Food neophobia and its association with diet quality and weight in children aged 24 months : a cross sectional study

Background Food neophobia, the rejection of unknown or novel foods, may result in poor dietary patterns. This study investigates the cross-sectional relationship between neophobia in children aged 24 months and variety of fruit and vegetable consumption, intake of discretionary foods and weight. Methods Secondary analysis of data from 330 parents of children enrolled in the NOURISH RCT (control group only) and SAIDI studies was performed using data collected at child age 24 months. Neophobia was measured at 24 months using the Child Food Neophobia Scale (CFNS). The cross-sectional associations between total CFNS score and fruit and vegetable variety, discretionary food intake and BMI (Body Mass Index) Z-score were examined via multiple regression models; adjusting for significant covariates. Results At 24 months, more neophobic children were found to have lower variety of fruits (β=-0.16, p=0.003) and vegetables (β=-0.29, p<0.001) but have a greater proportion of daily energy from discretionary foods (β=0.11, p=0.04). There was no significant association between BMI Z-score and CFNS score. Conclusions Neophobia is associated with poorer dietary quality. Results highlight the need for interventions to (1) begin early to expose children to a wide variety of nutritious foods before neophobia peaks and (2) enable health professionals to educate parents on strategies to overcome neophobia.

The relationship between controlling feeding practices and boys’ and girls’ eating in the absence of hunger

Parental controlling feeding practices have been directly associated with maladaptive child eating behaviours, such as Eating in the Absence of Hunger (EAH). The aim of this study was to examine EAH in very young children (3-4 years old) and to investigate the association between maternal controlling feeding practices and energy intake from a standardised selection of snacks consumed ‘in the absence of hunger’. Thirty-seven mother-child dyads enrolled in the NOURISH RCT participated in a modified EAH protocol conducted in the child’s home. All children displayed EAH, despite 80% reporting to be full or very full following completion of lunch 15 minutes earlier. The relationship between maternal and child covariates and controlling feeding practices and EAH were examined using non-parametric tests, and were stratified by child gender. For boys only, pressure to eat was positively associated with EAH. Neither restriction nor monitoring practices were associated with EAH in either boys or girls. Overall, the present findings suggest gender differences in the relationship between maternal feeding practices and children’s eating behaviours emerge early and should be considered in future research and intervention design.

The timing of solid introduction in an ‘obesogenic’ environment : a narrative review of the evidence and methodological issues.

Objective To evaluate the evidence for association between obesity risk outcomes >12 months of age and timing of solid introduction in healthy term infants in developed countries, the large majority of whom are not exclusively breastfed to 6 months of age. Methods Studies included were published 1990-March 2013. Results Twenty-six papers with weight status or obesity prevalence outcomes were identified. Studies were predominantly cohort design, most with important methodological limitations. Ten studies reported a positive association. Of these only two were large good quality studies and both examined the outcome of early (<4 months) solid introduction. None of the four good quality studies that directly evaluated current guidelines provided evidence of any clinically relevant protective effect of solid introduction from 4-5 versus ≥ 6 months of age. Conclusion Overall the introduction of solids prior to 4 months may result in increased risk of childhood obesity but there is little evidence of adverse weight status outcomes associated with introducing solids at 4-6 rather than at 6 months. Implications More and better quality evidence is required to inform guidelines on the ‘when, what and how’ of complementary feeding.

Risk factors for delayed healing in venous leg ulcers : a review of the literature

Background Chronic leg ulcers, remaining unhealed after 4–6 weeks, affect 1-3% of the population, with treatment costly and health service resource intensive. Venous disease contributes to approximately 70% of all chronic leg ulcers and these ulcers are often associated with pain, reduced mobility and a decreased quality of life. Despite evidence-based care, 30% of these ulcers are unlikely to heal within a 24-week period and therefore the recognition and identification of risk factors for delayed healing of venous leg ulcers would be beneficial. Aim To review the available evidence on risk factors for delayed healing of venous leg ulcers. Methods: A review of the literature in regard to risk factors for delayed healing in venous leg ulcers was conducted from January 2000 to December 2013. Evidence was sourced through searches of relevant databases and websites for resources addressing risk factors for delayed healing in venous leg ulcers specifically. Results Twenty-seven studies, of mostly low-level evidence (Level III and IV), identified risk factors associated with delayed healing. Risk factors that were consistently identified included: larger ulcer area, longer ulcer duration, a previous history of ulceration, venous abnormalities and lack of high compression. Additional potential predictors with inconsistent or varying evidence to support their influence on delayed healing of venous leg ulcers included decreased mobility and/or ankle range of movement, poor nutrition and increased age. Discussion Findings from this review indicate that a number of physiological risk factors are asso- ciated with delayed healing in venous leg ulcers and that social and/or psychological risk factors should also be considered and examined further. Conclusion The findings from this review can assist health professionals to identify prognostic indicators or risk factors significantly associated with delayed healing in venous leg ulcers. This will facilitate realistic outcome planning and inform implementation of appropriate early strategies to promote healing.

Starting with strengths : an Indigenous early years intervention

Aboriginal protocol usually links the right to tell a story with a declaration of involvement or connection to the story. I am Aboriginal . . . I am a woman, daughter, sister, aunty and wife. I am also a mother to three beautiful children aged 6, 4 and 2 years. To my children at this point in their lives, I am their provider, nurturer, teacher, cook, taxi driver, mediator, stylist, Elder, slave, and expert on all there is to know in the world. Being the centre of the universe to three impressionable young minds is a role that I cherish deeply, and I take the responsibilities of it very seriously. I love the job of parenting. As any parent would agree, it is the most challenging and difficult job of all, but the opportunity to bring a life into the world and shape and mould a little person into a big person brings rewards that no career can.

Literacy and Digital Culture in the Early Years

In this chapter we present data drawn from observations of kindergarten children using iPads and talk with the children, their parents/guardians and teachers. We identify a continuum of practices that extends from ‘educational apps’ teaching handwriting, sight words and so forth to uses of the iPad as a device for multimodal literacy development and substantive conversation around children’s creative work. At the current time high stakes testing and the implementation of the Australian Curriculum are prompting new public and professional conversations about literacy and digital technology. The iPad is construed as both cause of and solution to problems of traditional literacy education. In this context we describe the literacies enabled by educational software available on iPads. We higlight the time constraints which bore on teachers' capacity to enact their visions of literacy education through the iPad platform and suggest ways of reflecting on responses to this constraint.

“Heroic victims”: Discursive constructions of early childhood teacher professional identities

Significant changes to qualification requirements for staff working in early childhood contexts are occurring globally. A key reform in Australia is a call for teachers in prior to school early childhood contexts to be university-qualified. The “universal access” strategy (Department of Education, Employment of Workplace Relations [DEEWR], 2009a, 2009b; Rudd & Macklin, 2007b) requires four-year qualified early childhood teachers who are prepared to work in child care contexts. Yet studies in identify that cohorts of preservice teachers resist child care as a career option (see Ailwood & Boyd, 2006; Gibson, 2013a; Vadja, 2005a, 2005b). It is this point of tension that has prompted further inquiry into child care and work in child care, and forms the basis for this paper.

The ‘state of play’ in Australia: Early childhood educators and play-based learning

This article provides an overview of the Education Meets Play study that will investigate early childhood educators’ use of play-based learning, now mandatory under the National Quality Standard. By building on what can be gleaned about educators’ approaches to play-based learning prior to the implementation of the Early Years Learning Framework, the study will contribute to the evidence base concerning the implementation and effects of Australia’s early childhood education and care policy reform initiatives.

Using strengths-based approaches in early years practice and research

Strengths-based approaches draw upon frameworks and perspectives from social work and psychology but have not necessarily been consistently defined or well articulated across disciplines. Internationally, there are increasing calls for professionals in early years settings to work in strengths-based ways to support the access and participation of all children and families, especially those with complex needs. The purpose of this paper is to examine a potential promise of innovative uses of strengths-based approaches in early years practice and research in Australia, and to consider implications for application in other national contexts. In this paper, we present three cases (summarised from larger studies) depicting different applications of the Strengths Approach, under pinned by collaborative inquiry at the interface between practice and research. Analysis revealed three key themes across the cases: (i) enactment of strengths-based principles, (ii) the bi-directional and transformational influences of the Strengths Approach (research into practice/practice into research), and (iii) heightened practitioner and researcher awareness of, and responsiveness to, the operation of power. The findings highlight synergies and challenges to constructing and actualising strengths-based approaches in early years childhood research and practice. The case studies demonstrate that although constructions of what constitutes strengths-based research and practice requires ongoing critical engagement, redefining, and operationalising, using strengths-based approaches in early years settings can be generative and worthwhile.

The protective mechanisms of first aid training within a school-based program for early adolescents

This thesis was concerned with the protective mechanisms of first aid training in the context of peer support. Using a randomised control trial design the current program of research explores first aid training in the school setting and identifies the key components of effective school-based first aid training programs. In particular, examining whether first aid training and associated knowledge could be protective for early adolescents. This broader framing considered whether first aid impacted on increasing behaviour and attitudes towards helping an injured friend, and reducing personal risk taking and related injury.

"Doing” social justice in early childhood: The potential of leadership

Early childhood education and care (ECEC) has long been connected with objectives related to social justice. ECEC in Australia has its roots in philanthropic and educational reform movements, and more recently with the National Early Childhood Reform Agenda, ECEC has once more been linked to the redressing inequality and disadvantage. Drawing on extant literature, including data from two previously reported Australian studies in which leadership emerged as having a transformational impact on service delivery, this paper examines the potential of early childhood leadership to generate ‘socially just’ educational communities. With reference to critical theory, we argue that critically informed, intentional and strategic organisational leadership can play a pivotal role in creating changed circumstances and opportunities for children and families.