Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke

BackgroundChildren's exposure to other people's cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children are also at risk of exposure to ETS in child care or educational settings. Preventing exposure to cigarette smoke in infancy and childhood has significant potential to improve children's health worldwide.ObjectivesTo determine the effectiveness of interventions aiming to reduce exposure of children to ETS.Search methodsWe searched the Cochrane Tobacco Addiction Group Specialized Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, ERIC, and The Social Science Citation Index & Science Citation Index (Web of Knowledge). Date of the most recent search: September 2013.Selection criteriaControlled trials with or without random allocation. Interventions must have addressed participants (parents and other family members, child care workers and teachers) involved with the care and education of infants and young children (aged 0 to 12 years). All mechanisms for reduction of children's ETS exposure, and smoking prevention, cessation, and control programmes were included. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions.Data collection and analysisTwo authors independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcome measures, no summary measures were possible and results were synthesised narratively.Main resultsFifty-seven studies met the inclusion criteria. Seven studies were judged to be at low risk of bias, 27 studies were judged to have unclear overall risk of bias and 23 studies were judged to have high risk of bias. Seven interventions were targeted at populations or community settings, 23 studies were conducted in the 'well child' healthcare setting and 24 in the 'ill child' healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether the visits were to well or ill children, and another included both well and ill child visits. Thirty-six studies were from North America, 14 were in other high income countries and seven studies were from low- or middle-income countries. In only 14 of the 57 studies was there a statistically significant intervention effect for child ETS exposure reduction. Of these 14 studies, six used objective measures of children's ETS exposure. Eight of the studies had a high risk of bias, four had unclear risk of bias and two had a low risk of bias. The studies showing a significant effect used a range of interventions: seven used intensive counselling or motivational interviewing; a further study used telephone counselling; one used a school-based strategy; one used picture books; two used educational home visits; one used brief intervention and one study did not describe the intervention. Of the 42 studies that did not show a significant reduction in child ETS exposure, 14 used more intensive counselling or motivational interviewing, nine used brief advice or counselling, six used feedback of a biological measure of children's ETS exposure, one used feedback of maternal cotinine, two used telephone smoking cessation advice or support, eight used educational home visits, one used group sessions, one used an information kit and letter, one used a booklet and no smoking sign, and one used a school-based policy and health promotion. In 32 of the 57 studies, there was reduction of ETS exposure for children in the study irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure, but rather aimed to reduce symptoms of asthma, and found a significant reduction in symptoms in the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions.Authors' conclusionsWhile brief counselling interventions have been identified as successful for adults when delivered by physicians, this cannot be extrapolated to adults as parents in child health settings. Although several interventions, including parental education and counselling programmes, have been used to try to reduce children's tobacco smoke exposure, their effectiveness has not been clearly demonstrated. The review was unable to determine if any one intervention reduced parental smoking and child exposure more effectively than others, although seven studies were identified that reported motivational interviewing or intensive counselling provided in clinical settings was effective.

Baby, it`s you : international capital discovers the under threes

Well-established international entertainment firms such as Disney and Fisher-Price are joining new start-up firms such as Baby Einstein to create a 'Baby' market of products (including toys, games and videos) specifically targeted at children aged 0-3 years. Despite its novelty, the 'Baby' market mirrors older markets that these firms have created around other demographic groups (e.g. older children, adolescents and adults) - it redefines its target demographic group around specific commodities and promotes its redefinition as 'common sense'. The 'Baby' firms redefine babies solely as early learners whose potential to learn can be released by these firms' brand-name 'educational' or 'developmental' products. Many adults buy these products because they accept the firms' redefinition of babies, but other adults ignore the firms' promotional messages and buy the products to give themselves some time apart from their babies. The 'Baby' market is significant for children and adults because it changes young children's relationships with adults and because it subordinates local cultural differences to a children's culture that purports to be 'global' but has, in reality, extremely narrow foundations in class, race and gender.

The social validity of interventions for promoting preschool childrens peer interactions

This analogue study investigated the social validity of classroom interventions designed to promote peer interactions in young children. The influences of child characteristics and diagnostic labels on social validity ratings were examined, as were the relationships among three components of social validity. Forty-two preschool teachers completed a 15-item social validity scale that yielded scores pertaining to intervention goals, procedures and effects. Participants rated three types of intervention, which varied according to individuals targeted and intensity of programming procedures, with reference to one of three case descriptions of children with social interaction problems. Half the participants were provided with the child’s diagnostic label. Results indicated that social validity is affected by interactions between intervention methods and child characteristics. The inclusion of diagnostic labels in the case descriptions had no effect on social validity ratings. Strong positive relationships were found among the components of social validity. Implications for the use of empirically validated interventions in inclusive preschools are discussed.

Learn to design vs design to learn: enhancing educational opportunities using game technoloy

Recognizing as children’s input in game design and development process is critical, we applied cooperative inquiry experiences working with young children as game design partners. The computer-based games specifically were designed and developed for the acquisition of survival literacy by 12-14 year old intellectually disabled children. During the design and development game process, children learnt game design techniques without their acknowledgement. Importantly, the development process will be undertaken by the students with the minimum guidance of team members. The experiences, challenges and lesson learned through game design process are discussed.

Early childhood caries: current evidence for aetiology and prevention

Background: Despite the fact that it is largely preventable, dental caries (decay) remains one of the most common chronic diseases of early childhood. Dental decay in young children frequently leads to pain and infection necessitating hospitalization for dental extractions under general anaesthesia. Dental problems in early childhood have been shown to be predictive of not only future dental problems but also on growth and cognitive development by interfering with comfort nutrition, concentration and school participation. Objective: To review the current evidence base in relation to the aetiology and prevention of dental caries in preschool-aged children. Methods: A search of MEDLINE, CINALH and Cochrane electronic databases was conducted using a search strategy which restricted the search to randomized controlled trials, meta-analyses, clinical trials, systematic reviews and other quasi-experimental designs. The retrieved studies were then limited to articles including children aged 5 years and under and published in English. The evidence of effectiveness was then summarized by the authors. Conclusions: The review highlighted the complex aetiology of early childhood caries (ECC). Contemporary evidence suggests that potentially effective interventions should occur in the first 2 years of a child's life. Dental attendance before the age of 2 years is uncommon; however, contact with other health professionals is high. Primary care providers who have contact with children well before the age of the first dental visit may be well placed to offer anticipatory advice to reduce the incidence of ECC.

Shake rattle and roll: a journey with Parkinson's

This is the journey of a man suffering from Parkinson's disease. Ross Collins tells of his past twelve years' experiences of living with Parkinson's. Before, he had a steady job with Victoria Police, with promising future prospects; and was happily married with two young children. The disease struck him at an early age, changing his life and setting him on a different course. His outlook on life has changed, and his decision-making influenced; as well, his relationships with his family affected. He feels normal only when he is shaking, rattling and rolling along on his Harley. His wish for a cure leads him to pin his hopes on faith healing by the 'miracle man', in Brazil. The first two visits did not seem to have done anything to improve his physical condition. Ross is returning to Brazil for the third time, hoping against hope that his condition could be improved by a miracle healing. This documentary gives an intimate look into the life of a Parkinson's disease sufferer and that of his family. Includes al.

The influence of leisure preference, life priority and making time on regular participation in leisure time physical activity

Using an attitude-behaviour theory approach this study examined the direct and indirect influence of preference, life priority and time allocation on regular participation in leisure-time physical activity (LTPA). The crosssectional study used self-report questionnaires to collect data from a random sample of 250 people aged 19 to 87 years living in an Australian city. The findings suggest that people’s regular participation in LTPA is not directly influenced by their preference for it. Rather, making LTPA a high life priority and allocating time for LTPA are intervening factors that explain the relationship. The outcomes emphasise the importance of encouraging the formation of a preference for physical activity in young children. They suggest all levels of government and the leisure profession emphasise work/life balance by prioritising LTPA, educating people about time management and helping them to develop time management skills.

Mother and toddler activity in the zone of proximal development for pretend play as a predictor of higher child IQ

This study investigated the pretend play of mother—toddler dyads in relation to later child IQ. Twenty-one toddlers were videotaped in monthly play sessions with their mothers, from age 8 to 17 months, and later assessed at 5 years of age on the Stanford-Binet IV. Children's and mothers' pretend play levels and frequencies were measured using Brown's (1997) Pretend Play Observation Scale. Dyadic play activity was analyzed using the conceptual frameworks of scaffolding and Vygotsky's Zone of Proximal Development (ZPD). Toddlers later assessed as having higher IQ demonstrated more rapid learning in the ZPD for pretend play and experienced earlier maternal transfer of responsibility for play. These findings support other evidence on the differential early development of high ability or gifted children and the role of caregiver interactions in that development.

Putting the Research to Use: This study provides evidence that gifted children show differential development, in this case more rapid learning, from the first year of life. It also demonstrates how responsive parental interactions can support this advanced development. For family and professional caregivers, the findings imply that optimum caregiving for the young gifted child involves interactions that are both responsive to individual potential and appropriately challenging. In regard to the methodological challenges of researching early giftedness, the study demonstrated that the constructs of the ZPD and scaffolding were useful frameworks for investigating early gifted development and caregiver influences on that development. Pretend play activity was also shown to be an effective measure and a useful context for the study of gifted development in infants and toddlers. It would be valuable for future researchers in this area to utilize similar approaches that are grounded in the unique developmental characteristics of young children, and that aim to account for the interactive contexts that are so important in children's lives. The field of gifted education, in general, would also benefit from an increased awareness and exploration of the role of play in the development of intellect, imagination and creativity.

Contrasting longitudinal and cross-sectional relationships between insulin resistance and percentage of body fat, fitness, and physical activity in children—the LOOK study

Background: Knowledge of individual changes in insulin resistance (IR) and longitudinal relationships of IR with lifestyle-associated factors are of important practical significance, but little longitudinal data exist in asymptomatic children. We aimed to determine (a) changes in the homeostatic model of insulin resistance (HOMA-IR) over a 2-yr period and (b) comparisons of longitudinal and cross-sectional relationships between HOMA-IR and lifestyle-related risk factors.

Methods: Our subjects, 241 boys and 257 girls, were assessed at age 8.1 yr (SD 0.35) and again 2 yr later for fasting blood glucose and insulin, dual X-ray absorptiometry-assessed percentage of body fat (%BF), pedometer-assessed physical activity (PA), and cardio-respiratory fitness (CRF) by multistage running test.

Results: HOMA-IR was initially 9% greater in girls than boys and 27% greater 2 yr later. There was no evidence of longitudinal relationships between HOMA-IR and %BF in boys or girls, despite significant cross-sectional relationships (p < 0.001). In boys, there was evidence of a longitudinal relationship between HOMA-IR and both PA (p < 0.001) and CRF (p = 0.05). In girls, we found a cross-sectional relationship between HOMA-IR and CRF (p < 0.001).

Conclusions: HOMA-IR increases between 8 and 10 yr of age and to a greater extent in girls. Longitudinal, unlike cross-sectional, relationships do not support the premise that body fat has any impact on HOMA-IR during this period or that PA or CRF changes affect HOMA-IR in girls. These data draw attention to difficulties in interpreting observational studies in young children.

Picture books stimulate the learning of mathematics

In this article we describe our experiences using picture books to provide young children (five- to six-year-olds) with a learning environment where they can explore and extend preliminary notions of mathematics-related concepts, without being taught these concepts explicitly. We gained these experiences in the PICO-ma project, which aimed to generate more knowledge about the effect of picture books on young children's learning of mathematics. The project's goal is to investigate how picture books can contribute to the development of mathematical concepts in young children, and how the actions of the teacher can strengthen the characteristics of picture books that support learning. The reading sessions described in this article were not intended to be mathematics 'lessons'. Instead, the reading sessions were intended to tell the children a pleasant story and, at the same time, give them something to think about. Based on our research we provide reasons for using picture books to develop mathematical thinking, and include recommendations for practitioners interested in using picture books for mathematics learning.

Skin prick test can identify eczematous infants at risk of asthma and allergic rhinitis

Background: Assessment of allergic sensitization is not routinely performed in infants and young children with eczema.

Objective: To determine whether infants who have atopic eczema (with sensitization) are at a greater risk of developing asthma and allergic rhinitis (AR) than those with non-atopic eczema (without concurrent sensitization).

Methods: The presence of eczema was prospectively documented until 2 years of age in a birth cohort of 620 infants with a family history of atopic disease. Sensitization status was determined by skin prick tests (SPTs) at 6, 12, and 24 months using six common allergens. Interviews were conducted at 6 and 7 years to determine the presence of asthma and AR.

Results: Within the first 2 years of life, 28.7% of the 443 children who could be classified had atopic eczema: 20.5% had non-atopic eczema, 19.0% were asymptomatic but sensitized and 31.8% were asymptomatic and not sensitized. When compared with children with non-atopic eczema in the first 2 years of life, children with atopic eczema had a substantially greater risk of asthma [odds ratio (OR)=3.52, 95% confidence interval=1.88–6.59] and AR (OR=2.91, 1.48–5.71). The increased risk of asthma was even greater if the infant had a large SPT (OR=4.61, 2.34–9.09) indicative of food allergy. There was no strong evidence that children with non-atopic eczema had an increased risk of asthma or AR compared with asymptomatic children.

Conclusion: In children with eczema within the first 2 years of life, SPT can provide valuable information on the risk of childhood asthma and AR.

The relationship between job status, interviewing experience, gender, and police officers' adherence to open-ended questions

Purpose : The current study examined whether several factors related to the job and demographic profile of police officers are associated with adherence to best-practice guidelines when interviewing children.

Method : One hundred and seventy-eight police officers completed a standardized (simulated) interview regarding an allegation of abuse by a 5-year-old child. Immediately prior to this interview, details were obtained from the officers' regarding their job status, gender, interview experience, the timing and nature of prior training/supervision, and experience outside the policing profession with young children.

Results : The results showed that timing of training was the only factor that related to interview performance. The proportion of open-ended questions among participants who completed their interviewer training course less than 1 month prior to the simulated interview was better than those who completed the training earlier. Interestingly, the performance of the latter group was identical to that of a group of participants who had not yet received any formal interview training. The implications of the findings are discussed, along with directions for future research.

Spatial thinking processes employed by primary school students engaged in mathematical problem solving

This thesis describes changes in the spatial thinking of Year 2 and Year 4 students who participated in a six-week long spatio-mathematical program. The main investigation, which contained quantitative and qualitative components, was designed to answer questions which were identified in a comprehensive review of pertinent literatures dealing with (a) young children's development of spatial concepts and skills, (b) how students solve problems and learn in different types of classrooms, and (c) the special roles of visual imagery, equipment, and classroom discourse in spatial problem solving. The quantitative investigation into the effects of a two-dimensional spatial program used a matched-group experimental design. Parallel forms of a specially developed spatio-mathematical group test were administered on three occasions—before, immediately after, and six to eight weeks after the spatial program. The test contained items requiring spatial thinking about two-dimensional space and other items requiring transfer to thinking about three-dimensional space. The results of the experimental group were compared with those of a ‘control’ group who were involved in number problem-solving activities. The investigation took into account gender and year at school. In addition, the effects of different classroom organisations on spatial thinking were investigated~one group worked mainly individually and the other group in small cooperative groups. The study found that improvements in scores on the delayed posttest of two-dimensional spatial thinking by students who were engaged in the spatial learning experiences were statistically significantly greater than those of the control group when pretest scores were used as covariates. Gender was the only variable to show an effect on the three-dimensional delayed posttest. The study also attempted to explain how improvements in, spatial thinking occurred. The qualitative component of the study involved students in different contexts. Students were video-taped as they worked, and much observational and interview data were obtained and analysed to develop categories which were described and inter-related in a model of children's responsiveness to spatial problem-solving experiences. The model and the details of children's thinking were related to literatures on visual imagery, selective attention, representation, and concept construction.

User participation in the performance assessment of school buildings : a study of six primary schools in the Bellarine Peninsula region

Young children spend a significant portion of their lives at primary school. This research traces the development of school facilities in Victoria and examines the performance of six primary schools from the users' perspective. Performance assessments were carried out using participatory evaluation methods that included Touring Interviews with small groups of students aged from six to twelve years. The study found that participatory evaluation methods with both student and staff users generate significant information to improve school facilities. User comments were analysed with respect to 14 aspects of building quality and serviceability including character, thermal environment, privacy and flexibility. The study concludes that school buildings do not meet a number of key user requirements. Children expressed dissatisfaction with furniture and equipment in their classrooms and the playground, and to a lesser extent with student toilets, security of their school bags and personal privacy. Staff were dissatisfied with the provision of withdrawal areas and specialist spaces. Department of School Education facilities guidelines do not address the concerns of school users or meet user needs.

Lay healing practices in the household

This thesis explores the power-knowledge relationship underlying lay healing practices in the household; a non-traditional area of study in public health. Lay knowledge continues to be discounted as illegitimate and !non-expert' by policymakers, health professionals and academics. Given the absence of theory on lay knowledge and decision-making, an eclectic theoretical approach was undertaken in this study. Theory is drawn from medical anthropology, sociology of the body, health economics, gender studies, social theory, psychology, nursing, ethics, philosophy and history of medicine in order to contribute to and advance debate. Operating within the genre of a 'multi-sited ethnography' (working across different sites), methods for data collection included 'anthropology at home' by undertaking fieldwork in Geelong, Victoria, Australia. I conducted interviews and focus group discussions with, and administered a questionnaire to, 98 participants who are parents of young children. They were recruited via primary schools and snowball sampling. The quantitative data presents a socio-demographic 'picture' of 78 women and 20 men (representing 98 households) from urban, rural and coastal areas of the region. The qualitative data contains case studies as well as narratives, analysed for their content and discourses. Additional methods included maintenance of a 'reflexive journal', inter-sectoral consultations and public health policy analysis. Research findings indicate laypeople's conceptualisations of the body, self, health and illness rest upon a notion of the embodied self and health that is physical, mental and spiritual. Lay people have a substantial knowledge base on health and ill-health that derives from many sources, is both generalised and specialised, and is set within the context of everyday life. Laypeople make diagnoses and treat illness and injury within the household. They also exercise substantial agency in determining their choice of healer(s) for therapeutic intervention and management of ill-health outside the household. This study has substantial implications for public health in terms of healers' clinical practices, research and policy.