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This article presents an integrative approach to the problem of pediatric obesity, which is a multifaceted medical condition that is epidemic in the United States and elsewhere in the world. In this article, definitions of pediatric obesity are provided, and its prevalence, etiological factors, medical complications, and comorbidities are reviewed. Psychological and spiritual factors associated with pediatric obesity are discussed, together with their importance to integrative treatment. This review suggests that the use of psychological interventions, such as cognitive behavioral therapy (CBT) and animal-assisted therapy (AAT), can be considered in conjunction with medical and educational interventions to treat pediatric obesity successfully.

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BACKGROUND: There is currently a gap in our knowledge of how eating disorder symptomatology is impacted by spirituality and religiosity. To date, studies examining the role of ethnicity in women's self-reported levels of eating disorder symptomatology have neglected the roles of spirituality and religiosity. AIMS: This study addresses this gap in the literature by investigating ethnicity, spirituality, religiosity, body shame, body mass index (BMI) and age in relation to eating disorder symptomatology in women. METHODS: A representative non-clinical sample of ethnically diverse Canadian women (N = 591) was surveyed. RESULTS: Younger women, particularly those with higher body shame, BMI and lower spirituality, reported more eating disorder symptomatology. Hispanic and Asian women had higher body shame and lower BMI compared to white women. Spirituality was more strongly related to eating disorder symptomatology than religiosity. CONCLUSIONS: This is the first study identifying interactive relationships between ethnicity, spirituality, body shame, BMI and age on eating disorder symptomatology in women. Particularly significant is that higher spirituality was related to a lower level of eating disorder symptomatology. These findings have important implications for treatment and women's physical and psychological health and wellness.

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The behavior of 643 pedestrians and 1749 motorists at two signal-controlled intersections was observed over a 2-mo. period of observation in March and November. One intersection had a coffin-shaped traffic sign with the wording "Fatality" erected during the first month of observation (March). The second intersection was identical in traffic and pedestrian volume but lacked a "Fatality" sign in either March or November. "Fatality" signs are erected and maintained by the City of Edmonton for 6 mo. whenever a pedestrian death has occurred, and they are intended to raise the awareness of both pedestrians and motorists concerning the risks at dangerous intersections. This sign had been removed for nearly 3 mo. when a follow-up observation was made in November. While female pedestrians and pedestrians over the age of 50 years showed greater caution at both intersections, the presence or absence of the "Fatality" sign had no statistically significant influence on safety. Similarly, the presence or absence of a sign did not significantly influence motorists' behavior. Of motorists 7.6% ran either amber or red traffic control lights at the two intersections. The "Fatality" sign did not affect the rates of these violations.

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Observers recorded the duration of scanning by six lifeguards in three indoor swimming pools. Duration of scanning was significantly predicted by the absolute numbers of child swimmers (< 17 years) in the pools and when numbers of child swimmers were represented in terms of bits of information. Duration of scanning increased as a linear function of both numbers of children and child bits of information. These results are interpreted in terms of the Hick-Hyman law of information theory. Lifeguards appear to simplify the task of information processing and decision-making by concentrating on children as a more at-risk group of swimmers. Duration of scanning was not significantly related to changes in number of adult swimmers.

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398 children, 1 to 6 years of age, and the adults accompanying them in two supermarkets were exposed to one of four treatments. Two experimental treatments featured variations on a warning sign, prompting adults to prevent their children from standing while in the cart seat and basket portions of shopping carts. The two control treatments exposed the adults to advertisements rather than warning signs. No effect was observed of either warning on standing while in cart seats, standing while in baskets, climbing on carts, or standing on the ends or sides of carts; nor was any effect noted on three measures of adult supervision. This lack of effect is attributed to adults' perceptions of the low risk of serious injury to children in carts, their familiarity with carts, the costliness of ensuring compliance with the warnings, and the lack of natural contingencies supporting the prompts. Risky activities by children were related to the child's location in the cart, child's sex, and adult supervision.

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Observations of 246 children and the adults accompanying them were carried out in supermarkets. Of those arriving and leaving by automobile (n = 194), 36% of adults used safety belts, and 51.1% of children used safety belts or restraining seats. While shopping, 79% of adults lost sight of the children in their care at least once, and 73.2% were 10 feet or more from their children at least once. 48% of children climbed or attempted to climb from carts; 27% stood in carts, and 23.6% handled hazardous products. 24% of adults purchased tobacco products. Poor adult supervision of children was related to adult's nonuse of safety belts and the child's and adult's ages. Climbing from the cart was related in a logistic regression to both poor adult supervision and child's age. Tobacco purchases were related to handling of hazards by children and standing in carts. Child's age and adult's safety belt use related to the restraint of children in vehicles.

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Systematic observations of 231 children (infancy to 5 years) and the 231 adults accompanying them were made in 29 supermarkets in Edmonton, Alberta, Canada. The objective of the study was to describe the influence of two indices of adult supervision in supermarkets on children's activities in shopping carts. Adult supervision was measured by whether the adult ever lost sight of the child and whether the adult was 10 feet or more from the child at any time during a shopping trip. 23% of the children stood on the ends or sides of carts; 49% climbed or tried to climb out of carts. Adults lost sight of a child, whether in or outside the cart, a mean of 3.3 times and were 10 feet away 2.7 times during an average shopping trip. Logistic regression showed that a child rather than an adult pushing a shopping cart through the store was the strongest factor related to standing on ends or sides of carts. Pushing by a child was more likely to occur when adult monitoring was low and when children were older. Climbing out was predicted by the number of times an adult was > or = 10 feet away, older children, and a child being in the cart basket as opposed to outside the cart or in the child safety seat.

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