Going online : young children and teachers accessing knowledge through web interactions

Children accessing and using internet-connected technology is a relatively recent phenomenon, and rapidly having an impact on their experiences and activities in homes and early childhood classrooms. Technology refers to devices such as computers, smart phones and tablets - many capable of being connected to the internet - and the products, such as websites, games, and interactive stories (Plowman and McPake, 2013). These activities can be played, created, watched, listened to and read, and incorporated into traditional everyday activities. This article provides suggestions for strategies for teachers to consider when incorporating technology into early childhood education.

Long-term azithromycin for Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease (Bronchiectasis Intervention Study) : a multicentre, double-blind, randomised controlled trial

Background Indigenous children in high-income countries have a heavy burden of bronchiectasis unrelated to cystic fibrosis. We aimed to establish whether long-term azithromycin reduced pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. Methods Between Nov 12, 2008, and Dec 23, 2010, we enrolled Indigenous Australian, Maori, and Pacific Island children aged 1—8 years with either bronchiectasis or chronic suppurative lung disease into a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. Eligible children had had at least one pulmonary exacerbation in the previous 12 months. Children were randomised (1:1 ratio, by computer-generated sequence with permuted block design, stratified by study site and exacerbation frequency [1—2 vs ≥3 episodes in the preceding 12 months]) to receive either azithromycin (30 mg/kg) or placebo once a week for up to 24 months. Allocation concealment was achieved by double-sealed, opaque envelopes; participants, caregivers, and study personnel were masked to assignment until after data analysis. The primary outcome was exacerbation (respiratory episodes treated with antibiotics) rate. Analysis of the primary endpoint was by intention to treat. At enrolment and at their final clinic visits, children had deep nasal swabs collected, which we analysed for antibiotic-resistant bacteria. This study is registered with the Australian New Zealand Clinical Trials Registry; ACTRN12610000383066. Findings 45 children were assigned to azithromycin and 44 to placebo. The study was stopped early for feasibility reasons on Dec 31, 2011, thus children received the intervention for 12—24 months. The mean treatment duration was 20·7 months (SD 5·7), with a total of 902 child-months in the azithromycin group and 875 child-months in the placebo group. Compared with the placebo group, children receiving azithromycin had significantly lower exacerbation rates (incidence rate ratio 0·50; 95% CI 0·35—0·71; p<0·0001). However, children in the azithromycin group developed significantly higher carriage of azithromycin-resistant bacteria (19 of 41, 46%) than those receiving placebo (four of 37, 11%; p=0·002). The most common adverse events were non-pulmonary infections (71 of 112 events in the azithromycin group vs 132 of 209 events in the placebo group) and bronchiectasis-related events (episodes or investigations; 22 of 112 events in the azithromycin group vs 48 of 209 events in the placebo group); however, study drugs were well tolerated with no serious adverse events being attributed to the intervention. Interpretation Once-weekly azithromycin for up to 24 months decreased pulmonary exacerbations in Indigenous children with non-cystic-fibrosis bronchiectasis or chronic suppurative lung disease. However, this strategy was also accompanied by increased carriage of azithromycin-resistant bacteria, the clinical consequences of which are uncertain, and will need careful monitoring and further study.

Ethics in Research with Children

Widespread scholarly interest in ethics in research with children, as an extant field of inquiry and practice, is a relatively new phenomenon. The discipline of ethics can be traced back to the Hippocratic school, but its contemporary applications in the everyday worlds of children and those around them are gaining greater attention from theorists, practitioners, and those involved in policy. Heightened international awareness of the United Nations Convention on the Rights of the Child (1979) gave significant impetus to increasing international awareness of children’s rights to provision, protection, and participation in everyday contexts, including those in which research occurs. Understandings of research ethics and of children’s involvement in research relate to broader understandings of children and childhood drawn from developmental science, sociology, human geography, health sciences, and children’s human rights to participation and protection. Key understandings pertain to children’s competence to participate in research, to operate as reliable informants with respect to their own lives, to provide voluntary informed consent and dissent in research, and to make meaningful decisions about the nature and extent of their participation. The field is international and interdisciplinary, although bounded by legislative, policy, and jurisdictional requirements governing research—its conduct and dissemination. So, too, the burgeoning work of ethics committees, whether in relation to health research or social research, is evidence of a sharpened focus on governance of child research. Oxford Bibliographies offers a suite of perspectives, resources, and strategies to guide the researcher, practitioner, and policymaker and serves to challenge readers to interrogate conceptual understandings, methodologies, and dissemination of research with and about children. Exploration of the suite opens up new possibilities for considering children’s rights to participation in matters that affect their lives and for children to be seen and heard in research.

Choroidal thickness in myopic and non-myopic children assessed with enhanced depth imaging optical coherence tomography

Purpose To examine choroidal thickness (ChT) and its topographical variation across the posterior pole in myopic and non-myopic children. Methods One hundred and four children aged 10-15 years of age (mean age 13.1 ± 1.4 years) had ChT measured using enhanced depth imaging optical coherence tomography (OCT). Forty one children were myopic (mean spherical equivalent -2.4 ± 1.5 D) and 63 non-myopic (mean +0.3 ± 0.3 D). Two series of 6 radial OCT line scans centred on the fovea were assessed for each child. Subfoveal ChT and ChT across a series of parafoveal zones over the central 6mm of the posterior pole were determined through manual image segmentation. Results Subfoveal ChT was significantly thinner in myopes (mean 303 ± 79 µm) compared to non-myopes (mean 359 ± 77 µm) (p<0.0001). Multiple regression analysis revealed both refractive error (r = 0.39, p<0.001) and age (r = 0.21, p = 0.02) were positively associated with subfoveal ChT. ChT also exhibited significant topographical variations, with the choroid being thicker in more central regions. The thinnest choroid was typically observed in nasal (mean 286 ± 77 µm) and inferior-nasal (306 ± 79 µm) locations, and the thickest in superior (346 ± 79 µm) and superior-temporal (341 ± 74 µm) locations. The difference in ChT between myopic and non-myopic children was significantly greater in central foveal regions compared to more peripheral regions (>3 mm diameter) (p<0.001). Conclusions Myopic children have significantly thinner choroids compared to non-myopic children of similar age, particularly in central foveal regions. The magnitude of difference in choroidal thickness associated with myopia appears greater than would be predicted by a simple passive choroidal thinning with axial elongation.

Light exposure and physical activity in myopic and emmetropic children

Purpose: To objectively assess daily light exposure and physical activity levels in myopic and emmetropic children. Methods: One hundred and two children (41 myopes and 61 emmetropes) aged 10 to 15 years old had simultaneous objective measures of ambient light exposure and physical activity collected over a 2 week period during school term, using a wrist worn actigraphy device (Actiwatch-2). Measures of visible light illuminance and physical activity were captured every 30 seconds, 24 hours a day over this period. Mean hourly light exposure and physical activity for weekdays and weekends were examined. To ensure that seasonal variations didn’t confound comparisons, the light and activity data of the 41 myopes, was compared with 41 age and gender matched emmetropes who wore the Actiwatch over the same two week period. Results: Mean light exposure and physical activity for all 101 children with valid data exhibited significant changes with time of day and day of the week (p<0.0001). On average greater daily light exposure occurred on weekends compared to weekdays (p<0.05), and greater physical activity occurred on weekdays compared to weekends (p<0.01). Myopic children (n = 41, mean daily light exposure 915 ± 519 lux) exhibited significantly lower average light exposure compared to 41 age and gender matched emmetropic children (1272 ± 625 lux, p<0.01). The amount of daily time spent in bright light conditions (>1000 lux) was also significantly greater in emmetropes (127 ± 51 minutes) compared to myopes (91 ± 44 minutes, p<0.001). No significant differences were found between the average daily physical activity levels of myopes and emmetropes (p>0.05). Conclusions: Myopic children exhibit significantly lower daily light exposure, but no significant difference in physical activity compared to emmetropic children. This suggests the important factor involved in documented associations between myopia and outdoor activity is likely exposure to bright outdoor light rather than greater physical activity.

Maternal report of young children's eating styles. Validation of the Children's Eating Behaviour Questionnaire in three ethnically diverse Australian samples

The aim of this study was to validate the Children’s Eating Behaviour Questionnaire (CEBQ) in three ethnically and culturally diverse samples of mothers in Australia. Confirmatory factor analysis utilising structural equation modelling examined whether the established 8-factor model of the CEBQ was supported in our three populations: (i) a community sample of first-time mothers allocated to the control group of the NOURISH trial (mean child age = 24 months [SD = 1]; N = 244); (ii) a sample of immigrant Indian mothers of children aged 1–5 years (mean age = 34 months [SD = 14]; N = 203), and (iii) a sample of immigrant Chinese mothers of children aged 1–4 years (mean age = 36 months [SD = 14]; N = 216). The original 8-factor model provided an acceptable fit to the data in the NOURISH sample with minor post hoc re-specifications (two error covariances on Satiety Responsiveness and an item-factor covariance to account for a cross-loading of an item (Fussiness) on Satiety Responsiveness). The re-specified model showed reasonable fit in both the Indian and Chinese samples. Cronbach’s α estimates ranged from .73 to .91 in the Australian sample and .61–.88 in the immigrant samples. This study supports the appropriateness of the CEBQ in the multicultural Australian context.

Validity of maternal-reported weight and height of children 2-5 year olds

To the Editor: In affluent-urban areas of India, overweight (6 %) and obesity (8 %) are prevalent in children as young as 2–5 y [1]. A potential risk factor for childhood obesity could be parent’s under-reporting their child’s anthropometry. In Indian culture, a larger body size is typically acceptable, and mothers may consider a chubby baby as healthy [2]. Therefore, it was proposed that Indian mothers may under-report their child’s weight status. The present study examined the validity of maternal reported height and weight of young, urban-affluent Indian children aged 2–5 y. After receiving approval from the QUT Human Research Ethics Committee, Australia 111 mothers with children aged 2–5 y attending private medical clinics (n = 5) in the affluent areas of Mumbai were recruited. Child’s height and weight were measured by the researcher using standard equipment/protocols. Mothers also reported their child’s height and weight.

Underlying beliefs influencing Vietnamese nurses and doctors in screening for victims of domestic violence: An exploratory study

Many health professionals in Vietnam have limited knowledge and experience in coordinating care for victims of Domestic Violence (DV). This qualitative study aimed to elicit the beliefs of nurses and doctors that are influencing the care of victims of DV. Data were collected by semistructured interviews with nineteen nurses and doctors. Data were analyzed by content analysis and organized by three main themes; behavioral beliefs, normative beliefs and control beliefs. The outcomes of this study will inform the development of intervention strategies that will enable health professionals to better respond to and manage care for women who experience domestic violence in Vietnam.

Teachers and academics researching together : children's views on play

An international early years project led by QUT and University of Iceland researchers has investigated children’s accounts of play and the teacher’s role in play in kindergarten settings. While most commonly associated with young children’s activities and the work of childhood, play is recognised also as an activity that extends over the life span, from early childhood to adulthood, and across cultures, worldwide. As shown in national and state policy and curriculum documents, play is being subjected increasingly to specific guidelines that address the physical environment and educator involvement in early years settings. Parents and educators have strong opinions regarding the value and place of play. Children also have strong views about play, although little is known about their views and what they think play encompasses, and the value of play in their everyday lives.

The impact of heat waves on children's health : a systematic review

Young children are thought to be particularly sensitive to heatwaves, but relatively less research attention has been paid to this field to date. A systematic review was conducted to elucidate the relationship between heat waves and children’s health. Literature published up to August 2012 were identified using the following MeSH terms and keywords: “heatwave”, “heat wave”, “child health”, “morbidity”, “hospital admission”, “emergency department visit”, “family practice”, “primary health care”, “death” and “mortality”. Of the 628 publications identified, 12 met the selection criteria. The existing literature does not consistently suggest that mortality among children increases significantly during heat waves, even though infants were associated with more heat-related deaths. Exposure to heat waves in the perinatal period may pose a threat to children’s health. Pediatric diseases or conditions associated with heat waves include renal disease, respiratory disease, electrolyte imbalance and fever. Future research should focus on how to develop a consistent definition of a heat wave from a children’s health perspective, identifying the best measure of children’s exposure to heat waves, exploring sensitive outcome measures to quantify the impact of heat waves on children, evaluating the possible impacts of heat waves on children’s birth outcomes, and understanding the differences in vulnerability to heat waves among children of different ages and from different income countries. Projection of the children’s disease burden caused by heat waves under climate change scenarios, and development of effective heat wave mitigation and adaptation strategies that incorporate other child protective health measures, are also strongly recommended.

The professional identity of child care practitioners : self-authorship as a theoretical framework

This research contributes new understandings about the development of the professional identity of child care practitioners and how professional identity changes during the transition from student to practitioner. Self-authorship theory was used as the framework to investigate the development of professional identity through exploration of beliefs about practice, sense of self, and capabilities for collaborative engagement. Students recruited for this research were completing their qualifications to work with young children in child care settings. Data from initial and follow-up interviews were analysed to understand change over time in professional identity. Findings indicated a need for training institutions and workplaces to move beyond competency-based training approaches to include more critically reflective learning opportunities. Such a focus on critical reflection has implications for improving the skills, status, and recognition of child care practitioners as educators.

Raising Children in Single-Parent Families

Children from single-parent families fare more poorly on multiple outcomes than those in two-parent families. Most explanations for these differences assume that compromised parenting and parent mental health play a central role. This chapter explores the contribution of a range of factors to the parenting and mental health of single mothers using data from approximately 1000 Australian single mothers with a child aged 4–5 or 8–9 years. The findings show that single mothers are more likely than couple mothers to experience parenting and mental health difficulties; however, they also face heightened adversity in their home and extra-familial environments. Importantly, this comparison of single and couple mothers facing similar levels of adversity shows no difference in poor parenting practices, although single mothers remain more vulnerable to psychological distress. These findings have policy implications since they challenge the prevailing view that single-parent families inherently provide sub-optimal environments for raising children.

Practices surrounding children's photos in homes

New parents cherish photos of their children. In their homes one can observe a varied set of arrangements of their young ones' photos. We studied eight families with young children to learn about their practices related to photos. We provide preliminary results from the field study and elaborate on three interesting themes that came out very strongly from our data: physical platforms; family dynamics and values; and creative uses of photos. These themes provide an insight into families' perceived values for photo curating, displaying and experiencing them over a longer period. We provide future directions for supporting practices surrounding children's photos.