Children’s Adherence to Antiretroviral Therapy and Associated Factors: Multi-center Cross-sectional Study

Background- Sub- optimal adherence to antiretroviral therapy will lead drug resistance, treatment failure, clinical deterioration, death and failure to thrive in children. Studies conducted among children below 15 years old were limited in Ethiopia in general and in study area in particular. Therefore, this study was aimed to assess status of children’s adherence to ART and associated factors in study area. Methods- We conduct a facility-based cross-sectional study by including total of 282 children <15 years, who received Anti retro viral therapy for at least one month. All children/caregivers who were attending ART clinic during data collection period were consecutively recruited to the study. Both bivariate and multivariate logistic regression were performed. Result- Out of 282 caregivers included with their children, 226(80.2%) were females (mean age= 38.6 and SD = 12.35) and out of the total children, half (50%) were female and 246(87.2%) were between the ages 5–14 years (mean age= 8.5 and SD = 2.64). Two hundred forty six (87.2%) children had adherence status of ≥95% in the month prior to interview. Children whose caregivers were residing in urban were 3.3 (95% CI: 1.17, 9.63) times more adherent to ART than those whose caregivers were residing in rural. Children whose caregivers were biological parent were 2.37(95% CI: 1.59, 3.3) times more adherent than those whose caregivers were non biological parent. Also children of caregivers who were knowledgeable about ART treatment, were 4.5(95% CI: 1.79, 9.8) times more adherent to ART than their counter partsConclusion and recommendation- Adherence status of children in our study area was comparable. Being biological caregivers, residing in urban and knowledgeable about ART treatment were facilitate adherence to ART. Ongoing education about treatment and further study with multiple adherence assessment method were recommended.

The Stepparent Role: How It Is Defined and Negotiated in Stepfamilies in New Zealand

<p>Many children in New Zealand spend at least part of their lives growing up in stepfamilies. Yet despite the prevalence of stepfamilies and indications that they are increasing, there is little certainty regarding the parenting role stepparents should adopt to benefit their stepchildren the most. This ambiguity is further reflected in the law; with stepparents having few legal responsibilities to their stepchildren. This research sought to identify how individuals define and negotiate the stepparent‘s role in newly formed stepfamilies in New Zealand. Previous research and clinical practice indicates that how this role is defined is closely tied to stepfamily well-being. However there is still a great deal we do not understand about how stepfamily members construct this role, the nature of change over time, and how it is negotiated among stepfamily members. One hundred and five stepfamilies that had been cohabiting full-time for less than four years completed questionnaires assessing individual perceptions of stepparent roles and stepfamily functioning. Three stepfamily members completed questionnaires at two points in time, twelve months apart– a target stepchild between the ages of seven and eleven, the resident biological parent, and stepparent. Results suggest that stepparents, parents and children perceive stepparents to play active roles in both the warmth and control aspects of the stepparent role and these perceptions change minimally over a twelve-month period. When discrepancies between actual and ideal role scores were examined (intra-role discrepancies), all stepfamily members reported wanting the stepparent to be more involved in warmth behaviours than they actually were. However, although parents and stepparents reported ideally wanting stepparents to be more involved in control behaviours as well, children wanted them to be less involved in control behaviours than they were currently. Role discrepancies at time 1 were associated with aspects of stepfamily functioning at time 2, particularly for children.There was some evidence that role discrepancies reduced over time. In particular, stepparents and children reported lower inter-role discrepancies (higher role agreement) and stepparents and children both reported lower intra-role discrepancies over time. When role discrepancies between stepfamily members were examined (inter-role discrepancies), stepchildren reported wanting stepparents to be less involved in warmth and control dimensions than either parents or stepparents. Regression analyses revealed that children‘s inter and intra role discrepancies were significantly associated with their reports of stepfamily functioning twelve months later, after taking into account the stepparent‘s actual involvement. Adults in stepfamilies used various strategies to negotiate the stepparent role; including partner discussions, talks with children, checking in for feedback with children and biological parents, and gate keeping behaviours by the biological parent. Role negotiation was more likely to occur in the following twelve months when stepfamily functioning was more problematic at time 1, and there was some evidence that this led to improvements in functioning over time. This was not the case for gate keeping behaviours—while these were reported to be more frequently used when stepfamily functioning was problematic; they had a detrimental effect on the quality of the stepparent-stepchild relationships. These findings have important implications for organisations that work with, and make decisions affecting stepfamilies.</p>

The Stepparent Role: How It Is Defined and Negotiated in Stepfamilies in New Zealand

<p>Many children in New Zealand spend at least part of their lives growing up in stepfamilies. Yet despite the prevalence of stepfamilies and indications that they are increasing, there is little certainty regarding the parenting role stepparents should adopt to benefit their stepchildren the most. This ambiguity is further reflected in the law; with stepparents having few legal responsibilities to their stepchildren. This research sought to identify how individuals define and negotiate the stepparent‘s role in newly formed stepfamilies in New Zealand. Previous research and clinical practice indicates that how this role is defined is closely tied to stepfamily well-being. However there is still a great deal we do not understand about how stepfamily members construct this role, the nature of change over time, and how it is negotiated among stepfamily members. One hundred and five stepfamilies that had been cohabiting full-time for less than four years completed questionnaires assessing individual perceptions of stepparent roles and stepfamily functioning. Three stepfamily members completed questionnaires at two points in time, twelve months apart– a target stepchild between the ages of seven and eleven, the resident biological parent, and stepparent. Results suggest that stepparents, parents and children perceive stepparents to play active roles in both the warmth and control aspects of the stepparent role and these perceptions change minimally over a twelve-month period. When discrepancies between actual and ideal role scores were examined (intra-role discrepancies), all stepfamily members reported wanting the stepparent to be more involved in warmth behaviours than they actually were. However, although parents and stepparents reported ideally wanting stepparents to be more involved in control behaviours as well, children wanted them to be less involved in control behaviours than they were currently. Role discrepancies at time 1 were associated with aspects of stepfamily functioning at time 2, particularly for children.There was some evidence that role discrepancies reduced over time. In particular, stepparents and children reported lower inter-role discrepancies (higher role agreement) and stepparents and children both reported lower intra-role discrepancies over time. When role discrepancies between stepfamily members were examined (inter-role discrepancies), stepchildren reported wanting stepparents to be less involved in warmth and control dimensions than either parents or stepparents. Regression analyses revealed that children‘s inter and intra role discrepancies were significantly associated with their reports of stepfamily functioning twelve months later, after taking into account the stepparent‘s actual involvement. Adults in stepfamilies used various strategies to negotiate the stepparent role; including partner discussions, talks with children, checking in for feedback with children and biological parents, and gate keeping behaviours by the biological parent. Role negotiation was more likely to occur in the following twelve months when stepfamily functioning was more problematic at time 1, and there was some evidence that this led to improvements in functioning over time. This was not the case for gate keeping behaviours—while these were reported to be more frequently used when stepfamily functioning was problematic; they had a detrimental effect on the quality of the stepparent-stepchild relationships. These findings have important implications for organisations that work with, and make decisions affecting stepfamilies.</p>

Dissonant relationships to biological parents and stepparents and the well-being of adult children

We examined the importance of adult children’s ties with biological parents and stepparents for well-being in adulthood. We particularly focused on situations in which adult children are not close with the new partner of their biological parent, their stepparent. Following balance theory, it is straining to be in an unbalanced pattern (i.e., close to biological parent, not close to stepparent). Firstly, we studied how many adults are close to their biological parent only (dissonance), to both the biological parent and stepparent (positive consonance), or to neither parent in the stepfamily household (negative consonance). Secondly, we examined if the ties to biological parents and stepparents - as well as, the patterns between the two ties - were associated with the subjective well-being of the adult child. The OKiN data was used, which includes N = 1,477 adults with a stepfather and N = 1,274 adults with a stepmother. OLS regression models suggested that parent-child ties were important for depression and loneliness in adulthood, although associations with stepmother-child ties were insignificant. Moreover, the prevalence of dissonant ties was low, but the consequences for depression and loneliness were considerable. A distant or conflictual stepparent-child tie attenuated the benefits of having a close tie with the biological parent. Consequently, adult children in dissonant patterns are not necessarily better off in terms of well-being than those in negative consonant patterns.

Hak Waris Anak yang Dilahirkan melalui Perjanjian Surogasi

The development of technology in the medical world has led to surrogation methods as an alternative for married couples who cannot have children due to medical indications. Surrogation is an agreement between a woman and the husband and wife to become pregnant by donating the embryo of the husband and wife into the woman's womb and the child born is handed over to the husband and wife who make this agreement. This raises legal issues, namely how the existence of a surrogation agreement according to the health law and the Civil Code and how the inheritance rights of children born as a result of the surrogation agreement. This study uses normative research with a statutory and conceptual approach using primary, secondary and tertiary legal materials. The results of this study indicate that the existence of a surrogation agreement does not exist specifically, but based on the logic of argumentum a contrario, article 127 paragraph (1) letter a of the Health Law, article 40 paragraph (2) and article 43 paragraph (3) letter b Government regulations concerning reproductive health prohibits the practice of surrogation in Indonesia and the surrogation agreement is declared invalid according to article 1320 of the Civil Code because it does not meet the objective requirements. If the child is born, according to the Marriage Law, the child has the right to inherit to the surrogate woman's legal husband or to the surrogate woman and her family. However, if the child is adopted by the biological parent, the civil relationship between the child and the biological parent will be cut off and the right to inherit from the adoptive parent, in this case the biological parent of the child.

Grandparent Affection and Emotional Well-being of Adolescents with Different Family Types

Despite the increasing importance of grandparents in raising their grandchildren, few studies analyze the impact that these intergenerational relationships have on the grandchildren, especially during adolescence. With a sample of 3432 adolescents between 11 years and 16 years old, we analyze to what degree grandparent affection explains adolescent emotional well-being. The results reveal interesting findings according to family type: traditional two-parent families, families with joint custody, or families with only one biological parent (specifying between father or mother). Lastly, we analyze and discuss the implications of the relevant results related to the grandparents’ sex, lineage, and state of health, the adolescent’s age, as well as finding a higher impact of grandparent affection has on adolescents from families with only the father as a reference figure. This study advocates for reinforcing the role of the grandparents during adolescence, becoming especially relevant for boys and girls living in father-only families.

Family structure and children’s cognitive development

Previous research on family structure and child development has largely focused on the disadvantages faced by children who transitioned out of married families. However, we know less about how family structure affects child outcomes for children starting out in single-mother families. In this article, we use the kindergarten cohort of the Early Childhood Longitudinal Study to analyse children’s academic outcomes between kindergarten and eighth grade. We found that living in single-mother or step-families was clearly associated with lower test scores for children starting kindergarten in married biological-parent families, but the same disadvantages associated with living outside a married biological-parent family structure were not found for children starting kindergarten in single-mother families. We also found preliminary evidence of a buffering effect of maternal education in the relationship between family structure and children’s academic outcomes.

Sleep: population epidemiology and concordance in Australian children aged 11–12 years and their parents

ObjectivesTo describe objectively measured sleep characteristics in children aged 11–12 years and in parents and to examine intergenerational concordance of sleep characteristics.DesignPopulation-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children.SettingData were collected between February 2015 and March 2016 across assessment centres in Australian major cities and selected regional towns.ParticipantsOf the participating CheckPoint families (n=1874), sleep data were available for 1261 children (mean age 12 years, 50% girls), 1358 parents (mean age 43.8 years; 88% mothers) and 1077 biological parent–child pairs. Survey weights were applied and statistical methods accounted for the complex sample design, stratification and clustering within postcodes.Outcome measuresParents and children were asked to wear a GENEActive wrist-worn accelerometer for 8 days to collect objective sleep data. Primary outcomes were average sleep duration, onset, offset, day-to-day variability and efficiency. All sleep characteristics were weighted 5:2 to account for weekdays versus weekends. Biological parent–child concordance was quantified using Pearson’s correlation coefficients in unadjusted models and regression coefficients in adjusted models.ResultsThe mean sleep duration of parents and children was 501 min (SD 56) and 565 min (SD 44), respectively; the mean sleep onset was 22:42 and 22:02, the mean sleep offset was 07:07 and 07:27, efficiency was 85.4% and 84.1%, and day-to-day variability was 9.9% and 7.4%, respectively. Parent–child correlation for sleep duration was 0.22 (95% CI 0.10 to 0.28), sleep onset was 0.42 (0.19 to 0.46), sleep offset was 0.58 (0.49 to 0.64), day-to-day variability was 0.25 (0.09 to 0.34) and sleep efficiency was 0.23 (0.10 to 0.27).ConclusionsThese normative values for objective sleep characteristics suggest that, while most parents and children show adequate sleep duration, poor-quality (low efficiency) sleep is common. Parent–child concordance was strongest for sleep onset/offset, most likely reflecting shared environments, and modest for duration, variability and efficiency.