Association between Australian-Indian mothers' controlling feeding practices and children's appetite traits

This cross-sectional study examined the association between controlling feeding practices and children's appetite traits. The secondary aim studied the relationship between controlling feeding practices and two proxy indicators of diet quality. Participants were 203 Australian-Indian mothers with children aged 1-5 years. Controlling feeding practices (pressure to eat, restriction, monitoring) and children's appetite traits (. food approach traits: food responsiveness, enjoyment of food, desire to drink, emotional overeating; food avoidance traits: satiety responsiveness, slowness in eating, fussiness and emotional undereating) were measured using self-reported, previously validated scales/questionnaires. Children's daily frequency of consumption of core and non-core foods was estimated using a 49-item list of foods eaten (yes/no) in the previous 24 hours as an indicator of diet quality. Higher pressure to eat was associated with higher scores for satiety responsiveness, slowness in eating, fussiness and lower score for enjoyment of food. Higher restriction was related to higher scores for food responsiveness and emotional overeating. Higher monitoring was inversely associated with fussiness, slowness in eating, food responsiveness and emotional overeating and positively associated with enjoyment of food. Pressure to eat and monitoring were related to lower number of core and non-core foods consumed in the previous 24 hours, respectively. All associations remained significant after adjusting for maternal and child covariates (n = 152 due to missing data). In conclusion, pressure to eat was associated with higher food avoidance traits and lower consumption of core foods. Restrictive feeding practices were associated with higher food approach traits. In contrast, monitoring practices were related to lower food avoidance and food approach traits and lower non-core food consumption.

The unequal distribution of road trauma in China : understanding risk factors to improve public health

The World Health Organization identifies road trauma as a major public health issue in every country; most notably among low-to-middle income countries. More than 90% of all road fatalities occur in these countries, although they have only 48% of all registered vehicles [1]. Unprecedented focus has been placed on reducing the global road trauma burden through the United Nations Decade of Action for Road Safety (2011-2020). China is rapidly transitioning from a nation of bicycle riders and pedestrians to one where car ownership and use is increasing. This transition presents important public health, mobility, and safety challenges. Rapid motorisation has resulted in an increased road trauma burden, shouldered disproportionately among the population. Vulnerable road users (bicyclists, pedestrians, and motorcyclists) are of particular concern, representing 70% of all road-related fatalities [1]. Furthermore, those at greatest risk of sustaining a crash-related disability are: male, older, less educated, and earning a lower income [2] and residing in urban areas [3], with higher fatality rates in north-western poorer provinces [3]. Speeding is a key factor in road crashes in China [1, 4] and is one of two risk factors targeted in the Bloomberg Philanthropies-funded Global Road Safety Program operating in two Chinese cities over five year [5] to which the first author has provided expert advice. However, little evidence exists to help understand the factors underpinning speeding behaviour. Previous research conducted by the authors in Beijing and Hangzhou explored personal, social, and legal factors relating to speeding to assist in better understanding the motivations for non-compliance with speed limits. Qualitative and quantitative research findings indicated that speeding is relatively common, including self-reported travel speeds of greater than 30 km/hour above posted speed limits [6], and that the road safety laws and enforcement practices may, in some circumstances, contribute to this [7]. Normative factors were also evident; the role of friends, family members and driving instructors were influential. Additionally, using social networks to attempt to avoid detection and penalty was reported, thereby potentially reinforcing community perceptions that speeding is acceptable [8, 9]. The authors established strong collaborative links with the Chinese Academy of Sciences and Zhejiang Police College to conduct this research. The first author has worked in both institutions for extended time periods and recognises that research must include an understanding of culturally-relevant issues if road safety is to improve in China. Future collaborations to assist in enhancing our understanding of such issues are welcomed. References [1] World Health Organization. (2009). Global status report on road safety: Time for action; Geneva. [2] Chen, H., Du, W., & Li, N. (2013). The socioeconomic inequality in traffic-related disability among Chinese adults: the application of concentration index. Accident Analysis & Prevention, 55(101-106). [3] Wang, S. Y., Li, Y. H., Chi, G. B., Xiao, S. Y., Ozanne-Smith, J., Stevenson, M., & Phillips, M. (2008). Injury-related fatalities in China: an under-recognised public-health problem. The Lancet (British edition), 372(9651), 1765-1773. [4] He, J., King, M. J., Watson, B., Rakotonirainy, A., & Fleiter, J. J. (2013). Speed enforcement in China: National, provincial and city initiatives and their success. Accident Analysis & Prevention, 50, 282-288. [5] Bhalla, K., Li, Q., Duan, L., Wang, Y., Bishai, D., & Hyder, A. A. (2013). The prevalence of speeding and drink driving in two cities in China: a mid project evaluation of ongoing road safety interventions. Injury, 44, 49-56. doi:10.1016/S0020-1383(13)70213-4. [6] Fleiter, J. J., Watson, B., & Lennon, A. (2013). Awareness of risky behaviour among Chinese drivers. Peer-reviewed paper presented at 23rd Canadian Multidisciplinary Road Safety Conference, Montréal, Québec. [7] Fleiter, J. J., Watson, B., Lennon, A., King, M. J., & Shi, K. (2009). Speeding in Australia and China: A comparison of the influence of legal sanctions and enforcement practices on car drivers. Peer-reviewd paper presented at Australasian Road Safety Research Policing Education Conference, Sydney. [8] Fleiter, J. J., Watson, B., Lennon, A., King, M. J., & Shi, K. (2011). Social influences on drivers in China. Journal of the Australasian College of Road Safety, 22(2), 29-36. [9] Fleiter, J. J., Watson, B., Guan, M. Q., Ding, J. Y., & Xu, C. (2013). Characteristics of Chinese Drivers Attending a Mandatory Training Course Following Licence Suspension. Peer-reviewed paper presented at Road Safety on Four Continents, Beijing, China.

Health consequences of exposure to e-waste : a systematic review

Background The population exposed to potentially hazardous substances through inappropriate and unsafe management practices related to disposal and recycling of end-of-life electrical and electronic equipment, collectively known as e-waste, is increasing. We aimed to summarise the evidence for the association between such exposures and adverse health outcomes. Methods We systematically searched five electronic databases (PubMed, Embase, Web of Science, PsycNET, and CINAHL) for studies assessing the association between exposure to e-waste and outcomes related to mental health and neurodevelopment, physical health, education, and violence and criminal behaviour, from Jan 1, 1965, to Dec 17, 2012, and yielded 2274 records. Of the 165 full-text articles assessed for eligibility, we excluded a further 142, resulting in the inclusion of 23 published epidemiological studies that met the predetermined criteria. All studies were from southeast China. We assessed evidence of a causal association between exposure to e-waste and health outcomes within the Bradford Hill framework. Findings We recorded plausible outcomes associated with exposure to e-waste including change in thyroid function, changes in cellular expression and function, adverse neonatal outcomes, changes in temperament and behaviour, and decreased lung function. Boys aged 8–9 years living in an e-waste recycling town had a lower forced vital capacity than did those living in a control town. Significant negative correlations between blood chromium concentrations and forced vital capacity in children aged 11 and 13 years were also reported. Findings from most studies showed increases in spontaneous abortions, stillbirths, and premature births, and reduced birthweights and birth lengths associated with exposure to e-waste. People living in e-waste recycling towns or working in e-waste recycling had evidence of greater DNA damage than did those living in control towns. Studies of the effects of exposure to e-waste on thyroid function were not consistent. One study related exposure to e-waste and waste electrical and electronic equipment to educational outcomes. Interpretation Although data suggest that exposure to e-waste is harmful to health, more well designed epidemiological investigations in vulnerable populations, especially pregnant women and children, are needed to confirm these associations. Funding Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Australia.

“Do I really need a nap?”: The role of sleep science in informing sleep practices in early childhood education and care settings

A compelling body of studies identifies the importance of sleep for children’s learning, behavioral regulation, and health. These studies have primarily focused on nighttime sleep or on total sleep duration. The independent contribution of daytime sleep, or napping, in childhood is an emerging research focus. Daytime sleep is particularly pertinent to the context of early childhood education and care (ECEC) where, internationally, allocation of time for naps is commonplace through to the time of school entry. The biological value of napping varies with neurological maturity and with individual circumstance. Beyond the age of 3 years, when monophasic sleep patterns become typical, there is an increasing disjuncture between children’s normative sleep requirements and ECEC practice. At this time, research evidence consistently identifies an association between napping and decreased quality and duration of night sleep. We assess the implications of this evidence for educational practice and health policy. We identify the need to distinguish the functions of napping from those of rest, and assert the need for evidence-based guidelines on sleep–rest practices in ECEC settings to accommodate individual variation in sleep needs. Given both the evidence on the impact of children’s nighttime sleep on long-term trajectories of health and well-being and the high rates of child attendance in ECEC programs, we conclude that policy and practice regarding naptime have significant implications for child welfare and ongoing public health.

Parent feeding interactions and practices during childhood cancer treatment: A qualitative investigation

In the general population it is evident that parent feeding practices can directly shape a child’s life long dietary intake. Young children undergoing childhood cancer treatment may experience feeding difficulties and limited food intake, due to the inherent side effects of their anti-cancer treatment. What is not clear is how these treatment side effects are influencing the parent–child feeding relationship during anti-cancer treatment. This retrospective qualitative study collected telephone based interview data from 38 parents of childhood cancer patients who had recently completed cancer treatment (child’s mean age: 6.98 years). Parents described a range of treatment side effects that impacted on their child’s ability to eat, often resulting in weight loss. Sixty-one percent of parents (n = 23) reported high levels of stress in regard to their child’s eating and weight loss during treatment. Parents reported stress, feelings of helplessness, and conflict and/or tension between parent and the child during feeding/eating interactions. Parents described using both positive and negative feeding practices, such as: pressuring their child to eat, threatening the insertion of a nasogastric feeding tube, encouraging the child to eat and providing home cooked meals in hospital. Results indicated that parent stress may lead to the use of coping strategies such as positive or negative feeding practices to entice their child to eat during cancer treatment. Future research is recommended to determine the implication of parent feeding practice on the long term diet quality and food preferences of childhood cancer survivors.

‘Ngulluck Katitj Wah Koorl Koorliny/ Us mob going along learning to research together’ : drawing on action research to develop a literature review on Indigenous gendered health and wellbeing

This paper describes the collaborative work practices of the Health and Wellbeing Node within the National Indigenous Research and Knowledges Network (NIRAKN). The authors reflect on the processes they used to research and develop a literature review. As a newly established research team, the Health and Wellbeing Node members developed a collaborative approach that was informed by Action Research practices and underpinned by Indigenous ways of working. The authors identify strong links between Action Research and Indigenous processes. They suggest that, through ongoing cycles of research and review, the NIRAKN Health and Wellbeing Node developed a culturally safe, respectful and trulycollaborative way of working together and forming the identity of their work group. In this paper, they describe their developing work processes and explain the way that pictorial conceptual models contributed to their emerging ideas.

Sustainability of public health interventions to reduce the risk of dioxin exposure at severe dioxin hot spots in Vietnam

Severe dioxin contamination at Bien Hoa and Da Nang airbases, Vietnam is of international concern. Public Health risk reduction programs were implemented in Bien Hoa in 2007-2009 and in Da Nang in 2009-2011. In 2009 and 2011 we reported the encouraging results of these interventions in improving the knowledge, attitude and practices (KAP) of local residents in reducing the dioxin exposure risk through foods. In 2013 we revisited these dioxin hot spots, aimed to evaluate whether the results of the intervention were maintained and to identify factors affecting the sustainability of the programs. To assess this, 16 in-depth interviews, six focus group discussions, and pre and post intervention KAP surveys were undertaken. 800 respondents from six intervention wards and 200 respondents from Buu Long Ward (the control site) were randomly selected to participate in the surveys. The results showed that as of 2013, the programs were rated as "moderately sustained" with a score of 3.3 out of 5.0 (cut off points 2.5 to <3.5) for Bien Hoa, and "well sustained" with a score of 3.8 out of 5.0 (cut off points 3.5 to <4.5) for Da Nang. Most formal intervention program activities had ceased and dioxin risk communication activities were no longer integrated into local routine health education programs. However, the main outcomes were maintained and were better than that in the control ward. Migration, lack of official guidance from City People's Committees and local authorities as well as the politically sensitive nature of dioxin issues were the main challenges for the sustainability of the programs.

Relationships between maternal overweight prior to pregnancy, feeding mode and infant feeding beliefs and practices

Aim To examine whether pre-pregnancy weight status was associated with maternal feeding beliefs and practices in the early post-partum period. Methods Secondary analysis of longitudinal data from Australian mothers. Participants (N=486) were divided into two weight status groups based on self-reported pre-pregnancy weight and measured height: healthy weight (BMI <25kg/m2; n=321) and overweight (BMI>25kg/m2; n=165). Feeding beliefs and practices were self-reported via an established questionnaire that assessed concerns about infant overeating and undereating, awareness of infant cues, feeding to a schedule, and using food to calm. Results Infants of overweight mothers were more likely to have been given solid foods in the previous 24hrs (29% vs 20%) and fewer were fully breastfed (50% vs 64%). Multivariable regression analyses (adjusted for maternal education, parity, average infant weekly weight gain, feeding mode and introduction of solids) revealed pre-pregnancy weight status was not associated with using food to calm, concern about undereating, awareness of infant cues or feeding to a schedule. However feeding mode was associated with feeding beliefs and practices. Conclusions Although no evidence for a relationship between maternal weight status and early maternal feeding beliefs and practices was observed, differences in feeding mode and early introduction of solids was observed. The emergence of a relationship between feeding practices and maternal weight status may occur when the children are older, solid feeding is established and they become more independent in feeding.

The relationship between controlling feeding practices and boys’ and girls’ eating in the absence of hunger

Parental controlling feeding practices have been directly associated with maladaptive child eating behaviours, such as Eating in the Absence of Hunger (EAH). The aim of this study was to examine EAH in very young children (3-4 years old) and to investigate the association between maternal controlling feeding practices and energy intake from a standardised selection of snacks consumed ‘in the absence of hunger’. Thirty-seven mother-child dyads enrolled in the NOURISH RCT participated in a modified EAH protocol conducted in the child’s home. All children displayed EAH, despite 80% reporting to be full or very full following completion of lunch 15 minutes earlier. The relationship between maternal and child covariates and controlling feeding practices and EAH were examined using non-parametric tests, and were stratified by child gender. For boys only, pressure to eat was positively associated with EAH. Neither restriction nor monitoring practices were associated with EAH in either boys or girls. Overall, the present findings suggest gender differences in the relationship between maternal feeding practices and children’s eating behaviours emerge early and should be considered in future research and intervention design.

The second chance project: A multi-level examination of secondary prevention practices for Saudi people following a recent cardiac event

The study examined the health-related behaviours of Saudi people following a recent cardiac event and identified the factors that influence these behaviours using McLeroy et al.'s (1988) Ecological Model of Health Behaviours as a guiding framework. The study was one of the first in Saudi Arabia to examine the health-related behaviours of Saudi people following a recent cardiac event. The study findings emphasise the importance of a program that integrates secondary prevention practices, educational approaches and targeted supportive services in cardiac care in Saudi Arabia.

An investigation of the knowledge and practices relating to drink driving among Chinese drivers

This project was a comprehensive study of drink driving in two Chinese cities. It examined general motor vehicle drivers' and drunk driving offenders' knowledge on and practices of drinking and driving, and their interaction with alcohol misuse problems. In addition, traffic police officers' perceptions of drink driving and their legal enforcement practices were studied. The differences between the two cities (Guangzhou and Yinchuan) were discussed and the approaches by China and Australia to drink driving legislation, legal enforcement and policy were also compared.

Practices and knowledge levels of prehospital doctors in traumatic brain injury management in Hubei, China

This thesis is a cross-sectional questionnaire survey of pre-hospital doctors' knowledge and practice of managing traumatic brain injury in two major cities of Hubei province, China. This study provides evidence for future research on improving the quality of pre-hospital management in China.

An early feeding practices intervention for obesity prevention

Objective - Report long term outcomes of the NOURISH randomized controlled trial (RCT) that evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on ‘protective’ complementary feeding practices which were hypothesized to reduce childhood obesity risk. Subjects and Methods - The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD=5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed five times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear Mixed Models evaluated intervention (group) effect across time. Results - Retention at 5 years of age was 61%. Across ages 2-5 years, intervention mothers reported less frequent use of non-responsive feeding practices on 6/9 scales. At 5 years they also reported more appropriate responses to food refusal on 7/12 items (Ps ≤.05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P=.06), or the prevalence of overweight/obesity (control 13.3% vs. intervention 11.4%, P=.66). Conclusions - Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to five years of age and were paralleled by a non-significant trend for lower child BMI Z-scores at all post-intervention assessment points.

The sleeping elephant in the room: Practices and policies regarding sleep-rest time in ECEC

The National Quality Framework (NQF) for Early Childhood Education and Care (ECEC) in Australia identifies the need for services to make provision for each child’s sleep, rest and relaxation within a national early year’s policy framework that also requires that opportunities for learning and physical health are optimised, and that the agency of each child and their family is respected. Against this background, the scheduling of a standard sleep-time in ECEC centres remains a common practice, even in rooms catering for older children for whom daytime sleep may no longer be necessary. This article draws upon existing scholarship to explore the issues and tensions associated with sleep-rest, in the context of Australian curriculum and quality standards documents. We review accounts from educators, parents and children and contemporary views regarding high quality practice in ECEC, with an aim of supporting critical reflection on practice and continuous quality improvement in ECEC.

Impact of agricultural chemicals on the environment and human health in Asia: Are there solutions?

Modern commercial agricultural practices in Asia during the last three to four decades involving chemicals (fertilisers and pesticides) have been associated with large increases in food production never witnessed before, especially under the Green Revolution technology in South Asia. This also involves large-scale increases in commercial vegetable crops. However, the high reliance on chemical inputs to bring about these increases in food production is not without problems. A visible, parallel correlation between higher productivity, high artificial input use and environmental degradation and human ill-health is evident in many countries where commercial agriculture is widespread. In this chapter, we focus on the impact of chemical inputs, in particular the impact of pesticides on the environment and on human health in South Asia with special reference to Sri Lanka...