Is Distribution a Problem in Iron-Folic Acid Consumption in India? An Exploration of District Level Household Survey

Aims: Anemia accounts for 40% of maternal deaths in India. In order to address this problem, the Government of India implemented the largest programme with the greatest potential to reduce maternal mortality by free distribution of Iron-Folic Acid (IFA) supplementations especially during Antenatal Care (ANC) visits. But the major concern among the policymakers and researchers has been poor adherence to the supplement among pregnant women. However, we tend to think that given the severity of the problem, there is no investigation on the adherence issue. Hence, the aim of the paper is to understand whether IFA consumption by pregnant women in India is largely a distribution problem of IFA supplements through ANC. Background: The distribution of Iron-Folic Acid (IFA) supplementation is not working especially through Antenatal Care (ANC) attendance. The program implementers believe that it is because of lack of adherence to IFA supplements by pregnant women. It is important to investigate the problem before any policy changes are made without proper evidence. Objectives: The purpose of this study is to examine whether the problem of IFA consumption by pregnant women is due to the problem of public distribution of IFA supplements through ANC attendance. Methods: This study had used the fourth round of District Level Household Survey data, which collects information on IFA supplements, their distribution and consumption. Bivariate and tri-variate analyses were used to understand the relationship between IFA distribution to pregnant women and their consumption patterns in 19 Indian states and two Union Territories (UTs) of pregnant women (88,487) and between the age of 15-49 years. Results: In almost all the states except Chhattisgarh, more than 75% of the pregnant women consumed 100 or more IFA supplements when they received 100 or more IFA supplements from providers. Similar is the case even among those women who received 100 or more IFA supplements through 1 or 2 ANC attendance except Arunachal Pradesh (60%), Meghalaya (67%), Pondicherry (57%) and Andaman and Nicobar (0%). The consumption of IFA supplements among pregnant women gets better than 75% if they receive 100 or more supplements only after attending three or more ANCs. Conclusion: It seems that distribution is a problem in the consumption of IFA supplements by pregnant women in India. Full antenatal attendance by the women could be part of the problem but not supplying at least 100 IFA supplementations to even those who attend ANC due to stock-outs and ineffective management is a serious concern. Hence, Governments should distribute at least the recommended 100 IFA supplements to the women in their 1st ANC attendance to address anaemia.

Parent-Child Interaction Therapy for Children with Autism Spectrum Disorder: Research, Training, and Clinical Considerations

This research briefly promotes the inclusion of Parent-Child Interaction Therapy (PCIT) for children with Autism Spectrum Disorder (ASD) in a continuum of empirically-supported ASD treatments. PCIT is a manualized, short-term intervention that improves child compliance and the caregiver-child bond, and is an empirically-supported treatment backed by over 40 years of research. Caregivers are often unprepared to handle the needs of children with ASD presenting with comorbid behavioral problems. As a result, families frequently require mental health services for their children on the autism spectrum; however, access to empirically supported treatments for these families is limited. Furthermore, many mental health providers feel unequipped to treat this special population. Families with children on the autism spectrum are in desperate need of quality, time-limited, evidence-based treatments targeting disruptive behaviors. PCIT is a well-established treatment for disruptive behaviors that represents a promising treatment for complementing other evidenced-based ASD services. Research shows that after PCIT, children with ASD demonstrate improvements in disruptive behavior, social awareness, adaptability, and positive affect. Currently, the PCIT-ASD literature provides a case for conducting PCIT with preschool children who are in the higher functioning range of the autism spectrum (Levels 1 and 2) and display comorbid behavioral problems. Providing PCIT clinicians with training about the special needs of children with ASD could lead to improved access to services for this population. This paper accomplishes the following objectives: 1) Provides an overview of PCIT, 2) Summarizes the PCIT-ASD research, 3) Reviews PCIT-ASD clinical considerations and training requirements, and 3) Suggests future directions for PCIT-ASD research.

Building Connections: Reducing Social Isolation for Mothers in Culturally and Linguistically Diverse Communities through a Sharing and Learning Group

Background: Social isolation is an everyday experience for many mothers and children within culturally and linguistically diverse communities. Engaging in group experiences with others provides authentic opportunities to make social connections, along with sharing common interests. Aim: This paper reports on a project that involved working within a transdisciplinary team at a community group in Brisbane, Australia. The Women and Children’s Learning and Sharing Community Group was a targeted program to foster mental health and feelings of well-being for mothers and children who were identified as at risk of social isolation. Methods: Semi-structured, audio-recorded interviews were conducted to gain the experiences of being involved in the community group from the perspectives of mothers and support workers. Summative Content Analysis is used to explore the transcribed accounts of the mothers and support workers who came together at the women’s sharing and learning group and, in particular, how the group facilitated growth-fostering connections to reduce the impact of social isolation. Results: Using a Relational-Cultural Theory and a Relational Agency Framework lens, thematic Content Analysis of the mothers’ accounts reveal three themes of 1) Freedom, 2) Connection, and 3) Transformation. Exploration of mothers and support workers’ accounts highlighted four interactional elements as foundational to the program: 1) Respecting Group Identity, 2) Building a relaxed, mother-focused, and child-inclusive atmosphere, 3) Respecting diversity and the mutual enhancement of competence and 4) Fostering positives and strengths of the members. Conclusion: Recommendations are provided when working with culturally and linguistically diverse communities include: 1) Provide concrete support; 2) Make use of participants’ strengths and partnerships, 3) Provide culturally sensitive and inclusive practice, 4) Build a sense of community, mutual support and connections. Proposed key learnings highlight the importance of transdisciplinary teams and strength-based approaches when working in culturally and linguistically diverse communities.

“Fostering” Effective Foster Parent Training Programs : Parent-Child Interaction Therapy Adaptations for the Child Welfare Setting

Foster parents face considerable challenges in caring for children in the child welfare system, many of whom have significant behavioral difficulties [1]. Foster parents often lack the training and support needed to manage these externalizing behaviors, which contribute to parenting stress and are highly predictive of placement breakdowns [2, 3]. Although child welfare agencies provide foster parents with pre-service training experiences, they often lack the capacity and financial resources to implement gold standard, evidence-based interventions that address child behavior difficulties. Parent-Child Interaction Therapy (PCIT) has been well-established as an empirically supported treatment for disruptive behavior, yet standard delivery of PCIT to children in the foster care system is often impractical due to time, financial, childcare, and personnel constraints. Adaptations of PCIT for the foster care setting may remove some of these barriers to treatment. These adaptations have typically retained the parent-coaching principles inherent to PCIT but replaced the traditional 12- to 20-week format with a shorter, less intensive treatment regimen in order to maintain feasibility within the child welfare context. Preliminary findings from studies using abbreviated formats of PCIT suggest effectiveness of such adaptations in reducing externalizing behavior in foster children and maintaining behavioral improvements several months after the end of the treatment.

Areas for Reforming and Complementing the Family and School Interaction

Background: The Family and School Interaction (FSI) is undoubtedly very effective in promoting the education of children in a society, but this interaction requires the adoption of educational goals as well as frameworks that can produce the best educational outcomes. The educational goals and frameworks, on the one hand, depend on the theoretical foundations and our view of the educational role and position of the family and its relation to that of the school, and on the other hand the environmental conditions and opportunities or challenges for the FSI. Aim: The overall purpose of the present study is to explore the areas and ways of reforming and complementing the FSI. Methods: The study is a qualitative research relying on analyzing the views of Iranian family and education experts. The areas under consideration for reforming and complementing the FSI are the school curricula, and the study examines the role of the family in the most important elements of a curriculum, namely objectives, content, method and evaluation. Results: The results show that most scholars, professionals, principals, and teachers consider the educational role of the family and its contribution to school education, but their beliefs about this role and its status in relation to that of the school are still unclear. They have often become accustomed to giving the less importance to the family and the most important to the school, and the curricula are often formulated without considering the views and expectations of the family and without parental involvement. Conclusion: The consideration of the real role of the family and its lasting effects have important implications, including reforming the family education programs, reforming the academic education and in-service teacher trainings, modifying the FSI models, rationalizing the family interventions in school affairs, as well as enhancing the students’ self-esteem and their sense of belonging to school.

The Edinburgh Postnatal Depression Scale: Model Comparison of Factor Structure and its Psychosocial Correlates Among Mothers at One Month After Childbirth in Japan

Background:The Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden & Sagovsky, 1987) has been widely used as a screening instrument. It is also used as a measure of Postnatal Depression (PND) severity. Various EPDS factor structure models have been proposed in many studies without an unequivocal conclusion. We compared first-order, higher-order factor, and bifactor models of the EPDS, and examined possible predictors of subscales by Structural Equation Modelling (SEM).Methods:Data came from a follow-up study of 758 women after childbirth on two occasions (five days and one month postnatal). We used the EPDS together with items tapping Negative Life Events (NLEs) and coping styles and behaviours.Results:The bifactor model showed the best fit with data compared with all other models: CFI = 0.999, RMSEA = 0.14, and AIC = 79.637. A single general dimension alongside three distinct subfactors (anhedonia, anxiety, and dysphoria) was predicted differentially by various predictor variables.Conclusion:Our study expanded on a previous factor structural study of the EPDS and developed the hierarchical (bifactor) model. The model’s construct validity was confirmed by its meaningful associations with NLEs and coping styles and behaviours.

The Relationship between Peer Victimization, Perceived Parental Support, Family Characteristics and Internalizing Symptoms. A Cross-Sectional Study

Background: Bullying and peer victimization are important, yet underestimated public health issues. Methods: Data were obtained in a sample of N=3454 children at the age of 12.6 (+/- 1.3) in Austria. 75% of the participants were not involved in bullying (uninvolved), 16% were victims, 4% bully/victims and 5% bullies. We applied a multivariate regression model relating to gender, established a classification into bullying and victimization, and investigated parental behavior, family characteristics, physical or mental illness of a parent, as well as internalizing symptoms of pupils. Results: Our data analysis demonstrated gender-related effects and the development of internalizing symptoms: Boys showed fewer internalizing symptoms than girls. Pupils with low perceived parental support displayed higher symptomatic scores. The variables of family break-up and parental health led to similar observations. Victims have an approximately 30% higher score on the internalizing scale than bullies and 60% higher scores than uninvolved. The results of the regression model indicated that these predictors explained 25% of the variance. Conclusion: School policies, teachers, parents, the media, school physicians, as well as GPs must recognize early warning signs of bullying and diligently assess risk behaviors. Early social support (by parents and teachers) is discussed as an important protective factor.

Recent Trends of Marriage in Iran

Background:In Iran, historically, establishing, maintaining, and continuing family units have been perpetuated through the development of strong ideals about marriage and reproduction that are integrated with Islamic values. Despite the long tradition of marriage as the foundation of both family and society, the data show there are declines in both the rate and the number of marriages. The popular belief among both laymen and social scientists is that, while there has been a decline in permanent marriages, there has been an increase in the number of what can be called temporary marriages. There are no data demonstrating trends in these marriages.Methods:In this paper, we present data on the declining trend in marriage and review the literature on factors considered as a barrier toward marriage. In addition, we examine data from a snowball sample of couples involved in temporary marriages orSighe.Results:Our analysis suggests that those in such marriages may generally ignore or defy cultural prescriptions and proscriptions about marriage, seemingly reflecting a more modernistic view.Conclusion:From this perspective, we suggest that both recorded and non-recorded temporary marriages may reflect changing attitudes that stress individualism, autonomy, and secularism and, particularly for the young who are engaged inSighe, the postponing of parenthood and, indeed, of adulthood.

Possibilities for Home and School Partnering Interactions Among Children with Emotional and Behavioral Disorders and Attachment Issues

Background: Students with Emotional Behavioral Disorder (EBD) and those with attachment issues, such as Reactive Attachment Disorder (RAD), present school professionals with some of the most challenging behaviors experienced in schools. Family participation can be critical for promoting positive outcomes for children with behavioral concerns. Positive school and family partnering interactions can positively impact students behaviorally, academically, and socially. Objective: This article aims to provide an introductory framing for this special issue regarding school and family partnering interactions among students with EBD, including those with attachment issues, such as RAD. Method: Qualitative research was employed to consider this topic across included special issue articles. Conclusion: A variety of studies showcase ways of effectively attending to the experiences of students with EBD and RAD and their families. There is further much that might be gained by making use of an interdisciplinary lens for approaching this issue, such as from the perspective of education, psychotherapy, educational psychology, and family studies. This multi-perspectival approach might contribute to the life quality and success of youth with EBD and RAD and their families.

Attachment Aware Schools: Working with Families to Enhance Parental Engagement and Home-School Relationships

Background:Application of attachment theory in school contexts lacks empirical evidence. The Attachment Aware Schools pilot project was commissioned by two Local Authorities in England to improve the educational outcomes of Looked After Children, and to build an evidence base. Informed by attachment research, the Attachment Aware Schools program provides a coherent and integrated theoretical framework, discourse, and practice for all practitioners working with children and young people.Objective:The primary focus was to provide whole school and targeted attachment-based strategies to support children’s well-being, behavior, and academic attainment. This paper; however, documents a secondary objective, which was to facilitate collaborative partnerships with families.Method:As part of the mixed methods approach to the Attachment Aware Schools project, a series of case studies were collected and thematically coded. The case studies were generated by practitioners using an outcomes-based framework.Results:Although the case study sample size is small (N=10), the case studies presented here illustrate how the Attachment Aware Schools program can promote increased home-school engagement and shared practice between home and school. Outcomes include improved home-school relationships, reductions in behavioral incidents, and improved family dynamics.Conclusion:Attachment Aware Schools can be a vehicle for facilitating supportive home-school collaborative partnerships with positive outcomes for vulnerable children and young people.