650 resultados para HIV-exposed uninfected children


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Research has found that children exposed to family violence exhibit higher rates of maladjustment. We review relevant literature on family violence, marital conflict, and cognitive factors implicated in child behaviour problems. A bias toward perceiving threat in ambiguous contexts has been identified as one factor mediating both aggressive and anxious behaviour disorders. We conducted a study utilizing the ambiguous situations paradigm to assess whether children exposed to violent spousal conflict were more likely than children not exposed to violence (divided into children with an externalizing behaviour disorder and non-clinic children) to perceive threat in two classes of ambiguous situations: Peer and Inter-Parental. The results indicated that children exposed to violent spousal conflict perceived more threat in parental situations than either of the other two groups. A number of considerations were taken into account given the exploratory nature of the study, particularly sample limitations. We conclude with suggestions for improvements to the research design and the further relevance of exploring cognitive factors involved in the adjustment of children from backgrounds of violence.

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Children accessing and using internet-connected technology is a relatively recent phenomenon, and rapidly having an impact on their experiences and activities in homes and early childhood classrooms. Technology refers to devices such as computers, smart phones and tablets - many capable of being connected to the internet - and the products, such as websites, games, and interactive stories (Plowman and McPake, 2013). These activities can be played, created, watched, listened to and read, and incorporated into traditional everyday activities. This article provides suggestions for strategies for teachers to consider when incorporating technology into early childhood education.

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Background Indigenous children in high-income countries have a heavy burden of bronchiectasis unrelated to cystic fibrosis. We aimed to establish whether long-term azithromycin reduced pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. Methods Between Nov 12, 2008, and Dec 23, 2010, we enrolled Indigenous Australian, Maori, and Pacific Island children aged 1—8 years with either bronchiectasis or chronic suppurative lung disease into a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. Eligible children had had at least one pulmonary exacerbation in the previous 12 months. Children were randomised (1:1 ratio, by computer-generated sequence with permuted block design, stratified by study site and exacerbation frequency [1—2 vs ≥3 episodes in the preceding 12 months]) to receive either azithromycin (30 mg/kg) or placebo once a week for up to 24 months. Allocation concealment was achieved by double-sealed, opaque envelopes; participants, caregivers, and study personnel were masked to assignment until after data analysis. The primary outcome was exacerbation (respiratory episodes treated with antibiotics) rate. Analysis of the primary endpoint was by intention to treat. At enrolment and at their final clinic visits, children had deep nasal swabs collected, which we analysed for antibiotic-resistant bacteria. This study is registered with the Australian New Zealand Clinical Trials Registry; ACTRN12610000383066. Findings 45 children were assigned to azithromycin and 44 to placebo. The study was stopped early for feasibility reasons on Dec 31, 2011, thus children received the intervention for 12—24 months. The mean treatment duration was 20·7 months (SD 5·7), with a total of 902 child-months in the azithromycin group and 875 child-months in the placebo group. Compared with the placebo group, children receiving azithromycin had significantly lower exacerbation rates (incidence rate ratio 0·50; 95% CI 0·35—0·71; p<0·0001). However, children in the azithromycin group developed significantly higher carriage of azithromycin-resistant bacteria (19 of 41, 46%) than those receiving placebo (four of 37, 11%; p=0·002). The most common adverse events were non-pulmonary infections (71 of 112 events in the azithromycin group vs 132 of 209 events in the placebo group) and bronchiectasis-related events (episodes or investigations; 22 of 112 events in the azithromycin group vs 48 of 209 events in the placebo group); however, study drugs were well tolerated with no serious adverse events being attributed to the intervention. Interpretation Once-weekly azithromycin for up to 24 months decreased pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. However, this strategy was also accompanied by increased carriage of azithromycin-resistant bacteria, the clinical consequences of which are uncertain, and will need careful monitoring and further study.

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Widespread scholarly interest in ethics in research with children, as an extant field of inquiry and practice, is a relatively new phenomenon. The discipline of ethics can be traced back to the Hippocratic school, but its contemporary applications in the everyday worlds of children and those around them are gaining greater attention from theorists, practitioners, and those involved in policy. Heightened international awareness of the United Nations Convention on the Rights of the Child (1979) gave significant impetus to increasing international awareness of children’s rights to provision, protection, and participation in everyday contexts, including those in which research occurs. Understandings of research ethics and of children’s involvement in research relate to broader understandings of children and childhood drawn from developmental science, sociology, human geography, health sciences, and children’s human rights to participation and protection. Key understandings pertain to children’s competence to participate in research, to operate as reliable informants with respect to their own lives, to provide voluntary informed consent and dissent in research, and to make meaningful decisions about the nature and extent of their participation. The field is international and interdisciplinary, although bounded by legislative, policy, and jurisdictional requirements governing research—its conduct and dissemination. So, too, the burgeoning work of ethics committees, whether in relation to health research or social research, is evidence of a sharpened focus on governance of child research. Oxford Bibliographies offers a suite of perspectives, resources, and strategies to guide the researcher, practitioner, and policymaker and serves to challenge readers to interrogate conceptual understandings, methodologies, and dissemination of research with and about children. Exploration of the suite opens up new possibilities for considering children’s rights to participation in matters that affect their lives and for children to be seen and heard in research.

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Purpose To examine choroidal thickness (ChT) and its topographical variation across the posterior pole in myopic and non-myopic children. Methods One hundred and four children aged 10-15 years of age (mean age 13.1 ± 1.4 years) had ChT measured using enhanced depth imaging optical coherence tomography (OCT). Forty one children were myopic (mean spherical equivalent -2.4 ± 1.5 D) and 63 non-myopic (mean +0.3 ± 0.3 D). Two series of 6 radial OCT line scans centred on the fovea were assessed for each child. Subfoveal ChT and ChT across a series of parafoveal zones over the central 6mm of the posterior pole were determined through manual image segmentation. Results Subfoveal ChT was significantly thinner in myopes (mean 303 ± 79 µm) compared to non-myopes (mean 359 ± 77 µm) (p<0.0001). Multiple regression analysis revealed both refractive error (r = 0.39, p<0.001) and age (r = 0.21, p = 0.02) were positively associated with subfoveal ChT. ChT also exhibited significant topographical variations, with the choroid being thicker in more central regions. The thinnest choroid was typically observed in nasal (mean 286 ± 77 µm) and inferior-nasal (306 ± 79 µm) locations, and the thickest in superior (346 ± 79 µm) and superior-temporal (341 ± 74 µm) locations. The difference in ChT between myopic and non-myopic children was significantly greater in central foveal regions compared to more peripheral regions (>3 mm diameter) (p<0.001). Conclusions Myopic children have significantly thinner choroids compared to non-myopic children of similar age, particularly in central foveal regions. The magnitude of difference in choroidal thickness associated with myopia appears greater than would be predicted by a simple passive choroidal thinning with axial elongation.

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Purpose: To objectively assess daily light exposure and physical activity levels in myopic and emmetropic children. Methods: One hundred and two children (41 myopes and 61 emmetropes) aged 10 to 15 years old had simultaneous objective measures of ambient light exposure and physical activity collected over a 2 week period during school term, using a wrist worn actigraphy device (Actiwatch-2). Measures of visible light illuminance and physical activity were captured every 30 seconds, 24 hours a day over this period. Mean hourly light exposure and physical activity for weekdays and weekends were examined. To ensure that seasonal variations didn’t confound comparisons, the light and activity data of the 41 myopes, was compared with 41 age and gender matched emmetropes who wore the Actiwatch over the same two week period. Results: Mean light exposure and physical activity for all 101 children with valid data exhibited significant changes with time of day and day of the week (p<0.0001). On average greater daily light exposure occurred on weekends compared to weekdays (p<0.05), and greater physical activity occurred on weekdays compared to weekends (p<0.01). Myopic children (n = 41, mean daily light exposure 915 ± 519 lux) exhibited significantly lower average light exposure compared to 41 age and gender matched emmetropic children (1272 ± 625 lux, p<0.01). The amount of daily time spent in bright light conditions (>1000 lux) was also significantly greater in emmetropes (127 ± 51 minutes) compared to myopes (91 ± 44 minutes, p<0.001). No significant differences were found between the average daily physical activity levels of myopes and emmetropes (p>0.05). Conclusions: Myopic children exhibit significantly lower daily light exposure, but no significant difference in physical activity compared to emmetropic children. This suggests the important factor involved in documented associations between myopia and outdoor activity is likely exposure to bright outdoor light rather than greater physical activity.

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This study reports on an intervention program designed to facilitate transition to school of a whole community of Indigenous Australian children who had previously not been attending. The children were from families displaced from their traditional lands and experienced on-going social marginalisation and transience. A social capital framework was employed to track change in the children’s social inclusion and family-school engagement for two years, from school entry. Sociometric measurement and interview techniques were applied to assess the children’s social connectedness and peer relationship quality. Using these data, analyses examined whether bonding within the group supported or inhibited formation of new social relationships. Although transience disrupted attendance, there was a group trend towards increased social inclusion with some evidence that group bonds supported bridging to new social relationships. Change in family-school engagement was tracked using multi-informant interviews. Limited engagement between school and families presented an on-going challenge to sustained educational engagement.

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Fire safety has become an important part in structural design due to the ever increasing loss of properties and lives during fires. Conventionally the fire rating of load bearing wall systems made of Light gauge Steel Frames (LSF) is determined using fire tests based on the standard time-temperature curve in ISO834 [1]. However, modern commercial and residential buildings make use of thermoplastic materials, which mean considerably high fuel loads. Hence a detailed fire research study into the fire performance of LSF walls was undertaken using realistic design fire curves developed based on Eurocode parametric [2] and Barnett’s BFD [3] curves using both full scale fire tests and numerical studies. It included LSF walls without cavity insulation, and the recently developed externally insulated composite panel system. This paper presents the details of finite element models developed to simulate the full scale fire tests of LSF wall panels under realistic design fires. Finite element models of LSF walls exposed to realistic design fires were developed, and analysed under both transient and steady state fire conditions using the measured stud time-temperature curves. Transient state analyses were performed to simulate fire test conditions while steady state analyses were performed to obtain the load ratio versus time and failure temperature curves of LSF walls. Details of the developed finite element models and the results including the axial deformation and lateral deflection versus time curves, and the stud failure modes and times are presented in this paper. Comparison with fire test results demonstrate the ability of developed finite element models to predict the performance and fire resistance ratings of LSF walls under realistic design fires.

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The aim of this study was to validate the Children’s Eating Behaviour Questionnaire (CEBQ) in three ethnically and culturally diverse samples of mothers in Australia. Confirmatory factor analysis utilising structural equation modelling examined whether the established 8-factor model of the CEBQ was supported in our three populations: (i) a community sample of first-time mothers allocated to the control group of the NOURISH trial (mean child age = 24 months [SD = 1]; N = 244); (ii) a sample of immigrant Indian mothers of children aged 1–5 years (mean age = 34 months [SD = 14]; N = 203), and (iii) a sample of immigrant Chinese mothers of children aged 1–4 years (mean age = 36 months [SD = 14]; N = 216). The original 8-factor model provided an acceptable fit to the data in the NOURISH sample with minor post hoc re-specifications (two error covariances on Satiety Responsiveness and an item-factor covariance to account for a cross-loading of an item (Fussiness) on Satiety Responsiveness). The re-specified model showed reasonable fit in both the Indian and Chinese samples. Cronbach’s α estimates ranged from .73 to .91 in the Australian sample and .61–.88 in the immigrant samples. This study supports the appropriateness of the CEBQ in the multicultural Australian context.

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To the Editor: In affluent-urban areas of India, overweight (6 %) and obesity (8 %) are prevalent in children as young as 2–5 y [1]. A potential risk factor for childhood obesity could be parent’s under-reporting their child’s anthropometry. In Indian culture, a larger body size is typically acceptable, and mothers may consider a chubby baby as healthy [2]. Therefore, it was proposed that Indian mothers may under-report their child’s weight status. The present study examined the validity of maternal reported height and weight of young, urban-affluent Indian children aged 2–5 y. After receiving approval from the QUT Human Research Ethics Committee, Australia 111 mothers with children aged 2–5 y attending private medical clinics (n = 5) in the affluent areas of Mumbai were recruited. Child’s height and weight were measured by the researcher using standard equipment/protocols. Mothers also reported their child’s height and weight.

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Journalists work in an intensively time-pressured environment, researching and writing to daily, often 24 hour, deadlines and always aware of the competition with other news outlets to be first with the news. This results, as Karen Sanders has observed, in journalists having very little time for reflection. “If they do reflect, it’s usually after a decision has been made” (Sanders 2003, 168). Yet time for reflection upon professional practice is important, especially in an era of extremely rapid and seismic technological change in the global media. This paper will reflect upon how freelance journalists can use advances in social media and web-based connectedness to tell global stories via mainstream media outlets. In exploring this question, I will examine the techniques and communications technologies used by three reporters working in the UK and Australia to find, investigate and break a series of articles, published simultaneously on the front pages of The Australian and The Times (London) newspapers, was a result of a six month investigation. The series exposed a 50-year cover-up of the serial abuse of children by one of the Church of England's most senior clergy, Robert Waddington, in Australia and the UK. It unearthed the existence of a culture of physical and sexual abuse at St Barnabas boarding school in Queensland, the sudden closure of the school and disappearance of student files - as well as Waddington's subsequent offences against children while Dean of Manchester Cathedral. We produced more than 20 articles. The coverage sparked church-ordered investigations in both countries, and also prompted the Archbishop of Canterbury to order a commission of inquiry – headed by a sitting UK judge - as well as a nationwide child safety audit of dioceses in Britain. In Australia, the church referred the case and handed its files to the Royal Commission into Child Sexual Abuse. The coverage marked the first publishing collaboration between The Australian and The Times to break an exclusive story in Australia and Britain simultaneously, on May 10, 2013.

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An international early years project led by QUT and University of Iceland researchers has investigated children’s accounts of play and the teacher’s role in play in kindergarten settings. While most commonly associated with young children’s activities and the work of childhood, play is recognised also as an activity that extends over the life span, from early childhood to adulthood, and across cultures, worldwide. As shown in national and state policy and curriculum documents, play is being subjected increasingly to specific guidelines that address the physical environment and educator involvement in early years settings. Parents and educators have strong opinions regarding the value and place of play. Children also have strong views about play, although little is known about their views and what they think play encompasses, and the value of play in their everyday lives.

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Young children are thought to be particularly sensitive to heatwaves, but relatively less research attention has been paid to this field to date. A systematic review was conducted to elucidate the relationship between heat waves and children’s health. Literature published up to August 2012 were identified using the following MeSH terms and keywords: “heatwave”, “heat wave”, “child health”, “morbidity”, “hospital admission”, “emergency department visit”, “family practice”, “primary health care”, “death” and “mortality”. Of the 628 publications identified, 12 met the selection criteria. The existing literature does not consistently suggest that mortality among children increases significantly during heat waves, even though infants were associated with more heat-related deaths. Exposure to heat waves in the perinatal period may pose a threat to children’s health. Pediatric diseases or conditions associated with heat waves include renal disease, respiratory disease, electrolyte imbalance and fever. Future research should focus on how to develop a consistent definition of a heat wave from a children’s health perspective, identifying the best measure of children’s exposure to heat waves, exploring sensitive outcome measures to quantify the impact of heat waves on children, evaluating the possible impacts of heat waves on children’s birth outcomes, and understanding the differences in vulnerability to heat waves among children of different ages and from different income countries. Projection of the children’s disease burden caused by heat waves under climate change scenarios, and development of effective heat wave mitigation and adaptation strategies that incorporate other child protective health measures, are also strongly recommended.