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Both mental and physical health problems have significant, costly effects on children and on society, particularly through the health-care delivery system. Many years of research show more mental health problems among children with chronic health conditions, but the research is contradictory and inconclusive. This study is the first to examine the physical health status and problems of children with known mental health problems.The study compares Medicaid children with and without serious mental health problems ( n = 965) using parent reports of global health status, physical functioning, and general health perceptions. Children with more serious mental health problems were significantly more likely to have chronic health conditions.The number of chronic health conditions was the most powerful variable in predicting children's global health status, physical functioning, and general health perceptions. Children's mental health status, however, was a significant predictor as well, and the inclusion of this variable in the analyses significantly improved the fit of the regression model. Implications for the health-care delivery system are discussed.

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The study of family factors that relate to diabetes management and metabolic control is crucial because of the family's central role in this management. Four sequential phases of diabetes management are specified in this review: (1) the pre-onset stage; (2) the onset, crisis stage; (3) the accommodation stage; and (4) the stabilization stage. Each stage can be expected to influence the following stage. Thus, each is important to later management of the condition. No theory of family functioning provides a satisfactory framework for understanding the complex relationships between family development and diabetes. The Peabody Family Development Model is introduced as a more complex and systematic way of understanding the stages of management and the long-term view of the individual and family development. Individual and family are acting and reacting, and at the same time, coping with outside influences while moving from one life stage to the other. Historic factors of family and community influence one's view of the world and, consequently, the way regular routines are carried out. Individual characteristics influence individual behavior at any given point in time. The model has at its core a stress-support paradigm, and has an ecologic frame of reference. Behavior is a result of all preceding factors, and information processed is fed back into the system. The Peabody Family Development Model is a way to organize a variety of information on family functioning and to specify how it might relate to the control of diabetes in children.