Will rising household incomes solve China's micronutrient deficiency problems?

Rapid economic growth in China has resulted in substantially improved household incomes. Diets have also changed, with a movement away from traditional foods and towards animal products and processed foods. Yet micronutrient deficiencies, particularly for calcium and vitamin A, are still widespread in China. In this research we model the determinants of the intakes of these micronutrients using household panel data, asking particularly whether continuing income increases are likely to cause the deficiencies to be overcome. Nonparametric kernel regressions and random effects panel regression models are employed. The results show a statistically significant but relatively small positive income effect on both nutrient intakes. The local availability of milk is seen to have a strong positive effect on intakes of both micronutrients. Thus, rather than relying on increasing incomes to overcome deficiencies, supplementary government policies, such as school milk programmes, may be warranted.

Patients' understanding of risk associated with medication use: impact of European Commission guidelines and other risk scales

Patients want and need comprehensive and accurate information about their medicines so that they can participate in decisions about their healthcare: In particular, they require information about the likely risks and benefits that are associated with the different treatment options. However, to provide this information in a form that people can readily understand and use is a considerable challenge to healthcare professionals. One recent attempt to standardise the Language of risk has been to produce sets of verbal descriptors that correspond to specific probability ranges, such as those outlined in the European Commission (EC) Pharmaceutical Committee guidelines in 1998 for describing the incidence of adverse effects. This paper provides an overview of a number of studies involving members of the general public, patients, and hospital doctors, that evaluated the utility of the EC guideline descriptors (very common, common, uncommon, rare, very rare). In all studies it was found that people significantly over-estimated the likelihood of adverse effects occurring, given specific verbal descriptors. This in turn resulted in significantly higher ratings of their perceived risks to health and significantly lower ratings of their likelihood of taking the medicine. Such problems of interpretation are not restricted to the EC guideline descriptors. Similar levels of misinterpretation have also been demonstrated with two other recently advocated risk scales (Caiman's verbal descriptor scale and Barclay, Costigan and Davies' lottery scale). In conclusion, the challenge for risk communicators and for future research will be to produce a language of risk that is sufficiently flexible to take into account different perspectives, as well as changing circumstances and contexts of illness and its treatments. In the meantime, we urge the EC and other legislative bodies to stop recommending the use of specific verbal labels or phrases until there is a stronger evidence base to support their use.

Worry and problem-solving skills and beliefs in primary school children

Objective. To examine the association between worry and problem-solving skills and beliefs (confidence and perceived control) in primary school children. Method. Children (8–11 years) were screened using the Penn State Worry Questionnaire for Children. High (N ¼ 27) and low (N ¼ 30) scorers completed measures of anxiety, problem-solving skills (generating alternative solutions to problems, planfulness, and effectiveness of solutions) and problem-solving beliefs(confidence and perceived control). Results. High and low worry groups differed significantly on measures of anxiety and problem-solving beliefs (confidence and control) but not on problem-solving skills. Conclusions. Consistent with findings with adults, worry in children was associated with cognitive distortions, not skills deficits. Interventions for worried children may benefit froma focus on increasing positive problem-solving beliefs.

The effect of cleft lip on socio-emotional functioning in school-aged children

Background: Children with cleft lip are known to be at raised risk for socio-emotional difficulties, but the nature of these problems and their causes are incompletely understood; longitudinal studies are required that include comprehensive assessment of child functioning, and consideration of developmental mechanisms. Method: Children with cleft lip (with and without cleft palate) (N = 93) and controls (N = 77), previously studied through infancy, were followed up at 7 years, and their socio-emotional functioning assessed using teacher and maternal reports, observations of social interactions, and child social representations (doll play). Direct and moderating effects of infant attachment and current parenting were investigated, as was the role of child communication difficulties and attractiveness. Results: Children with clefts had raised rates of teacher-reported social problems, and anxious and withdrawn-depressed behaviour; direct observations and child representations also revealed difficulties in social relationships. Child communication problems largely accounted for these effects, especially in children with cleft palate as well as cleft lip. Insecure attachment contributed to risk in both index and control groups, and a poorer current parenting environment exacerbated the difficulties of those with clefts. Conclusions: Children with clefts are at raised risk for socio-emotional difficulties in the school years; clinical interventions should focus on communication problems and supporting parenting; specific interventions around the transition to school may be required. More generally, the findings reflect the importance of communication skills for children’s peer relations.

The 'algebra as object' analogy: a view from school

Treating algebraic symbols as objects (eg. “‘a’ means ‘apple’”) is a means of introducing elementary simplification of algebra, but causes problems further on. This current school-based research included an examination of texts still in use in the mathematics department, and interviews with mathematics teachers, year 7 pupils and then year 10 pupils asking them how they would explain, “3a + 2a = 5a” to year 7 pupils. Results included the notion that the ‘algebra as object’ analogy can be found in textbooks in current usage, including those recently published. Teachers knew that they were not ‘supposed’ to use the analogy but not always clear why, nevertheless stating methods of teaching consistent with an‘algebra as object’ approach. Year 7 pupils did not explicitly refer to ‘algebra as object’, although some of their responses could be so interpreted. In the main, year 10 pupils used ‘algebra as object’ to explain simplification of algebra, with some complicated attempts to get round the limitations. Further research would look to establish whether the appearance of ‘algebra as object’ in pupils’ thinking between year 7 and 10 is consistent and, if so, where it arises. Implications also are for on-going teacher training with alternatives to introducing such simplification.