Stories seldom told: paediatric nurses` experiences of caring for hospitalized children with special needs and their families.

Stories seldom told: paediatric nurses' experiences of caring for hospitalized children with special needs and their families

Aims of the study. This study explored paediatric nurses' experiences of caring for children with special needs and their families in an acute care setting. The aim of the study was to increase understanding of nurses' experiences of caring for these children and their families. The study was designed to reveal the caring practices embedded within these relationships through exploring nurses' stories.

Study design/methods. Gadamerian hermeneutic phenomenology and feminist research principles were the approaches used to guide the study. Interviews were held with experienced paediatric nurses and interpretation of interview transcripts using a Gadamerian hermeneutic phenomenological approach resulted in the identification of four themes.

Findings. The four themes revealed were: Special Relationships; Multiple Dimensions of Who is Expert; Development of Trust Between Nurses and Families; and Feelings of Frustration and Guilt.

Conclusions. The study emphasized the context-specific nature of relationships between nurses and children and their families. The nurses spoke about the difficulties they encountered in their practice and some of the ways that they dealt with these problems. They discussed the things that they valued and those that made them feel guilty and frustrated. In doing so, they revealed their warmth, strength, humanity and caring.

What makes a good investigative interviewer of children? A comparison of police officers' and experts; perceptions

Purpose – The purpose of this paper is to examine police officers’ perceptions about their role in interviewing children, and to compare these perceptions with those of child eyewitness memory experts.

Design/methodology/approach – A diverse sample of 23 police officers (from three states of Australia) individually participated in in-depth interviews where they were asked to define what makes a good interviewer in the area of child abuse investigation.

Findings – Irrespective of the background of the officers, the important role of interviewers’ personal attributes was emphasised (e.g. having a relaxed, empathetic, warm nature). Such personal attributes were more prominent in the participants’ descriptions than knowledge of legislation and children’s
development, prior job experience, and interviewing techniques.

Research limitations/implications – The paper shows that while child eyewitness memory experts acknowledge the importance of establishing a bond of mutual trust between the interviewer and the child, the importance of utilising an open-ended questioning style for enhancing rapport, and
for eliciting a detailed and accurate account of abuse cannot be overstated. The possible reasons for the police officers’ emphasis on personal qualities are discussed.

Originality/value – This paper has revealed that limitations in the competency of police officers in interviewing children is not merely a problem of “doing” (i.e. learning to ask open-ended questions),
but may also reflect ingrained attitudinal and organisational barriers.

Where is all the pressure coming from? Messages from mothers and teachers about preschool children's appearance, diet and exercise

This study used interviews and qualitative analyses to investigate the nature of the messages that preschool children receive from mothers and teachers about their bodies, general appearance, exercise and eating practices. Participants were 10 female teachers and 53 mothers. The behaviours of the 53 children (24 boys, 29 girls) were also observed to determine the nature of their eating and exercise behaviours. The results demonstrated that both mothers and teachers expressed concerns about their own bodies. Mothers also communicated messages to their daughters about losing weight and messages to their sons about increasing their muscles. Both girls and boys were concerned about their appearance, particularly their clothes and hair. Girls also demonstrated some concerns about losing weight, and boys with increasing muscles. Implications of these results are discussed in terms of designing education programs for mothers, teachers and children to prevent the development of body image concerns and disordered eating among children. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.

Overweight and obesity in children from Shenzhen, Peoples Republic of China

We describe overweight and obesity prevalence in Shenzhen school children (2146 girls and 2428 boys) aged 7 to 12 years, Guangdong Province, China. Nineteen percent of boys and 11% of girls were overweight or obese. Boys had odds of almost 2 to 1 (1.92, 95% CI 1.62,2.27) of being overweight or obese compared to girls and children aged 9 years and over were at greater odds of being overweight or obese than those aged 7 years (p<0.05). Overweight and obesity prevalence among children from Shenzhen rivals that of children from developed nations. Current obesity levels in Shenzhen may represent future levels for urban China.

Where did all these books come from? The Publishing Industry and American Intellectual Life

The American book publishing industry shapes the character of American intellectual life. While the newspaper and television industries have been accused of and investigated for bias and lowering America’s intellectual standards, book publishing has gone largely unexamined by scholars. The existing studies of the publishing industry have focused on finance, procedure and history. “There are few ‘theories’ of publishing – efforts to understand the ‘whys’ as well as the ‘hows.’ Few scholarly scientists have devoted significant scholarly attention to publishing” (Altbach and Hoshino, xiii). There are many possible reasons for this lacuna. First, there is a perception that books have always been around, that they are an “old” technology and therefore they don’t appear to have had as much of an impact on our society as television and other media (which were developed quickly and suddenly) seem to have had (Altbach and Hoshino, xiv). Also, despite books’ present and past popularity, television, radio, and now the internet reach more people more easily, and are therefore more topical points of study and observation. In studying the effects of mass media on everyday American life, television and the internet may be the most logical points of study. Regarding public intellectual life however, books play a much more important role. Public intellectual life has always been associated with independent thinkers publishing their work for the masses. For this reason, this I focus on trade publishing. Trade publishing produces fiction and non-fiction works for the general reading public, as opposed to technical manuals, textbooks, and other fiction and nonfiction books targeted to small and specific audiences. Although, quantitatively speaking, “the largest part of book publishing business is embodied in that great complex of companies and activities producing educational, business, scientific, technical, and reference books and materials,” (Tebbel 1987, 439) the trade industry publishes most of the books that most people read. It is the most public segment of the industry, and the most likely place to find public intellectualism. Trade publishing is not only the most public segment of the industry, but it is also the most susceptible to corruption and lowered intellectual standards. Unlike specialty publishing, which caters to a specific, known segment of society, trade publishers must compete with countless other publications, as well as with other forms of media, for the patronage of the general public. As John Tebbel (author of a widely referenced history of the publishing industry) puts it, “The textbook, scientific, or technical book is subjected to much more rigorous scrutiny by buyers and users, and in an intensively competitive market inferior products are quickly lost" (Tebbel 1987, xiv). Since the standards for trade publishing are not nearly as specific – trade books simply need to catch the attention of a significant number of readers, they don’t have to measure up to a given level of quality – the quality of trade books is much more variable. And yet, a successful trade publication can have a much greater impact on society than the most rigorously researched and edited textbook or scholarly study.

Evaluation of outcome in child and adolescent mental health services: children with persistent conduct problems

This article focuses on the evaluation of outcome in child and adolescent mental health services. We examined the outcomes of 46 children with persistent conduct problems by gathering at baseline and six months information from multiple informants on multiple domains including the functioning of the child, risk factors, and parents’ and children&rsquo;s perceptions of the treatment process. A statistically significant reduction in oppositional/conduct symptoms was reported six months after the initial clinical contact. However, the majority of the group still scored within the clinical range. The various outcome measures are correlated to only a mild to moderate degree. Teachers did not notice the same degree of change at school, despite the changes noticed by parents. Symptom improvement and satisfaction with a service are two separate issues. Parents’ satisfaction was related to their perception of the therapist and the therapy offered. Their satisfaction was high if they perceived that the therapist was able to communicate well, show care and concern, and if the therapy was perceived as organized. Much can be learned from a comprehensive outcome measurement system within a mental health service.

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.

New world orders in contemporary children's literature : utopian transformations

"New World Orders shows how texts for children and young people have responded to the cultural, economic, and political movements of the last 15 years. With a focus on international children's text produced between 1988 and 2006, the authors discuss how utopian and dystopian tropes are pressed into service to project possible futures to child readers. The book considers what these texts have to say about globalisation, neocolonialism, environmental issues, pressures on families and communities, and the idea of the posthuman."--BOOK JACKET.

Double disadvantage : the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children

Objective: To examine the relationship between overweight/obesity in children, socioeconomic status and ethnicity/cultural background.

Design: Cross-sectional survey of children aged 4–13 years.

Setting: A total of 23 primary (elementary) schools in an inner urban municipality of Melbourne, Australia.

Participants: A total of 2685 children aged 4–13 years and their parents.

Main exposure measures: Ethnicity/cultural background – maternal region of birth; socioeconomic position (SEP) indicators – maternal and paternal educational attainment, family employment status, possession of a healthcare card, ability to buy food, indicator of disadvantage (Socioeconomic Index for Areas, SEIFA) score for school; parental weight status.

Main outcome measure: Prevalence of overweight/obesity.

Results: Prevalence of overweight/obesity approached 1 in 3 (31%) in this sample. Prevalence of overweight/obesity was greater for children of both North Africa and Middle Eastern background and children of Southern, South Eastern and Eastern European background compared with children of Australian background. This difference remained after adjusting for age, sex, height, clustering by school, SEP indicators and parental weight status; odds ratio, OR=1.57 (95% confidence interval, CI 1.12–2.19) and 1.88 (95%CI 1.24–2.85), respectively.

Conclusions: There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.

Children's fruit and vegetable intake : Associations with the neighbourhood food environment

Objective : To examine associations between availability of different types of food outlets and children's fruit and vegetable intake.
Method : Parents of 340 5–6 and 461 10–12 year-old Australian children reported how frequently their child ate 14 fruits and 13 vegetables in the last week in 2002/3. A geographic information system (GIS) was used to determine the availability of the following types of food outlets near home: greengrocers; supermarkets; convenience stores; fast food outlets; restaurants, cafés and takeaway outlets. Logistic regression analyses examined the likelihood of consuming fruit ≥ 2 times/day and vegetables ≥ 3 times/day, according to access to food outlets.
Results : Overall, 62.5% of children ate fruit ≥ 2 times/day and 46.4% ate vegetables ≥ 3 times/day. The more fast food outlets (OR = 0.82, 95%CI = 0.67–0.99) and convenience stores (OR = 0.84, 95%CI = 0.73–0.98) close to home, the lower the likelihood of consuming fruit ≥ 2 times/day. There was also an inverse association between density of convenience stores and the likelihood of consuming vegetables ≥ 3 times/day (OR = 0.84, 95%CI = 0.74–0.95). The likelihood of consuming vegetables ≥ 3 times/day was greater the farther children lived from a supermarket (OR = 1.27, 95%CI = 1.07–1.51) or a fast food outlet (OR = 1.19, 95%CI = 1.06–1.35).
Conclusion : Availability of fast food outlets and convenience stores close to home may have a negative effect on children's fruit and vegetable intake.

Features of public open spaces and physical activity among children : findings from the CLAN study

Objective : To examine associations between features of public open spaces, and children's physical activity.
Participants : 163 children aged 8–9 years and 334 adolescents aged 13–15 years from Melbourne, Australia participated in 2004.
Methods : A Geographic Information System was used to identify all public open spaces (POS) within 800 m of participants' homes and their closest POS. The features of all POS identified were audited in 2004/5. Accelerometers measured moderate-to-vigorous physical activity (MVPA) after school and on weekends. Linear regression analyses examined associations between features of the closest POS and participants' MVPA.
Results : Most participants had a POS within 800 m of their home. The presence of playgrounds was positively associated with younger boys' weekend MVPA (B = 24.9 min/day; p ≤ 0.05), and lighting along paths was inversely associated with weekend MVPA (B = − 54.9 min/day; p ≤ 0.05). The number of recreational facilities was inversely associated with younger girls' MVPA after school (B = − 2.6 min/day; p ≤ 0.05) and on the weekend (B = − 8.7 min/day; p ≤ 0.05). The presence of trees providing shade (5.8 min/day, p ≤ 0.01) and signage regarding dogs (B = 6.8 min/day, p ≤ 0.05) were positively associated with adolescent girls' MVPA after school.
Conclusion : Certain features of POS were associated with participants' MVPA, although mixed associations were evident. Further research is required to clarify these complex relationships.

Understanding participation in sport and physical activity amongst children and adults : A systematic review of qualitative studies

Qualitative research may be able to provide an answer as to why adults and children do or do not participate in sport and physical activity. This paper systematically examines published and unpublished qualitative research studies of UK children's and adults' reasons for participation and non-participation in sport and physical activity. The review covers peer reviewed and gray literature from 1990 to 2004. Papers were entered into review if they: aimed to explore the participants' experiences of sport and physical activity and reasons for participation or non-participation in sport and physical activity, collected information on participants who lived in the United Kingdom and presented data collected using qualitative methods. From >1200 papers identified in the initial search, 24 papers met all inclusion criteria. The majority of these reported research with young people based in community settings. Weight management, social interaction and enjoyment were common reasons for participation in sport and physical activity. Concerns about maintaining a slim body shape motivated participation among young girls. Older people identified the importance of sport and physical activity in staving off the effects of aging and providing a social support network. Challenges to identity such as having to show others an unfit body, lacking confidence and competence in core skills or appearing overly masculine were barriers to participation.

Family influences on children's physical activity and fruit and vegetable consumption

Background : There is evidence of a clustering of healthy dietary patterns and physical activity among young people and also of unhealthy behaviours. The identification of influences on children's health behaviors, particularly clustered health behaviors, at the time at which they develop is imperative for the design of interventions. This study examines associations between parental modelling and support and children's physical activity (PA) and consumption of fruit and vegetables (FV), and combinations of these behaviours.

Methods : In 2002/3 parents of 775 Australian children aged 10–12 years reported how frequently their child ate a variety of fruits and vegetables in the last week. Children wore accelerometers for eight days during waking hours. Parental modelling and parental support (financial and transport) were self-reported. Binary logistic and multinomial logistic regression analyses examined the likelihood of achieving ≥ 2 hours of PA per day (high PA) and of consuming ≥ 5 portions of FV per day (high FV) and combinations of these behaviors (e.g. high PA/low FV), according to parental modelling and support.

Results : Items of parental modelling and support were differentially associated with child behaviours. For example, girls whose parents reported high PA modelling had higher odds of consuming ≥ 5 portions of FV/day (OR = 1.95, 95% CI = 1.32–2.87, p < 0.001). Boys whose parents reported high financial support for snacks/fast foods had higher odds of having 'high PA/low FV' (OR = 2.0, 95% CI = 1.1–3.7).

Conclusion : Parental modelling of and support for physical activity and fruit and vegetable consumption were differentially associated with these behaviours in children across behavioural domains and with combinations of these behaviours. Promoting parents' own healthy eating and physical activity behaviours as well encouraging parental modelling and support of these behaviours in their children may be important strategies to test in future research.

Parental exercise is associated with Australian children's extracurricular sports participation and cardiorespiratory fitness : a cross-sectional study

Background: The relationship between parental physical activity and children's physical activity and cardiorespiratory fitness has not been well studied in the Australian context. Given the increasing focus on physical activity and childhood obesity, it is important to understand correlates of children's physical activity. This study aimed to investigate whether parental exercise was associated with children's extracurricular sports participation and cardiorespiratory fitness.

Methods: The data were drawn from a nationally representative sample (n = 8,484) of 7–15 year old Australian schoolchildren, surveyed as part of the Australian Schools Health and Fitness Survey in 1985. A subset of 5,929 children aged 9–15 years reported their participation in extracurricular
sports and their parents' exercise. Cardiorespiratory fitness was measured using the 1.6 km (1- mile) run/walk and inaddition for children aged 9, 12 or 15 years, using a physical work capacity test (PWC170).

Results: While the magnitude of the differences were small, parental exercise was positively associated with children's extracurricular sports participation (p < 0.001), 1.6 km run/walk time (p < 0.001) and, in girls only, PWC170 (p = 0.013). In most instances, when only one parent was active, the sex of that parent was not an independent predictor of the child's extracurricular sports participation and cardiorespiratory fitness.

Conclusion: Parental exercise may influence their children's participation in extracurricular sports and their cardiorespiratory fitness levels. Understanding the correlates of children's extracurricular sport participation is important for the targeting of health promotion and public health interventions, and may influence children's future health status.

Getting the complete picture : combining parental and child data to identify the barriers to social inclusion for children living in low socio-economic areas

Background: Childhood mental health problems are prevalent in Australian children (14–20%). Social exclusion is a risk factor for mental health problems, whereas being socially included can have protective effects. This study aims to identify the barriers to social inclusion for children aged 9–12 years living in low socio-economic status (SES) areas, using both child-report and parent-report interviews.

Methods: Australian-born English-speaking parents and children aged 9–12 years were sampled from a low SES area to participate in semi-structured interviews. Parents and children were asked questions around three prominent themes of social exclusion; exclusion from school, social activities and social networks.

Results: Many children experienced social exclusion at school, from social activities or within social networks. Overall, nine key barriers to social inclusion were identified through parent and child interviews, such as inability to attend school camps and participate in school activities, bullying and being left out, time and transport constraints, financial constraints and safety and traffic concerns. Parents and children often identified different barriers.

Discussion: There are several barriers to social inclusion for children living in low SES communities, many of which can be used to facilitate mental health promotion programmes. Given that parents and children may report different barriers, it is important to seek both perspectives.

Conclusion: This study strengthens the evidence base for the investments and action required to bring about the conditions for social inclusion for children living in low SES communities.