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Science, Technology and Medicine open access publisher.Publish, read and share novel research. Behavioral Problems and Depressive Symptoms in Adolescents with Type 1 Diabetes Mellitus: Self and Parent ReportsNienke M.
People with type 2 diabetes are at greater risk of serious liver disease than those without the condition, new research has shown. According to the Mayo Clinic, Childhood obesity[1] occurs when a child is well above the normal weight for his or her age and height. Most cases of childhood obesity is caused by kids eating too much and exercising too little. On average, people who are considered obese pay $1,429 (42 percent) more in health care costs than normal-weight individuals.
Medicaid pays $213 more for an inpatient service, $175 more for a non-inpatient service, and $230 more for prescription drugs in comparison with normal-weight patients. Private insurers pay $443 more for an inpatient service, $398 more for a non-inpatient service, and $284 more for prescription drugs in comparison with normal-weight patients. Data show average age-sex-race-adjusted Medicare spending per enrollee by state and by hospital referral regions for 2006.
The Marriage and Family Encyclopedia said it best in the article, Children's Rights-Issues for the Future[8]: Globalization will bring about powerful new linkages among people and nations through law, technology, the media, and the marketplace.
If a child's physical welfare is of concern, then childhood obesity would be a cause of global concern.
Over the past three decades, the childhood obesity rate has more than doubled for preschool children aged 2-5 years and adolescents aged 12-19 years, and it has more than tripled for children aged 6-11 years.
Throughout the decades, laws have been put into place to protect the well being of children. Besides the fact of nutrition help, more advantages of computer technology are here to help people.
Computers can help with educating people and developing different kinds of abilities with the help of the internet. Another bad result of playing to much on the computer is children will receive very limited and one-sided media infomation so that they are easy to be lured.
PE Central and other online resources have helped educators and parent volunteers in understanding how to provide a proper physical education curriculum to students.
With school districts and teachers in a budget crunch, free, researched-based online resources can provide a well-rounded educational program. Cupertino Union School District's Student Nutrition Website states,  "Proper nutrition in the school age years can reinforce lifelong eating habits that contribute to a student's overall well being. Many schools have adopted a Wellness Policy in order to address the importance of nutrition and exercise among students. Although there are disadvantages associated in regards to childhood obesity and technology, there are advantages too. Content is available under the Creative Commons Attribution Share Alike License unless otherwise noted. An organ in the human or animal body that secretes particular chemical substances for use in the body or for discharge into the surround. If your username or email address exist in our database, you will receive instructions how to reset your password. The doctor can do this by calculating the child's body mass index(BMI.) The doctor will then compare the child's BMI to the other children of the same sex and age.
An important question is how these new linkages will affect the lives of families and children across the world. In the 19th century, the Industrial Revolution caused laws to be passed in order to protect children who were working in factories, mines and mills. During the Shanghai Expo, a Korean band "Super Junior" came to Shanghai to perform a live show. Children who are addicted to computer will tend to eat more fast food since they need more time on computer.
There are a variety of ways to teach kids the importance of eating healthy and exercising regularly. The National Dairy Council, provides free curriculum, on-line resources, music CD's and DVD's to teachers to help educate kids on proper nutrition. Cupertino Union School District,(CUSD) in Cupertino, California has a website in which parents and educators can access school menus, the wellness policy and information on why a wellness policy is so important.
Due to the power of technology parents, educators and organizations can combat the process of childhood obesity and other health related illnesses.
First lady Michelle Obama discusses the findings of the Childhood Obesity Task Force report. The body contains a collection of glands, each of which secretes different types of hormones that regulate metabolism, growth, development, tissue function, sleep, mood, sexual function, and reproduction. The last decade of the twentieth century witnessed an unprecedented increase in the level of international cooperation around the issue of children's rights. By using computers and the internet, people can entertain themselves, work at home or study overseas. The builder of the pyramid in the nutrition department of Harvard stated that: "Based on the latest science, and unaffected by businesses and organizations with a stake in its messages, the Healthy Eating Pyramid is a simple, trustworthy guide to choosing a healthy diet. With this gaming console, players have to do different actions in order to let the character in the game acts the way people want it to, like run, jump, or punch. Computer games may help improve people's abilities, but what the games have done more is making children less mobile. The computer lab can easily be turned into a nutrition and exercise learning environment with websites, such as Nutrition Exploration, and Nourish Interactive. Teaching good eating habits and the importance of exercising can start at a very young age. The status of children and their social, intellectual, and physical welfare came to be a topic of great worldwide concern, and calls were raised for the creation of clear universal guidelines to ensure that children's rights were protected around the globe. Its foundation is daily exercise and weight control, since these two related elements strongly influence your chances of staying healthy. Playing a computer game may cost a long period of time and children wouldn't want to go out unless he has finished the whole game or a specific chapter. Noticing this tragedy, many Chinese netizens felt so angry that they got together planned an online protest. With more and more children buying fast food, fast food companies will lower the price and so more people will be attracted to eat them, which may cause more obesity problems in the country. With the advancement of technology parents can research their child's nutritional needs, look up healthy kid friendly recipes, participate in parenting blogs and research ideas on how to raise health conscience kids.


These receptor proteins receive specified messages from the hormones, which tell the cell what to do. Hood, 2010Depressive symptoms in adolescents with type 1 diabetes: associations with longitudinal outcomes.
The increased risk varies by cause of death, and most of this increased risk is due to cardiovascular causes. There was a mother who was so addicted to the Facebook that has left her baby alone for days. Playing too much computer games will lower children's social skills such as how to negotiate with people peacefully and with proper manners.
On June, 9th, thousands of netizens started their so called "protest" towards the official website of "Super Junior" and the BBS of Super Junior fans. Schools: Unfortunately, due to budget cuts in education, physical education classes have been cut from everyday school curriculum. However, there will always be changing factors in our lives that can alter the preventative steps we put in place. IntroductionChildren and adolescents with chronic diseases are at higher risk for mental health problems. Drash, 1997Major depressive disorder in youth with IDDM: a controlled prospective study of course and outcome. Obesity is associated with over 112,000 excess deaths due to cardiovascular disease, over 15,000 excess deaths due to cancer, and over 35,000 excess deaths due to non-cancer, non-cardiovascular disease causes per year in the U.S.
Not going outside also make those children less friends, which may have impact on children's personality.
They used their hacking skills to "blow those websites off",  and caused paralysis to both websites. Although California State Standards still require a certain amount of physical education hours per week, many credentialed physical education teachers have been laid off, taking their wealth of knowledge with them. In order to keep up with changing times, society will have to work in making sure the steps against childhood obesity are always kept up to date. Especially in adolescence, which involves a multitude of physical, cognitive and emotional developmental changes, a chronic disease such as diabetes mellitus type 1 (T1DM) that requires daily, careful attention, may influence social and emotional functioning.
Offord, 1993The outcome of adolescent depression in the Ontario Child Health Study follow-up. Children, adolecents and adults who use too much computer per day may be overweight easily. Thus, physical education, which involves much more than playing on the playground, is left up to the classroom teacher. Adolescents with T1DM must deal with disease-specific stressors, in addition to age-specific stressors (Reid, Dubow, Carey, & Dura, 1994).
Cakan, 2004Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: a prospective study.
Garralda, 2009Neuro-cognitive performance in children with type 1 diabetes--a meta-analysis.
Technology has it own advantages and disadvantages and they are both critical to people and the society. Stress, in itself, may dysregulate diabetes through psycho-physiological processes or associated changes in self-management behaviors (Snoek, 2000).
Cicognani, 2008Quality of life, psychological adjustment and metabolic control in youth with type 1 diabetes : a study with self- and parent-report questionnaires. Dura, 1994Contribution of coping to medical adjustment and treatment responsibility among children and adolescents with diabetes.
Therefore, diabetic treatment guidelines include metabolic goals, as well as facilitation of normal social and emotional development (Grey & Boland, 1996).
Problems in social-emotional functioning are reflected in the occurrence of internalizing or externalizing behavior problems. Werther, 2005Psychiatric comorbidity and health outcome in type 1 diabetes; perspectives from a prospective longitudinal study.
Hershey, 2008Effects of prior hypoglycemia and hyperglycemia on cognition in children with type 1 diabetes mellitus. PE Central is an organization that provides free, online information on how to implement a physical education program in your school or classroom. Snoek, 2007Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation to glycemic control. The kind of mental health problems experienced by adolescents with T1DM needs to be clarified, in order to improve guidelines for treatment of diabetes.
To this end, researchers should rely upon both adolescent-reported measures that might be applied in regular care, as well as parent-reported measures. Young, 2004Relationship of depression and diabetes self-care, medication adherence, and preventive care. Comparing answers of these youths to those from healthy peers can indicate the extent to which differences exist between these groups.We studied whether Dutch adolescents with T1DM had increased levels of behavior problems in comparison to peers without T1DM, both according to their self-reports and reports from their mothers and fathers.
Additionally, we examined the extent to which metabolic control is related to depressive symptoms and specific behavior problems.
Mc Keown, 2006Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth study. Sample Patients with T1DM between 12 and 18 years of age (n=302) and their parents were recruited for participation.
Medical information (most recent HbA1c, duration of the disease, and treatment regimen) was recorded from the hospital charts. HbA1c was analyzed with similar assays, using gas chromatography, in the different hospitals. Schools were approached for cooperation in the same time period in order to recruit the comparison group. Healthy adolescents without T1DM and their parents were invited to participate, matching school type, age, and gender to that of the adolescents with T1DM.
The comparison group comprised 122 adolescents without T1DM; In formation was also collected from 114 of these mothers and 61 of the fathers. Exclusion criteria for both groups were no participation of a parent, and comorbid medical or psychiatric illness of the adolescent. The children’s depression inventoryThe Children’s Depression Inventory (CDI) was developed to measure self-reported depressive symptoms in children and adolescents aged 7 to 17 years (Kovacs, 1992). The inventory assesses a variety of self-reported depressive symptoms, including disturbance in mood, self-evaluation, and interpersonal behaviors. A cutoff score of 13 was used to indicate a serious level of depressive complaints, at risk for a clinical depression (Kovacs, 1992).


The child behavior checklist (CBCL) and youth self-report (YSR)The presence of behavior problems was studied using information from different sources, namely the adolescent themselves (YSR), and their mothers (CBCL) and fathers (CBCL). The Child Behavior Checklist (CBCL) measures behavior problems and competencies of children and adolescents between the ages of 6 to 18, as reported by their parents (Achenbach & Rescorla, 2001). The Youth Self-Report (YSR) is a self-report derivative of the CBCL for adolescents between 11 and 18 years.
The CBCL and YSR questionnaires have been shown to have adequate reliability and validity (Evers et al., 2000). ProcedureThe adolescents with T1DM answered the questionnaires when they visited the diabetes team, or at home. For the control group, the questionnaires were sent to the adolescents and their parents at home.
Data analysesPotential differences in group characteristics were analyzed using chi-square or t-tests. Within the T1DM group, a regression analysis was conducted to study the relationship between HbA1c and the depressive symptoms and behavior syndrome scales.3. Group characteristics A description of baseline group characteristics can be found in table 1. The total group of adolescents with T1DM did not differ from the comparison group in age, gender, or education level, as expected in light of the matching procedure.
In the group with T1DM, 18 adolescents (12.4% of a total 145 with complete data) were identified as being at risk for a clinical depression, as were18 adolescents in the control group (14,8% of in total 122 with complete data). Behavior problems Means and standard deviations for the YSR (as assessed by the adolescents) are presented in table 2, as are CBCL behavioral syndromes (as assessed by mothers and fathers).
This table also indicates significant differences found with univariate analyses of variance. Mean factor scores (internalizing, externalizing, and total behavior problems,) and mean scores for the behavioral syndrome scales for adolescents with and without T1Dm, are presented in figures 2 and 3. One behavioral syndrome scale differed significantly between the groups, reflecting Thought problems, (F(1,247)=11,63, p=0.001), see table 2. Glycemic control and social emotional functioningA regression analysis, using the enter procedure, was conducted in order to study the relationship between glycemic control and social-emotional functioning of adolescents with T1DM, as represented by their CDI score and the scores on the eight behavioral syndromes of the YSR (see table 3).
DiscussionOur study on the types and extent of social-emotional problems among adolescents with T1DM revealed that emotional and behavior problems are related to glycemic control.
Blood glucose regulation was found to be related specifically to depressive symptoms and rule breaking behavior among the adolescents with T1DM.
The adolescents with poor blood glucose regulation experienced difficulties, in general, as well as problems followng rules; This likely also extends to difficulties in following the rules of their treatment for diabetes. The problems adolescents with T1DM experienced in social emotional functioning could be specifically related to diabetes and diabetes management tasks. The questionnaires used in this study were not diabetes-specific, however, so we cannot indicate diabetes-specific burdens yet.We also found a remarkable difference, in that the adolescents with DM1 reported more thought problems than the comparison group.
The results of our comparison group were in the same range as those of the original norm group of the YSR (Achenbach & Rescorla, 2001). The reports of both mothers and fathers did not show an overall significant difference, but looking univariately at the dimension, a difference in thought problems also appeared in mothers’ and fathers’ reports of youths’ functioning, with parents of adolescents with T1DM reporting more thought problems than the parents of healthy adolescents. The fact that mothers and fathers of youths with T1DM agreed with their children regarding the higher prevalence of Thought problems may underline the importance of these kinds of behavioral difficulties.
Thought problems refer to a variety of problems in learning behavior and information processing. These adolescents more often ruminate on certain thoughts, and have twitches, strange thoughts, or sleeping problems.
An explanation for such group differences may be found in subtle neuropsychological effects of diabetes.
Both hypo- and hyperglycemia affect cognitive functioning, but in different ways (Periantie et al., 2006). In a recent meta-analysis, Naguib and colleagues (Naguib, Kulinskaya, Lomax & Garralda, 2009) found mild cognitive impairments in adolescents with T1DM, especially poorer visuospatial ability, motor speed, writing, and sustained attention. The relationship between thought problems and blood glucose regulation was only marginally significant in our study.
It is conceivable, however, that the fluctuating blood glucose levels that all patients with diabetes experience, and the high blood glucose regulation in our group (mean 8.3%), may influence thinking and perception. Our findings are also in line with Nardi (Nardi et al., 2008), who found more thought problems among adolescents in the age of 14 to 18 with T1DM, relative to a comparison group. Our findings indicate that one in eight youths with T1DM met the clinical cut off for depression.
This level of depressive symptoms is comparable with the results of Hood (Hood et al., 2006), who reported that one in seven adolescents with T1DM met the same criteria for depression as used in our study. Clinical implications In view of the elevated thought problems, and the important associations that blood glucose regulation held with both depressive symptoms and rule breaking behaviors, routine screening for behavioral problems in adolescents with T1DM is recommended. Increased attention should be devoted to the large group of adolescents who have poor metabolic control.
Although strict diabetic treatment management is necessary to maintain adequate levels of HbA1c, this may indicate greater interference with daily life. Adolescents need to be stimulated by their parents and health care professionals to find intrinsic motivation for their own disease management, and to maintain their mental health.
Thought problems may need special consideration, and it seems useful to investigate whether and how these problems interfere with diabetes management and daily living.
To optimize glycemic levels, specific attention should be paid to adolescents reporting depressive symptoms or rule breaking behavior, in general, because they may experience the most adaptation problems when it comes to treatment rules. Strengths, limitations, and future directions A strength of our study is that we examined a relatively large group of 151 adolescents with T1DM. The self-selection evolving from voluntary participation may have led to an underestimation of the number of adolescents with depressive symptoms in the group with T1DM.
Nevertheless, the group differences found in a behavioral syndrome like thought problems need further study, as it may be important to consider for treatment improvements. The adolescents with T1DM did not differ from healthy peers in their number of depressive complaints. However, the combination of depressive symptoms and rule breaking behavior was related to metabolic control. Further, elevated thought problems were found among adolescents with T1DM, in comparison to healthy peers.



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