Low health-related quality of life in school-aged children in Tonga, a lower-middle income country in the South Pacific

Background:
Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children’s perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries.

Objectives:
To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region.

Design:
A cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old) on the outer island of Vava’u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0.

Results:
HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen’s d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen’s d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen’s d 0.6).

Conclusion:
The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

The effects of practice on children's ability to apply ground rules in a narrative interview

Despite the widespread use of ground rules in forensic interview guidelines, it is unknown whether children retain and apply these rules throughout narrative interviews. We evaluated the capacity of 260 five- to nine-year-olds to utilize three ground rules. At the beginning of the interview all children heard the rules; half also practiced them. Children then responded to open-ended prompts about a repeated laboratory event and were assessed for their application of the rules. Logistic regressions revealed that practice only benefitted the use of the "don't know" rule. Although the children accurately answered "don't understand" and "correct me" practice questions, practice appeared to give no greater benefit than just hearing the rules. Results suggest that the current format of ground rule practice in interview guidelines is appropriate for the "don't know" rule, but the other rules may require more extensive practice with this age group. Copyright © 2015 John Wiley & Sons, Ltd.

Young children learning about well-being and environmental education in the early years: a funds of knowledge approach

Early childhood educators currently provide content focused learning opportunities for children in the areas of well-being and environmental education. However, these are usually seen as discrete content areas and educators are challenged with responding to children’s interests in popular-culture inspired food products given these influence their consumption of energy-dense, nutrient-poor and highly packaged food in the early childhood setting. This paper reports preliminary findings from a pilot randomised trial examining the interconnectedness of sustainability, well-being and popular-culture in early childhood education. Planning, assessment documentation and summaries from twenty-four learning experiences implemented by six educators over a six-week period were analysed using a deductive approach. Twenty well-being and environmental education topics were identified and shown to be generated by the educators when considering the children’s ‘funds of knowledge’ on popular-culture inspired food products. We argue that topics derived from children’s engagement with popular-culture may help educators to create an integrated approach to curriculum provision. This may impact child weight and facilitate obesity prevention and environmental sustainability as children create stronger connections between these content areas and their everyday choices and practices.

Ethical issues and lessons in the voices of Pacific children project

Knowledge of the needs and experiences of children with disability living in Vanuatu and Papua New Guinea (PNG) is limited and that which does exist, does not focus on data collected directly from children themselves. This project aims to establish a method of data collection to determine the self-reported needs and priorities of children living with disability in Vanuatu and PNG. The project involves a multi-staged capacity building approach between two Disabled People’s Organisations (DPOs): PNG Assembly of Disabled Persons (PNGADP) and the Disability Promotion and Advocacy Association Vanuatu (DPA); and Save the Children and Deakin University. The research is funded by an Australian Development Research Award and is being undertaken between 2013 and 2015. The research will collect data from up to 50 children with disability aged between 5 and 18 years in each country.

Identification of the Communicative Abilities of Brazilian Children With Cerebral Palsy in the Family Context

This article highlights the importance of the information obtained from the family in the implementation of the augmentative and alternative communication (AAC) system. The objective was to investigate the communicative abilities of children with severe communication deficit through their parents' reports within the family routine. Eleven parents of children affiliated with a rehabilitation program in a public university in Brazil participated in this research. Per their parents' reports, the children demonstrated a variety of communication skills related to comprehension, expressive skills, and vocabulary. Parents further reported their children's daily communication routines including social partners, communication environment, and the materials the children enjoyed the most. These results emphasize the importance of family involvement in planning AAC so that it is functional within the family context.

Consequences of Chronic Nasal Obstruction on the Laryngeal Mucosa and Voice Quality of 4- to 12-Year-Old Children

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Salivary alpha amylase and cortisol levels in children with global developmental delay and their relation with the expectation of dental care and behavior during the intervention

The purpose of this study was to analyze the alpha-amylase (sAA) and cortisol levels in children with Global developmental delay (GDD) before and after dental treatment and its association with the children's behavior during treatment. The morning salivary cortisol levels and activity of sAA of 33 children with GDD were evaluated before and after dental treatment and were compared to 19 healthy children. The behavior of children with GDD during dental care was assessed by the Frankl scale. Children with GDD showed lower levels of sAA activity than healthy children, but this result was not significant. The salivary cortisol levels were similar between GOD and healthy children. GDD children showed increased levels of sAA (but not cortisol) prior to the dental treatment as compared to the post-treatment phase. GOD children who showed less favorable behavior during dental care had higher levels of sAA and salivary cortisol than GOD children with more favorable behavior, but only the sAA results were significant. In conclusion, GOD children show hyperactivity of the SNS-axis in anticipation of dental treatment which indicates the need for strategies to reduce their anxiety levels before and during dental care. (C) 2011 Elsevier Ltd. All rights reserved.

Art in the inclusion of children with special needs in dentistry

A proposta deste estudo é relatar a utilização da arte e seus segmentos, como recurso para inclusão da criança portadora de necessidades especiais ao ambiente odontológico. Foi utilizado como método a aplicação da arte em atividades de socioterapia e oficinas, divididas em módulos: sessão de socialização, oficinas de arte e atividades complementares, visando à elaboração de uma anamnese cultural por meio de questionários e a obtenção das preferências artísticas dos 313 participantes, previamente às suas assistências odontológicas no CAOE (Centro de Assistência Odontológica a Portadores de Necessidades Especiais) FOA/Unesp. de acordo com os questionários respondidos, a música e a pintura, segundo a preferência dos participantes, são os segmentos artísticos que mais auxiliam nas atividades de inclusão e adaptação. Concluímos que a utilização da arte na adaptação e inclusão ambiental do paciente, previamente à assistência odontológica, é favorável e eficaz.

Effects on permanent teeth after luxation injuries to the primary predecessors: a study in children assisted at an emergency service

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

INFLUENCE OF ENTERAL PARASITES ON THE BLOOD VITAMIN-A LEVELS IN PRESCHOOL-CHILDREN ORALLY SUPPLEMENTED WITH RETINOL AND OR ZINC

A sample of 471 pre-school children who frequented schools and creches in a poor district of Manaus (Amazonas), Brazil, were randomly submitted to faecal parasitological tests. Two-hundred-and-forty children from both sexes between the ages of 3 and 7 years with Ascaris lumbricoides and/or Giardia lamblia were selected. The objective of the study was to determine the possible influence of these two intestinal parasites and vitamin A and/or zinc supplementation on the serum retinol levels of primary school children. The children were submitted to clinical and anthropometric examinations, dietary interviews and biochemical examinations of retinol and carotene in the serum and of zinc in the hair. The parasitic incidence was 85.0% and about 54% of the children were polyparasitic. During the pretreatment phase, the retinol and carotene serum levels were 36% and 57%, respectively, below the normal levels. Using the Waterlow classification, the anthropometric analyses revealed that 88% of the children showed normal growth. A significant effect was observed of the anti-parasitic medicine on the serum retinol levels.

Prevalence of caries and developmental defects of enamel in 9-10 year old children living in areas in Brazil differing water fluoride histories

Aims To assess the prevalences of caries, of developmental defects of enamel and their interrelationship in Brazilian 9-10-year-olds from areas of contrasting fluoridation histories.Methods systematic random sampling procedures were used to select children from an area where water had been fluoridated in 1963 and from a second area where water had been fluoridated since 1998. Clinical examinations for caries were carried out using the DMFT index and WHO diagnostic criteria. Developmental defects of enamel on upper incisors were diagnosed using the DDE index.Results A difference of 40% in DMFT was observed, with a lower prevalence of disease in the area fluoridated since 1963. Diffuse opacities affected 14.3% of the children from the area fluoridated since 1963 compared with only 2.4% in the area fluoridated in 1998. Children living in the area fluoridated in 1963 who had diffuse defects had twice the chance of being free from caries compared with those living in the same area who had no defects or who had only demarcated or hypoplastic defects.Conclusions This study confirms previous ones in showing the benefits of water fluoridation. Diffuse opacities of upper incisors affected relatively few subjects in either of the two areas.

Attending to the non-preferred hand improves bimanual coordination in children

The effect of attentional focus in bimanual coordination was investigated from a developmental perspective by examining performance of right- and left-handed children, 5-8-years and 9-12-years old, on bimanual reciprocal tapping tasks. Attentional focus was either specified, by asking the children to attend to the preferred or to the non-preferred hand, or unspecified for the execution of the tasks. When attention was oriented to the non-preferred hand we found a reduced movement time and a lower frequency of errors. Performance differences for handedness and age-groups were observed when the children were oriented to attend to the preferred hand or when there was no instruction regarding attention. These differences in performance were eliminated when attention was oriented to the non-preferred hand. (C) 2004 Elsevier B.V. All rights reserved.

Cinedacryocystography in the diagnosis of lacrimal obstruction in children

Purpose: To analyze the cinedacryocystography in children with congenital nasolacrimal obstruction suspicion. Methods: The cinedacryocystographic examination was done in 143 children (58% of girls and 42% of boys) younger than 5 years old, suspected of congenital nasolacrimal obstruction. The exams were done under general anesthesia and the children were probed immediately when obstruction was detected. Results: Epiphora, discharge or both were the most common complaints. Nevertheless 11% children had undergone unsuccessfully probing once, no one had any radiologic evaluation previously. The cinedacryocystographic exam showed nasolacrimal duct obstruction in 65,73%. Permeable lacrimal vies were presented in 34,3% of the children with epiphora. The obstruction was mainly at the Arlt's sinus. Using the cinedacryocystography, it was possible to observe the lacrimal sac enlargement and alterations in the contiguous structures such as hypertrophic turbinates (91,1%), sinusitis (44,6%) and septum deviation (24,1%). Conclusion: Cinedacryocystographic evaluation provides important information about lacrimal system obstruction in children, therefore, it is useful in all children with suspected congenital lacrimal obstruction.

Assessment of the diet of 0- to 6-year-old children in municipal schools in a Brazilian city

Diet control is one of the important factors in the prevention of dental caries because food functions as substratum for fermentation and, consequently, for the formation of the organic acids that demineralize the tooth surface. This study aims to descriptively assess school diet and the associated caries-preventive methods applied to children in all municipal nursery schools of a Brazilian city (Aragatuba/SP). For this, a questionnaire with open and closed questions was used. The results showed that all schools serve school meal, which is composed mainly of sugar, carbohydrates, and proteins. The students enjoy the meal very much because for most of them, the meal served at school is the only source of food. It was observed that 90% of the schools offer other kinds of food besides the main school meal. The snacks served such as cakes, white hominy, and milk fudge are composed of sweet and highly cariogenic foods. It was also verified that in 13.30% of the schools, the daily supervised dental hygiene, an important procedure that should not be neglected, is not carried out. This procedure introduces the children to healthy habits that are added to those acquired in the family environment. It was concluded that the school diet is potentially cariogenic and, in association with the lack of daily dental hygiene, this potential may become even higher.

Consumption of bottled water by children in the city of Bauru, State of São Paulo, Brazil - A brief communication

Objectives: To determine the consumption of bottled water by children in the city of Bauru, State of São Paulo, Brazil. Methods: A stratified sample of the 17 areas established by the city plan was used to identify a total of 1,000 homes for visitation. Information was collected using a questionnaire concerning the type of water consumed and population demographics. Results: Overall, around 30 percent of all residences used bottled water. Among all households where bottled water was consumed, about 26 percent had children residing. For those with children and bottled water, 81 percent reported to use bottled water for the preparation of the children's foods and beverages. Conclusions: An important percentage of children consume bottled water in the city of Bauru, State of São Paulo, Brazil. Considering previous studies showing that fluoride concentrations vary in bottled water, public health measures should be implemented in order to guarantee adequate levels of fluoride in commercialized water. © 2007, American Association of Public Health Dentistry.