Childhood atopic dermatitis : a cross-sectional study of relationships between child and parent factors, atopic dermatitis management, and disease severity

Background: Successful management of atopic dermatitis poses a significant and ongoing challenge to parents of affected children. Despite frequent reports of child behaviour problems and parenting difficulties, there is a paucity of literature examining relationships between child behaviour and parents' confidence and competence with treatment. Objectives: To examine relationships between child, parent, and family variables, parents' self-efficacy for managing atopic dermatitis, self-reported performance of management tasks, observed competence with providing treatment, and atopic dermatitis severity. Design: Cross-sectional study design. Participants A sample of 64 parent-child dyads was recruited from the dermatology clinic of a paediatric tertiary referral hospital in Brisbane, Australia. Methods: Parents completed self-report questionnaires examining child behaviour, parents' adjustment, parenting conflict, parents' relationship satisfaction, and parents' self-efficacy and self-reported performance of key management tasks. Severity of atopic dermatitis was assessed using the Scoring Atopic Dermatitis index. A routine home treatment session was observed, and parents' competence in carrying out the child's treatment assessed. Results: Pearson's and Spearman's correlations identified significant relationships (p< .05) between parents' self-efficacy and disease severity, child behaviour difficulties, parent depression and stress, parenting conflict, and relationship satisfaction. There were also significant relationships between each of these variables and parents' self-reported performance of management tasks. More profound child behaviour difficulties were associated with more severe atopic dermatitis and greater parent stress. Using multiple linear regressions, significant proportions of variation in parents' self-efficacy and self-reported task performance were explained by child behaviour difficulties and parents' formal education. Self-efficacy emerged as a likely mediator for relationships between both child behaviour and parents' education, and self-reported task performance. Direct observation of treatment sessions revealed strong relationships between parents' treatment competence and parents' self-efficacy, outcome expectations, and self-reported task performance. Less competent task performance was also associated with greater parent-reported child behaviour difficulties, parent depression and stress, parenting conflict, and relationship dissatisfaction. Conclusion: This study revealed the importance of child behaviour to parents' confidence and practices in the context of atopic dermatitis management. Children with more severe atopic dermatitis are at risk of presenting with challenging behaviour problems and their parents struggle to manage the condition successfully.

Hosting an asylum seeker in Australia: A nationwide exploratory study

In recent years, there has been a rise in the number of people seeking asylum in Australia, resulting in over-crowded detention centres in various parts of the country. Appropriate management and assistance of asylum seekers has been an issue of major socio-political concern. In mid-2012, the Australian ruling government introduced a ‘first of its kind’ community placement initiative, which involved relocating low-risk asylum seekers from detention centres to homes of those Australian families who volunteered for this program. The present study investigated host families’ motivations for volunteering into this scheme and their resulting experiences. Twenty-four men and women from all over Australia were interviewed in person or over the telephone. Consistent with theoretical frameworks of altruism, acculturation, and intergroup contact, thematic analysis indicated participants’ interest in diversity/humanitarian issues were major factors that motivated them to host asylum seekers. Language and cultural barriers were reported as challenges, but generally, participants found the experience positive and rewarding. The initiative was regarded as an excellent avenue of learning about new cultures. The hosts played a strong role in promoting the English language proficiency and intercultural settlement of the asylum seekers. The scheme was considered as one way of diffusing fear/biases against asylum seekers prevalent amongst the Australian community at-large. Participants also provided suggestions to improve the scheme.

The impact of childhood malnutrition on schooling : evidence from Bangladesh

Summary This paper examines the impact of childhood malnutrition on schooling performance in rural Bangladesh. The results reveal that malnourished children are less likely to enrol in school on time and achieve an age-appropriate grade by 26 percentage points and 31 percentage points, respectively. Other important determinants of schooling outcomes include infrastructure and education level of parents. One major contribution of this paper is the control for the endogeneity of malnutrition status, which otherwise might lead to bias estimates.

“Heroic victims”: Discursive constructions of early childhood teacher professional identities

Significant changes to qualification requirements for staff working in early childhood contexts are occurring globally. A key reform in Australia is a call for teachers in prior to school early childhood contexts to be university-qualified. The “universal access” strategy (Department of Education, Employment of Workplace Relations [DEEWR], 2009a, 2009b; Rudd & Macklin, 2007b) requires four-year qualified early childhood teachers who are prepared to work in child care contexts. Yet studies in identify that cohorts of preservice teachers resist child care as a career option (see Ailwood & Boyd, 2006; Gibson, 2013a; Vadja, 2005a, 2005b). It is this point of tension that has prompted further inquiry into child care and work in child care, and forms the basis for this paper.

The ‘state of play’ in Australia: Early childhood educators and play-based learning

This article provides an overview of the Education Meets Play study that will investigate early childhood educators’ use of play-based learning, now mandatory under the National Quality Standard. By building on what can be gleaned about educators’ approaches to play-based learning prior to the implementation of the Early Years Learning Framework, the study will contribute to the evidence base concerning the implementation and effects of Australia’s early childhood education and care policy reform initiatives.

"Doing” social justice in early childhood: The potential of leadership

Early childhood education and care (ECEC) has long been connected with objectives related to social justice. ECEC in Australia has its roots in philanthropic and educational reform movements, and more recently with the National Early Childhood Reform Agenda, ECEC has once more been linked to the redressing inequality and disadvantage. Drawing on extant literature, including data from two previously reported Australian studies in which leadership emerged as having a transformational impact on service delivery, this paper examines the potential of early childhood leadership to generate ‘socially just’ educational communities. With reference to critical theory, we argue that critically informed, intentional and strategic organisational leadership can play a pivotal role in creating changed circumstances and opportunities for children and families.

The cultures of Restaurant Australia: epicurean food experiences for tourists in south east Queensland

Tourism Australia’s launch of the ‘Restaurant Australia’ marketing campaign in 2014 is aimed at changing perceptions of the ‘prawn on the barbeque’ image of Australian culinary culture. The campaign is the government's response to global research that reveals that tourists want ‘good’ food and wine experiences (in Australia?). In effect, ‘Restaurant Australia’, and the AUS$10 million supporting it, is promoting? the notion that Australian tourism should provide epicurean food experiences associated with high quality and ‘authentic cultural’ tourism, rather than contrived versions of national identity articulated via stereotypical notions of national cuisine. This paper adopts a cultural tourism approach, especially in relation to theories of authenticity and the relationship of post-tourists, cultural tourists, and tactical tourists to examine two very different areas of wine and food production in Australia in the context of the Restaurant Australia campaign. In particular, it considers issues associated with defining Australian cuisine and the development of a narrative about Australia as a epicurean destination.

Peripapillary choroidal thickness in childhood

Changes in the thickness of the invivo peripapillary choroid have been documented in a range of ocular conditions in adults; however, choroidal thickness in the peripapillary region of children has not been examined in detail. This study therefore aimed to investigate the thickness of the peripapillary choroid and the overlying retinal nerve fibre layer (RNFL) in a population of normal children with a range of refractive errors. Ninety-three children (37 myopes and 56 non-myopes) aged between 11 and 16 years, had measurements of peripapillary choroidal and RNFL thickness derived from enhanced depth imaging optical coherence tomography images (EDI-OCT, Heidelberg Spectralis). The average thickness was determined in a series of five 0.25 mm width concentric annuli (each divided into 8 equal sized 45° sectors) centred on the optic nerve head boundary, accounting for individual ocular magnification factors and the disc-fovea angle. Significant variations in peripapillary choroidal thickness were found to occur with both annulus location (p<0.001) and sector position (p<0.001) in this population of children. The innermost annulus (closest to the edge of the optic disc) exhibited the thinnest choroid (mean 77 ± 16 μm) and the outermost annulus, the thickest choroid (191 ± 52 μm). The choroid was thinnest inferior to the optic nerve head (139 ± 38 μm) and was thickest in the superior temporal sector (157 ± 40 μm). Significant differences in the distribution of choroidal thickness were also associated with myopia, with myopic children having significantly thinner choroids in the inner and outer annuli of the nasal and temporal sectors respectively (p<0.001). RNFL thickness also varied significantly with annulus location and sector (p<0.001), and showed differences in thickness distribution associated with refractive error. This study establishes the normal variations in the thickness of the peripapillary choroid with radial distance and azimuthal angle from the optic nerve head boundary. A significant thinning of the peripapillary choroid associated with myopia in childhood was also observed in both nasal and temporal regions. The changes in peripapillary RNFL and choroidal thickness associated with refractive error are consistent with a redistribution of these tissues occurring with myopic axial elongation in childhood.

Assessment of temperature effects on childhood pneumonia and diarrhoea

This thesis has identified the high risk areas of childhood pneumonia and diarrhoea in Queensland and quantified the effects of temperature on emergency department visits for childhood pneumonia and diarrhoea. It adds to the increasing evidence about the impacts of climate variability and change on children's health and may have significant implications for developing climate change adaptation strategies and paediatric care policies.

Pre-packaging preschool literacy: What drives early childhood teachers to use commercially produced phonics programs in prior to school settings

Language-rich environments are key to overall quality in early childhood settings, including frequent child–staff interactions around picture books and dramatic play. In a language-rich environment, explicit teaching of literacy concepts, such as phonics, is embedded in authentic and meaningful situations where alphabet letters and sounds are taught in a context meaningful to the child. Recent research, however, suggests that the use of commercial pre-packaged phonics programs (such as Letterland and Jolly Phonics) is widespread in prior to school settings in Sydney, Australia. Little is known about why early childhood teachers choose to use such programs with children aged five and under. In the present study, thematic analysis of data from interviews with five early childhood teachers using commercial phonics programs found that their reasons were pragmatic rather than pedagogical. Motivations included the idea that the programs reduced their workload, provided tangible evidence to parents of their child’s ‘school readiness’, and served as a marketing tool to attract parents. Further analysis found that the teachers were unable to articulate what phonics and phonological awareness are and how they are learnt in early childhood.