Outdoor fungi and child asthma health service attendances

Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outdoor fungi play a significant role in child asthma exacerbations. Systematic search of seven electronic databases and hand searching for peer-reviewed studies published in English, up to 31 August 2013. Inclusion criteria were study population aged <18 yr, diagnosis of asthma, attended a health service; outdoor fungi exposure was reported. Quality and risk of bias assessments were conducted. Due to significant heterogeneity, meta-analysis was not conducted. Of the 1896 articles found, 15 were eligible. Findings were not consistent, possibly due to methodological variations in exposure classifications, statistical methods and inclusion of confounders. Cross-sectional studies found no or weak associations. All but one time series studies indicated an association that varied between fungal species. Increasing evidence indicates that asthmatic children are susceptible to asthma exacerbations when exposed to outdoor fungal spores. There is limited understanding of the contributions of different fungal species. Research is needed to investigate interactions of outdoor fungi with pollen, air pollutants and respiratory viruses.

"I tell ya who needs educatin’”: non-Indigenous cultural self-awareness and prisoner education.

Glen says, “current education is colonial; it ain’t ours. I tell ya who needs educatin’, wadjellas”. Glen is a Noongar man who, along with several other Aboriginal adults living in Western Australia, teaches me in a PhD research project about prisoner education from their perspective. His words pose a question for wadjellas like myself who are raised, taught and work in a white neo-colonial society. We have been raised in, taught in and work in a colonial system. As non-Aboriginal people we have unearned privileges which are often invisible and unacknowledged. How then to address the outcomes of this in a way that might lead to working co-operatively alongside Aboriginal people? What kind of ‘educatin’ could teach us about our own unacknowledged privilege and the disadvantage this can lead to for others? Is the standard cross-cultural awareness training enough?This paper shares some of the teachings of Glen and other participants in this research. It expresses the view that, ultimately, the usually unacknowledged legacy of colonisation and associated issue of denied Aboriginal sovereignty lies at the heart of much of the disadvantage experienced by Aboriginal people today when considering education and the prison system. Addressing gaps in non-Indigenous cultural self-awareness by learning from Aboriginal people is an important factor in improving their experiences of education.

Australian children's independent mobility levels: secondary analyses of cross-sectional data between 1991 and 2012

This study investigated changes in Australian children's independent mobility levels between1991 and 2012. Data from five cross-sectional studies conducted in 1991, 1993, 2010, 2011 and 2012 were analysed. Parent and child surveys were used to assess parental licences for independent mobility and actual independent mobility behaviour in children aged 8–13 years. Findings show declines in the proportion of young children (≤10 years of age) being allowed to travel home from school alone (1991: 68%, 1993: 50%, 2010: 43%, 2011: 45%, 2012: 31%) and travel on buses alone (1991: 31%, 1993: 15%, 2010: 8%, 2011: 6%, 2012: 9%). Furthermore, the proportion of children travelling independently to school decreased (1991: 61%, 1993: 42%, 2010: 31%, 2011: 32%, 2012: 32%). Significantly fewer girls than boys travelled independently to school at each time point (p ≤ .001). Overall, the findings suggest that Australian children's independent mobility levels declined between 1991 and 2012.

Cultural and social factors and quality of life of Maori in advanced age. Te puawaitanga o nga tapuwae kia ora tonu - Life and living in advanced age: a cohort study in New Zealand (LiLACS NZ)

AIM: To establish 1) the socioeconomic and cultural profile and 2) correlates of quality of life (QOL) of Maori in advanced age. METHOD: A cross sectional survey of a population based cohort of Maori aged 80-90 years, participants in LiLACS NZ, in the Rotorua and Bay of Plenty region of New Zealand. Socioeconomic and cultural engagement characteristics were established by personal interview and QOL was assessed by the SF-12. RESULTS: In total 421 (56%) participated and 267 (63%) completed the comprehensive interview. Maori lived with high deprivation areas and had received a poor education in the public system. Home ownership was high (81%), 64% had more than 3 children still living and social support was present for practical tasks and emotional support in 82%. A need for more practical help was reported by 21%. Fifty-two percent of the participants used te reo Maori me nga tikanga (Maori language and culture) daily. One in five had experienced discrimination and one in five reported colonisation affecting their life today. Greater frequency of visits to marae/sacred gathering places was associated with higher physical health-related QOL. Unmet need for practical help was associated with lower physical health-related QOL. Lower mental health-related QOL was associated with having experienced discrimination. CONCLUSION: Greater language and cultural engagement is associated with higher QOL for older Maori and unmet social needs and discrimination are associated with lower QOL.

Morbidity patterns among the underweight, overweight and obese between 2 and 18 years: population-based cross-sectional analyses

CONTEXT: No study has documented how symptomatic morbidity varies across the body mass index (BMI) spectrum (underweight, normal weight, overweight and obese) or across the entire child and adolescent age range. OBJECTIVE: To (1) quantify physical and psychosocial morbidities experienced by 2-18-year-olds according to BMI status and (2) explore morbidity patterns by age. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional data from two Australian population studies (the Longitudinal Study of Australian Children and the Health of Young Victorians Study) were collected during 2000-2006. Participants were grouped into five age bands: 2-3 (n=4606), 4-5 (n=4983), 6-7 (n=4464), 8-12 (n=1541) and 13-18 (n=928) years. MAIN MEASURES: Outcomes-Parent- and self-reported global health; physical, psychosocial and mental health; special health-care needs; wheeze; asthma and sleep problems. Exposure-measured BMI (kg m(-2)) categorised using standard international cutpoints. ANALYSES: The variation in comorbidities across BMI categories within and between age bands was examined using linear and logistic regression models. RESULTS: Comorbidities varied with BMI category for all except sleep problems, generally showing the highest levels for the obese category. However, patterns differed markedly between age groups. In particular, poorer global health and special health-care needs were associated with underweight in young children, but obesity in older children. Prevalence of poorer physical health varied little by BMI in 2-5-year-olds, but from 6 to 7 years was increasingly associated with obesity. Normal-weight children tended to experience the best psychosocial and mental health, with little evidence that the U-shaped associations of these variables with BMI status varied by age. Wheeze and asthma increased slightly with BMI at all ages. CONCLUSIONS: Deviation from normal weight is associated with health differences in children and adolescents that vary by morbidity and age. As well as lowering risks for later disease, promoting normal body weight appears central to improving the health and well-being of the young.

Current and future friends of the earth: assessing cross-national theories of environmental attitudes

Empirical studies of public opinion on environmental protection have typically been grounded in Inglehart’s post-materialism thesis, proposing that societal affluence encourages materially-sated publics to look beyond their interests and value the environment. These studies are generally conducted within, or at best across, Western, democratic, industrialized countries. Absence of truly cross-cultural research means the theory’s limitations have gone undetected. This article draws on an exceptionally broad dataset—pooling cross-sectional survey data from 80 countries, each sampled at up to three different points over 15 years—to investigate environmental attitudes. We find that post-materialism provides little account of pro-environment attitudes across diverse cultures, and a far from adequate explanation even in the affluent West. We suggest that unique domestic interests, more than broad value systems, are driving emerging global trends in environmental attitudes. The environment’s future champions may be the far from ‘post-material’ citizens of those developing nations most at risk of real material harm from climate change and environmental degradation.

Trends in child and adolescent obesity prevalence according to socioeconomic position: protocol for a systematic review

BACKGROUND: Obesity is a significant public health issue and is socially patterned, with greater prevalence of obesity observed in the most socioeconomically disadvantaged groups. Recent evidence suggests that the prevalence of childhood obesity is levelling off in some countries. However, this may not be the case across all socioeconomic strata. The aim of this review is to examine whether trends in child and adolescent obesity prevalence since 1990 differ according to socioeconomic position in developed countries.

METHODS: An electronic search will be conducted via Ovid Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus and Cochrane Collaboration to identify articles that report trends in obesity prevalence in children and adolescents according to socioeconomic position. We will also search grey literature databases including the Virtual Library for Public Health and the System for Information on Grey Literature, as well as websites from relevant organisations. Articles that report on a series of cross sectional studies; describe one or more measure of obesity with data recorded at two or more time points since 1990; and report trends by at least one indicator of socioeconomic position will be included. Quality of included studies will be evaluated according to criteria that consider both internal and external validity. Descriptive analysis will be performed to examine trends since 1990 in childhood obesity prevalence according to socioeconomic position.

DISCUSSION: The review will provide a picture of change over time in developed countries of childhood obesity prevalence across socioeconomic strata and identify whether changes in childhood obesity prevalence are experienced equally across socioeconomic groups.

Physical activity guidelines and cardiovascular risk in children: a cross sectional analysis to determine whether 60 minutes is enough

BACKGROUND: Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects.

METHODS: PA was measured using accelerometry in 182 children (9-11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score ≥ 1SD indicated 'higher risk'). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile.

RESULTS: Active children (92 (53 boys)) undertook more MVPA (38 ± 11 min, P < 0.001), had greater VO2peak (4.5 ± 0.8 ml/kg/min P < 0.001), and lower fat % (3.9 ± 1.1 %, P < 0.001) than inactive. No difference were observed between active and inactive for CCVR or OR (P > 0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9 ± 0.6, P < 0.05), and the OR was 4.7 times higher.

CONCLUSION: Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines.