Associations between skill perceptions and young children's actual fundamental movement skills

-Given that children with low movement skill competence engage in less physical activity, it is important to understand how children's perceptions relate to actual movement competence. This study examined relationships between (i) children's self-perception and objective assessments of their movement skills (object control and locomotor) and (ii) parents' perceptions of the children's movement skills and objective assessment. Children's skill perceptions were assessed using the Pictorial Scale of Perceived Movement Skill Competence for Young Children. Parent perceptions of their child's skills were assessed using a modified version of this instrument. The Test of Gross Motor Development-2nd edition assessed children's skills objectively. Participants were 136 Australian children (51% boys; M = 6.5 yr., SD = 1.1) and 133 parents. Regression analyses (by sex) examined the relationship between perceptions and children's scores for actual skilled performance. Boys' perceptions were associated with their actual object control ability. Parents accurately perceived boys' object control ability and girls' locomotor ability, but not the reverse. This suggests interventions aiming to improve children's movement skills could target parents and be designed to teach parents how to recognize good and poor skill performance in their children.

Modeling the cost effectiveness of child care policy changes in the U.S.

INTRODUCTION: Child care facilities influence diet and physical activity, making them ideal obesity prevention settings. The purpose of this study is to quantify the health and economic impacts of a multi-component regulatory obesity policy intervention in licensed U.S. child care facilities. METHODS: Two-year costs and BMI changes resulting from changes in beverage, physical activity, and screen time regulations affecting a cohort of up to 6.5 million preschool-aged children attending child care facilities were estimated in 2014 using published data. A Markov cohort model simulated the intervention's impact on changes in the U.S. population from 2015 to 2025, including short-term BMI effects and 10-year healthcare expenditures. Future outcomes were discounted at 3% annually. Probabilistic sensitivity analyses simulated 95% uncertainty intervals (UIs) around outcomes. RESULTS: Regulatory changes would lead children to watch less TV, get more minutes of moderate and vigorous physical activity, and consume fewer sugar-sweetened beverages. Within the 6.5 million eligible population, national implementation could reach 3.69 million children, cost $4.82 million in the first year, and result in 0.0186 fewer BMI units (95% UI=0.00592 kg/m(2), 0.0434 kg/m(2)) per eligible child at a cost of $57.80 per BMI unit avoided. Over 10 years, these effects would result in net healthcare cost savings of $51.6 (95% UI=$14.2, $134) million. The intervention is 94.7% likely to be cost saving by 2025. CONCLUSIONS: Changing child care regulations could have a small but meaningful impact on short-term BMI at low cost. If effects are maintained for 10 years, obesity-related healthcare cost savings are likely.

Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia

BACKGROUND: Adequate nutrition is needed to ensure optimum growth and development of infants and young children. Understanding of the risk factors for stunting and severe stunting among children aged less than five years in North Maluku province is important to guide Indonesian government public health planners to develop nutrition programs and interventions in a post conflict area. The purpose of the current study was to assess the prevalence of and the risk factors associated with stunting and severe stunting among children aged less than five years in North Maluku province of Indonesia. METHODS: The health and nutritional status of children aged less than five years was assessed in North Maluku province of Indonesia in 2004 using a cross-sectional multi-stage survey conducted on 750 households from each of the four island groups in North Maluku province. A total of 2168 children aged 0-59 months were used in the analysis. RESULTS: Prevalence of stunting and severe stunting were 29% (95%CI: 26.0-32.2) and 14.1% (95%CI: 11.7-17.0) for children aged 0-23 months and 38.4% (95%CI: 35.9-41.0) and 18.4% (95%CI: 16.1-20.9) for children aged 0-59 months, respectively. After controlling for potential confounders, multivariate analysis revealed that the risk factors for stunted children were child's age in months, male sex and number of family meals per day (

The views of parents who experience intergenerational poverty on parenting and play: a qualitative analysis

BACKGROUND: There is minimal literature on how parents experiencing intergenerational poverty view their role as parents and the value they place on children's play. The objective of this study was to examine how these parents view their parenting role and their beliefs about children's play. METHODS: Thirteen mothers of preschool-aged children who experienced intergenerational poverty were recruited to the study. Semi-structured interviews were conducted and were analysed using interpretive phenomenological analysis. RESULTS: Parents described their role as guiding their children to become 'good' people, to teach them skills and provide a routine within the home. There were two disconnections in the data including the view that whilst parenting was hard and lonely, it was also a private matter and participants preferred not to seek support. A second disconnection was in terms of their beliefs about play. Parents believed that whilst play was valuable to their child's development, it was not their role to play with children. However, if parents did play with their child, they noticed positive changes in their child's behaviour. CONCLUSION: The views of parents who experienced intergenerational poverty were similar to other reported findings in parenting studies. However, the current sample differed on not seeking help for support as well as not seeing their role as playing with their children, even though occasions of joining their child in play were associated with a positive change in their relationship with their child. This has implications for communicating about parenting issues with parents who have experienced intergenerational poverty.

Cross-sectional and longitudinal associations between parents' and preschoolers' physical activity and TV viewing: the HAPPY Study

Background: Parental modelling has been shown to be important for school-aged children’s physical activity (PA) and television (TV) viewing, yet little is known about its impact for younger children. This study examined cross-sectional and three-year longitudinal associations between PA and TV viewing behaviours of parents and their preschool children. Method: In 2008-9 (T1), parents in the HAPPY cohort study (n=450) in Melbourne, Australia self-reported their weekly PA and TV viewing, and proxy-reported their partner’s PA and TV viewing, and their 3-5 year-old preschool child’s TV viewing. Children’s PA was assessed via accelerometers. Repeat data collection occurred in 2011-12 (T2). Results: Mothers’ and fathers’ PA were associated with PA among preschool girls at T1, but not boys. Parents’ TV viewing times were significant correlates of girls’ and boys’ TV viewing at T1. Longitudinally, mothers’ PA at baseline predicted boys’ PA at T2, while sex-specific associations were found for TV viewing, with mothers’ and fathers’ TV viewing at T1 associated with girls’ and boys’ TV viewing respectively at T2. Conclusions: The PA and TV viewing of both parents are significantly associated with these behaviours in preschool children. The influence of the sex-matched parent appears to be important longitudinally for children’s TV viewing&period.

The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children

BACKGROUND: Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. METHOD: A cost-utility economic framework, using Disability-Adjusted-Life-Years (DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio (ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. RESULTS: The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. CONCLUSIONS: Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken.

Exploring child dental service use among migrant families in metropolitan Melbourne, Australia

Abstract Background This study describes and explores factors related to dental service use among migrant children. Methods A cross-sectional analysis of baseline data from Teeth Tales, an exploratory trial implementing a community based child oral health promotion intervention. The sample size and target population was 600 families with 1-4 year old children from Iraqi, Lebanese and Pakistani backgrounds residing in metropolitan Melbourne. Participants were recruited into the study using purposive and snowball sampling techniques. Results Most (88%; 550/625) children had never visited the dentist (mean (SD) age 3.06 years (1.11)). In the fully adjusted model the variable most significantly associated with child dental visiting was parent reported 'no reason for child to visit the dentist' (OR = 0.07, p < 0.001). Of those children whose parents reported their child had no reason to visit the dentist, 22% (37/165) experienced dental caries with 8% (13/165) at the level of cavitation. Conclusions Dental service use by migrant preschool children was very low. The relationship between perceived dental need and dental service use is currently not aligned. One in 10 children of select migrant background had visited a dentist, which is in the context of 1 in 3 with dental caries. To improve utilization, health services should consider organizational cultural competence, outreach and increased engagement with the migrant community.

Cross-cultural comparison of motor competence in children from Australia and Belgium

Motor competence in childhood is an important determinant of physical activity and physical fitness in later life. However, childhood competence levels in many countries are lower than desired. Due to the many different motor skill instruments in use, children's motor competence across countries is rarely compared. The purpose of this study was to evaluate the motor competence of children from Australia and Belgium using the Körperkoordinationstest für Kinder (KTK). The sample consisted of 244 (43.4% boys) Belgian children and 252 (50.0% boys) Australian children, aged 6-8 years. A MANCOVA for the motor scores showed a significant country effect. Belgian children scored higher on jumping sideways, moving sideways and hopping for height but not for balancing backwards. Moreover, a Chi squared test revealed significant differences between the Belgian and Australian score distribution with 21.3% Belgian and 39.3% Australian children scoring "below average." The very low levels reported by Australian children may be the result of cultural differences in physical activity contexts such as physical education and active transport. When compared to normed scores, both samples scored significantly worse than children 40 years ago. The decline in children's motor competence is a global issue, largely influenced by increasing sedentary behavior and a decline in physical activity.

Social connections among parents of pre-school-age children in an inner and outer area of Melbourne, Australia

Abstract
Parents’ social connectedness is an important factor in child health and development outcomes and has been strongly linked to place. This study aimed to compare social connectedness amongst parents in inner versus outer-suburbs of Melbourne using a mixed methods approach. Parents were recruited via playgroups, mother’s groups and preschools and interviewed face- to-face regarding their social networks, with a second open-ended interview focusing on parents’ ideals and experiences of raising children in their current location. Parents in the two areas identified a similar number of contacts, but had differently structured networks. Outer-suburban parents were more likely than inner-suburban parents to have very few contacts, and to name their general practitioner as among their significant contacts. They were less likely to have more extended networks or to include neighbours among their contacts. Parents in both areas had met at least some of their network members through local organisations or services with outer-suburban parents having met a greater proportion of their contacts in this way. Qualitative interview data supported the network analysis revealing the different priorities parents placed on neighbours, barriers experienced in connecting with neighbours in the outer- suburbs and the consequent heavy reliance on organised activities to form social connections. The different types of social connections parents in inner and outer Melbourne made in relation to raising their preschool-aged children revealed in this study have implications for both service delivery and social planning of new developments.

Toward a standard approach to measurement and reporting of perioperative mortality rate as a global indicator for surgery

INTRODUCTION: The proportion of patients who die during or after surgery, otherwise known as the perioperative mortality rate (POMR), is a credible indicator of the safety and quality of operative care. Its accuracy and usefulness as a metric, however, particularly one that enables valid comparisons over time or between jurisdictions, has been limited by lack of a standardized approach to measurement and calculation, poor understanding of when in relation to surgery it is best measured, and whether risk-adjustment is needed. Our aim was to evaluate the value of POMR as a global surgery metric by addressing these issues using 4, large, mixed, surgical datasets that represent high-, middle-, and low-income countries. METHODS: We obtained data from the New Zealand National Minimum Dataset, the Geelong Hospital patient management system in Australia, and purpose-built surgical databases in Pietermaritzburg, South Africa, and Port Moresby, Papua New Guinea. For each site, we calculated the POMR overall as well as for nonemergency and emergency admissions. We assessed the effect of admission episodes and procedures as the denominator and the difference between in-hospital POMR and POMR, including postdischarge deaths up to 30 days. To determine the need for risk-adjustment for age and admission urgency, we used univariate and multivariate logistic regression to assess the effect on relative POMR for each site. RESULTS: A total of 1,362,635 patient admissions involving 1,514,242 procedures were included. More than 60% of admissions in Pietermaritzburg and Port Moresby were emergencies, compared with less than 30% in New Zealand and Geelong. Also, Pietermaritzburg and Port Moresby had much younger patient populations (P < .001). A total of 8,655 deaths were recorded within 30 days, and 8-20% of in-hospital deaths occurred on the same day as the first operation. In-hospital POMR ranged approximately 9-fold, from 0.38 per 100 admissions in New Zealand to 3.44 per 100 admissions in Pietermaritzburg. In New Zealand, in-hospital 30-day POMR underestimated total 30-day POMR by approximately one third. The difference in POMR if procedures were used instead of admission episodes ranged from 7 to 70%, although this difference was less when central line and pacemaker insertions were excluded. Age older than 65 years and emergency admission had large, independent effects on POMR but relatively little effect in multivariate analysis on the relative odds of in-hospital death at each site. CONCLUSION: It is possible to collect POMR in countries at all level of development. Although age and admission urgency are strong, independent associations with POMR, a substantial amount of its variance is site-specific and may reflect the safety of operative and anesthetic facilities and processes. Risk-adjustment is desirable but not essential for monitoring system performance. POMR varies depending on the choice of denominator, and in-hospital deaths appear to underestimate 30-day mortality by up to one third. Standardized approaches to reporting and analysis will strengthen the validity of POMR as the principal indicator of the safety of surgery and anesthesia care.

Child learning and development: concerns and perceptions of Chinese urban mothers

Child development is deservedly dominant in the discourses on education. In populated communities such as China’s, awareness of the prevalent ideas about child development within families is particularly important. Drawing on a series of conversations between parents and teachers through synchronous online text chat, this paper investigated the perceptions and concerns of Chinese urban parents on child development. The participants were mothers of three to six year old children from Changchun, China. Results were presented in terms of the nature of the questions the mothers raised and what they talked about when discussing their questions. Analyses of the mothers’ texts revealed their concerns on those elements of child development which challenged their roles in parenting, such as inappropriate social behaviours or regulated emotions. Data from the study provided insights into key characteristics of contemporary Chinese preschool children’s learning and development within families that might identify issues and trends of early childhood education on a larger contextual scope.

O pré-escolar no município de Cuiabá: subsídios para um diagnóstico

No presente trabalho procede-se a uma análise da educação pré-escolar brasileira segundo as propostas oficiais e seus resultados até 1981, definindo-se como foco de interesse o Estado de Mato Grosso e, principalmente, o município de Cuiabá. Examina-se a legislação e planos do governo que definem, normatizam ou orientam a pré-escola, a nível nacional, bem como as avaliações, no mesmo nível, constantes em alguns estudos já realizados. Faz-se apreciações sobre a situação do pré-escolar no âmbito do Estado de Mato Grosso e do município de Cuiabá, com base em documentação pertinente a essa modalidade de ensino. Apresenta-se uma descrição e análise dos resultados obtidos numa pesquisa efetuada em Cuiabá, em estabelecimentos de ensino da rede estadual, para obtenção, junto a diretores, professores e pré-escolares, de informações relativas ao funcionamento da pré-escola nesse município. O estudo vem mostrar que a proposta oficial da pré-escola é contraditória, a partir mesmo de seus pressupostos teóricos, e que os resultados de sua implantação correspondem, não a uma garantia de bom desempenho escolar mas a uma antecipação do processo discriminatório da escola. Vem mostrar, ainda, que os resultados da implantação da proposta em Mato Grosso nao são nada animadores, podendo-se considerar a pré-escola cuiabana como um elucidativo exemplo: identifica-se uma quase absoluta deficiência dessas escolas em termos materiais, administrativos, técnicos e principalmente pedagógicos para atendimento à proposta de "educação compensatória". Vem mostrar, por fim, este estudo, que um contato com 447 crianças, ditas "carentes" ou "marginalizadas", po de apontar a distância havida entre sua "cultura", de bases concretas e a cultura escolar que a pré-escola pretende, antecipadamente, lhes impor.

Os contos de fadas: suas origens histórico-culturais e implicações psicopedagógicas para crianças em idade pré-escolar

Esta dissertação tem como objetivo principal elucidar as implicações de se relatar contos de fadas às crianças em idade pré-escolar, destacando-se suas origens histórico- culturais e a sua função psicopedagógica. Com subsidios obtidos em obras de alguns autores da área de história, literatura, filosofia, psicologia e pedagogia, foi feita uma análise considerando-se alguns tópicos, dentre os quais a possibilidade de serem os contos mitos transformados, cuja evolução ou construção da narrativa tem uma característica análoga aos ritos iniciáticos das sociedades consideradas "primitivas" ou pré-letradas. Neste sentido, trazem em seu bojo a nossa herança cultural. Além disso, possuem função psicopedagógica, que possibilita à criança em idade pré-escolar identificar-se com a imagem arquetípica do herói ou heroina, na medida em que estes passam por provações, e adotar uma postura positiva frente às mesmas. Argumentou-se, ainda, quanto às criticas de que estas narrativas têm sido alvo, como, por exemplo, a sua "crueldade", a visão de mundo "deturpada e irreal" que elas promoveriam de acordo com alguns autores que privilegiam o racionalismo, e o papel "degradante e passivo" destinado a algumas personagens femininas de algumas histórias. Conclui-se o trabalho avaliando-se o papel doscontos de fadas no contexto pré-escolar, e de que forma a experiência de relatá-los às crianças pode ser enriquecedora do ponto de vista pedagógico. Apoiando-se na abordagem junguiana, trata-se de um trabalho de pesquisa e análise teórica que visa ampliar, esclarecer, bem como justificar o papel dos contos de fadas na educação pré-escolar, levando-se em conta suas funções psicopedagógicas e o seu caráter socializante, na medida em que a criança tem acesso a valores sócio-culturais que predominaram e ainda repercutem nas relações sociais contemporâneas.

Competência e desempenho nas habilidades primarias: um estudo a luz dos determinantes socio-econômicos

Este trabalho, pretende ser uma contribuição, no sentido de aguçar as atenções despertadas na área do desenvolvimento cognitivo do pré-escolar, para que não se desviem do grave problema há muito instalado na nossa sociedade: as dificuldades nos primeiros anos escolares da população procedente da classe baixa. O desempenho neste período, é um dos fatores determinantes no futuro acadêmico. Portanto, faz-se necessário que a compreensão do ambiente social se torne definida, permitindo planejar medidas de intervenção, que resultem em promoção social, especialmente para as classes e grupos carentes. As preocupações mencionadas, orientaram os esforços deste estudo, afim de se entender as variações intelectuais em função do nível socioeconômico de pré-escolares, assim como, as possíveis interrelações entre essas variáveis. Partindo-se de uma sucinta análise através de uma breve revisão das principais concepções da inteligência, buscou-se interpretar e relacionar essas contribuições e suas consequências em nível pragmático. Destaque marcante atribuiu-se aos estudos de AF inspirados no instrumental de D. Wechsler, enfatizando-se a avaliação dos fatores mais comumente encontrados. O aspecto central do trabalho é representado por uma pesquisa instrumentada através do WISC e de um questionário sôcio-econômico. A Análise Fatorial (AF) dos dados coletados, levou a detectar 4 fatores, cuja interpretação constituiu um tema paralelo deste trabalho.

Desigualdades na rede de creches conveniadas da prefeitura de São Paulo: um olhar a partir da teoria de implementação de políticas públicas

Esta tese buscou identificar e analisar os fatores que influenciam a implementação da política de Educação Infantil nas creches conveniadas da prefeitura de São Paulo. Ao constatar a existência de um cenário de desigualdade no atendimento oferecido pelas creches, a pesquisa investigou coincidências e singularidades entre dois grupos de creches, respectivamente consideradas de boa e de má qualidade. O objetivo principal foi verificar as causas que contribuem para a diferença na qualidade do atendimento e as implicações desses fatores para a implementação da política de Educação Infantil. Foram analisadas 25 creches pertencentes às Diretorias Regionais de Educação de Butantã, Campo Limpo e Guaianases. Verificou-se que os recursos da entidade mantenedora e a forma como esta apoia a creche têm grande peso no atendimento oferecido, além do papel exercido pela direção do equipamento e a sua localização. Adicionalmente, foi investigada a influência da atuação da Prefeitura, por meio da Secretaria Municipal de Educação e, mais especificamente, das suas Diretorias Regionais. Constatou-se que, ao não lidar institucionalmente com as desigualdades existentes na rede conveniada, o poder público municipal contribui para sua manutenção. As condições que interferem no atendimento são materializadas por meio do espaço físico e dos materiais pedagógicos disponíveis, das características da equipe de profissionais (número de funcionários, acesso à formação continuada e nível de remuneração) e da diversidade de atividades oferecidas às crianças. A partir dos resultados encontrados propõem-se o aprofundamento do debate sobre as desigualdades presentes na rede de creches conveniadas que leve em conta a diferenciação existente entre rede direta e conveniada, a formação disponibilizada pela Prefeitura às equipes das creches conveniadas e outros recursos necessários para apoiar as creches que não dispõem de condições adequadas para oferecer um bom atendimento.