Randomized Controlled Trials as Topic; Self Concept
PubMed: 22696327
DOI: 10.1002/14651858.CD002020.pub3 -
AIDS Care 2012The number of children losing one or both parents to HIV/AIDS has continued to rise in the past decade, with most of them being school-aged children. This study reviews... (Review)
Review
The number of children losing one or both parents to HIV/AIDS has continued to rise in the past decade, with most of them being school-aged children. This study reviews global literature on the effects of HIV/AIDS (e.g., parental HIV-related illness or death) on children's schooling. Systematic review procedures generated 23 studies for examination. Existing studies show educational disadvantages among children affected by AIDS in various educational outcomes, including school enrollment and attendance, school behavior and performance, school completion, and educational attainment. A number of individual and contextual factors potentially moderate or mediate the effect of HIV/AIDS on children's education. These factors include gender of child, pattern of parental loss (maternal vs. paternal vs. dual), living arrangement (relationship with caregivers, gender of the household head), and household poverty. Current literature indicates limitations in number and scope of existing studies and in educational outcome measurements. There is a lack of studies with longitudinal design and data collection from multiple sources (e.g., students, teachers, caregivers), and a lack of studies on the relationship between psychosocial well-being of children affected by AIDS and their educational outcomes. Future studies need to employ more rigorous methodology and incorporate both individual and contextual factors for children affected by AIDS in various regions. More efforts are needed to design and implement culturally appropriate and context-specific approaches to improve the educational outcomes of children affected by AIDS.
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adolescent Development; Adult; Child; Child Development; Education; Educational Status; Female; HIV Infections; Humans; Male; Parents; Risk Factors; Young Adult
PubMed: 22519300
DOI: 10.1080/09540121.2012.668170 -
Psychological Bulletin Mar 2012Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental... (Meta-Analysis)
Meta-Analysis Review
Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental incarceration, including traumatic separation, loneliness, stigma, confused explanations to children, unstable childcare arrangements, strained parenting, reduced income, and home, school, and neighborhood moves. Children of incarcerated parents often have multiple, stressful life events before parental incarceration. Theoretically, children with incarcerated parents may be at risk for a range of adverse behavioral outcomes. A systematic review was conducted to synthesize empirical evidence on associations between parental incarceration and children's later antisocial behavior, mental health problems, drug use, and educational performance. Results from 40 studies (including 7,374 children with incarcerated parents and 37,325 comparison children in 50 samples) were pooled in a meta-analysis. The most rigorous studies showed that parental incarceration is associated with higher risk for children's antisocial behavior, but not for mental health problems, drug use, or poor educational performance. Studies that controlled for parental criminality or children's antisocial behavior before parental incarceration had a pooled effect size of OR = 1.4 (p < .01), corresponding to about 10% increased risk for antisocial behavior among children with incarcerated parents, compared with peers. Effect sizes did not decrease with number of covariates controlled. However, the methodological quality of many studies was poor. More rigorous tests of the causal effects of parental incarceration are needed, using randomized designs and prospective longitudinal studies. Criminal justice reforms and national support systems might be needed to prevent harmful consequences of parental incarceration for children.
Topics: Adolescent; Adult; Antisocial Personality Disorder; Australasia; Child; Child Behavior; Child, Preschool; Educational Status; Europe; Female; Humans; Juvenile Delinquency; Life Change Events; Male; Maternal Deprivation; Mental Disorders; Parent-Child Relations; Parents; Paternal Deprivation; Prisoners; Prisons; Psychology, Child; Research Design; Risk Factors; Social Stigma; Stress, Psychological; Substance-Related Disorders; United States
PubMed: 22229730
DOI: 10.1037/a0026407 -
Archives of Pediatrics & Adolescent... Jan 2012A systematic review and meta-analysis of studies of the association between secondhand tobacco smoke (SHTS) and middle ear disease (MED) in children. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
A systematic review and meta-analysis of studies of the association between secondhand tobacco smoke (SHTS) and middle ear disease (MED) in children.
DATA SOURCES
MEDLINE, EMBASE, and CAB abstracts (through December 2010) and reference lists.
STUDY SELECTION
Sixty-one epidemiological studies of children assessing the effect of SHTS on outcomes of MED. Articles were reviewed, and the data were extracted and synthesized by 2 researchers. MAIN OUTCOME EXPOSURES: Children's SHTS exposure.
MAIN OUTCOME MEASURES
Middle ear disease in children.
RESULTS
Living with a smoker was associated with an increased risk of MED in children by an odds ratio (OR) of 1.62 (95% CI, 1.33-1.97) for maternal postnatal smoking and by 1.37 (95% CI, 1.25-1.50) for any household member smoking. Prenatal maternal smoking (OR, 1.11; 95% CI, 0.93-1.31) and paternal smoking (OR, 1.24; 95% CI, 0.98-1.57) were associated with a nonsignificant increase in the risk of MED. The strongest effect was on the risk of surgery for MED, where maternal postnatal smoking increased the risk by an OR of 1.86 (95% CI, 1.31-2.63) and paternal smoking by 1.83 (95% CI, 1.61-2.07).
CONCLUSIONS
Exposure to SHTS, particularly to smoking by the mother, significantly increases the risk of MED in childhood; this risk is particularly strong for MED requiring surgery. We have shown that per year 130 200 of child MED episodes in the United Kingdom and 292 950 of child frequent ear infections in the United States are directly attributable to SHTS exposure in the home.
Topics: Child; Female; Humans; Maternal Behavior; Odds Ratio; Otitis Media; Paternal Behavior; Pregnancy; Prenatal Exposure Delayed Effects; Regression Analysis; Risk; Tobacco Smoke Pollution
PubMed: 21893640
DOI: 10.1001/archpediatrics.2011.158 -
The Cochrane Database of Systematic... Jan 2009Many learning needs arise in the early postpartum period and it is important to examine interventions being used to educate new parents about caring for themselves and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Many learning needs arise in the early postpartum period and it is important to examine interventions being used to educate new parents about caring for themselves and their newborns during this time.
OBJECTIVES
To assess the effects of structured postnatal education delivered by an educator to an individual or group on maternal/paternal and infant outcomes and health services, and whether the effects of structured postnatal education vary by length or type of intervention and by population.
SEARCH STRATEGY
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2007), MEDLINE (1950 to September 2007), CINAHL (1982 to September 2007), ERIC (1966 to September 2007), HealthSTAR (1966 to September 2007), PsycINFO (1806 to September 2007), Sociological Abstracts (1974 to September 2007), ClinicalTrials.gov (August 2007), Current Controlled Trials (August 2007), Trialscentral.org (August 2007) and The National Research Register (August 2007).
SELECTION CRITERIA
We included randomized controlled trials of any structured postnatal education provided by an educator to individual parents or groups of parents within the first two months post birth related to the care of an infant or of the family. We excluded studies of educational interventions for parents of infants in neonatal intensive care units.
DATA COLLECTION AND ANALYSIS
Both authors assessed trial quality and extracted data from published reports.
MAIN RESULTS
We included 14 trials (2934 women) and excluded 24. Of the 14 included studies, education tested included: four on infant sleep enhancement, four on infant behaviour, two on general post-birth health, three on infant safety, and one on father involvement/skills with infants. Details of the randomization procedures, allocation concealment, blinding of outcome assessors, and/or participant accrual/loss were often not reported. Of the outcomes analyzed, only five were measured similarly enough by more than one study to be combined in meta-analyses and these included the same two studies. Of these five meta-analyses, only one was found to have a low enough level of heterogeneity to provide an overall estimate of effect; education on sleep enhancement resulted in a mean difference of 29 more minutes of sleep in 24 hours (95% confidence interval 18.53 to 39.73) than usual care.
AUTHORS' CONCLUSIONS
The benefits of educational programs to participants and their newborn infants remain unclear. Education on sleep enhancement appears to increase infant sleep although more and larger studies are needed to confirm this.
Topics: Adult; Child Development; Female; Health Behavior; Humans; Infant Welfare; Infant, Newborn; Male; Parent-Child Relations; Parenting; Postpartum Period; Randomized Controlled Trials as Topic; Sleep
PubMed: 19160230
DOI: 10.1002/14651858.CD004068.pub2 -
Journal of Family Psychology : JFP :... Dec 2007Research on parenting has generally focused on mothers, with fathers' parenting approaches and interventions for fathers being relatively less studied. To investigate... (Review)
Review
Research on parenting has generally focused on mothers, with fathers' parenting approaches and interventions for fathers being relatively less studied. To investigate the involvement of fathers in behavioral parent training (BPT), the literature on BPT for attention-deficit/hyperactivity disorder (ADHD) was reviewed. A systematic review of this literature (N = 32) indicated that the majority of research studies are composed of mothers as participants in treatment and raters of outcome (87% of reviewed studies did not include information on father-related outcomes). Present barriers to father participation in BPT (e.g., content of classes, characteristics of fathers) are discussed. Strategies for increasing father participation are offered and include establishing the expectation that fathers will be involved in treatment at initial clinical contacts, collecting treatment-related information from both parents, conducting BPT classes that focus on issues of direct relevance to fathers, and integrating parent-child interactions in recreational settings into BPT programs.
Topics: Attention Deficit Disorder with Hyperactivity; Behavior Therapy; Father-Child Relations; Fathers; Humans; Male; Parenting; Paternal Behavior
PubMed: 18179340
DOI: 10.1037/0893-3200.21.4.683 -
Journal of Advanced Nursing Jul 2006This paper reports a systematic review of the effectiveness of interventions for fathers with infants or toddlers. (Review)
Review
AIM
This paper reports a systematic review of the effectiveness of interventions for fathers with infants or toddlers.
BACKGROUND
Nurses and other healthcare professionals work closely with families of infants and young children. This contact provides an opportunity to promote positive parent-child interactions and optimal child development. Previous research has demonstrated that interventions with mothers of infants can be effective in promoting sensitive, responsive parent-child interactions and positive child development. Recent research has indicated that fathers also contribute to child development, but little is known about what types of interventions with fathers are effective in promoting sensitive, responsive father-child interactions.
METHODS
Literature from 1983 to 2003 in the Medline, CINAHL, and PsycINFO databases was searched to locate intervention studies published in English that included a control group or used a pretest and post-test design; measured an aspect of father-child interaction; analysed father outcomes separately from mother outcomes; had a sample greater than one; and included infants or toddlers. Additional studies were located by cross-checking reference lists.
RESULTS
Fourteen papers describing 12 interventions met the inclusion criteria. The interventions included infant massage, observation and modelling of behaviour with infant, kangaroo care, participation with child in a preschool programme, discussion groups, and parent training programmes.
CONCLUSION
Although the number of intervention studies is limited, there is evidence that, if interventions involve active participation with or observation of the father's own child, the intervention may be effective in enhancing the father's interactions with the child and a positive perception of the child. There is less information on how interventions influence child development. More research is needed to determine the influence of interventions over time, the differential influence on mothers and fathers, and the optimal dose of intervention required.
Topics: Child Development; Child, Preschool; Father-Child Relations; Fathers; Humans; Infant; Infant, Newborn; Male; Mothers; Parenting; Paternal Behavior; Randomized Controlled Trials as Topic; Research Design
PubMed: 16866816
DOI: 10.1111/j.1365-2648.2006.03896.x