All in the Family? Parental Roles in the Epidemic of Childhood Obesity

Childhood obesity is a serious global health challenge. Families and consumption are at the nexus of the problem, as childhood weight issues depend significantly on family-related influences (genetic predispositions, physical activities, and household food consumption practices). This article focuses on how a family socializes a child toward or away from obesity. It advances a family consumer socialization framework to characterize key elements and processes. Biological predispositions, parent/family inputs, elements of child development, parent-child interactions, and intergenerational transfer are all major contributors to weight status and life course potentials. Time is also a crucial component, here represented in two forms -- linear and cyclical. Drawing on extensive research from other disciplines and related consumer research, five “Foundational Properties” are distilled, representing fundamental tenets underpinning the family’s role in this problem. Each property is then used to chart promising opportunities for consumer researchers and others interested in advancing knowledge on this pressing concern.

Reframing reporting of childhood sexual exploitation: three journalists reflect

This article explores three national and local journalists’ experiences of reporting on child sexual exploitation by so-called “Asian street grooming gangs” in UK towns and cities, with a particular emphasis on journalists framing journalists. In response to coverage of a series of cases, journalists have been accused by academics, policymakers and rival media organizations of fixating on perpetrators’ ethnicity and creating distorted, racist media frames. Few, if any, studies have garnered practitioners’ perspectives on how framing occurs, so we interview three prominent journalists who have covered such cases in order to deepen our understanding of the processes and causative factors behind particular editorial angles. While offering only a snapshot view, our findings reveal these individual journalists to be caught at the nexus of a range of factors that impact upon their work, both internally and externally driven.

Children’s access to beneficial information in Arab states: Implementation of Article 17 of the Convention on the Rights of the Child in Egypt, Morocco and the United Arab Emirates

In theory, the multiple platforms and transnational nature of digital media, along with a related proliferation of diverse forms of content, make it easier for children’s right to access socially and culturally beneficial information and material to be realised, as required by Article 17 of the UN Convention on the Rights of the Child (CRC). Drawing on data collected during research on children’s screen content in the Arab world, combined with scrutiny of documents collated by the Committee on the Rights of the Child, which monitors compliance with the CRC, this paper explores how three Arab countries, Egypt, Morocco and the United Arab Emirates, presented their efforts to implement Article 17 as part of their periodic reporting on their overall performance in putting the CRC into effect. It uncovers tensions over the relationship between provision, participation and protection in relation to media, reveals that Article 17 is liable to get less attention than it deserves in contexts where governments keep a tight grip on media, and that, by appearing to give it a lower priority, all parties neglect the intersection between human rights in relation to media and children’s rights.

Los más pequeños toman la palabra: La Escuela Infantil que a ellos les gustaría

El derecho a ser escuchado y participar en aquellos asuntos que afectan a los niños es un derecho fundamental de la infancia escasamente respetado por el adulto, quien tiende a silenciar su voz, infravalorando su visión y posible aportación. Ante esta realidad, la Escuela Infantil se erige como un marco privilegiado para la escucha y la participación de la infancia en aquellos temas que les afectan, contribuyendo a la formación de ciudadanos democráticos. A partir de un marco de escucha donde se concibe al pequeño como un sujeto activo, competente y experto en su propia vida, se ha llevado a cabo una investigación que ha adoptado el formato de estudio de caso, en la que se ha recogido a través de las técnicas del dibujo y de las conversaciones con niños, la visión que poseen los más pequeños sobre la Escuela Infantil, analizando el bienestar del niño en el contexto escolar, el sentido y finalidad que los niños otorgan a la escuela; el grado de satisfacción con la misma; sus gustos y preferencias en el contexto escolar; la autonomía y libertad que dicen poseer en la escuela; su visión sobre los aspectos organizativos que rigen el funcionamiento del centro y su perspectiva sobre cómo es y cómo les gustaría que fuera la participación de las familias en la escuela. Finalmente, se recogen sus propuestas de mejora para hacer de la Escuela Infantil a la que asisten su escuela ideal. Los resultados del estudio ponen de manifiesto la demanda de los niños de una Escuela Infantil diferente a la que conocen y la existencia de un pensamiento divergente del pensamiento adulto que es necesario escuchar y tener en consideración, siendo sus aportaciones de gran valía para poder iniciar procesos de innovación y mejora educativa.

Task sharing within a managed clinical network to improve child health in Malawi

BACKGROUND: Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric specialists working in two of the four central hospitals which serve the urban population as well as accepting referrals from district hospitals. In order to provide expert paediatric care as close to home as possible, we describe our plan to task share within a managed clinical network and our hypothesis that this will improve paediatric care and child health.

PRESENTATION OF THE HYPOTHESIS: Managed clinical networks have been found to improve equity of care in rural districts and to ensure that the correct care is provided as close to home as possible. A network for paediatric care in Malawi with mentoring of non-physician clinicians based in a district hospital by paediatricians based at the central hospitals will establish and sustain clinical referral pathways in both directions. Ultimately, the plan envisages four managed paediatric clinical networks, each radiating from one of Malawi's four central hospitals and covering the entire country. This model of task sharing within four hub-and-spoke networks may facilitate wider dissemination of scarce expertise and improve child healthcare in Malawi close to the child's home.

TESTING THE HYPOTHESIS: Funding has been secured to train sufficient personnel to staff all central and district hospitals in Malawi with teams of paediatric specialists in the central hospitals and specialist non-physician clinicians in each government district hospital. The hypothesis will be tested using a natural experiment model. Data routinely collected by the Ministry of Health will be corroborated at the district. This will include case fatality rates for common childhood illness, perinatal mortality and process indicators. Data from different districts will be compared at baseline and annually until 2020 as the specialists of both cadres take up posts.

IMPLICATIONS OF THE HYPOTHESIS: If a managed clinical network improves child healthcare in Malawi, it may be a potential model for the other countries in sub-Saharan Africa with similar cadres in their healthcare system and face similar challenges in terms of scarcity of specialists.

Planning for the Unseen and Unheard: the child with ASD

“Children are a kind of indicator species.
If we can build a successful city for children,
we will have a successful city for all people.”

Enrique Peñalosa (former mayor of Bogotá)

Should society be judged by how they treat their weakest members, the concept of the Child Friendly City offers more than ample scope for critiquing the genuine health and inclusivity of our urban environments. If we accept childhood as a crucial human development phase that demands inclusive and welcoming places for play, exploration and growth, many cities today are becoming increasingly barren habitats, arguably full of nothing but empty childhoods. (Raven-Ellison 2015) With children today less able to roam and explore our streets than those of yesteryear, (Bird 2007) the situation is now developing where our young are becoming increasingly socially and spatially excluded from our supposedly shared Built Environment. That progressively restrictive urban realm is particularly pronounced for those with Autism Spectrum Disorder, for whom our cities can be disorientating, difficult and even frightening places.

As a profession we have a responsibility to provide inclusive built environments that do not preclude the presence of the most vulnerable in society, among them those with ASD. Accordingly this paper seeks to introduce emerging research into the current challenges facing these young urban stakeholders before discussing how planning processes and design interventions might make our cities more accessible to those with ASD.

References:

Bird, W. (2007) Natural Thinking, Sandy, Bedfordshire: RSPB.

Raven-Ellison, D. (2015) “London’s Empty Childhoods” in London Essays – Green Spaces, Issue 3 – found at: http://essays.centreforlondon.org/issues/green/londons-empty-childhoods/ accessed 9th May 2016.

Exploring the effects of a universal classroom management training programme on teacher and child behaviour: a group randomised controlled trial and cost analysis

Teachers frequently struggle to cope with conduct problems in the classroom. The aim of this study was to assess the effectiveness of the Incredible Years Teacher Classroom Management Training Programme for improving teacher competencies and child adjustment. The study involved a group randomised controlled trial which included 22 teachers and 217 children (102 boys and 115 girls). The average age of children included in the study was 5.3 years (standard deviation = 0.89). Teachers were randomly allocated to an intervention group (n = 11 teachers; 110 children) or a waiting-list control group (n = 11; 107 children). The sample also included 63 ‘high-risk’ children (33 intervention; 30 control), who scored above the cut-off (>12) on the Strengths and Difficulties Questionnaire for abnormal socioemotional and behavioural difficulties. Teacher and child behaviours were assessed at baseline and 6 months later using psychometric and observational measures. Programme delivery costs were also analysed. Results showed positive changes in teachers’ self-reported use of positive classroom management strategies (effect size = 0.56), as well as negative classroom management strategies (effect size = −0.43). Teacher reports also highlight improvements in the classroom behaviour of the high-risk group of children, while the estimated cost of delivering the Incredible Years Teacher Classroom Management Training Programme was modest. However, analyses of teacher and child observations were largely non-significant. A need for further research exploring the effectiveness and cost-effectiveness of the Incredible Years Teacher Classroom Management Training Programme is indicated.

Maternal history of early adversity and child emotional development : investigating intervening factors

L’objectif de cette thèse était de contribuer à l’avancement des connaissances quant aux circonstances permettant une transmission intergénérationnelle du risque émanant de l’adversité maternelle et aux mécanismes sous-tendant cette transmission, dans quatre articles empiriques. Le premier visait à explorer la relation entre un historique d’adversité maternelle, la sécurité d’attachement mère-enfant et le tempérament de l’enfant. Les mères ont complété une entrevue semi-structurée portant sur leurs représentations d’attachement avec leurs parents, à 6 mois, et ont évalué le tempérament de leur enfant à 2 ans. La sécurité d’attachement fut également évaluée à 2 ans. Les résultats ont démontré que les enfants dont les mères rapportaient des niveaux supérieurs d’adversité présentaient de moins bons niveaux d’activité comportementale, uniquement lorsqu’ils avaient un attachement sécurisant avec leur mère. Ces résultats suggèrent une transmission intergénérationnelle des effets d’un historique d’adversité maternelle sur le tempérament des enfants. Le deuxième article visait à investiguer si le transporteur de sérotonine (5-HTTLPR) module la transmission de risque intergénérationnelle de l’adversité maternelle sur le tempérament des enfants. L’historique d’adversité maternelle fut évalué en combinant deux mesures auto-rapportées. Les mères ont également évalué le tempérament de leur enfant à 18 et à 36 mois. Le génotype des enfants fut extrait à 36 mois. Les résultats ont révélé un effet d’interaction entre l’adversité maternelle et le génotype de l’enfant sur le tempérament, suggérant une transmission intergénérationnelle des effets de l’adversité maternelle sur le fonctionnement émotionnel des enfants. Le troisième article visait à explorer la relation entre les difficultés d’adaptation psychosociale des mères, la sensibilité maternelle et les symptômes intériorisés de leurs enfants. Les mères ont complété plusieurs questionnaires desquels un score composite de difficultés d’adaptation psychosociale fut extrait. La sensibilité maternelle fut observée à 12 mois. Les symptômes intériorisés des enfants furent évalués par les deux parents à 2 et à 3 ans. Les résultats ont démontré qu’une augmentation des difficultés maternelles d’adaptation psychosociale étaient associée à davantage de symptômes intériorisés chez les enfants, mais seulement chez ceux dont les mères étaient moins sensibles. Ces résultats ont été observés par les mères à 2 ans et par les deux parents à 3 ans. Ces résultats suggèrent que les enfants peuvent être différemment affectés par l’adaptation émotionnelle de leur mère tout en mettant l’emphase sur le rôle protecteur de la sensibilité maternelle. Le quatrième article visait à investiguer les rôles médiateurs de la dépression et de la sensibilité maternelle dans la relation entre un historique d’adversité maternelle et le tempérament de l’enfant. L’historique d’adversité maternelle fut évalué en combinant deux mesures auto-rapportées. Les mères ont également rapporté leurs symptômes dépressifs à 6 mois. La sensibilité maternelle fut évaluée de façon concomitante. Les mères ont évalué le tempérament de leur enfant à 36 mois. Les résultats ont révélé une transmission intergénérationnelle des effets d’un historique d’adversité maternelle à la génération suivante suivant une médiation séquentielle passant d’abord par la dépression maternelle et ensuite par la sensibilité maternelle. Finalement, les résultats des quatre articles ont été intégrés dans la conclusion générale.

Classifying Child Maltreatment by Brain Imaging Data

Thesis (Master's)--University of Washington, 2016-08

Providing Palliative Care for the Child with Cancer: The Experience of GPs

Background Childhood cancers are rare and general practitioners (GPs) have limited experience in caring for these children and even less in providing their palliative care. Most families prefer that their child is cared for at home in the palliative phase of their illness, with professional support from those known to them (Chambers and Oakhill 1995, Vickers and Carlisle 2000, Craft and Killen 2007). A community based qualitative study examined the experiences of ten GPs following their involvement in the care of a child with cancer receiving palliative care within the family home. Methods Data collection was through 1:1 in-depth interviews and facilitated case discussion supported by field notes and grounded theory analysis (chronological comparative data analysis identifying generated themes). Social worlds theory was used as a framework to aid examination, and facilitate critical understanding, of the experiences of the GPs. Findings This presentation focuses on five of the findings relating to the experiences of the GP; the impact of minimal contact; lack of knowledge and experience, uncertain role, out of hours service provision and the emotional toll. Findings highlighted that GPs often have to re-establish their role at the child’s transition to palliative care. Factors hindering the GP in this process include a deficit of specialist knowledge and experience of paediatric palliative care and lack of role clarity. Conclusions/points of interest Strategies for enhancing the role of the Macmillan team in supporting GPs have been identified by this study, such as enhanced collaborative working. Findings have also provided further confirmation of the substantial variation in out of hours medical palliative care provision; with evidence that some GPs work beyond their remit in providing informal out of hours care. This presentation details the findings of one aspect (the experiences of GPs) of a wider study that explored the experiences of 54 community based health professionals (GPs, community nurses and allied health professionals) who had been involved in caring for a dying with cancer receiving palliative care at home (Neilson 2009).

Influence of household remittance on childhood stunting in Nepal

Thesis (Master's)--University of Washington, 2016-08

Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Preschoolers’ Executive Control and Diurnal Cortisol as Mediators of the Relations of Prenatal Stress to Child Adjustment

Thesis (Ph.D.)--University of Washington, 2016-08

Talking everyday science to very young children: a study involving parents and practitioners within an early childhood centre

The acquisition of everyday scientific concepts by 3-6 year old children attending early childhood institutions has been widely studied. In contrast, research on science learning processes among younger children is less extensive. This paper reports on findings from an exploratory empirical study undertaken in a ‘stay and play’ service used by parents with children aged 0-3 and located within an East London early childhood centre. The research team collaborated with practitioners to deliver a programme of activities aimed at encouraging parents’ confidence in their own ability to support emergent scientific thinking among their young children. The programme generated children’s engagement and interest. Parents and practitioners reported increased confidence in their ability to promote young children’s natural curiosity at home and in early childhood provision. The authors see no reason for positing qualitative differences between the way children acquire scientific and other concepts in their earliest years.