Results from New Zealand's 2014 report card on physical activity for children and youth

BACKGROUND: This brief report provides grades for the 2014 New Zealand Report Card on Physical Activity for Children and Youth. The Report Card presents a review of current evidence across 9 key indicators, including physical activity (PA), organized sport and free play, sedentary behavior, and community and government initiatives across New Zealand. METHODS: Nationally representative survey data were collated by researchers at the University of Auckland, New Zealand, between June and December 2013. The grade for each indicator is based on the percentage of children and youth meeting a defined benchmark: A is 81%-100%; B is 61%-80%; C is 41%-60%, D is 21%-40%; F is 0%-20%; INC is incomplete data. RESULTS: Overall PA received a score of B, as did Organized Sport Participation and Active Play. PA participation in School Environment scored slightly less with a score of B-. Sedentary Behaviors, Family and Peers, and Community and Built Environment scored a grade of C. Active transportation received a score of C-. An inconclusive grade was given for the Government indicator due to a lack of established international criteria for assessment. CONCLUSIONS: PA participation in New Zealand is satisfactory, but could improve. However, sedentary behavior is high. Of particular concern is the age-related decline in PA participation, particularly among adolescent females, and the increase in sedentary behavior.

Physical activity of children: a global matrix of grades comparing 15 countries

The Active Healthy Kids Canada (AHKC) Report Card on Physical Activity for Children and Youth has been effective in poweringthe movement to get kids moving by influencing priorities, policies, and practice in Canada. The AHKC Report Card process wasreplicated in 14 additional countries from 5 continents using 9 common indicators (Overall Physical Activity, Organized SportParticipation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Built Environment,and Government Strategies and Investments), a harmonized process and a standardized grading framework. The 15 ReportCards were presented at the Global Summit on the Physical Activity of Children in Toronto on May 20, 2014. The consolidatedfindings are summarized here in the form of a global matrix of grades. There is a large spread in grades across countries for mostindicators. Countries that lead in certain indicators lag in others. Overall, the grades for indicators of physical activity (PA) aroundthe world are low/poor. Many countries have insufficient information to assign a grade, particularly for the Active Play and Familyand Peers indicators. Grades for Sedentary Behaviors are, in general, better in low income countries. The Community and BuiltEnvironment indicator received high grades in high income countries and notably lower grades in low income countries. There wasa pattern of higher PA and lower sedentary behavior in countries reporting poorer infrastructure, and lower PA and higher sedentarybehavior in countries reporting better infrastructure, which presents an interesting paradox. Many surveillance and researchgaps and weaknesses were apparent. International cooperation and cross-fertilization is encouraged to tackle existing challenges,understand underlying mechanisms, derive innovative solutions, and overcome the expanding childhood inactivity crisis.

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan

BACKGROUND: Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children.

METHODS: Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates.

RESULTS: The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese.

CONCLUSIONS: This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.

‘Out of the loop’: early childhood educators gaining confidence with unfamiliar policy discourse

It has been seven years since the Early Years Learning Framework (EYLF) was introduced in Australia and four years since the National Quality Standard (NQS) was implemented. To gain insight into how educators are understanding practice in the Australian early childhood and care context, the study draws on a praxeological frame where educators have the opportunity to inquire and critically reflect on practice in a supported research environment. Data were analysed using critical discourse analysis, enabling a close examination of participant reflections and understandings about practice. Findings reveal that educators are confident when describing their teaching using familiar educational discourse, whereas educators were apprehensive when confronted with new and unfamiliar concepts. The third finding illustrates the ways educators gain confidence with unfamiliar policy discourse. The study’s findings add to limited empirical evidence about how early childhood educators understand key concepts introduced by the EYLF and NQS.

The perspectives of secondary school students with special needs in Spain during the crisis

This paper presents an overview of a situational analysis of inclusive schooling in Spain from the perspective of students with special educational needs. The purpose of this work was to learn how young people collectively considered their experiences of school inclusion. The participants—aged 12–19 years who attended six different settings—highlighted the school community, resources, teacher pedagogy, support and social cohesion as germane aspects of their inclusion. Through a presentation of these characteristics, this analysis demonstrates how schools can effectively fulfil the core requirement of teaching and supporting diversity and, in so doing, how they can incite included subjectivities of differently abled students. This analysis is positioned within the climate of economic instability in Spain, which threatens to derail the headway made towards inclusive schooling via the introduction of severe austerity measures.

Between education and psychology: school staff perspectives

When discussing contributions from psychology in/to educational practices like school-based mental health promotion, it is peculiar that psychologists (of an educational or clinical kind) or education-oriented sociologists, both not often based in schools or classrooms, dominate the topic. It has been acknowledged that school staff have been over looked and underutilised in contributing to the discussion, particularly as this pertains to sharing perspectives on how they experience their role in relationship to education policy and practice. The study presented here looked to address this situation by seeking the perspectives of school staff on a range of concerns situated at the nexus between education and psychology. Contrary to the type of displaced assessment intimated above, this group of school staff generally accepts they perform a crucial task in supporting students, their main concern being to incisively question how they might negotiate existing role-related pressures to better current school-based practice.

Teachers’ perspectives and practices on social and emotional learning: multiple case study approach

 This thesis has explored how Preparatory teachers in two Victorian primary schools understand and implement social and emotional learning in their classrooms. The findings of this research indicated that the participating teachers paid more attention to children's social skills rather than to their emotional skills. Another important finding was that social and emotional learning has a very limited place within the policies and the curricula of the participating schools.

Psychosocial paediatric training in Iraq: perspectives of trainers and students

There is an absence of education regarding psychosocial issues in Iraqi paediatric training programmes. The aim of this study is to examine current knowledge and perspectives around these topics and to explore potential development in these programmes. 56 paediatric trainers and students at the Child Central Teaching Hospital, a hospital affiliated to the Al-Mustansyria medical college in Baghdad, responded to a questionnaire to evaluate knowledge and perspectives regarding psychosocial approaches to child and adolescent health as delivered presently via academic training and used in professional practice. The majority of the respondents reported having no training in psychosocial interventions. Using a scale from 0 ('not relevant') to 10 ('very important'), psychosocial issues were rated 7.1 in their relevance to everyday paediatric practice. On a scale of 0 ('very poor') to 10 ('totally adequate'), respondents rated formal current psychosocial training at 2.5. It is concluded that incorporating psychosocial approaches in paediatric training will lead to a broader base of knowledge in children's health and contribute to the promotion of multidisciplinary practice in Iraq.

Does cochlear implantation improve speech recognition in children with auditory neuropathy spectrum disorder? A systematic review

OBJECTIVE: Cochlear implantation (CI) is a standard treatment for severe-profound sensorineural hearing loss (SNHL). However, consensus has yet to be reached on its effectiveness for hearing loss caused by auditory neuropathy spectrum disorder (ANSD). This review aims to summarize and synthesize current evidence of the effectiveness of CI in improving speech recognition in children with ANSD. DESIGN: Systematic review. STUDY SAMPLE: A total of 27 studies from an initial selection of 237. RESULTS: All selected studies were observational in design, including case studies, cohort studies, and comparisons between children with ANSD and SNHL. Most children with ANSD achieved open-set speech recognition with their CI. Speech recognition ability was found to be equivalent in CI users (who previously performed poorly with hearing aids) and hearing-aid users. Outcomes following CI generally appeared similar in children with ANSD and SNHL. Assessment of study quality, however, suggested substantial methodological concerns, particularly in relation to issues of bias and confounding, limiting the robustness of any conclusions around effectiveness. CONCLUSIONS: Currently available evidence is compatible with favourable outcomes from CI in children with ANSD. However, this evidence is weak. Stronger evidence is needed to support cost-effective clinical policy and practice in this area.

Language policy and critical discourse studies:towards an integrated approach

This chapter offers a framework for combining critical language policy with critical discourse studies (CDS) to analyse language policy as a process in the context of minority language policy in Wales. I propose a discursive approach to language policy, which starts from the premise that language policy is constituted, enacted, interpreted and (re)contextualised in and through language. This approach extends the critical language policy framework provided by Shohamy (Language policy: hidden agendas and new approaches. Routledge, London, 2006) and integrates perspectives from the context-sensitive discourse-historical approach in CDS. It incorporates discourse as an essential lens through which policy mechanisms, ideologies and practices are constituted and de facto language policy materialises. This chapter argues that conceptualising and analysing language policy as a discursive phenomenon enables a better understanding of the multi-layered nature of language policy that shapes the management and experience of corporate bilingualism in Wales.

Playgrounds going wrong: study of the adult style and children's rights during recess in an early childhood and primary education center

Recent perspectives on Pedagogy for Early Childhood Education emphasize children's participation in line with the Children's Rights Convention. The study aimed to analyse how children's rights are dealt with during recess in a school (Early Childhood and Primary Education) in Portugal. The aims were: to characterize the style of the adult (teaching assistants) and the interactions that are established with the children at the playground/recess, and analyse them in terms of children's rights. The qualitative approach was based on the observation during the recess for three weeks. The Adult Style Observation Schedule for Early Childhood Education (ASOS-ECE) was used to register and code the dynamics of six teaching assistants (3 ECE and 3 PE). Critical incidents were also registered. Statistical analysis of the ASOS-ECE levels were complemented with the content analysis of the notes. The playground space was quite limited and affected children's play and well-being. The outdoor playground was never used for the Early Childhood classes, only for Primary Education students but with little supervision. Children were often deprived of playground time by decision of the teaching assistants, as punishment. The results obtained through the Adult Style Observation Schedule for Early Childhood Education (ASOS-ECE) are not satisfactory and are below what would meet the minimum quality value (3,5). For Early Childhood Education, sensibility is the most valued dimension but with very low levels (<2,5). For Primary Education it was autonomy that scored highest (<2,5). The analysis of the notes/critical incidents highlighted articles 12 (expression of own views), 13 (freedom of expression), 19 (protection against violence), 29 (development of personality) and 31 (rest and leisure, play and recreational activities) as being put into question by actions of the adults responsible for the children. Children's rights and well-being need to be put forward in the knowledge base for all adults working with children so that Pedagogy can fulfil its purpose fully.

Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review

The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of over-weight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.

Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system

Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.

Professionals’ perspectives about the challenges of using interpreters in child sexual abuse interviews

Interpreters play a crucial role in many investigative interviews with child complainants of sexual abuse; however, little has been written about the interpreting process from the perspective of the interviewers. This study elicited interviewers’ perspectives about the challenges of using interpreters, with the aim of understanding how investigative interviews could be improved. The participants consisted of 21 investigative interviewers and prosecutors of child abuse cases (from a range of jurisdictions) who use interpreters on a regular basis. Thematic analysis of semi-structured interviews with the professionals about the interpreting process revealed two main challenges particular to child abuse interviews, namely the interpreters’ lack of preparedness to deal with the traumatic and sensitive nature of children's abuse histories, and an insufficient understanding of ‘best-practice’ child interview process. The recommendations focus on the need for more specialised training for, and screening of, interpreters, and more extensive use of pre-conferencing to familiarise children with the interpreter-mediated interview process.