Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: A case control study

Background With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs. Methods A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise children into the two weight groups. Blood pressure (BP) was taken, and blood was drawn after an overnight fast to determine fasting blood glucose (FBG) and full lipid profile, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). International Diabetes Federation (2007) criteria for children were used to identify metabolic syndrome. Results Participants comprised 60.9% (n = 245) Malay, 30.9% (n = 124) Chinese and 8.2% (n = 33) Indian. Overweight/obese children showed significantly poorer biochemical profile, higher body fat percentage and anthropometric characteristics compared to the normal-weight group. Among the metabolic risk factors, WC ≥90th percentile was found to have the highest odds (OR = 189.0; 95%CI 70.8, 504.8), followed by HDL-C≤1.03 mmol/L (OR = 5.0; 95%CI 2.4, 11.1) and high BP (OR = 4.2; 95%CI 1.3, 18.7). Metabolic syndrome was found in 5.3% of the overweight/obese children but none of the normal-weight children (p < 0.01). Overweight/obese children had higher odds (OR = 16.3; 95%CI 2.2, 461.1) of developing the metabolic syndrome compared to normal-weight children. Binary logistic regression showed no significant association between age, gender and family history of communicable diseases with the metabolic syndrome. However, for ethnicity, Indians were found to have higher odds (OR = 5.5; 95%CI 1.5, 20.5) compared to Malays, with Chinese children (OR = 0.3; 95%CI 0.0, 2.7) having the lowest odds. Conclusions We conclude that being overweight or obese poses a greater risk of developing the metabolic syndrome among children. Indian ethnicity is at higher risk compared to their counterparts of the same age. Hence, primary intervention strategies are required to prevent this problem from escalating.

Educational stress among Chinese adolescents : individual, family, school and peer influences

Educational stress is common among school children and adolescents, especially in Asian countries. This study aims to identify factors associated with perceived educational stress among students in China. A cross-sectional questionnaire survey was conducted with 1627 students (Grades 7–12) from six secondary schools in rural and urban areas of Shandong Province. A wide range of individual, family, school and peer factors were associated with stress measured using the Educational Stress Scale for Adolescents (ESSA). Rural school location, low school connectedness, perceived poor academic grades, female gender, older age and frequent emotional conflicts with teachers and peers were among the strongest correlates, and most of them are school- or study-related. Unexpectedly, family and parental factors were found to have little or no association with children’s perceived educational stress. These findings may offer directions for interventions in secondary school settings.

An elicitation of speeding behaviour beliefs in school zones in Australia

This elicitation study was designed to explore salient behavioural, normative, and control beliefs in accordance with the Theory Planned Behaviour (TPB) and in relation to drivers’ speeding behaviour in school zones. The study also explored mindfulness and habit as additional constructs in the TPB framework. The aim of this study was to identify those beliefs which influenced drivers’ speeding behaviour in school zones and thus gain greater insight into the motivating factors underpinning the behaviour which may inform interventions to reduce this behaviour. Seventeen Australian drivers participated in one of a series of focus group discussions. Overall, conceptual content analysis revealed some similar issues across the groups. In particular, highlighting the influence of behavioural and normative beliefs, there was much agreement that there were no real advantages to speeding in school zones with the behaviour considered dangerous and unacceptable and likely to also be regarded as such by important others. In addition, given the public concern about safety of school children, acknowledgment of such concern represented an important factor discouraging one’s likelihood of engaging in speeding in school zones (i.e., complying with the school zone speed limit). However, despite normative support not to speed, and the need to ensure children’s safety as an important factor discouraging speeding, the study also found that there was a tendency for drivers to report unintentionally speeding in a school zone. Instances of unintentional speeding were reported as occurring due to several reasons including a driver’s current affective state (e.g., more likely to speed in a school zone if they were in a bad mood), the extent to which they were familiar with the environment (i.e., more likely to drive mindlessly – on ‘autopilot’ - in more familiar contexts) and when feeling fatigued. The theoretical implications of including mindfulness and habit with TPB constructs and the practical implications in terms of suggested interventions are discussed.

Airborne concentration of Volatile Organic Compounds in school environment in Brisbane

Traffic emissions are considered as a major source of pollutants, particularly ultrafine particles, in the urban environment. There is an increased concern about airborne particles not only because of their environmental effects but also due to their potential adverse health effects on humans. There have been a number of studies related to the number concentration and size distribution of these particles but studies on the chemical composition of aerosols, especially in the school environment, are very limited. Mejia et. al (2011) reviewed studies on the exposure to and impact of air pollutants on school children and found that there were only a handful of studies on this topic. Therefore, the main focus of this research is on an analysis of the chemical composition of airborne particles, as well as source apportionment and the quantification of ambient concentrations of organic pollutants in the vicinity of schools, as a part of “Ultrafine Particles from Traffic Emissions on Children’s Health” (UPTECH) project. The aim of the present study was to find out the concentrations of different Volatile Organic Compounds (VOCs) in both outdoor and indoor locations from six different schools in Brisbane.

Refraction in children : a comparison of two methods of accommodation control

Purpose: The prevalence of refractive errors in children has been extensively researched. Comparisons between studies can, however, be compromised because of differences between accommodation control methods and techniques used for measuring refractive error. The aim of this study was to compare spherical refractive error results obtained at baseline and using two different accommodation control methods – extended optical fogging and cycloplegia, for two measurement techniques – autorefraction and retinoscopy. Methods: Participants comprised twenty-five school children aged between 6 and 13 years (mean age: 9.52 ± 2.06 years). The refractive error of one eye was measured at baseline and again under two different accommodation control conditions: extended optical fogging (+2.00DS for 20 minutes) and cycloplegia (1% cyclopentolate). Autorefraction and retinoscopy were both used to measure most plus spherical power for each condition. Results: A significant interaction was demonstrated between measurement technique and accommodation control method (p = 0.036), with significant differences in spherical power evident between accommodation control methods for each of the measurement techniques (p < 0.005). For retinoscopy, refractive errors were significantly more positive for cycloplegia compared to optical fogging, which were in turn significantly more positive than baseline, while for autorefraction, there were significant differences between cycloplegia and extended optical fogging and between cycloplegia and baseline only. Conclusions: Determination of refractive error under cycloplegia elicits more plus than using extended optical fogging as a method to relax accommodation. These findings support the use of cycloplegic refraction compared with extended optical fogging as a means of controlling accommodation for population based refractive error studies in children.

Problem solving in the primary school (K-2)

This article focuses on problem solving activities in a first grade classroom in a typical small community and school in Indiana. But, the teacher and the activities in this class were not at all typical of what goes on in most comparable classrooms; and, the issues that will be addressed are relevant and important for students from kindergarten through college. Can children really solve problems that involve concepts (or skills) that they have not yet been taught? Can children really create important mathematical concepts on their own – without a lot of guidance from teachers? What is the relationship between problem solving abilities and the mastery of skills that are widely regarded as being “prerequisites” to such tasks?Can primary school children (whose toolkits of skills are limited) engage productively in authentic simulations of “real life” problem solving situations? Can three-person teams of primary school children really work together collaboratively, and remain intensely engaged, on problem solving activities that require more than an hour to complete? Are the kinds of learning and problem solving experiences that are recommended (for example) in the USA’s Common Core State Curriculum Standards really representative of the kind that even young children encounter beyond school in the 21st century? … This article offers an existence proof showing why our answers to these questions are: Yes. Yes. Yes. Yes. Yes. Yes. And: No. … Even though the evidence we present is only intended to demonstrate what’s possible, not what’s likely to occur under any circumstances, there is no reason to expect that the things that our children accomplished could not be accomplished by average ability children in other schools and classrooms.

Modeling as a means for making powerful ideas accessible to children at an early age

The SimCalc Vision and Contributions Advances in Mathematics Education 2013, pp 419-436 Modeling as a Means for Making Powerful Ideas Accessible to Children at an Early Age Richard Lesh, Lyn English, Serife Sevis, Chanda Riggs … show all 4 hide » Look Inside » Get Access Abstract In modern societies in the 21st century, significant changes have been occurring in the kinds of “mathematical thinking” that are needed outside of school. Even in the case of primary school children (grades K-2), children not only encounter situations where numbers refer to sets of discrete objects that can be counted. Numbers also are used to describe situations that involve continuous quantities (inches, feet, pounds, etc.), signed quantities, quantities that have both magnitude and direction, locations (coordinates, or ordinal quantities), transformations (actions), accumulating quantities, continually changing quantities, and other kinds of mathematical objects. Furthermore, if we ask, what kind of situations can children use numbers to describe? rather than restricting attention to situations where children should be able to calculate correctly, then this study shows that average ability children in grades K-2 are (and need to be) able to productively mathematize situations that involve far more than simple counts. Similarly, whereas nearly the entire K-16 mathematics curriculum is restricted to situations that can be mathematized using a single input-output rule going in one direction, even the lives of primary school children are filled with situations that involve several interacting actions—and which involve feedback loops, second-order effects, and issues such as maximization, minimization, or stabilizations (which, many years ago, needed to be postponed until students had been introduced to calculus). …This brief paper demonstrates that, if children’s stories are used to introduce simulations of “real life” problem solving situations, then average ability primary school children are quite capable of dealing productively with 60-minute problems that involve (a) many kinds of quantities in addition to “counts,” (b) integrated collections of concepts associated with a variety of textbook topic areas, (c) interactions among several different actors, and (d) issues such as maximization, minimization, and stabilization.

Aerosol mass spectrometric analysis of the chemical composition of non- refractory PM1 samples from school environments in Brisbane, Australia

Long term exposure to vehicle emissions has been associated with harmful health effects. Children are amongst the most susceptible group and schools represent an environment where they can experience significant exposure to vehicle emissions. However, there are limited studies on children’s exposure to vehicle emissions in schools. The aim of this study was to quantify the concentration of organic aerosol and in particular, vehicle emissions that children are exposed to during school hours. Therefore an Aerodyne compact time-of-flight aerosol mass spectrometer (TOF-AMS) was deployed at five urban schools in Brisbane, Australia. The TOF-AMS enabled the chemical composition of the non- refractory (NR-PM1) to be analysed with a high temporal resolution to assess the concentration of vehicle emissions and other organic aerosols during school hours. At each school the organic fraction comprised the majority of NR-PM1 with secondary organic aerosols as the main constitute. At two of the schools, a significant source of the organic aerosol (OA) was slightly aged vehicle emissions from nearby highways. More aged and oxidised OA was observed at the other three schools, which also recorded strong biomass burning influences. Primary emissions were found to dominate the OA at only one school which had an O:C ratio of 0.17, due to fuel powered gardening equipment used near the TOF-AMS. The diurnal cycle of OA concentration varied between schools and was found to be at a minimum during school hours. The major organic component that school children were exposed to during school hours was secondary OA. Peak exposure of school children to HOA occurred during school drop off and pick up times. Unless a school is located near major roads, children are exposed predominately to regional secondary OA as opposed to local emissions during schools hours in urban environments.

Teachers’ knowledge of anxiety and identification of excessive anxiety in children

This study examined primary school teachers’ knowledge of anxiety and excessive anxiety symptoms in children. Three hundred and fifteen primary school teachers completed a questionnaire exploring their definitions of anxiety and the indications they associated with excessive anxiety in primary school children. Results showed that teachers had an understanding of what anxiety was in general but did not consistently distinguish normal anxiety from excessive anxiety, often defining all anxiety as a negative experience. Teachers were able to identify symptoms of excessive anxiety in children by recognizing anxiety-specific and general problem indications. The results provided preliminary evidence that teachers’ knowledge of anxiety and anxiety disorders does not appear to be a barrier in preventing children’s referrals for mental health treatment. Implications for practice and directions for future research are discussed.

Alveolar dose of ultrafine particles for children in urban environments

The aim of this study was to quantify school children’s exposure to ultrafine particles (UFP) in urban environments. The study was conducted as part of a larger epidemiological project aiming to determine the association between exposures to UFPs and children’s health, titled “Ultrafine Particles from Traffic Emissions and Children’s Health”1 (UPTECH). School children aged 8-11 years old at 24 state schools within the Brisbane Metropolitan Area participated in the present study. This paper presents the methodology and results for calculating deposited UFP surface area in the alveolar region (dose), where UFP deposition is more efficient for particles larger than 6 nm...

School children’s personal exposure to ultrafine particles in the urban environment

There has been considerable scientific interest in personal exposure to ultrafine particles (UFP). In this study, the inhaled particle surface area doses and dose relative intensities in the tracheobronchial and alveolar regions of lungs were calculated using the measured 24-hour UFP time series of school children personal exposures for each recorded activity. Bayesian hierarchical modelling was used to determine mean doses and dose intensities for the various microenvironments. Analysis of measured personal exposures for 137 participating children from 25 schools in the Brisbane Metropolitan Area showed similar trends for all the participating children. Bayesian regression modelling was performed to calculate the daily proportion of children's total doses at different microenvironments. The proportion of alveolar doses in the total daily dose for \emph{home}, \emph{school}, \emph{commuting} and \emph{other} were 55.3\%, 35.3\%, 4.5\% and 5.0\%, respectively, with the \emph{home} microenvironment contributing a majority of children's total daily dose. Children's mean indoor dose was never higher than the outdoor's at any of the schools, indicating there were no persistent indoor particle sources in the classrooms during the measurements. Outdoor activities, eating/cooking at home and commuting were the three activities with the highest dose intensities. Personal exposure was more influenced by the ambient particle levels than immediate traffic.

Physical activity promotion as a school priority : what do parents think?

The demands and responsibilities placed on schools in contemporary education systems are vast. However, with growing obesity levels and physical inactivity, the prevention of chronic disease has focused on youth populations, with schools playing the focal educative asset in this strategy. Parents play a decisive role in their child’s educational setting, and as fee and tax payers, are ultimately a consumer. Parents (82 males and 208 females) of secondary school children were recruited from three private (n=151) and two government schools (n=150) in Brisbane, Australia. The mean (standard deviation) age was 44.57 (6.21) years. Participants responded to a series of questions about physical activity at their child’s school, in addition to completing the International Physical Activity Questionnaire. Data were analysed using descriptive statistics, frequency distributions and logistic regressions. Parents were deemed sufficiently physically active if they participated in at least 150 minutes of moderate-to-vigorous physical activity per week. Overall, 83 (59.7%) parents from private and 60 (50.8%) parents from government schools were deemed sufficiently physically active. Concerning whether physical activity promotion should be a priority at their child’s school, 111 (73.5%) parents from private schools either agreed or strongly agreed, as opposed to 97 (64.7%) parents from government schools. Logistic regressions indicated that the concept of physical activity promotion being prioritised at schools was dependent on whether the child attended a private school (OR =1.34, z = 2.30, p = 0.02), and whether the participant was sufficiently active (OR =.71, z = -2.48, p = 0.01). Physical activity promotion within schools may provide substantial future benefits on a population scale. The demands on schools may need to be addressed to meet the needs of students and the desires of their parents.

Getting there, being there, staying and belonging: a case study of two indigenous Australian children’s transition to school

Indigenous Australians are among the most unhealthy populations in the world and yet they reside in a country where the non-Indigenous population enjoys high standards of well-being. Education has been identified as the key mechanism for closing this equity gap. At school commencement many Indigenous children are already at risk of disengagement. This four-year longitudinal study of two Indigenous boys from a socially marginalised community examined key factors affecting transitional trajectories into school. While child characteristics affected level of achievement the critical factors in sustaining positive educational engagement were social support, school practices, inclusion of family and positive expectation.

Physical activity and determinants of physical activity in obese and non-obese children

OBJECTIVE To compare the physical activity (PA) patterns and the hypothesized psychosocial and environmental determinants of PA in an ethnically diverse sample of obese and non-obese middle school children. DESIGN Cross-sectional study. SUBJECTS One-hundred and thirty-three non-obese and 54 obese sixth grade children (mean age of 11.4 +/-0.6). Obesity status determined using the age-, race- and gender-specific 95th percentile for BMI from NHANES-1. MEASUREMENTS Objective measurements were collected of PA over a 7-day period using the CSA 7164 accelerometer: total daily counts; daily moderate (3-5.9 METs) physical activity (MPA); daily vigorous physical activity (greater than or equal to 6 METs; VPA); and weekly number of 5, 10 and 20 min bouts of moderate-to-vigorous physical activity (greater than or equal to 3 METs, MVPA). Self-report measures were collected of PA self-efficacy; social influences regarding PA, beliefs about PA outcomes; perceived PA levels of parents and peers, access to sporting and/or fitness equipment at home, involvement in community-based PA organizations; participation in community sports teams; and hours spent watching television or playing video games. RESULTS Compared to their non-obese counterparts, obese children exhibited significantly lower daily accumulations of total counts, MPA and VPA as well as significantly fewer 5, 10 and 20 min bouts of MVPA. Obese children reported significantly lower levels of PA self-efficacy, were involved in significantly fewer community organizations promoting PA and were significantly less likely to report their father or male guardian as physically active. CONCLUSIONS The results are consistent with the hypothesis that physical inactivity is an important contributing factor in the maintenance of childhood obesity. Interventions to promote PA in obese children should endeavor to boost self-efficacy perceptions regarding exercise, increase awareness of, and access to, community PA outlets, and increase parental modeling of PA.

Calibration of the biotrainer pro activity monitor in children

The unique physical and movement characteristics of children necessitate the development of accelerometer equations and cut points that are population specific. The purpose of this study is to develop an ecologically valid cut point for the Biotrainer Pro monitor that reflects a threshold for moderate-intensity physical activity in elementary school children. A sample of 30 children (ages 8-12) wore a Biotrainer monitor while completing a series of 7 movement tasks (calibration phase) and while participating in an organized group activity (cross-validation phase). Videotapes from each session were processed using a computerized direct-observation technique to provide a criterion measure of physical activity. Analyses involved the use of mixed-model regression and receiver operator characteristic (ROC) curves. The results indicated that a cut point of 4 counts/min provides the optimal balance between the related needs for sensitivity (accurately detecting activity) and specificity (limiting misclassification of activity as inactivity). Results with the cross-validation data demonstrated that this value yielded the best overall kappa (.58) and a high classification agreement (84%) for activity determination. The specificity of 93% demonstrates that the proposed cut point can accurately detect activity; however, the lower sensitivity value of 61% suggests that some minutes of activity might be incorrectly classified as inactivity. The cut point of 4 counts/min provides an ecologically valid cut point to capture physical activity in children using the Biotrainer Pro activity monitor.