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).

Framing the discourses of harm and loss: a case study of power relations, mobile phones, and children in Australia

The current penetration of mobile phones in Australia is 92% and it records one of the world’s highest rates of ownership among children under 18. The paper reviews the literature on mobile phones and Australian children and examines the various discourses dominating the public debates; the systematic frames used in these discourses; and whose interests are served in the process. The frames discussed fall under the optimistic (gains); pessimistic (losses, costs or harms); pluralistic (technology per se is neutral but how it is used matters); historical development (skills learnt and the importance of using mobiles); futuristic predictions (promises and dangers for the future); current uses (connectivity, convergence and interactivity); and the techno-realist view (as a mixed blessing) views of technology. Taking the critical perspective and borrowing from Joshua Meyrowitz, the paper illustrates how mobile phones have eroded parental power over how, when, where and with whom their children communicate, surpassing adult supervision, intervention or knowledge, while at the same time, becoming a ‘digital leash’ for parents to re-establish their control an d an ‘umbilical cord’ for their off spring to remain connect! ed with parents, at all times.

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.

Reading practices experienced by preschool children in areas of disadvantage

The purpose of this survey investigation was to gain insight into the different home literacy practices of preschool children in some disadvantaged areas across the state of Victoria, Australia. Findings indicate that parents read to their children regularly from a young age, found libraries easy to access and use, and have children who enjoy books and paper and pencil activities. However, more than half of them found there was not enough information available to support them in their child's literacy development. It is argued here that such information should be made available as a matter of some urgency and be distributed through libraries.

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.

How active are rural children in Australian physical education

Physical education lessons offer a venue for children to accrue valuable and health-conferring time being physically active. The first Australian direct observational data are presented on activity of year 3 and 4 children during physical education. Analysis accounts for the nested nature of the data through multi level logistic regression using 13,080 records within 231 lessons within 18 randomly selected schools. Activity was analysed in relation to lesson context (focus of lesson), child gender, school year of child, teacher gender, lesson duration and start time. Children spent 36.7% of a lesson in moderate to vigorous and 12.9% in vigorous activity. Most of the lesson was spent in the context of management/instruction (37.4%), followed by games (25.0%), skill (21.4%), and fitness (14.7%). The highest level of moderate to vigorous activity was observed in the fitness lesson context (61.9%), followed by skill (46.4%), games (42.6%) and management/instruction (17.1%). Moderate to vigorous activity was significantly higher for boys than girls. There was no significant difference in moderate to vigorous activity in lessons led by male or female teachers. However vigorous activity was significantly higher for female led lessons. Children participated in less physical activity during physical education lessons timetabled in the afternoon, compared to physical education lessons time-tabled in the morning. Physical activity levels were not related to lesson duration. Physical education lessons can potentially be more active. However improvement rests on school capacity and may require a health promoting schools approach to implement curricular policy.