Parenting behaviors and nutrition in children with leukemia

The aim of this study was to examine whether parenting behaviors are associated with child nutrition amongst pre-school children receiving treatment for acute lymphoblastic leukemia (ALL), and to determine whether this association differs from that observed amongst a healthy population. Participants were 73 parents of children aged 2–6 years. The children were either a) receiving treatment for ALL (n = 43), or b) had no major medical history (n = 30). Participants completed psychometrically validated questionnaires that assessed parenting behaviors and child diet. Increased parental overprotection was associated with higher fruit and vegetable consumption for the control group but lower fruit and vegetable consumption for the ALL group. Parental overprotection, inconsistent discipline and emotional feeding were positively associated with non-core (“junk”) food consumption for the ALL group, particularly those who had recently received steroid treatment. To the best of our knowledge, this is the first study to show that certain parenting behaviors may be associated with poor nutrition during treatment for ALL. In light of these results, parenting interventions, specifically targeting parenting behaviors such as assertive discipline, may be a mechanism for nutrition promotion amongst this vulnerable group.

Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents

INTRODUCTION AND AIMS: Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample. DESIGN AND METHODS: School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated. RESULTS: Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23). CONCLUSIONS: We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2015].

Screen-based behaviors of children and cardiovascular risk factors

OBJECTIVE: To determine whether the amount of time spent in screen-based behaviors (SBBs; television viewing, computer use, and playing electronic games) is independently associated with individual and clustered cardiovascular disease (CVD) risk factors among elementary school children. STUDY DESIGN: Baseline data were used from 264 children (age 7-10 years) participating in the Transform-Us! cluster-randomized controlled trial. Time (h/d) spent in SBBs was obtained using a parent proxy-report questionnaire. Anthropometrics, blood pressure (BP), and lipids were measured using standard techniques. A clustered CVD risk score was calculated as the average of the standardized values of the subcomponents (waist circumference [WC], systolic BP, diastolic BP, and lipids). RESULTS: After adjusting for sex, parent education, physical activity (accelerometry), diet, and WC (when adiposity was not the outcome), television viewing time was positively associated with body mass index z-score (P = .002), WC (P = .02), and systolic BP (P = .05). Electronic games was positively associated with low density lipoprotein levels (P = .05), and total screen-time was positively associated with body mass index (P = .02). CONCLUSIONS: Differential associations were observed between types of SBBs and CVD risk factors, indicating that not all SBBs are adversely associated with obesity and CVD risk. There is a need to differentiate between types of SBBs when evaluating the CVD risk associated with screen behaviors in children. TRIAL REGISTRATION: International Standard Randomized Controlled Trial: ISRCTN83725066; Australian New Zealand Clinical Trials Registry: ACTRN12609000715279.

A mobile phone based method to assess energy and food intake in young children: a validation study against the doubly labelled water method and 24 h dietary recalls

Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 ± 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 ± 820 kJ/24 h and 6040 ± 680 kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls (ρ = 0.665-0.896, p < 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.

The development of a screening questionnaire for childhood cruelty to animals

Childhood cruelty to animals may be a marker of poor prognosis amongst conduct disordered children. However, other than semistructured interviews with parents or children, there are no screening instruments for this behavior. The aim of this study was to develop such an instrument. In the first phase of the study, a parent-report questionnaire, Children's Attitudes and Behaviors Towards Animals (CABTA) was designed and piloted on 360 elementary school children, enabling community norms and a factor structure for the instrument to be derived. In the second phase, the questionnaire was completed by the parents of a small sample of children (N= 17) to establish its test-retest reliability. In the third phase of the study, the CABTA was completed by the parents of 19 children who had been diagnosed with either a Disruptive Behavioral Disorder or Attention Deficit Hyperactivity Disorder, and the results were compared with the outcome of a semistructured interview with parents regarding their child's behavior toward animals. The results of the various phases of the study indicated that the CABTA consists of two factors, Typical and Malicious Cruelty to animals, and is a reliable and valid tool for detecting childhood cruelty to animals. Possible use and adaptations of the CABTA as a screening instrument in clinical and community samples are discussed.

Teacher and peer assessment of creativity in technology education

This study, part of a PhD thesis, investigates a number of aspects relating to technology education, creativity and the assessment of creativity and aesthetics. Following tuitional sessions, panels of upper primary school children were involved in assessing the creative and aesthetic characteristics of technological products made by other children. Teachers assessed a selection of student drawings for creativity and these results were compared against the corresponding products assessed by the panels of Year 5 children. Subjects were administered a test on their knowledge of technology and these scores were compared to product creativity scores. The results showed high correlations between the assessor ranks for both creativity and aesthetics although there was generally more consistency with creativity. While some subjects produced both creative drawings and products, others showed creativity in only one outcome. A further finding of the investigation identified the relationship between students' knowledge of technology and the creative product constructed by the older children in the study.

Preliminary validation of the Chinese version of the pediatric quality of life inventory

The Pediatric Quality of Life Inventory (PedsQL) is a scale for assessing health-related quality of life of children and adolescents aged 2-18 years. Three reports of PedsQL for the age ranges 2-4 years and 5-7 years were translated into Chinese and their validities were examined. A total of 186 children and parents were involved in the study. Content validity, test-retest reliability, internal consistency reliability and construct validity were assessed. The correlation of parents' and children's reports was also examined. The results showed that the internal consistency is generally good, test-retest reliability ranged from moderate to good, differences between disabled and non-disabled individuals are significant in total scores and in all subscales except for the physical functioning subscale for the children's self-report for the age ranges of 2-4 years and 5-7 years and the correlation between the reports of the parents and children for the age range of 5-7 years is moderate to high. This suggests that the newly translated Chinese PedsQL for children aged 2-4 years and 5-7 years seems to be reliable and valid to be used as a measure of health-related quality of life in Chinese pediatric research and clinical applications.

Health promotion and health education in schools : trends, effectiveness and possibilities

This report involved an extensive literature review as well as discussions with ten leading school health and traffic safety education researchers and practitioners. The findings of the report show that despite health promotion and health education activities occurring in all Victorian schools, school health related initiatives could be improved by focusing on cognitive outcomes and involving appropriate components of Health Promoting School (HPS) framework. Providing teachers with professional development and utilising interactive resources that complement the curriculum is also important. The report recommendations outline ways to improve the Health Promotion and Health Education and provide a potential framework for delivering TSE provision in schools.

The relationship between childhood cruelty to animals and psychological adjustment : a Malaysian study

In Western research, cruelty to animals in childhood has been associated with comorbid conduct problems and with interpersonal violence in later life. However, there is little understanding of the etiology of cruelty to animals, and what in the child's life may require attention if the chain linking animal cruelty and later violence is to be broken. The study reported in this paper investigated the association between parent-reported cruelty to animals, and parent- and self-reported psychological strengths and weaknesses in a sample of 379 elementary school children in an Eastern context, Malaysia. No gender differences were found in relation to cruelty to animals or psychological problems, as assessed with the Strengths and Difficulties Questionnaire (SDQ). However, there were different predictors of cruelty to animals for boys and girls. Regression analyses found that for boys, parent-reported hyperactivity was a unique predictor of Malicious and Total Cruelty to animals. For girls, self-reported conduct problems was a unique predictor of Typical Cruelty to animals. Parent-reported total difficulties were associated with Typical, Malicious, and Total Cruelty to animals. We suggest that routine screening of children with an instrument such as the SDQ may help to detect those children who may need to undergo further assessment and perhaps intervention to break the chain linking childhood cruelty to animals and later conduct problems.

The lifestyle of our kids (LOOK) project : outline of methods

This methods paper outlines the overall design of a community-based multidisciplinary longitudinal study with the intent to stimulate interest and communication from scientists and practitioners studying the role of physical activity in preventive medicine. In adults, lack of regular exercise is a major risk factor in the development of chronic degenerative diseases and is a major contributor to obesity, and now we have evidence that many of our children are not sufficiently active to prevent early symptoms of chronic disease. The lifestyle of our kids (LOOK) study investigates how early physical activity contributes to health and development, utilizing a longitudinal design and a cohort of eight hundred and thirty 7–8-year-old (grade 2) school children followed to age 11–12 years (grade 6), their average family income being very close to that of Australia. We will test two hypotheses, that (a) the quantity and quality of physical activity undertaken by primary school children will influence their psychological and physical health and development; (b) compared with existing practices in primary schools, a physical education program administered by visiting specialists will enhance health and development, and lead to a more positive perception of physical activity. To test the first hypothesis we will monitor all children longitudinally over the 4 years. To test the second we will involve an intervention group of 430 children who receive two 50 min physical education classes every week from visiting specialists and a control group of 400 who continue with their usual primary school physical education with their class-room teachers. At the end of grades 2, 4, and 6 we will measure several areas of health and development including blood risk factors for chronic disease, cardiovascular structure and function, physical fitness, psychological characteristics and perceptions of physical activity, bone structure and strength, motor control, body composition, nutritional intake, influence of teachers and family, and academic performance.

Australian dental policy reform and the use of dental therapists and hygienists

Oral diseases including dental caries and periodontal disease are among the most prevalent and costly diseases in Australia today. Around 5.4% of Australia’s health dollar is spent on dental services totalling around $2.6 billion, 84% of which are delivered through the private sector (AIHW 2001). The other 16% is spent providing public sector services in varied and inadequate ways. While disease rates among school children have declined significantly in the past 20 years the gains made among children are not flowing on to adult dentitions and our aging population will place increasing demands on an inadequate system into the future (AHMAC 2001). Around 50% of adults do not received regular care and this has implications for widening health inequalities as the greatest burden falls on lower income groups (AIHW DSRU 2001). The National Competition Policy agenda has initiated, Australia-wide, reviews of dental legislation applying to delivery of services by dentists, dental specialists, dental therapists and hygienists and dental technicians and prosthetists. The review of the Victorian Dentists Act 1972, was completed first in 1999, followed by the other Australian states with Queensland, the ACT and the Northern Territory still developing legislation. One of the objectives of the new Victorian Act is to ‘…promote access to dental care’. This study has grown out of the need to know more about how dental therapists and hygienists might be utilised to achieve this and the legislative frameworks that could enable such roles. This study used qualitative methods to explore dental health policy making associated with strategies that may increase access to dental care using dental therapists and hygienists. The study used a multiple case study design to critically examine the dental policy development process around the Review of the Dentists Act 1972 in Victoria; to assess legislative and regulatory dental policy reforms in other states in Australia and to conduct a comparative analysis of dental health policy as it relates to dental auxiliary practice internationally. Data collection has involved (I) semi-structured interviews with key participants and stakeholders in the policy development processes in Victoria, interstate and overseas, and (ii) analysis of documentary data sources. The study has taken a grounded theory approach whereby theoretical issues that emerged from the Victorian case study were further developed and challenged in the subsequent interstate and international case studies. A component of this study has required the development of indicators in regulatory models for dental hygienists and therapists that will increase access to dental care for the community. These indicators have been used to analyse regulation reform and the likely impacts in each setting. Despite evidence of need, evidence of the effectiveness and efficiency of dental therapists and hygienists, and the National Competition Policy agenda of increasing efficiency, the legislation reviews have mostly produces only minor changes. Results show that almost all Australian states have regulated dental therapists and hygienists in more prescriptive ways than they do dentists. The study has found that dental policy making is still dominated by the views of private practice dentists under elitist models that largely protect dentist authority, autonomy and sovereignty. The influence of dentist professional dominance has meant that governments have been reluctant to make sweeping changes. The study has demonstrated alternative models of regulation for dental therapists and hygienists, which would allow wider utilisation of their skills, more effective use of public sector funding, increased access to services and a grater focus on preventive care. In the light of theses outcomes, there is a need to continue to advocate for changes that will increase the public health focus of oral health care.

Little boys : the potency of peer culture in shaping masculinities

This study explores the peer group understandings of five male friends between the ages of six and eight years and seeks to examine the ways in which the group’s social dynamics interact to define, regulate and maintain dominant and collective understandings of masculinities. Within a self-selected affinity context, and drawing on their lived and imagined experiences, the boys’ enact and interpret their social worlds. Adopting the principles of ethnography within a framework of feminist poststructuralism and drawing on theories of ‘groupness’ and gender(ed) embodiment, the boys’ understandings of masculinities are captured and interpreted. The key analytic foci are directed towards examining the role of power in the social production of collective schoolboy knowledges, and understanding the processes through which boys subjectify and are subjectified, through social but also bodily discourses. The boys’ constructions of peer group masculinities are (re)presented through a narrative methodology which foregrounds my interpretation of the group’s personal and social relevances and seeks to be inductive in ways that ‘bring to life’ the boys’ stories. The study illuminates the potency of peer culture in shaping and regulating the boys’ dominant understandings of masculinity. Within this culture strong essentialist and hierarchical values are imported to support a range of gender(ed) and sexual dualisms. Here patriarchal adult culture is regularly mimicked and distorted. Underpinned by constructions of ‘femininity’ as the negative ‘other’, dominant masculinities are embodied, cultivated and championed through physical dominance, physical risk, aggression and violence. Through feminist poststructural analysis which enables a theorising of the boys’ subjectivities as fluid, tenuous and often characterised by contradiction and resistance, there exists a potential for interrupting and re-working particular masculinities. Within this framework, more affirmative but equally legitimate understandings and embodiments can be explored. The study presents a warrant for working with early childhood affinity groups to disrupt and contest the dominance and hierarchy of peer culture in an effort to counter-act broader gendered and heterosexist global, state and institutional structures. Framing these assertions is an understanding of the peer context as not only self-limiting and productive of hierarchies, but enabling and generative of affirmative subjectivities.

Technology and music in the early years of schooling

An investigation of junior primary school children's use of computer-based music technology found that, with active support from teachers, young children were able to participate effectively in relatively complex musical processes, with particular regard to listening, performing and composing, thus extending the traditional scope of young children's music education.

Evaluation of the Asthma Friendly Schools program

This thesis examined what makes schools want to embrace the Asthma Friendly Schools program. It also investigated the limitations and barriers of the Asthma Friendly Schools program and explored it's uptake by schools and the implications of the findings for the redesign of the program.

Subjective Wellbeing as an affective construct

This thesis quantifies the normative characteristics of Subjective Wellbeing amongst Australian high-school age students using the Personal Wellbeing Index adapted for school children. No previous study has undertaken this task. The results confirm the homeostatic model and corroborate previous research suggesting that Subjective Wellbeing is a construct driven primarily by Core Affect.