BACKGROUND AND OBJECTIVE: Parental perceptions of their children' s weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children' s weight and moderators of such misperceptions. METHODS:Original studies published to January 2013 were chosen through literature searches in PUBMED, PSYCHINFO, and CINAHL databases. References of retrieved articles were also searched for relevant studies. Studies were published in English and assessed parental perceptions of children' s weight and then compared perceptions to recognized standards for defining overweight based on anthropometric measures. Data were extracted on study-level constructs, child-and parent-characteristics, procedural characteristics, and parental underestimates separately for normal-weight and overweight/obese samples. Pooled effect sizes were calculated using random-effects models and adjusted for publication bias. Moderators were explored using mixed-effect models.RESULTS: A total of 69 articles (representing 78 samples; n = 15 791) were included in the overweight/obese meta-analysis. Adjusted effect sizes revealed that 50.7% (95% confidence interval 31.1%-70.2%) of parents underestimate their overweight/obese children' s weight. Significant moderators of this effect included child' s age and BMI. A total of 52 articles (representing 59 samples; n = 64 895) were included in the normal-weight meta-analysis. Pooled effect sizes indicated that 14.3% (95% confidence interval 11.7%-17.4%) of parents underestimate their children' s normal-weight status. Significant moderators of this effect included child gender, parent weight, and the method (visual versus nonvisual) in which perception was assessed. CONCLUSIONS:Half of parents underestimated their children' s overweight/obese status and a significant minority underestimated children' s normal weight. Pediatricians are well positioned to make efforts to remedy parental underestimates and promote adoption of healthy habits. Ms Lundahl conceptualized the study, coded the original studies, conducted the meta-analyses, and drafted the initial manuscript; Ms Kidwell coded a portion of the original studies, reviewed and revised the manuscript, and approved the final manuscript as submitted; and Dr Nelson contributed to the conceptualization of the study, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.www.pediatrics.org/cgi

The widespread successful implementation of evidence-based practices (EBPs) into community mental health settings will require a thorough understanding of practitioner attitudes toward these approaches. This study reports on the results of two community mental health practitioner focus groups investigating attitudes toward EBPs, perceived challenges to implementing EBPs, and recommendations for researchers interested in facilitating EBP use in community settings. The participants were child and adolescent mental health professionals (N=19) from two community mental health centers. The focus groups were taped, transcribed and coded for themes. Major themes included concerns regarding the applicability of some research supporting EBPs, a desire for a greater emphasis on the therapeutic relationship, and the need for flexibility within treatment protocols. Themes are discussed within the context of the recent movement toward implementing EBPs in community settings and recent research related to focus group themes.

In light of the recent movement toward evidence-based practice (EBP) in mental health services, practitioner adoption of EBPs in clinical settings has emerged as an important area for study. This paper reports on the results of a national online survey of mental health practitioners in an attempt to identify correlates of self-reported EBP use in practice. The survey consisted of 214 mental health practitioners from 15 states drawn from a diverse set of clinical settings and representing a variety of theoretical orientations. The results indicated that practitioner training (i.e., taking a class in EBPs), the perceived openness of the clinical setting toward EBPs, and the practitioner's attitudes toward treatment research were significant predictors of self-reported EBP use. The relationship between clinical setting and EBP use was partially mediated by attitudes toward treatment research. Negative attitudes toward treatment research partially mediated the relationship between practitioner training and self-reported EBP use. The findings are presented within the context of efforts to increase EBP use in clinical settings and implications for clinical training, treatment research, and EBP dissemination efforts are discussed.

Obesity is associated with headache frequency and disability in the pediatric headache population. For children who are overweight, weight loss can contribute to a reduction in headaches over time. Clinicians should consider child weight status in providing care for pediatric headache.

Study objectives New theory and measurement approaches have facilitated nuanced investigation of how sleep loss impacts dimensions of affective functioning. To provide a quantitative summary of this literature, three conceptually related meta-analyses examined the effect of sleep restriction and sleep deprivation on mood, emotion, and emotion regulation across the lifespan (i.e., from early childhood to late adulthood). Method A total of 241 effect sizes from 64 studies were selected for inclusion, and multilevel meta-analytic techniques were used when applicable. Results There was a moderate, positive effect of sleep loss on negative mood (g = .45), which was stronger for studies with younger samples, as well as a large, negative effect of sleep loss on positive mood (g = -.93); type of sleep manipulation (i.e., restriction or deprivation) did not moderate either effect. After correcting for publication bias, a modest but significant negative effect emerged for the effect of sleep on emotion (g = .11); the valence of emotional stimuli did not change the direction of this effect, and type of sleep manipulation was also not a significant moderator. Finally, sleep restriction had a small, negative effect on adaptive emotion regulation (g = -.32), but no significant impact on maladaptive emotion regulation (g = .14); all studies on adaptive emotion regulation were conducted with youth samples. Conclusions Sleep loss compromises optimal affective functioning, though the magnitude of effects varies across components. Findings underscore the importance of sleep for healthy affective outcomes.

CONTEXT: Mixed findings exist on whether stimulant medications alter youth sleep. OBJECTIVE:To determine the effect of stimulant medications on sleep.DATA STUDIES: Studies published through March 2015 were collected via CINAHL, PsycINFO, and PubMed. References of retrieved articles were reviewed.STUDY SELECTION: Eligibility criteria included studies with children/adolescents who had attention-deficit/hyperactivity disorder (ADHD), random assignment to stimulants, and objective sleep measurement. Studies that did not include information about key variables were excluded. DATA EXTRACTION: Study-level, child-level, and sleep data were extracted by 2 independent coders. Effect sizes were calculated by using random effects models. Potential moderators were examined by using mixed effect models.RESULTS: A total of 9 articles (N = 246) were included. For sleep latency, the adjusted effect size (0.54) was significant, indicating that stimulants produce longer sleep latencies. Frequency of dose per day was a significant moderator. For sleep efficiency, the adjusted effect size (20.32) was significant. Significant moderators included length of time on medication, number of nights of sleep assessed, polysomnography/actigraphy, and gender. Specifically, the effect of medication was less evident when youth were taking medication longer. For total sleep time, the effect size (20.59) was significant, such that stimulants led to shorter sleep duration. LIMITATIONS:Limitations include few studies, limited methodologic variability, and lack of unpublished studies.CONCLUSIONS: Stimulant medication led to longer sleep latency, worse sleep efficiency, and shorter sleep duration. Overall, youth had worse sleep on stimulant medications. It is recommended that pediatricians carefully monitor sleep problems and adjust treatment to promote optimal sleep.Department of Psychology, University of Nebraska-Lincoln, Lincoln, NebraskaMs Kidwell contributed to the conceptualization of the study, organized literature searches, coded the original studies, and drafted the introduction and discussion sections; Ms Van Dyk contributed to the conceptualization of the study, coded the original studies for reliability analyses, and reviewed and revised the manuscript; Ms Lundahl contributed to the conceptualization of the study, conducted the meta-analyses, and drafted the methods and results sections; Dr Nelson contributed to the conceptualization of the study and provided critical editing of the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

ease, and major depression (Irwin 2015). Because adolescents are a population vulnerable to poor sleep during a key developmental period of significant physiological and environmental change, they are an important group to systematically assess with regard to sleep patterns and social conditions linked to chronic Perceived Discrimination and Adolescent Sleep in a Community Sample br idget J. goosby, Jacob e. che a dle, W hit ney strongba K, tay lor c. roth, a nd timoth y d. nelson Sleep is a key restorative process, and poor sleep is linked to disease and mortality risk. The adolescent population requires more sleep on average than adults but are most likely to be sleep deprived. Adolescence is a time of rapid social upheaval and sensitivity to social stressors including discrimination. This study uses two weeks of daily e-diary measures documenting discrimination exposure and concurrent objective sleep indicators measured using actigraphy. We assess associations between daily discrimination and contemporaneous sleep with a diverse sample of adolescents. This novel study shows youth with higher average discrimination reports have worse average sleep relative to their counterparts. Interestingly, youth reporting daily discrimination have better sleep the day of the report than youth who do not.

WHAT'S KNOWN ON THIS SUBJECT:Children who are frequent targets (victims) or perpetrators of peer aggression are at increased risk for psychosocial problems. Linkages between health and involvement in peer aggression have been proposed, but research evidence remains sparse. WHAT THIS STUDY ADDS:This study shows that self-reported victimization and classmate-reported aggression toward peers are both associated with more frequent visits to a school nurse for illness with objective symptoms, somatic complaints without objective symptoms, and injuries. abstract OBJECTIVE: To examine how involvement in aggressor-victim interactions is linked to somatic complaints, illnesses, and physical injuries among elementary school-aged children. STUDY DESIGN:This study was composed of a school-based sample of 590 children in grades 3 through 5. Independent sources were used to assess victimization (self-report) and aggression (peer report) in the fall semester. School nursing logs for the entire school year were collected in May and coded for the number of times each child presented with a somatic complaint, illness, or injury. RESULTS:Both aggression and victimization were significantly related to all 3 reasons for nurse visits, controlling for demographic variables. Higher levels of aggression and victimization each were independently associated with more frequent visits to the school nurse for somatic complaints, illnesses, and injuries. A significant victimization-timesaggression interaction was found for illnesses, with nonaggressive victimized children presenting most frequently for illness visits. CONCLUSIONS:Involvement in aggressor-victim interactions, as either aggressor, victim, or both, is associated with more frequent health complaints, based on school nursing logs. Prevention, early identification, and treatment of problems with victimization and aggression may have important health implications for children.