Children with gender dysphoria deserve better from the law

An increasing number of Australian children are accessing specialist health services for gender dysphoria treatment, largely because of a growing awareness among doctors about available specialist health services. But the law is not in step with the needs of these children...

Mandatory naptimes in child care and children's nighttime sleep

Objectives To examine the relationship between mandatory naptimes in child care and children's nighttime sleep duration, both concurrently and 12 months later once in school. Methods A sample of 168 children (50-72 months; 55% males) attending licensed child care centers were observed across their morning and throughout their scheduled naptime. Mandatory naptime was determined as the period in which children were not permitted any alternative activity except lying on their bed. Teachers reported each child's napping in child care. Nighttime and total sleep duration was reported by parents at 2 time points, in child care and in the second semester of their first school year. General linear models were used to examine group differences in sleep duration between children experiencing 0 to 60 minutes and >60 minutes of mandatory naptime, adjusting for key confounders. Path analysis was conducted to test a mediation model in which mandatory naptime is associated with nighttime sleep duration through increased napping in child care. Results Children who experienced >60 minutes of mandatory naptime in child care had significantly less nighttime sleep than those with 0 to 60 minutes of mandatory naptime. This difference persisted at 12-month follow-up, once children were in school. Napping in child care mediated the relationship between mandatory naptime and duration of nighttime sleep. Conclusions Exposure to mandatory naptimes of >60 minutes in child care is associated with decreased duration of nighttime sleep that endures beyond child care attendance. Given the large number of children who attend child care, sleep practices within these settings present an important focus for child health.

The messaging kettle: Prototyping connection over a distance between adult children and older parents

A prototype "messaging kettle" is described. The connected kettle aims to foster communication and engagement with an older friend or relative who lives remotely, during the routine of boiling the kettle. We describe preliminary encounters and findings from demonstrating a working prototype in morning tea gatherings of people in their 50s-late 70s and from introducing it into the homes of two people in their 80s who live on another continent. Key findings are that: The concept of keeping in touch around a "habituated object" such as a kettle was well received; Simple and varied interaction modalities that allow asymmetric forms of communication are needed; Designing for use across different time zones requires attention; And, that even when augmenting a habituated object, the process of introduction, appropriation and habituation still needs significant attention and investigation.

Dietary intake in Australian children aged 4–24 months: Consumption of meat and meat alternatives

Meat/meat alternatives (M/MA) are key sources of Fe, Zn and protein, but intake tends to be low in young children. Australian recommendations state that Fe-rich foods, including M/MA, should be the first complementary foods offered to infants. The present paper reports M/MA consumption of Australian infants and toddlers, compares intake with guidelines, and suggests strategies to enhance adherence to those guidelines. Mother–infant dyads recruited as part of the NOURISH and South Australian Infants Dietary Intake studies provided 3 d of intake data at three time points: Time 1 (T1) (n 482, mean age 5·5 (SD 1·1) months), Time 2 (T2) (n 600, mean age 14·0 (SD 1·2) months) and Time 3 (T3) (n 533, mean age 24 (SD 0·7) months). Of 170 infants consuming solids and aged greater than 6 months at T1, 50 (29 %) consumed beef, lamb, veal (BLV) or pork on at least one of 3 d. Commercial infant foods containing BLV or poultry were the most common form of M/MA consumed at T1, whilst by T2 BLV mixed dishes (including pasta bolognaise) became more popular and remained so at T3. The processed M/MA increased in popularity over time, led by pork (including ham). The present study shows that M/MA are not being eaten by Australian infants or toddlers regularly enough; or in adequate quantities to meet recommendations; and that the form in which these foods are eaten can lead to smaller M/MA serve sizes and greater Na intake. Parents should be encouraged to offer M/MA in a recognisable form, as one of the first complementary foods, in order to increase acceptance at a later age.

Randomized controlled trial of an improved version of MobileMums, an intervention for increasing physical activity in women with young children

Background Women with young children (<5 years) are an important group for physical activity intervention. Purpose To evaluate the feasibility, acceptability and efficacy of MobileMums- a physical activity intervention for women with young children. Methods Women were randomized to MobileMums (n=133) or a control group (n=130). MobileMums was delivered primarily via individually-tailored text messages. Moderate to vigorous physical activity (MVPA) was measured by self-report and accelerometer at baseline, end of the intervention (13-weeks) and 6-months later (9-months). Changes were analyzed using repeated measures models. Results MobileMums was feasible to deliver and acceptable to women. Self-reported MVPA duration (minutes/week) and frequency (days/week) increased significantly post intervention (13-week intervention effect 48.5 min/week, 95%CI [13.4, 82.9] and 1.6 days/week, 95%CI [0.6, 2.6]). Intervention effects were not maintained 6-months later. No effects observed in accelerometer-derived MVPA. Conclusions MobileMums increased women’s self-reported MVPA immediately post intervention. Future investigations need to target sustained physical activity improvements.

Exploring how adults who work with young children conceptualise sustainability and describe their practice initiatives

The development of early Childhood Education for Sustainability (ECEfS) practices with young children from birth to eight years is an emerging area in academic and professional literature. ECEfS practices reflect growing awareness of the imperative for twenty-first century societies to respond to the pressures of unsustainable patterns of living. This article contributes to the growing area of ECEfS research by exploring sustainability conceptualisations and practice initiatives as reported by early childhood teachers, educators, pre-service educators and parents in Tasmania. We do this by analysing data collected from participants who attended ECEfS professional learning workshops, entitled Living and learning about sustainability in the early years. Findings show that environmental (nature/natural) aspects of sustainability dominate these adults' practice initiatives and understandings. While many of the reported educational initiatives are to be celebrated, the authors contend that there is much work to be done to extend thinking and practice beyond the natural/environmental dimension in order to embrace holistic notions of sustainability incorporating social, economic and political dimensions.

Genotyping streptococcus pneumoniae

Streptococcus pneumoniae is a potentially deadly human pathogen associated with high morbidity, mortality and global economic burden. The universally used bacterial genotyping methods are multilocus sequence typing and pulsed field gel electrophoresis. However, another highly discriminatory, rapid and less expensive genotyping technique,multilocus variable number of tandem repeat analysis (MLVA), has been developed. Unfortunately, no universal MLVA protocol exists, and some MLVA protocols do not amplify certain loci for all pneumococcal serotypes, leaving genotyping profiles incomplete. A number of other genotyping or characterization methods have been developed and will be discussed. This review examines the various protocols for genotyping S. pneumoniae and highlights the current direction technology and research is heading to understand this bacterium.

The respiratory health of urban Indigenous children aged less than 5 years: Study protocol for a prospective cohort study

Background Despite the burden of acute respiratory illnesses (ARI) among Aboriginal and Torres Strait Islander children being a substantial cause of childhood morbidity and associated costs to families, communities and the health system, data on disease burden in urban children are lacking. Consequently evidence-based decision-making, data management guidelines, health resourcing for primary health care services and prevention strategies are lacking. This study aims to comprehensively describe the epidemiology, impact and outcomes of ARI in urban Aboriginal and Torres Strait Islander children (hereafter referred to as Indigenous) in the greater Brisbane area. Methods/design A prospective cohort study of Indigenous children aged less than five years registered with a primary health care service in Northern Brisbane, Queensland, Australia. Children are recruited at time of presentation to the service for any reason. Demographic, epidemiological, risk factor, microbiological, economic and clinical data are collected at enrolment. Enrolled children are followed for 12 months during which time ARI events, changes in child characteristics over time and monthly nasal swabs are collected. Children who develop an ARI with cough as a symptom during the study period are more intensely followed-up for 28(±3) days including weekly nasal swabs and parent completed cough diary cards. Children with persistent cough at day 28 post-ARI are reviewed by a paediatrician. Discussion Our study will be one of the first to comprehensively evaluate the natural history, epidemiology, aetiology, economic impact and outcomes of ARIs in this population. The results will inform studies for the development of evidence-based guidelines to improve the early detection, prevention and management of chronic cough and setting of priorities in children during and after ARI.

Children who are homeless with their family: A literature review

This literature review was commissioned by the Commissioner for Children and Young People Western Australia to provide an overview of the issues affecting the wellbeing of children who are homeless with their families. This review outlines the scholarly evidence in relation to the following issues. • The causes and extent of children’s homelessness in Western Australia (and Australia), including pathways leading to family homelessness; • The impact of homelessness on children’s near-term and long-term wellbeing; • The service and support needs of children and families at risk of or experiencing homelessness; • Strategic approaches and systems for providing services to children and families; • Successful programs that are evidence-based and have been evaluated to show positive effects on children’s wellbeing (particularly programs replicated in multiple jurisdictions or applied across diverse population groups); • Children’s own views and experiences of homelessness and support services (particularly direct consultations with children), and; • Gaps in knowledge.

Ants, apples and the ABCs: The use of commercial phonics programmes in prior-to-school children's services

Commercial phonics programmes (e.g. Jolly Phonics and Letterland) are becoming widely used in the early years of school. These programmes claim to use a systematic explicit approach, considered as the preferred method of phonics instruction for teaching alphabetic code-breaking skills in Australia and the UK in the first years of school (Department of Education, Science and Training, 2005; Rose, 2006). However, little is known about the extent to which they are being used in prior-to-school settings, and the reasons behind decisions to use them. This study surveyed 283 early childhood staff in Sydney, Australia and found that commercial phonics programmes were being used in 36% of the early childhood settings surveyed. Staff with early childhood univer- sity qualifications and staff working in not-for-profit service types were less likely to use a commercial phonics programme than staff without university qualifications and staff working in for-profit services. Staff with less than 10 years’ experience were also more likely to use a commercial phonics programme. The rationale behind decisions deter- mining whether or not staff used the programmes ranged from pragmatic reasons, such as parent pressure or higher management decisions, to pedagogical reasons, such as teacher beliefs about how children learn to read and write. The practices staff engage in to teach phonics are explored.

Estimating the burden of disease attributable to childhood and maternal undernutrition in South Africa in 2000

OBJECTIVES To estimate the disease burden attributable to being underweight as an indicator of undernutrition in children under 5 years of age and in pregnant women for the year 2000. DESIGN World Health Organization comparative risk assessment (CRA) methodology was followed. The 1999 National Food Consumption Survey prevalence of underweight classified in three low weight-for-age categories was compared with standard growth charts to estimate population-attributable fractions for mortality and morbidity outcomes, based on increased risk for each category and applied to revised burden of disease estimates for South Africa in 2000. Maternal underweight, leading to an increased risk of intra-uterine growth retardation and further risk of low birth weight (LBW), was also assessed using the approach adopted by the global assessment. Monte Carlo simulation-modeling techniques were used for the uncertainty analysis. SETTING South Africa. SUBJECTS Children under 5 years of age and pregnant women. OUTCOME MEASURES Mortality and disability-adjusted life years (DALYs) from protein- energy malnutrition and a fraction of those from diarrhoeal disease, pneumonia, malaria, other non- HIV/AIDS infectious and parasitic conditions in children aged 0 - 4 years, and LBW. RESULTS Among children under 5 years, 11.8% were underweight. In the same age group, 11,808 deaths (95% uncertainty interval 11,100 - 12,642) or 12.3% (95% uncertainty interval 11.5 - 13.1%) were attributable to being underweight. Protein-energy malnutrition contributed 44.7% and diarrhoeal disease 29.6% of the total attributable burden. Childhood and maternal underweight accounted for 2.7% (95% uncertainty interval 2.6 - 2.9%) of all DALYs in South Africa in 2000 and 10.8% (95% uncertainty interval 10.2 - 11.5%) of DALYs in children under 5. CONCLUSIONS The study shows that reduction of the occurrence of underweight would have a substantial impact on child mortality, and also highlights the need to monitor this important indicator of child health.

Toward making inroads in reducing the disparity of lung health in Australian Indigenous and New Zealand Maori children

Globally, Indigenous populations, which include Aboriginal and Torres Strait islanders in Australia and M��ori people in New Zealand (NZ), have poorer health than their non-Indigenous counterparts (1). Indigenous peoples worldwide face substantial challenges in poverty, education, employment, housing, and disconnection from ancestral lands (1). While addressing social determinants of health is a priority, solving clinical issues is equally important. Indeed, ignoring the latter until social issues improve risks further disparity as this may take generations. A systematic overview of interventions addressing social determinants of health found a striking lack of reliable evaluations (2). Where evidence was available, health improvement associated with interventions was modest or uncertain (2). Thus, advances in healthcare remain essential and these require the best evidence available in preventing and managing common illnesses, including respiratory illnesses

Children's literature and the environment

Fiction offers creative and imaginative scenarios and solutions that may stimulate young people to consider their own relationship with the environment. Literature for young people also offers insights into ecocatastrophe, anthropocentrism, sustainability, and other important issues. A further significance of this project is that it aligns with the cross-curriculum priority of the Australian Curriculum, namely ‘sustainability’. The 'Children's Literature and the Environment' project in AustLit includes a variety of bibliographic records (fiction, information books, film, poetry, and multimedia) relevant to children and young adults that deal with the environment in imaginative, scientific, educational, and creative ways, which culminates in an online exhibition. There are a number of components clustered around key concepts and issues, such as sustainability, urban environments, and Indigenous perspectives. This exhibition allows researchers and students to access and engage with bibliographical data on a range of literary and critical texts that provide various environmental perspectives over a significant period of time.

A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

Introduction Poor medication adherence is common in children and adolescents with chronic illness, but there is uncertainty about the best way to enhance medication adherence in this group. The authors conducted a systematic review of controlled trials examining interventions that aim to improve medication adherence. Method A comprehensive literature search was undertaken to locate controlled trials that described specific interventions aiming to improve adherence to long-term medication, where participants were aged 18 years and under, medication adherence was reported as an outcome measure, and which could be implemented by individual health practitioners. Studies were reviewed for quality and outcome. Results 17 studies met inclusion criteria: seven studies examined educational strategies, seven studies examined behavioural interventions and three studies examined educational intervention combined with other forms of psychological therapies. Only two of seven studies reported a clear benefit for education on medication adherence, whereas four of seven trials indicated a benefit of behavioural approaches on medication adherence. One trial reported that combining education with behavioural management may be more effective than education alone. Studies which combined education with other non-medication specific psychological interventions failed to demonstrate a beneficial effect on medication adherence. Only two studies examined adherence-promoting interventions in young people with established adherence problems. Conclusion These findings suggest that education interventions alone are insufficient to promote adherence in children and adolescents, and that incorporating a behavioural component to adherence interventions may increase potential efficacy. Future research should examine interventions in high-risk groups.

Investigating teachers' concerns and experiences in teaching children with special educational needs in Bhutan

This study investigated Bhutanese teachers' concerns and experiences in teaching children with Special Educational Needs in both inclusive and special schools. A mixed method design, combining quantitative and qualitative methods was used to answer the research questions. The aim of collecting quantitative data was to identify the key concerns. The aim of collecting qualitative data was to find out how teachers were experiencing including students with SEN in the classrooms. In doing so, three major issues were highlighted from this study: lack of classroom and human resources, lack of policy and lack of professional development for teachers.