Problematic eating and food-related behaviours and excessive weight gain : why children in out-of-home care are at risk

Emerging evidence suggests that abuse and neglect in childhood may play a role in subsequent development of obesity. One population group particularly at risk is children and young people living in out-of-home care (OOHC). Given this population is already a vulnerable group, identifying potential mechanisms by which childhood abuse and neglect increases risk for obesity is essential. A possible explanation is that problematic eating and food-related behaviours (i.e., emotional eating, compulsive eating, overeating, binge eating, stealing or hoarding food) might mediate the association between adverse childhood experiences and obesity. Hence, the overall goal of this paper was to provide a narrative review of eating and food-related difficulties for children in care and their possible association with unhealthy and excessive weight gain. This review revealed a shortage of existing empirical papers and signalled particular need for further examination of the mediating effects of problematic eating.

Qualitative analysis of the care of children in hospital in four countries : part 2

As part of a large study of the care of children in Australian, British, Indonesian, and Thai hospitals, qualitative methods were used to examine differences influenced by culture. Two groups were surveyed: parents of hospitalized children, and staff caring for them. Vignettes were used to invoke discussion, and content analysis was used to examine the data. Subjects were interviewed singly, or in focus groups. These interviews were audiotaped and transcribed for analysis. This article is the second of a two-part series, and includes results of the staff's interviews and discussion. The parents' results and discussion were published in Part 1 (Shields [amp ] King, 2001). Staff in all the countries considered communication with parents to be an important part of care of the hospitalized child, and this was consistent with the parents' responses. Staff were mindful of safe practices, though more so in Australia and Britain than Indonesia and Thailand. Cost of treatment for the parents was an important consideration for staff in Indonesia and Thailand when they were planning care for the child. Cultural constructions were more likely to be considered by the Australian and British staff than the Indonesian and Thai staff, and this may have been influenced by the prevailing culture of medical dominance in those countries.

Qualitative analysis of the care of children in hospital in four countries : part 1

As part of a large study of the care of children in Australian, British, Indonesian, and Thai hospitals, qualitative methods were used to examine differences influenced by culture. Two groups were surveyed: parents of hospitalized children, and staff caring for them. Vignettes were used to invoke discussion, and content analysis was used to examine the data. Subjects were interviewed singly, or in focus groups. These interviews were audiotaped and transcribed verbatim. The data were explored by using content analysis to extract themes of understanding of cultural experiences. This article is the first of a two-part series, and includes a review of the literature, description of the methods used, and results of the parents' interviews. The staff results and discussion will be published in Part 2. Analysis revealed that parents in all countries were primarily concerned with treating the child's illness and the child's recovery. Parents were concerned with their work (employment), but this was a much larger consideration in Indonesia and Thailand, where no social security systems exist, than in Australia and Britain. Communication with staff was the most commonly mentioned theme for parents, indicating that irrespective of the culture in which the care was given, good communication between parents and staff was of paramount importance.

Providing sporting experiences for children in Out of School Hours Care (OSHC) environments : sport and physical activity participation and intentions

The Out of School Hours Sports Program (OSHSP) aimed to provide structured sporting experiences and community links to local clubs for children in Out of School Hours Care (OSHC). The OSHSP involved 17 State Sporting Associations (SSAs), 71 OSHC Services and local club representatives. This study explored children's participation in sport in and outside the OSHSP and parental intention for participation in sport in and outside the OSHSP. Surveys were received from 211 children (76 girls and 125 boys; mean age = 7.9 years, S.D. = 1.7) and their parents/guardians (37.9% response rate). OSHC is characterised by freedom of choice of participation in activities by children. The OSHSP was used to provide an opportunity to choose to participate in a sport while attending OSHC. At the OSHC Services surveyed, between 7.1 and 100% of the children attending OSHC chose to participate in the OSHSP. Of those children who chose to participate, 85% were participating in a sport, usually a different sport to the one offered in the OSHSP. This participation was largely club-based (49.8%), most often once a week for training and competition (55.2%). Parental intentions for children's participation in the OSHSP sports varied with respect to the number of years attending the OSHSP, where children played and trained in their main sport, and how many times a week a child played and trained in their main sport. Older children tended to play and train for sport more times per week and had been attending the OSHC for more years than younger children.

Obesity in children in out-of-home care : a review of the literature

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care.

Something normal in a very, very abnormal environment – Nursing work to honour the life of dying infants and children in neonatal and paediatric intensive care in Australia

The majority of deaths of children and infants occur in paediatric and neonatal intensive care settings. For nurses, managing an infant/child's deterioration and death can be very challenging. Nurses play a vital role in how the death occurs, how families are supported leading up to and after the infant/child's death. This paper describes the nurses' endeavours to create normality amidst the sadness and grief of the death of a child in paediatric and neonatal ICU. Focus groups and individual interviews with registered nurses from NICU and PICU settings gathered data on how neonatal and paediatric intensive care nurses care for families when a child dies and how they perceived their ability and preparedness to provide family care. Four themes emerged from thematic analysis: (1) respecting the child as a person; (2) creating opportunities for family involvement/connection; (3) collecting mementos; and (4) planning for death. Many of the activities described in this study empowered parents to participate in the care of their child as death approached. Further work is required to ensure these principles are translated into practice.

Mathematical thinking of preschool children in rural and regional Australia : research and practice

At what age do young children begin thinking mathematically? Can young children work on mathematical problems? How do early childhood educators ensure young children feel good about mathematics? Where do early childhood educators learn about suitable mathematics activities?

A good early childhood start in mathematics is critical for later mathematics success. Parents, carers and early childhood educators are teaching mathematics, either consciously or unconsciously, in any social interaction with a child.

Mathematical Thinking of Preschool Children in Rural and Regional Australia is an extension of a conference of Australian and New Zealand researchers that identified a number of important problems related to the mathematical learning of children prior to formal schooling. A project team of 11 researchers from top Australian universities sought to investigate how early childhood education can best have a positive influence on early mathematics learning.

The investigation complements and extends the work of Project Good Start by focusing attention on critical aspects of parents, carers and early childhood educators who care for young children. Early childhood educators from regional and rural New South Wales, Queensland and Victoria were interviewed, following a set of structured questions. The questions focused on: children’s mathematics learning; support for mathematics teaching; use of technology; attitudes to mathematics; and assessment and record keeping.

The researchers also reviewed research focusing on the mathematical capacities and potential foundations for further mathematical development in young children (0–5 years) published in the last decade and produced an annotated bibliography. This should provide a good basis for further research and reading.

Based upon the results of this investigation, the researchers make 11 recommendations for improving the practices of early childhood education centres in relation to young children’s mathematical thinking and development. The implications for policy and decision makers are outlined for teacher education, the provision of resources and further research.

A phenomenological analysis of the experience of security and contentment for latency aged children in shared-time parenting arrangements

This study explored the lived experience of security and contentment, and their absence, for latency-aged children (aged 8-12) living in shared-time parenting arrangements following their parents' separation. A descriptive phenomenological methodology was utilized (Giorgi, 1985, 2009; Giorgi & Giorgi, 2003, 2008). Sixteen children living in shared-time were interviewed about their experiences of two phenomena: "feeling secure and content living in shared-time" and "not feeling secure and content living in shared-time." The eight richest protocols were selected for analysis. The two resultant general structures and their core constituents are presented, and individual variations discussed. Central to each phenomenon is the parent/s' capacity, or incapacity, to create and sustain a physical and emotional space in which the child feels secure and held in the mind, feels the arrangements are responsive to their needs, feels free to access the "absent" parent, and experiences integration between the two parental homes. Implications for phenomenological human science research are considered, including the use of descriptive phenomenology with children.

Obesity and undernutrition in sub-Saharan African immigrant and refugee children in Victoria, Australia

The study assessed the anthropometric status of 337 sub-Saharan African children aged between 3-12 years who migrated to Australia. These children were selected using a snowball sampling method stratified by age, gender and region of origin. The prevalence rates for overweight and obesity were 18.4% (95%CI: 14 - 23%) and 8.6% (95%CI: 6% -12%) respectively. The prevalence rates for the indicators of undernutrition were: wasting 4.3% (95%CI: 1.6%-9.1%), underweight 1.2% (95%CI: 0.3%-3.0%), and stunting 0.3 (95%CI: 0.0%-1.6%). Higher prevalence of overweight/obesity was associated with lower household income level, fewer siblings, lower birth weight, western African background, and single parent households (after controlling for demographic and socio-economic factors). Higher prevalence rates for underweight and wasting were associated with lower household income and shorter lengths of stay in Australia respectively. No effect was found for child's age, gender, parental education and occupation for both obesity and undernutrition indices. In conclusion, obesity and overweight are very prevalent in SSA migrant children and undernutrition, especially wasting, was also not uncommon in this target group.

In the shadow of the volcanoes: the impact of intervention on the nutrition and health status of Rwandan refugee children in Zaire two years from the exodus

Objective: To evaluate the public health and nutritional situation of refugee children in Katale camp, Eastern Zaire, after two years of nutritional and health intervention from 1994 to 1996.
Design: Cross-sectional survey using a two-stage cluster sampling method. Anthropometric data were collected from 28 May 1996 to 4 June 1996. Retrospective review of food basket monitoring data over the preceding six months and the United Nations High Commission for Refugees' weekly mortality data was conducted. Measles immunisation coverage data were surveyed simultaneously, using child health records.
Main outcome measures: Nutritional status measured by weight-for-height index (W/H), measles immunisation status, average daily energy content of the general food ration and crude mortality rate.
Setting: Katale refugee camp, Zaire, June 1996.
Analysis: Weight-for-height index and proportion of immunised children were computed using EPINUT, part of EPINFO computer package.
Results: Malnutrition was found to be most prevalent in children aged six to 29 months old (W/H < -2 Z-score and/or oedema: 6.2%; 95% CI: 3.4%, 10.6%), among whom the malnutrition rate was almost double the overall malnutrition prevalence (W/H < -2 Z-score and/or oedema: 3.5% (95% CI: 1.5%, 7.2%). The general food ration, although conforming to the World Food Program minimum standards of adequacy in terms of variety (being composed of cereals, oil, beans, blended cereal and legume mixes and salt), provided only 6240 kJ on average (95% CI: 5040, 7140 kJ) per person per day, thus meeting only 57% to 84% of the minimum energy requirements for an adult, and falling well below the needs for sub groups with higher nutritional requirements such as children, pregnant and breastfeeding women and the sick. Measles immunisation coverage in children nine to 59 months was 88.6%. The crude mortality rate was found to be 0.3 per 10 000 per day. Refugees received 15 litres of clean water per person per day.
Conclusion: Public health interventions in Katale camp 1994 to 1996 had reduced mortality and morbidity rates dramatically. This was not reflected in the malnutrition rates for children under five years, that remained stable after an initial fall despite two years of nutritional intervention. The factors contributed to this were related to an inadequate general food ration (due to food shortages), lack of ability to supplement the diet, (due to economic restrictions that were imposed in the camp) and inequities in the food distribution process (due to food being siphoned off by camp leaders for military purposes).