A preventative approach to oral health for children in a regional/rural community in south-west Victoria Australia

Abstract Dental caries is a major health problem in most industrialised countries. Childhood dental disease can cause acute pain, difficulty eating resulting in reduced self-esteem and sleep deprivation. The treatment of oral disease using traditional methods is costly and in industrialized countries currently rates the fourth most expensive disease to treat. Dental professionals are currently facing an unfathomable task of how to manage the large burden of consequences associated with caries progression across the world. The Barwon South-West Region of Victoria, Australia is a diverse regional/rural area. Some communities are quite remote. Barwon Health and Colac Area Health Oral Health Services developed an outreach program to improve access to dental services for children. A Minimal Intervention Dentistry approach was incorporated and includes early diagnosis, risk assessment, early detection of mineral loss, non-surgical treatment and preservation of the tooth structure. Kindergartens throughout the region and children in the first year of Primary School are visited by Oral Health Therapists. Teeth are scored according to the International Caries Detection Assessment System and any early 'white spot' lesions identified have fluoride varnish applied. Children receive up to three dental check-ups during the year and given a toothbrush and toothpaste at each visit. Parent engagement sessions are conducted during Visit 2. Examinations and fluoride application take only 3 - 6 minutes for each child, compared with the usual 30 minute appointments in dental clinics. Two virtual chairs have been created as two dental teams visit Kindergartens throughout the Barwon Region, significantly easing pressure at Community dental clinics. The Kinder Wide Smiles program successfully intervened in the oral health of 5,305 children in the region. Most importantly, one of the barriers for children not presenting to static dental clinics for screening has been eliminated.

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children.

Balance ability of 7 and 10 year old children in the population:results from a large UK birth cohort study

OBJECTIVE: The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. METHODS: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. RESULTS: Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. CONCLUSIONS: This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic.

Descriptive analysis of the test of everyday attention for children in a Spanish normative sample

Introduction. Test of Everyday Attention for Children (TEA-Ch) has been validated in different countries demonstrating that it is an instrument with a correct balance between reliability and duration. Given the shortage of trustworthy instruments of evaluation in our language for infantile population we decide to explore the Spanish version of the TEA-Ch. Methods. We administered TEA-Ch (version A) to a sample control of 133 Spanish children from 6 to 11 years enrolled in school in the Community of Madrid. Four children were selected at random by course of Primary Education, distributing the sex of equivalent form. Descriptive analysis and comparison by ages and sex in each of the TEA-Ch's subtests were conducted to establish a profile of the sample. In order to analyze the effect of the age, subjects were grouped in six sub-samples: 6, 7, 8, 9, 10 and 11 years-old. Results. This first descriptive analysis demonstrates age exerted a significant effect on each measure, due to an important "jump" in children's performance between 6 and 7 years-old. The effect of sex was significant only in two visual attention measures (Sky Search & Map) and interaction age and sex exerted a significant effect only in the dual task (Score DT). Conclusions. The results suggest that the Spanish version of the TEA-Ch (A) might be a useful instrument to evaluate attentional processes in Spanish child population.

Psychosocial research with children in Iraq : current health practice and policy in a context of armed conflict

There is a need to show how psychosocial issues affect children in conflict areas like Iraq. Raising knowledge and awareness of children’s mental health status in Iraq has been difficult and the knowledge base has been limited by the shortage of resources, international sanctions and the isolation of Iraqi scholars. Many obstacles to research in Iraq exist but an agenda should be developed emphasising the need for high-quality contextualised psychosocial research. Health researchers in the country need to clarify basic population parameters and to provide culturally appropriate, evidence-based interventions for practitioners.

Reflection: humour in poetry: in praise of the light touch

While humour can be defined as something that is fun or amusing, it can also reference something much darker, such as l’humeur noir. André Breton’s Anthology of Black Humor, the first of its kind, was intended to “showcase…the Surrealist conception of humor” according to his translator, Mark Polizzoti (1997: v). The prose poems in this selection are often surreal and use a kind of gallows humour to discuss death and abandonment.

Mothers’ ideals and experiences of raising children in inner and outer suburban Melbourne, Australia

Parents’ perceptions of their neighbourhoods are important for child health outcomes. This study compared views among mothers in inner versus outer suburbs of Melbourne, Australia using a mixed methods approach. Mothers of preschool-aged children were recruited via playgroups, mother’s groups and preschools and interviewed face-to-face regarding their local area as a good place to raise a family, with a second open-ended interview focussing on mothers’ ideals and experiences of raising children in their current location. Findings demonstrated that mothers had different ideals for, and experiences of, raising their children in their neighbourhoods. Inner suburban mothers valued a manageable work/family balance and access to public transport over the size of their homes. However, access to childcare, secondary schooling and heavy traffic were issues, with the latter two being reasons for moving from the municipality. In contrast, outer suburban mothers preferred a larger home in neighbourhoods that they perceived as low crime, over accessibility to work. Access to a car and activities for their children were also important. Findings suggest no ‘one size fits all’ in respect to what features mothers expect from a good place to raise a family, or how they experience these features. This has implications for service delivery and social planning of suburbs.

Transportation of Children in Ground Ambulances: Professionals' Knowledge and Safety Measures

Background: The transport of children in ground ambulances is a rarely studied topic worldwide. The ambulance vehicle is a unique and complex environment with particular challenges for the safe, correct and effective transportation of patients. Unlike the well developed and readily available guidelines on the safe transportation of a child in motor vehicles, there is a lack on consistent specifications for transporting children in ambulances. Nurses are called daily to transfer children to hospitals or other care centers, so safe transport practices should be a major concern. Purpose: to know which are the safety precautions and specific measures used in the transport of children in ground ambulances by nurses and firefighters and to identify what knowledge these professionals had about safe modes of children transportation in ground ambulances. Methods: In this context, an exploratory - descriptive study and quantitative analysis was conducted. A questionnaire was completed by 135 nurses and firefighters / ambulance crew based on 4 possible children transport scenarios proposed by the NHTSA (National Highway Traffic Safety Administration) and covered 5 different children´s age groups (new born children, 1 to 12 months; 1 to 3 years old; 4 to 7 years old and 8 to 12 years old). Results: The main results showed a variety of safety measures used by the professionals and a significant difference between their actual mode of transportation and the mode they consider to be the ideal considering security goals. In addition, findings showed that achieved scores related to what ambulance crews do in the considered scenarios reflect mostly satisfactory levels of transportation rather than optimum levels of safety, according to NHTSA recommendations. Variables as gender, educational qualifications, occupational group and local where professionals work seem to influence the transport options. Female professionals and nurses from pediatric units appear to do a safer transportation of children in ground ambulances than other professionals. Conclusion: Several professionals refereed unawareness of the safest transportation options for children in ambulances and did not to know the existence of specific recommendations for this type of transportation. The dispersion of the results suggests the need for investment in professional training and further regulation for this type of transportation.

Transportation of Children In Ground Ambulances: Professionals' Knowledge and Safety Measures.

Summary The transport of children in ground ambulances is a rarely studied topic worldwide. The ambulance vehicle is a unique environment with particular challenges for the safe, correct and effective transportation of patients. Unlike the well developed and available guidelines on the transportation of children in motor vehicles, there is a lack on specifications for transporting children in ambulances. Nurses are called daily to transfer children to hospitals or other care centres, so safe transport practices should be a major concern. Methods An exploratory - descriptive study and quantitative analysis was conducted. The safety measures used by the professionals in the transportation of children in ambulances were analysed based on the NHTSA (National Highway Traffic Safety Administration) recommendations. A questionnaire was applied to 135 nurses and firefighters/crew of Portuguese ambulances using 4 possible transport situations and covering 5 paediatric age groups. Results There are a variety of safety measures used by professionals and a significant difference between actual mode of transportation and the mode they consider to be the ideal. In addition, findings showed that scores related to what ambulance crews do in these scenarios reflect most satisfactory levels of transportation rather than the optimum levels, according to NHTSA recommendations. Variables as gender, educational qualifications, occupational group and local where professionals work seem to influence the transport options. Female professionals and pediatric nurses do a safer transportation of children in ambulances than other professionals. Conclusion The results suggest the need for investment in professional training and further regulation for this type of transportation.

Impact of the two different iron fortifi ed cookies on treatment of anemia in preschool children in Brazil.

Nutritional intervention in pre-school children using cookies prepared with wheat fl our enriched with iron and folic acid (CWFFeFA) and cookies prepared with cowpea (Vigna unguiculata (L.) Walp) fl our fortifi ed with iron and zinc and wheat fl our enriched with iron and folic acid (CCFFeZn + WFFeFA).

Pictures and flowers for child-lovers ...

On cover: Walker, Wise & Co.

'We just make the pictures...?' How work is portrayed in children's feature length films

This article explores how adult paid work is portrayed in 'family' feature length films. The study extends previous critical media literature which has overwhelmingly focused on depictions of gender and violence, exploring the visual content of films that is relevant to adult employment. Forty-two G/PG films were analyzed for relevant themes. Consistent with the exploratory nature of the research, themes emerged inductively from the films' content. Results reveal six major themes: males are more visible in adult work roles than women; the division of labour remains gendered; work and home are not mutually exclusive domains; organizational authority and power is wielded in punitive ways; there are avenues to better employment prospects; and status/money is paramount. The findings of the study reflect a range of subject matters related to occupational characteristics and work-related communication and interactions which are typically viewed by children in contemporary society.

Gender differences in children's classroom behaviour and teacher-child relationships in early childhood: An Australian Study

Background: In the early school years, children need positive attitudes to school and experiences that promote academic and social competence. Positive relationships between children and teachers make a significant contribution to school achievement and social competence. Girls are more likely to display positive classroom behaviours and positive approaches to learning than boys. Gender differences have also been noted in teacher-child relationships. This study investigated the relationship between gender differences in classroom behaviour and gender differences in teacher-child relationships in the early years. Method: Data were drawn from The Longitudinal Study of Australian Children (LSAC). LSAC is a cross-sequential cohort study funded by the Australian Government. In these analyses, Wave 1 (2004) and Wave 2 (2006) data for 4464 children in the Kindergarten Cohort were used. Children, at Wave 2, were in the early years of formal school. They had a mean age of 6.8 years (SD= 0.24). Measures included a 6-item measure of Approaches to Learning (task persistence, independence) and teacher ratings on the SDQ. Teachers rated their relationships with children on the short form of the STRS. Results: Girls were found to have more positive relationships with their teachers and to display more positive classroom behaviours than boys. Teachers described their relationships with boys as less close than their relationships with girls and rated girls as displaying more positive approaches to learning and fewer problem behaviours than boys. Positive teacher – child relationships were significantly related to more positive classroom behaviours. The quality of the teacher-child relationship at time 1 (Wave 1) was the best predictor of the quality of the teacher-child relationship at time 2 (Wave 2). Conclusions: Findings highlight the importance of developing positive learning related classroom behaviours in understanding successful school transition and the key role played by early positive teacher-child relationships in promoting school adjustment.