This article identifies unmet needs and challenges of 37 families caring for children with special health care needs (CSHCN). Data were collected in focus groups. Data saturation occurred in the third group. Another group was conducted to ensure adequate inclusion of rural participants. Mean age of participants was 36 years. Most participants were women (92%), Caucasian (65%), high school graduates (89%), and employed, with 38% from rural communities. All families had health care insurance, primarily Medicaid (87%). An interdisciplinary team used NVIVO software to facilitate content analysis. Seven areas emerged: family support systems, early intervention/school systems, coordination of care, lack of knowledge, provider/family relationships, parent roles, and insurance systems. Caregivers noted the critical role of nurses but a lack of nurse presence in community care systems. This study adds to the multidimensional nature of caring for CSHCN and highlights the importance of considering how families interface with multiple community sectors.

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Black women such as our participants are critical partners as we develop systems of care to decrease disparities and increase Black women's successes in breastfeeding. Findings underscore the importance of having diverse, readily available, user-friendly, culturally sensitive options for Black women who choose to breastfeed.

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Objective To examine the relationships between parental patterns regarding child feeding and child Body Mass Index (BMI) percentile in Latino parent-preschooler dyads participating in a clinical trial. Methods This secondary analysis examined data collected during a randomized clinical trial of a culturally tailored healthy lifestyle intervention focused on childhood obesity prevention, Salud Con La Familia. We analyzed 77 Latino parent-child dyads who completed baseline and 3-month follow-up data collection, assessing associations between preschool child BMI percentile and parental response to the Child Feeding Questionnaire (CFQ) over time. Results Higher child BMI was related to higher parental CFQ concern scores (r = 0.41, p <.001). A general inverse association between child BMI percentile and parental responsibility was also observed (r = −0.23, p = .040). Over the 3-month period, no statistically significant associations between changes in the CFQ subscale scores and changes in child BMI percentile were identified. Conclusions Child BMI percentile consistent with overweight/obese is associated with parental concern about child weight and child BMI percentile consistent with normal weight is associated with perceived responsibility for feeding. Emphasizing parental responsibility to help children to develop healthy eating habits could be an important aspect of interventions aimed at both preventing and reducing pediatric obesity for Latino preschoolers.

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The loci for the complement proteins C2 and BF, and the two loci for C4 are closely linked to one another. In many hundreds of meioses no crossing over has been detected between these loci. In addition, the alleles of these four loci occur in specific combinations not predicted by their gene frequencies in much the same way as alleles of the Rh and MNS systems. These units are termed complotypes. There are 14 complotypes with frequencies in excess of 1% in our study population of normal sixth chromosomes from Caucasians. Since they are also intimately associated with HLA-DR, complotypes may also be of importance in screening programs for transplantation.

Pediatric overweight and obesity is a grave public health issue in the United States. With overweight and obesity come significant physical health problems, psychological problems, social problems, and school problems. In 2007, the American Academy of Pediatrics published clinical practice guidelines for the treatment of overweight and obesity in children and adolescents. However, health care providers are not using these guidelines due to a variety of barriers already identified in the literature. Treatment of overweight and obese students in SBHCs presents unique problems; however, this has not been assessed in the existing literature. This project identified unique barriers to treatment in SBHCs, including lack of parent or guardian presence and difficulties in promoting continuity of care between the SBHCs and PCPs. From this work, we can begin to develop interventions to help address these issues within the school-based clinical setting. Identifying barriers to guideline implementation will empower school-based health providers to address these barriers, perhaps leading to the implementation of changes that transform these barriers into facilitators. These actions may improve the quality of care provided to overweight and obese pediatric patients, which could also lead to positive impacts on BMI and may improve health outcomes for overweight and obese children.