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To characterize caregiver experiences in the context of advanced pediatric cancer by identifying individual (i.e., demographic factors, stress) and family context factors (i.e., family roles, social support) associated with caregiver strain.
Methods
Families of children (ages 5–25) with advanced cancer (i.e., physician-estimated prognosis < 60%, relapsed/refractory disease) were recruited from a large children’s hospital. Mothers (n = 55; 87% White) and fathers (n = 30; 83% White) reported on their caregiver strain, cancer-specific stress, general stress, social support, division of 7 family roles (e.g., medical care of ill child, household chores), and their satisfaction with each role.
Results
Parents reported moderate caregiver strain, cancer-specific stress, and general stress, and high social support and satisfaction with family roles. Fathers reported family roles were shared equally, whereas mothers reported either sharing roles or completing them independently. When accounting for income and partnership status, greater caregiver strain for mothers was associated with greater general stress, greater satisfaction with family roles, and lower social support. For fathers, greater caregiver strain was associated only with greater cancer-specific stress.
Significance of results
In the context of advanced pediatric cancer, fathers may experience caregiver strain as cancer-specific stress increases, whereas mothers’ strain may depend on broader family and social factors. Psychosocial providers should address general and cancer-specific stress within families, and provide resources for enhancing mothers’ social support. Additional research is needed with larger, more diverse samples to inform future intervention approaches.
Extension is uniquely positioned to reach and support underserved and underrepresented families. Although Extension excels at providing evidence-based programming for mothers, children, and youth, it has generally been less successful in engaging fathers. Recent evidence finds increased balanced sharing of caregiving responsibilities and fathers’ desire to engage with their children. Engaging fathers and incorporating father-centric programming is more important than ever. This chapter will highlight promising strategies for engaging fathers in Extension, including an example of a statewide needs assessment, technology-based programming, and community-based partnerships. We describe available evidence-based programs and approaches, both currently utilized with fathers and aptly positioned to accommodate fathers, along with promising opportunities and important considerations for Extension moving forward. Shifting the focus to better serve fathers in family-based programming will better engage and support underserved and vulnerable families, and Extension is a system that is critically important for meeting this challenge.
There are little reported data on the perspectives of fathers caring for children with chronic conditions. Although survival of children with advanced heart disease has improved, long-term morbidity remains high. This study describes the experience and prognostic awareness of fathers of hospitalised children with advanced heart disease.
Methods:
Cross-sectional survey study of parents caring for children hospitalised with advanced heart disease admitted for ≥ 7 days over a one-year period. One parent per patient completed surveys, resulting in 27 father surveys. Data were analysed using descriptive methods.
Results:
Nearly all (96%) of the fathers reported understanding their child’s prognosis “extremely well” or “well,” and 59% felt they were “very prepared” for their child’s medical problems. However, 58% of fathers wanted to know more about prognosis, and 22% thought their child’s team knew something about prognosis that they did not. Forty-one per cent of fathers did not think that their child would have lifelong limitations, and 32% anticipated normal life expectancies. All 13 fathers who had a clinical discussion of what would happen if their child got sicker found this conversation helpful. Nearly half (43%) of the fathers receiving new prognostic information or changes to treatment course found it “somewhat” or “a little” confusing.
Conclusions:
Fathers report excellent understanding of their child’s illness and a positive experience around expressing their hopes and fears. Despite this, there remain many opportunities to improve communication, prognostic awareness, and participation in informed decision-making of fathers of children hospitalised with advanced heart disease.
Previous research on infant-directed speech (IDS) and its role in infants’ language development has largely focused on mothers, with fathers being investigated scarcely. Here we examine the acoustics of IDS as compared to adult-directed speech (ADS) in Norwegian mothers and fathers to 8-month-old infants, and whether these relate to direct (eye-tracking) and indirect (parental report) measures of infants’ word comprehension. Forty-five parent-infant dyads participated in the study. Parents (24 mothers, 21 fathers) were recorded reading a picture book to their infant (IDS), and to an experimenter (ADS), ensuring identical linguistic context across speakers and registers. Results showed that both mothers’ and fathers’ IDS had exaggerated prosody, expanded vowel spaces, as well as more variable and less distinct vowels. We found no evidence that acoustic features of parents’ speech were associated with infants’ word comprehension. Potential reasons for the lack of such a relationship are discussed.
Scholars have acknowledged that there is a systemic aspect to Catholic clerical sex abuse that acts as a type of grammar structuring behaviors and responses. Feminist critics in particular stress the patriarchal nature of the abuse that connects bishops, priests, and boys together. This essay argues that in addition to public systems dominated by men, there are also private structures that facilitate abuse. Using the extensive primary documentation assembled by BishopAccountability.org, I focus on the space of the home and the unique orientations of mothers and fathers to better understand the dynamics of clerical sex abuse in the American Catholic church. The essay begins with the abuse of a Milwaukee priest who tormented his parishioners from 1945 until his forced “retirement” in 1970. Drawing on themes found in this case, I examine other abuse narratives—focusing on how the Catholic understanding of alter Christus and mid-twentieth-century gender roles made the “good Catholic home” a particularly vulnerable place for abuse. Since public and private systems overlap, it is essential that the domestic aspects of clergy sex abuse also receive a full analysis.
Infants’ difficulty, typically characterized as proneness to negative emotionality, is commonly considered a risk for future maladaptive developmental trajectories, mostly because it often foreshadows increased parental power assertion, typically linked to future negative child outcomes. However, growing evidence of divergent developmental paths that unfold from infant difficulty has invigorated research on causes of such multifinality. Kochanska et al. (2019) proposed that parent and child Internal Working Models (IWMs) of each other are key, with the parent’s IWM of the child moderating the link between child difficulty and parental power assertion, and the child’s IWM of the parent moderating the link between power assertion and child outcomes. In Children and Parents Study (200 community mothers, fathers, and children), child difficulty was observed at 8 months, parents’ power assertion at 16 months, and children’s outcomes rated by parents at age 3. Parents’ IWMs were assessed with a mentalization measure at 8 months and children’s IWMs were coded from semi-projective narratives at age 3. The cascade from infant difficulty to maternal power assertion to negative child outcomes was present only when both the mother’s and the child’s IWMs of each other were negative. We did not support the model for father-child dyads.
Research indicates that perinatal loss can cause profound psychological consequences in parents. However, a comprehensive summary of existing quantitative literature describing the association between perinatal loss and the development of depression/depressive symptoms or post-traumatic stress disorder (PTSD)/post-traumatic stress (PTS) symptoms in fathers has not been published.
Methods
A systematic literature search (from inception to December 2021), using the PubMed, EMBASE, and Web of Science databases to articles assessing depressive or PTS symptoms, was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Only studies investigating the period of intrauterine death from 20 weeks of gestation, stillbirth, or neonatal death within the first month after birth were included.
Results
A final sample of 13 articles were eligible for inclusion. Some studies showed an increased risk of depressive and PTS symptoms in fathers after perinatal loss. However, many study results did not show significant differences, symptoms generally decreased over time, and the majority of studies showed higher levels of depressive and PTS symptoms in mothers, compared with fathers.
Conclusions
Although the majority of the included studies showed elevated levels of depressive and/or PTSD symptoms after perinatal loss in fathers, no clear firm conclusion can be drawn, as the included studies were very heterogeneous. More homogeneous research measuring depressive and PTS symptoms in fathers is needed at the time of the loss, as the current literature available shows several limitations and gaps.
Infants’ high negative affectivity often initiates maladaptive parent-child relational processes that may involve both the parent’s and the child’s sides of the relationship. We proposed that infants’ high negative affectivity triggers distinct sequelae in dyads classified as avoidant, resistant, and disorganized, compared to secure dyads. In 200 community families, at 8 months, we observed infants’ negative affectivity; at 16 months, we assessed attachment organization and collected observations and reports of parent-related (responsiveness, resentment of child, power assertion, and intrusiveness) and child-related (social-emotional competence, opposition, and anger) constructs. In mother-child avoidant dyads, infants’ high negative affectivity was a significant precursor of mothers’ higher resentment and intrusiveness and children’s lower social-emotional competence. Those associations were significantly different than in secure dyads (in which none were significant). In father-child disorganized dyads, infants’ high negative affectivity was a significant precursor of fathers’ lower responsiveness and higher resentment; there were no association in secure dyads. Regardless of infants’ negative affectivity, compared to secure dyads, parents in resistant dyads expressed more resentment of child, and avoidant and resistant children were more oppositional to their fathers. The study illustrates multifinality in parent- and child-related processes that characterize unfolding early relational dynamics in dyads differing in just-emerging attachment.
This chapter foregrounds children’s involvement in documentary culture as a crucial element of their early political, spiritual and social education within the royal family. The chapter first addresses the documentary celebrations of children’s lives and children’s incorporation within intercessory prayers. Children were not dynamic actors in such cases, but these examples provide valuable evidence for the web of interwoven obligations, influences and expectations around them. As boys advanced through childhood, their active participation, political assent and testimony became important facets of the day-to-day activities of rule. After considering how charters reveal children’s importance as political actors, the chapter finally turns to examine shifts in documentary culture between the eleventh and thirteenth centuries which altered children’s status in royal documents. Young boys still had important roles to play in spiritual intercessions, familial actions and dynastic celebrations but, by c. 1200, royal charters were no longer as prominent a forum for displaying their centrality to rulership, especially not on an individual testimonial basis.
A major reason for the gendered division of parental leave use is the financial compensation during leave. Swedish national parental leave benefit provides 77.6 percent of earlier earnings up to an income ceiling, but collective agreements cover part of the income loss above the ceiling during leave. We focus on the importance of such collective agreements by examining fathers’ parental leave take-up across the 2000s, as agreements were expanded during this period in time. We combine register data for the period 2001 to 2011 with the Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA) being the key data source. The main division of agreements is between the state, the municipality and county, and the private sector. Results indicate that fathers with income above the income ceiling increase their use over the time period. Especially in the private sector a polarisation can be seen, where high income fathers increase their leave use, while fathers with lower income fall behind. As we do not find stronger increase in fathers’ leave use in sectors where agreements expanded across time there is no evident support of a direct effect of the top-ups.
Chapter 1, “Building the Nation and Modern Manhood,” examines the tense negotiations over different types of men, manhoods, and masculinities – spanning the early processes of nation-state formation and empire-building, through defeat and democratization, to the current challenges of a globalizing society and straining economy. Following the empire’s defeat in 1945, the soldier almost immediately lost his status as a hegemonic icon of masculinity. That role was taken on by a dramatically different kind of man: the white-collar, middle-class worker – who for decades was hailed not as the successor of the Imperial Army soldier but as the “modern samurai.” Two generations of men strove to embody that ideal manhood, but the heyday of the salaryman came to a crushing end in 1992. A new sense of vulnerability in the wake of the March 11, 2011 triple disaster – earthquake, tsunami, and nuclear meltdown – has fed into the processes of a rapid diversification of masculinity that continues to this day.
Changes in children’s attachment security to mother and father were examined for 230 firstborn children (M = 31.17 months), their mothers and fathers participating in a longitudinal investigation starting in the last trimester of the mothers’ pregnancy and 1, 4, 8, and 12 months after the birth of an infant sibling. Both parents completed the Attachment Q-set at prenatal, 4, and 12 months. Growth mixture models revealed four latent classes in which children’s attachments were (a) both secure with a modest decline to both parents (68.3%); (b) more secure with father than mother with a steep decline for both (12.6%); (c) both insecure with no change (10%); and (d) more secure with mother than father with a modest increase for both (9.1%). Multi-group latent growth curve analyses revealed that parenting and coparenting differed across families. Children had lower externalizing behavior problems in families with two secure attachments than in families with one secure attachment, either to mother or to father, who, in turn, had fewer problems than children with two insecure attachments. Findings underscore the strengths of a family systems framework to understand attachment relationships with multiple caregivers and the family risks and protective factors that covary with children’s behavioral adjustment after the birth of a sibling.
In King Lear and Coriolanus Shakespeare shows how parents who shame their children motivate them to commit violence that ultimately consumes the parent and child. To call this a perversion of parental love is virtually an understatement. Lear shames Goneril and Regan by loving Cordelia more than he loves them – so they bring about the deaths of both Lear and Cordelia. And Gloucester shames Edmund, who has his father’s eyes gouged out – an atrocity committed by American murderers we have seen – since people feel shamed in the eyes of others. Coriolanus shows how a mother’s teaching her son to achieve honor through violence ultimately rebounds on her and the very community she meant him to protect.
Breastfeeding has numerous health benefits for the mother and child. For breastfeeding to be successful and continue for longer, women need adequate support. Fathers/partners play an important role in providing this support to women, but research suggests that fathers/partners often feel inadequately informed and supported by health professionals. Midwives and health visitors are in ideal positions to offer women and their partner’s timely and relevant breastfeeding information and support throughout the perinatal period. This article discusses the benefits of breastfeeding, presents research evidence of the crucial role fathers/partners play in promoting and supporting breastfeeding, and recommends ways in which health professionals can provide breastfeeding information and support to fathers/partners.
Many family-based interventions for child and adolescent mental health problems rely on the engagement of mothers, and fathers have often been overlooked or excluded. However, given the evidence that children receive better outcomes from interventions when fathers participate, the lower participation rate of fathers relative to mothers represents an area for immediate action. This chapter describes the benefits of engaging both parents in assessment and interventions and common barriers to engaging fathers. It also explores a range of process strategies that clinicians can enact to enhance the engagement of fathers in assessment and treatment for child mental health problems. Finally, it describes a range of clinician competencies in relation to the engagement of fathers. The participation of fathers as well as mothers ensures a thorough approach to assessment, diagnosis, case formulation and treatment in family-based interventions, thereby potentially increasing the overall effectiveness of treatment for child mental health problems.
In “Family Dynamics and the Re-definitions of Papa-hood,” Suzanne del Gizzo tracks the construction of Hemingway’s famous “Papa” persona and the way, especially since the end of the twentieth century, scholars and critics have explored how the assumption his parternal if not paternalistic image may have been rooted in vulnerability and anxiety about masculinity – and indeed about identity more broadly – that began in the author’s childhood and extended into his public and private performances of “Papa”-hood into his adulthood, performances further complicated by a rapid decline in health and mental well-being in his fifties. Del Gizzo observes that the issue of “Papa”-hood is found at a busy intersection of Hemingway scholarship, where biography, psychoanalytic criticism, trauma studies, masculinity studies, and clinical assessments of the author’s mental health issues converge. Informed by developments in our understanding of the impact of mental health on family life, the essay surveys biographical criticism and literary scholarship related to representations of fathers and sons in Hemingway’s work.
Brazilians comprise a rapidly growing immigrant Latino group in the USA, yet little research has focused on health issues affecting Brazilian children in immigrant families. As increasing evidence is documenting fathers’ influential role in their children’s eating behaviours and ultimately weight status, the current study sought to explore the Brazilian immigrant fathers’ perspectives and practices related to child’s feeding practices and their preschool-aged children’s eating.
Design:
Qualitative study using in-depth, semi-structured interviews. Interviews were conducted in Portuguese by native Brazilian research staff using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed thematically using a hybrid approach that incorporated deductive and inductive analytical approaches.
Setting:
Massachusetts.
Participants:
Twenty-one Brazilian immigrant fathers who had at least one child aged 2–5 years.
Results:
Results revealed fathers’ awareness of the importance of healthy eating for their children, their influence as role models and their involvement in feeding routines of their preschool-aged children. Moreover, fathers were receptive to participating in family interventions to promote their children’s healthy eating. Nearly all fathers reported wanting to learn more and to do ‘what’s right’ for their children.
Conclusions:
The current study provides new information about Brazilian immigrant fathers’ views about factors influencing their children’s healthy eating behaviours and paternal feeding practices. Future research should quantify fathers’ feeding styles and practices and solicit fathers’ input in the design of culturally appropriate family interventions targeting the home environment of preschool-aged children of Brazilian immigrant families.
This essay explores father figures who meditate on their relation to a dominant late nineteenth- early twentieth-century construction of active masculinity, or figures who often find themselves uncomfortably far from the era’s gender ideals. Seeing their own lives as “limited” and constrained, or akin to the era’s fears of masculine “overcivilization,” these figures find solace in an imagined trajectory of masculine accomplishment. Their sons, however, appear to them as promising to restore the family’s depleted vigor, for the younger generation appears as more self-determined and more manly, especially in professional matters. Such meditations on manhood lead to a belief in the developmental potential of the next generation, which promises to supply a long-absent manliness. Not only are the young more active men, engaged in innovative fields that were not available to their elders, but they also seem poised to recover the kind of familial masculine distinction that their elders fear that they forfeited, both for themselves and for their families.
Dishion and Patterson's work on the unique role of fathers in the coercive family process showed that fathers' coercion explained twice the variance of mothers' in predicting children's antisocial behavior and how treatment and prevention of coercion and promotion of prosocial parenting can mitigate children's problem behaviors. Using these ideas, we employed a sample of 426 divorced or separated fathers randomly assigned to Fathering Through Change (FTC), an interactive online behavioral parent training program or to a waitlist control. Participating fathers had been separated or divorced within the past 24 months with children ages 4 to 12 years. We tested an intent to treat (ITT) mediation hypothesis positing that intervention-induced changes in child problem behaviors would be mediated by changes in fathers' coercive parenting. We also tested complier average causal effects (CACE) models to estimate intervention effects, accounting for compliers and noncompliers in the treatment group and would-be compliers in the controls. Mediation was supported. ITT analyses showed the FTC obtained a small direct effect on father-reported pre–post changes in child adjustment problems (d = .20), a medium effect on pre–post changes in fathers' coercive parenting (d = .61), and a moderate indirect effect to changes in child adjustment (d = .30). Larger effects were observed in CACE analyses.
Adverse effects of early exposure to parental mood disturbance on child adjustment have been documented for both mothers and fathers, but are rarely examined in tandem. Other under-researched questions include effects of changes over time in parental well-being, similarities and contrasts between effects of parental mood disturbance on children's internalizing versus externalizing problems, and potential mediating effects of couple relationship quality. The current study involved 438 couples who reported symptoms of depression and anxiety at each of four time points (i.e., last trimester of pregnancy and 4, 14, and 24 months postbirth). Mothers and fathers also rated their couple relationship quality and their child's socioemotional adjustment at 14 months, as well as internalizing and externalizing problems at 24 months. Latent growth models indicated direct effects of (a) maternal prenatal well-being on externalizing problems at 24 months, and (b) paternal prenatal well-being on socioemotional problems at 14 months. Internalizing symptoms at 24 months showed only indirect associations with parental well-being, with couple relationship quality playing a mediating role. Our findings highlight the importance of prenatal exposure to parental mood disturbance and demonstrate that, even in a low-risk sample, poor couple relationship quality explains the intergenerational stability of internalizing problems.