ORCID Profile
0000-0001-7501-9257
Current Organisations
University of Melbourne
,
The Liggins Institute, University of Auckland
,
Murdoch Childrens Research Institute
,
Child and Youth Health
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Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-022398
Abstract: To describe the distribution of health-related quality of life (HRQL) in a national s le of Australian children aged 11–12 years and their parents, and examine associations within parent–child dyads. The Child Health CheckPoint, a population-based cross-sectional study nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC). Assessment centres in seven Australian cities and eight regional towns, or home visit February 2015 to March 2016. Of all participating CheckPoint families (n=1874), 1853 children (49.0% girls) and 1863 parents (87.7% mothers) with HRQL data were included (1786 pairs). HRQL was self-reported using preference-based (Child Health Utility 9Dimension, CHU9D) and non-preference-based (Pediatric Quality of Life, PedsQL V.4.0) measures for children and preference-based measures for parents (CHU9D Assessment of Quality of Life 8 Dimension, AQoL-8D). Utility scores from preference-based measures were calculated using existing Australian algorithms to present a score on a 0–1 scale, where 1 represents full health. Parent–child concordance was assessed using Pearson’s correlation coefficients and adjusted linear regression models. Survey weights and methods were applied to account for LSAC’s complex s le design, stratification and clustering within postcodes. Children’s means and SD were 0.81 (SD 0.16) for CHU9D and 78.3 (SD 13.03) for PedsQL. In adults, mean HRQL for AQoL-8D and CHU9D were 0.78 (SD 0.16) and 0.89 (SD 0.10), respectively. Mean HRQL was similar for boys and girls, but slightly higher for fathers than mothers. The Pearson correlation coefficient for parent–child CHU9D values was 0.13 (95% CI 0.09 to 0.18). Percentiles and concordance are presented for both s les for males and females separately and together. We provide Australian paediatric population values for HRQL measures, and the first national CHU9D values for mid-life adults. At age 11–12 years in this relatively healthy s le, parent–child concordance in HRQL was small.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-023486
Abstract: To describe the epidemiology of lung function in Australian children aged 11–12 years and their parents, and explore the degree of intergenerational concordance. Cross-sectional study (the Child Health CheckPoint) nested in the Longitudinal Study of Australian Children (LSAC). Assessment centres in seven Australian cities and eight regional towns, February 2015 to March 2016. Families unable to attend a clinic appointment were offered a home visit during the same period. 1874 families (53% of all eligible) participated in the study. Lung function data were available for 1759 children aged 11–12 years and 1774 parents (1668 biological pairs). Participants completed spirometry with measures including forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC) and mid expiratory flow (MEF), converted to z-scores using Global Lung Initiative equations. Parent–child concordance was assessed using Pearson’s correlation coefficients and multivariable linear regression models. Survey weights and methods accounted for LSAC’s complex s ling, stratification and clustering within postcodes. All lung function measures followed approximately normal distributions. Mean (SD) for FEV 1 , FVC and MEF z-scores in children were 0.33 (1.07), 0.83 (1.14) and −0.48 (1.09), respectively. Mean (SD) in parents were 0.28 (1.10), 0.85 (1.15) and −0.45 (1.10), respectively. Parent FEV 1 , FVC and MEF were associated with child lung function with significant positive correlation coefficients (0.22, 95% CI 0.17 to 0.26 0.24, 95% CI 0.20 to 0.29 and 0.24, 95% CI 0.20 to 0.29, respectively). Mean lung volumes were larger but with smaller airway size than international standards for both parents and children in this population s le. Modest associations between parent and child lung function highlight the potential for better identification of ‘at risk’ populations. Therefore, these findings may aid the development of health policy that aims to prevent the onset or limit the progression of lung disease.
Publisher: Wiley
Date: 08-2019
DOI: 10.1111/OBR.12768
Abstract: Systematic reviews of nutritional interventions indicate limited efficacy in reducing childhood obesity, but their blanket conclusions could obscure promising components. This narrative review sought more detail on effective components within nutrition-related interventions involving children aged 2 to 11 years. In May 2016, the World Health Organization (WHO) searched the Cochrane Library and PubMed for relevant reviews. From 36 reviews, we screened 182 nutrition-related randomized trials for inclusion. We then reviewed those that reported at least 1 statistically significant (P < 0.05) treatment benefit on body weight and/or composition outcomes at their longest follow-up assessment. Fourteen trials met inclusion criteria (median n = 554 mean intervention duration = 10.8 mo follow-up = 4.4 mo). "Effective" approaches included environmental changes such as school water fountain installations and cafeteria menu changes and possibly less sustainable strategies such as health education lessons. However, effect sizes even of these selected significant treatment benefits were modest-significant body mass index z-score effects range from -0.1 to -0.2. Each trial was associated with very small improvements in body composition. Because this is a "best-case" scenario (reflecting our design), trialists should rigorously test these strategies alone and possibly together be open to novel strategies and ensure that each strategy is culturally relevant and self-sustainable.
Publisher: BMJ
Date: 13-07-2013
DOI: 10.1136/ARCHDISCHILD-2012-301659
Abstract: Secondary care could be the optimal sector for managing child and adolescent obesity, given low primary care uptake and limited tertiary services. We aimed to determine Australian paediatricians' self-reported competence and training in managing obesity and, in a linked patient-level audit, whether these predict rates of measurement and obesity diagnosis. Australian Paediatric Research Network members completed an online survey, plus a prospective patient-level audit of up to 100 consecutive consultations over 2 weeks. self-reported competencies, training in and use of clinical skills in obesity and its comorbidities. Audit: paediatricians reported each child's height, weight, age, sex and diagnoses including overweight/obesity. Of 166 (44.7% response) paediatricians, most felt very/quite competent in assessing (89%) and managing (68%) obesity, but few in making a difference to obesity (20%) or managing hypertension (45%), insulin resistance (32%), fatty liver disease (22%) or dyslipidaemia (21%). The audit of 200 (66.2% response) paediatricians included 8345 patients. On average paediatricians recorded height and weight for 66.5% of patients (SD 30.0%, range 0-100%). Of the 296 (12.3%) patients obese by CDC cutpoints, 118 (39.9%) were diagnosed as obese perceived competence increased the odds of recording this diagnosis but not measurement. Training levels were low, showed little association with measurement or obesity diagnosis, and skills learnt were not routinely used. There is a clear need for better paediatrician training in obesity management. However, care and outcomes for obese children are unlikely to improve unless effective management models can be operationalised systematically.
Publisher: Wiley
Date: 08-06-2015
DOI: 10.1111/JPC.12932
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-022399
Abstract: To describe distributions and concordance of retinal microvasculature measurements in a population-based s le of Australian parent–child dyads at child age 11–12 years. Cross-sectional Child Health CheckPoint study, between waves 6 and 7 of the national population-based Longitudinal Study of Australian Children (LSAC). Assessment centres in seven Australian cities, February 2015–March 2016. Of the 1874 participating families, 1288 children (51% girls) and 1264 parents (87% mothers, mean age 43.7) were analysed. Diabetic participants and non-biological pairs were excluded from concordance analyses. Retinal photographs were taken by non-mydriatic fundus camera. Trained graders scored vascular calibre using semi-automated software, yielding estimates of central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) and arteriolar–venular ratio (AVR). Pearson’s correlation coefficients and multivariable linear regression models assessed parent–child concordance. Survey weights and methods accounted for LSAC’s complex s ling, stratification and clustering within postcodes. Mean (SD) of CRAE and CRVE were larger in children (159.5 (11.8) and 231.1 (16.5) μm, respectively) than parents (151.5 (14.0) and 220.6 (19.0) μm), yielding similar AVR (children 0.69 (0.05), parents 0.69 (0.06)). Correlation coefficients for parent–child pairs were 0.22 (95% CI 0.16 to 0.27) for CRAE, 0.23 (95% CI 0.17 to 0.28) for CRVE and 0.18 (95% CI 0.13 to 0.24) for AVR. Mother–child and father–child values were similar (0.20 and 0.32 for CRAE, 0.22 and 0.29 for CRVE, respectively). Relationships attenuated slightly on adjustment for age, sex, blood pressure, diabetes and body mass index. Percentiles and concordance are presented for the whole s le and by sex. Arteriolar and venular calibre were similar to previously documented measures in midlife adult and late childhood populations. Population parent–child concordance values align with moderate polygenic heritability reported in smaller studies.
Publisher: Elsevier BV
Date: 09-2017
Publisher: BMJ
Date: 2007
Publisher: Oxford University Press (OUP)
Date: 14-08-2019
DOI: 10.1093/IJE/DYZ168
Publisher: American Medical Association (AMA)
Date: 03-2023
DOI: 10.1001/JAMAOTO.2022.4466
Abstract: Although more than 200 genes have been associated with monogenic congenital hearing loss, the polygenic contribution to hearing decline across the life course remains largely unknown. To examine the association of polygenic risk scores (PRSs) for self-reported hearing difficulty among adults (40-69 years) with measured hearing and speech reception abilities in mid-childhood and early midlife. This was a population-based cross-sectional study nested within the Longitudinal Study of Australian Children that included 1608 children and 1642 adults. Pure tone audiometry, speech reception threshold against noise, and genetic data were evaluated. Linear and logistic regressions of PRSs were conducted for hearing outcomes. Study analysis was performed from March 1 to 31, 2022. Genotypes were generated from saliva or blood using global single-nucleotide polymorphisms array and PRSs derived from published genome-wide association studies of self-reported hearing difficulty (PRS1) and hearing aid use (PRS2). Hearing outcomes were continuous using the high Fletcher index (mean hearing threshold, 1, 2, and 4 kHz) and speech reception threshold (SRT) and dichotomized for bilateral hearing loss of more than 15 dB HL and abnormal SRT. Included in the study were 1608 children (mean [SD] age, 11.5 [0.5] years 812 [50.5%] male children 1365 [84.9%] European and 243[15.1%] non-European) and 1642 adults (mean [SD] age, 43.7 [5.1] years 1442 [87.8%] female adults 1430 [87.1%] European and 212 [12.9%] non-European in iduals). In adults, both PRS1 and PRS2 were associated with hearing thresholds. For each SD increment in PRS1 and PRS2, hearing thresholds were 0.4 (95% CI, 0-0.8) decibel hearing level (dB HL) and 0.9 (95% CI, 0.5-1.2) dB HL higher on the high Fletcher index, respectively. Each SD increment in PRS increased the odds of adult hearing loss of more than 15 dB HL by 10% to 30% (OR for PRS1, 1.1 95% CI, 1.0-1.3 OR for PRS2, 1.3 95% CI, 1.1-1.5). Similar but attenuated patterns were noted in children (OR for PRS1, 1.1 95% CI, 0.8-1.2 OR for PRS2, 1.2 95% CI, 1.0-1.5). Both PRSs showed minimal evidence of associations with speech reception thresholds or abnormal SRT in children or adults. This population-based cross-sectional study of PRSs for self-reported hearing difficulty among adults found an association with hearing ability in mid-childhood. This adds to the evidence that age-related hearing loss begins as early as the first decade of life and that polygenic inheritance may play a role together with other environmental risk factors.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 2015
DOI: 10.1111/JPC.12819
Abstract: The last 50 years have seen the emergence of childhood obesity as a major public health concern and a condition now regularly encountered in routine general paediatric practice. Causes are extremely complex, bringing together multifactorial environmental factors and in idual genetics, and we still do not have a clear understanding of why some children appear predisposed to exaggerated and sometimes extreme weight gain. Overweight and obese children of today face an uncertain future. They are likely to experience higher rates of type 2 diabetes and heart disease, as well as many other health problems. However, while the prevalence of childhood obesity has progressively increased over the last few decades, so has research into its underlying causes. This has led to large-scale trials aimed at improving prevention or treatment. As data have emerged from such studies, we have begun to accept that the heterogeneity of obesity means that broad 'common sense' strategies to address diet and activity will not lead to success on their own. Now is the time to begin to build on this information, dispelling myths and beliefs, in order to focus research efforts and take first steps towards more sophisticated strategies that go beyond the surface behaviours that simply potentiate obesity. Through carefully designed studies, aimed at tackling fundamental questions missed in the hasty development of 'common sense' approaches, will come answers that can lead to the development of more effective community- and health-care-orientated prevention and treatment programmes.
Publisher: Wiley
Date: 11-09-2015
Abstract: Maternal responsiveness has been shown to predict child language outcomes in clinical s les of children with language delay and non-representative s les of typically developing children. An effective and timely measure of maternal responsiveness for use at the population level has not yet been established. To determine whether a global rating of maternal responsiveness at age 2 years predicts language outcomes at ages 3 and 4 in a community s le of slow-to-talk toddlers. In an Australian population-based study, at child age 1:6 years, 301 slow-to-talk toddlers (scoring ≤20th percentile on a parent-reported expressive vocabulary checklist) were invited to take part in a 15-min free-play video of mother-child interaction at 2:0 years. Each free-play video was rated for maternal responsiveness using a five-point global rating scale, where 1 is 'very low' responsiveness and 5 is 'very high' responsiveness. Language skills were measured at 3:0 years using PLS-4 and at 4:0 years using the CELF-P2. In adjusted linear regression models (potential confounders: gender, maternal education, socioeconomic status) maternal responsiveness strongly predicted receptive, expressive and total language standard scores at ages 3 (coefficient = 5.9, p < 0.001 coefficient = 5.4, p < 0.001 coefficient = 6.2, p < 0.001, respectively) and 4 years (coefficient = 4.6, p < 0.001 coefficient = 3.1, p = 0.004 coefficient = 4.0, p < 0.001, respectively). Slow-to-talk toddlers of mothers with higher global ratings of responsiveness have higher language scores at 3 and 4 years of age. This global measure of maternal responsiveness could be further developed as a clinical tool for identifying which slow-to-talk toddlers are most in need of early intervention.
Publisher: MDPI AG
Date: 07-12-2022
Abstract: Linking very large, consented birth cohorts to birthing hospitals clinical data could elucidate the lifecourse outcomes of health care and exposures during the pregnancy, birth and newborn periods. Unfortunately, cohort personally identifiable information (PII) often does not include unique identifier numbers, presenting matching challenges. To develop optimized cohort matching to birthing hospital clinical records, this pilot drew on a one-year (December 2020–December 2021) cohort for a single Australian birthing hospital participating in the whole-of-state Generation Victoria (GenV) study. For 1819 consented mother-baby pairs and 58 additional babies (whose mothers were not themselves participating), we tested the accuracy and effort of various approaches to matching. We selected demographic variables drawn from names, DOB, sex, telephone, address (and birth order for multiple births). After variable standardization and validation, accuracy rose from 10% to 99% using a deterministic-rule-based approach in 10 steps. Using cohort-specific modifications of the Australian Statistical Linkage Key (SLK-581), it took only 3 steps to reach 97% (SLK-5881) and 98% (SLK-5881.1) accuracy. We conclude that our SLK-5881 process could safely and efficiently achieve high accuracy at the population level for future birth cohort-birth hospital matching in the absence of unique identifier numbers.
Publisher: Springer Science and Business Media LLC
Date: 11-02-2021
DOI: 10.1038/S41598-020-80923-9
Abstract: Amino acid (AA) concentrations are influenced by both exogenous (e.g. diet, lifestyle) and endogenous factors (e.g. genetic, transcriptomic, epigenetic, and metabolomic). Fasting plasma AA profiles in adulthood are predictive of diabetes risk over periods of up to 12 years. Data on AA profiles in cross-generational cohorts, including in iduals from shared gene-environment settings are scarce, but would allow the identification of the contribution of heritable and environmental factors characterising the levels of circulating AAs. This study aimed to investigate parent–child (familial dyad) concordance, absolute differences between generations- (children versus adults), age- (in adults: 28–71 years), and sex-dependent differences in plasma AA concentrations. Plasma AA concentrations were measured by UHPLC/MS–MS in 1166 children [mean (SD) age 11 (0.5) years, 51% female] and 1324 of their parents [44 (5.1) years, 87% female]. AA concentrations were variably concordant between parents and their children (5–41% of variability explained). Most AA concentrations were higher in adults than children, except for the non-essential AAs arginine, aspartic acid, glutamine, hydroxy-proline, proline, and serine. Male adults and children typically had higher AA concentrations than females. The exceptions were alanine, glutamine, glycine, hydroxy-proline, serine, and threonine in girls and glycine and serine in women. Age, sex, and shared familial factors are important determinants of plasma AA concentrations.
Publisher: Hindawi Limited
Date: 03-11-2011
DOI: 10.1002/DA.20743
Abstract: This article discusses the importance of and one approach to translational research to prevent internalizing problems very early in life. The World Health Organisation (WHO) predicts that by 2,030 internalizing problems will be second only to HIV/AIDS in the international burden of disease. Internalizing problems affect one in every seven school age children, with negative impacts on peer relations, school engagement, and later mental health, adult relationships, and employment. There is persuasive evidence that intervention in the preschool years can have a cost-effective impact on general developmental outcomes, compared to later school or adult intervention. However, the development of early childhood prevention for internalizing problems is in its infancy. Two significant risk factors for child internalizing problems are temperamental inhibition (characterized by fearfulness and withdrawal) and overinvolved rotective parenting practices. Rapee et al. have conducted two randomized "efficacy" trials with inhibited preschoolers in which a parenting group intervention reduced internalizing disorders up to 3 years later. Translational "effectiveness" research is now underway at the population level, to determine the balance of benefits and harms of systematically screening preschoolers for inhibition and subsequent intervention for all those affected. This rigorous public health research, followed by effective dissemination, addresses gaps identified in the WHO Prevention of Mental Disorders report.
Publisher: MDPI AG
Date: 24-11-2022
DOI: 10.3390/NU14234990
Abstract: Fat-soluble vitamers (FSV) are a class of erse organic substances important in a wide range of biological processes, including immune function, vision, bone health, and coagulation. Profiling FSV in parents and children enables insights into gene-environment contributions to their circulating levels, but no studies have reported on the population epidemiology of FSV in these groups as of yet. In this study, we report distributions of FSV, their parent-child concordance and variation by key characteristics for 2490 children (aged 11–12 years) and adults (aged 28–71 years) in the Child Health CheckPoint of the Longitudinal Study of Australian Children. Ten A, D, E and K vitamers were quantified using a novel automated LC-MS/MS method. All three K vitamers (i.e., K1, MK-4, MK-7) and 1-α-25(OH)2D3 were below the instrument detection limit and were removed from the present analysis. We observed a strong vitamer-specific parent-child concordance for the six quantifiable A, D and E FSVs. FSV concentrations all varied by age, BMI, and sex. We provide the first cross-sectional population values for multiple FSV. Future studies could examine relative genetic vs. environmental determinants of FSV, how FSV values change longitudinally, and how they contribute to future health and disease.
Publisher: Mary Ann Liebert Inc
Date: 04-2021
Publisher: BMJ
Date: 10-06-2013
DOI: 10.1136/BMJ.F3092
Publisher: Wiley
Date: 22-03-2013
DOI: 10.1111/CCH.12032
Abstract: Pre-school communication problems are common, with implications for school readiness and educational achievement. Help is available from a variety of community healthcare providers. This study examined the extent to which help is received, and the predictors of service receipt. Prospective community study, in Melbourne, Victoria. At age 4 years, we assessed the speech, receptive and expressive language and fluency of 1607 children and gave feedback to their parents. At age 5 years, 983 families provided data on service use for communication problems between and 4 and 5 years. We compared service use between participants with and without impairment, and used logistic regression to estimate the strength of association between potential predictors (gender, socio-economic status, maternal education, English-speaking background status, family history of speech and language problems and parent concern) and service use (binary outcome). Data were available for both communication status and service use for 753 children. Only 44.9% of the 196 children with communication impairment received help from a professional. Furthermore, 7% of the 557 that did not meet criteria for communication impairment nevertheless received help from a professional. Parent concern was the strongest predictor of service use (adjusted odds ratio = 9.0 95% CI: 5.6-14.8). Both over- and under-servicing for communication problems were evident. This study shows that accessing help for communication problems requires more than simply informing parents about the problem and having services available there is a need for systematic support to get the right children to services.
Publisher: Springer Science and Business Media LLC
Date: 15-07-2021
DOI: 10.1186/S12889-021-11475-4
Abstract: The home environment is the most important location in young children’s lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play. Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a s le at Wave 3 (2013–2016) when participants were aged 6 years ( n = 1648). A sub-s le of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child’s sex, mother’s age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity. Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For ex le, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (β: 2.4, 95% CI: − 6.2, 11.0), light physical activity (β: 1.4, 95% CI: − 5.7, 8.5) or MVPA (β: -2.4, 95% CI: − 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play. In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children’s physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning.
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2010
Abstract: To quantify the contributions of child, family, and environmental predictors to language ability at 4 years. A longitudinal study was performed with a s le of 1910 infants recruited at 8 months in Melbourne, Australia. Predictors were child gender, prematurity, birth weight and order, multiple birth, socioeconomic status, maternal mental health, vocabulary, education, and age at child's birth, non–English-speaking background, and family history of speech/language difficulties. Outcomes were Clinical Evaluation of Language Fundamentals-Preschool, language scores, low language status (scores & .25 SDs below the mean), and specific language impairment (SLI) (scores & .25 SDs below the mean for children with normal nonverbal performance). A total of 1596 children provided outcome data. Twelve baseline predictors explained 18.9% and 20.9% of the variation in receptive and expressive scores, respectively, increasing to 23.6% and 30.4% with the addition of late talking status at age 2. A total of 20.6% of children (324 of 1573 children) met the criteria for low language status and 17.2% (251 of 1462 children) for SLI. Family history of speech/language problems and low maternal education levels and socioeconomic status predicted adverse language outcomes. The combined predictors discriminated only moderately between children with and without low language levels or SLIs (area under the curve: 0.72–0.76) this improved with the addition of late talking status (area under the curve: 0.78–0.84). Measures of social disadvantage helped explain more variation in outcomes at 4 years than at 2 years, but ability to predict low language status and SLI status remained limited.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2009
Abstract: BACKGROUND. Adequate sleep optimizes children's learning and behavior. However, the natural history and impact of sleep problems during school transition is unknown. OBJECTIVES. To determine (1) the natural history of sleep problems over the 2-year period spanning school entry and (2) associations of children's health-related quality of life, language, behavior, learning, and cognition at ages 6.5 to 7.5 years with (a) timing and (b) severity of sleep problems. METHODS. Data were drawn from the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1 and 6 to 7 years at wave 2. Parent-reported predictors included (1) timing (none, persistent, resolved, incident) of moderate/severe sleep problems over the 2 waves and (2) severity (none, mild, moderate/severe) of sleep problems at wave 2. Outcomes included parent-reported health-related quality of life and language, parent- and teacher-reported behavior, teacher-reported learning, and directly assessed nonverbal (matrix reasoning) and verbal (receptive vocabulary) cognition. Linear regression, adjusted for child age, gender, and social demographic variables, was used to quantify associations of outcomes with sleep-problem timing and severity. RESULTS. Sleep data were available at both waves for 4460 (89.5%) children, of whom 22.6% (17.0% mild, 5.7% moderate/severe) had sleep problems at wave 2. From wave 1, 2.9% persisted and 2.8% developed a moderate/severe problem, whereas 10.1% resolved. Compared with no sleep problems, persistent and incident sleep problems predicted poorest health-related quality of life, behavior, language, and learning scores, whereas resolving problems showed intermediate outcomes. These outcomes also showed a dose-response relationship with severity at wave 2, with effect sizes for moderate/severe sleep problems ranging from −0.25 to −1.04 SDs. Cognitive outcomes were unaffected. CONCLUSIONS. Sleep problems during school transition are common and associated with poorer child outcomes. Randomized, controlled trials could determine if population-based sleep interventions can reduce the prevalence and impact of sleep problems.
Publisher: American Academy of Pediatrics (AAP)
Date: 06-2017
Abstract: Early pubertal timing is linked with a range of adverse health outcomes later. Given recent trends of earlier pubertal maturation, there is growing interest in the factors influencing pubertal timing. Socioeconomic disadvantage has been previously linked with reproductive strategies later in life. In this study, we aim to determine the association between cumulative social disadvantages in early life and early puberty in a population-based birth cohort. Data are from the B (baby) cohort of The Longitudinal Study of Australian Children. Children (n = 5107) were aged 0 to 1 years when recruited in 2004 and 10 to 11 years (n = 3764) at Wave 6 in 2015. Household socioeconomic position (SEP) and neighborhood socioeconomic disadvantage were collected at all 6 waves. Trajectories of disadvantage were identified through latent class models. Early puberty at Wave 6 was assessed from parental reports using an adaptation of the Pubertal Development Scale. Cumulative exposure to extremely unfavorable household SEP in boys independently predicted a fourfold increase (odds ratio = 4.22, 95% confidence interval 2.27–7.86) in the rate of early puberty. In girls, the increase was twofold (odds ratio = 1.96, 95% confidence interval 1.08–3.56). We found no effect from neighborhood disadvantage once family SEP was taken into account. Cumulative exposure to household socioeconomic disadvantage in early life predicts earlier pubertal timing in both boys and girls. This may represent 1 mechanism underpinning associations between early life disadvantage and poor health in later life.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.IJCARD.2018.11.020
Abstract: Understanding early-life relationships between the Ideal Cardiovascular Health (ICVH) score and vascular phenotypes could inform likely effectiveness and timing of cardiovascular disease prevention strategies. We aimed to describe associations between ICVH scores and vascular phenotypes in 11- to 12-year-old children and their parents. Cross-sectional ICVH scores (range 0-7, higher indicating better health), derived by summing dichotomized metrics for cholesterol, glucose, blood pressure (BP), body mass index (BMI), diet, physical activity and smoking, were constructed for 1235 adults (89% female, mean age 43 years) and 1028 children (48% female, 12 years). The median scores were 4 and 5 for adults and children respectively. Child ICVH scores were associated with parent scores (0.18 higher child score per additional point in parent's score, 95% CI 0.12 to 0.22, P < 0.001). Each additional point in the adult ICVH score was associated with slower carotid-femoral pulse wave velocity (PWV, -0.32 m/s, 95% CI -0.37 to -0.27), greater carotid elasticity (0.017%/mm Hg, 95% CI 0.014 to 0.020) and reduced carotid intima-media thickness (IMT, -7.3 μm, 95% CI -12.0 to -2.5). An additional point in the child score was associated with functional phenotypes (PWV -0.07 m/s, 95% CI -0.11 to -0.03 carotid elasticity 0.009%/mm Hg, 95% CI 0.004 to 0.015) but not structural phenotypes (IMT -1.8 μm, 95% CI -5.2 to 1.5). Few Australian children and even fewer parents have ideal cardiovascular health. Lower ICVH scores were associated with adverse adult vascular phenotypes and adverse child vascular function. Family-based interventions optimizing ICVH metrics may delay onset and progression of subclinical atherosclerosis and later cardiovascular disease.
Publisher: Wiley
Date: 09-11-2006
DOI: 10.1111/J.1440-1754.2006.00974.X
Abstract: To describe changes in infant prelinguistic communication skills between 8 and 12 months, and identify factors associated with those skills. Parent questionnaire data for a prospective population-based cohort of infants in metropolitan Melbourne, Australia. 1911 infants born November 2002-August 2003. Infant communication (Communication and Symbolic Behaviour Scales (CSBS)) at 8 and 12 months. Potential risk factors: sex prematurity multiple birth sociodemographic indicators maternal mental health, vocabulary and education non-English speaking background and family history of speech-language difficulties. Linear regression models were fitted to total standardised CSBS scores at 8 and 12 months. Social communication, especially the use of gesture, developed rapidly from 8 to 12 months. Female sex, twin birth, and family history were strongly associated with CSBS scores. The combined model accounted for 5% and 6% of the total variation at 8 and 12 months, respectively. CSBS score at 8 months strongly predicted CSBS score at 12 months (coefficient = 0.56, partial R(2) = 37.0). There is a dramatic increase in communication skills between 8 and 12 months, particularly the development of gesture, which (as in previous studies) predates and predicts future language development. Risk factors explained little variation in early communication trajectories and therefore, based on our findings, this developmental course is more likely to be biologically predetermined. Rather than focusing on risk factors, we suggest that language promotion activities in otherwise healthy young infants should either be universal or, if targeted, be based on the level of communication skills displayed.
Publisher: American Academy of Pediatrics (AAP)
Date: 09-2014
Publisher: Elsevier BV
Date: 11-2006
DOI: 10.1016/J.AMBP.2006.08.005
Abstract: To investigate the relationship between overweight and obesity, and mental health problems in Australian 4- to 5-year-old children. The study used data from wave 1 (2004) of the Longitudinal Study of Australian Children (LSAC). The participants were 4983 4- to 5-year-old children (2537 boys and 2446 girls) with a mean age of 56.9 months (standard deviation 2.6 months range 51-67 months). Children were classified as nonoverweight, overweight, and obese on the basis of International Obesity Task Force definitions. Mental health problems were assessed by the Strengths and Difficulties Questionnaire (SDQ) completed by parents and teachers. Although obese 4- to 5-year-old boys had more mental health problems than nonoverweight boys, differences between the groups were small and substantially reduced when analyses controlled for children's sociodemographic characteristics. Parents reported that overweight/obese girls had more peer problems, whereas teachers reported they had more conduct problems. Children in all weight groups had mean scores within the normal range of scores on all the SDQ subscales. Differences in rates of mental health problems experienced by young children of different weight status appear relatively small. Higher rates of mental health problems experienced by more obese boys may reflect differences in their sociodemographic characteristics rather than their weight status per se. Policies that reduce the number of young children living in poverty or experiencing other adverse social circumstances have the potential to reduce rates of mental health problems experienced by older children with overweight/obesity.
Publisher: Oxford University Press (OUP)
Date: 07-2011
DOI: 10.5665/SLEEP.1122
Publisher: Wiley
Date: 03-2003
DOI: 10.1046/J.1440-1754.2003.00104.X
Abstract: To investigate relationships between children's body mass index (BMI) and parent reports of children's television and video game/computer habits, controlling for other potential risk factors for paediatric obesity. Child BMI was calculated from measured height and weight collected in 1997 as part of a large, representative, cross-sectional study of children in Victoria, Australia. Parents reported the amount of time children watched television and used video games/computers, children's eating and activity habits, parental BMI and sociodemographic details. A total of 2862 children aged 5-13 years participated. Child mean BMI z-score was significantly related to television (F = 10.23, P < 0.001) but not video game/computer time (F = 2.23, P = 0.09), but accounted for only 1 and 0.2% of total BMI variance, respectively. When parental BMI, parental education, number of siblings, food intake, organized exercise and general activity level were included, television ceased to be independently significantly related to child BMI. Using adjusted logistic regression, the odds of being overweight and obese generally increased with increasing television viewing. No relationship was found for video game/computer use. A small proportion of variance in child BMI was related to television, but not video game/computer time. This was far outweighed by the influence of other variables. Causal pathways are likely to be complex and interrelated.
Publisher: American Medical Association (AMA)
Date: 12-2013
DOI: 10.1001/JAMAPEDIATRICS.2013.2572
Abstract: IMPORTANCE Excessive infant crying is common, distressing, but without proven effective prevention or management options. Probiotics may be a promising solution. OBJECTIVE To examine whether probiotics are effective in the prevention/management of crying ("colic") in infants 3 months or younger. DATA SOURCES A systematic search of MEDLINE, EMBASE, and the Cochrane Library, supplemented by the metaRegister of Controlled Trials. STUDY SELECTION Studies that randomized infants 3 months or younger to oral probiotics vs placebo or no or standard treatment with the outcome of infant crying, measured as the duration or number of episodes of infant crying/distress or diagnosis of "infant colic." Twelve of the 1180 initially identified studies were selected. DATA EXTRACTION AND SYNTHESIS This review/meta-analysis was conducted according to guidelines from the Cochrane Handbook for Systematic Reviews of Interventions, with reporting following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were independently extracted by 3 of us. MAIN OUTCOME(S) AND MEASURE(S) Infant crying, measured as the duration or number of episodes of infant crying/distress, or diagnosis of "infant colic." RESULTS Of the 12 trials (1825 infants) reviewed, 6 suggested probiotics reduced crying, and 6 did not. Three of the 5 management trials concluded probiotics effectively treat colic in breastfed babies 1 suggested possible effectiveness in formula-fed babies with colic, and 1 suggested ineffectiveness in breastfed babies with colic. Meta-analysis of 3 small trials of breastfed infants with colic found that Lactobacillus reuteri markedly reduced crying time at 21 days (median difference, -65 minutes/d 95% CI, -86 to -44). However, all trials had potential biases. Meanwhile, of 7 prevention trials, 2 suggested possible benefits. Considerable variability in the study populations, study type, delivery mode/dose of probiotic supplementation, and outcomes precluded meta-analysis. CONCLUSIONS AND RELEVANCE Although L reuteri may be effective as treatment for crying in exclusively breastfed infants with colic, there is still insufficient evidence to support probiotic use to manage colic, especially in formula-fed infants, or to prevent infant crying. Results from larger rigorously designed studies applicable to all crying infants will help draw more definitive conclusions.
Publisher: BMJ
Date: 2013
Publisher: Elsevier BV
Date: 11-2021
Publisher: Wiley
Date: 21-03-2008
DOI: 10.1111/J.1440-1746.2007.04859.X
Abstract: The first aim of this study was to determine the health-related quality of life (HRQoL) of children with chronic hepatitis C virus (HCV) infection and compare HRQoL as reported by parents. The second aim was to ascertain parents' perceptions and concerns about current and future life for their child with HCV, and compare these findings with those reported by adolescents. The study group comprised children attending a tertiary pediatric HCV-clinic in Melbourne, Australia, who acquired HCV prior to 12 months of age by vertical transmission or blood transfusion. Two validated (parent- and self-reported) questionnaires of HRQoL were completed (CHQ-PF 50 and CHQ-CF 50). Scores for children with HCV were compared with normative data (representative s le of 3119 age-matched Victorian children). A study-designed questionnaire relating to the impact of the diagnosis of HCV on parent and child perceptions of current and future health was administered. In total, 83% (19/23) questionnaires were returned. Physical and psychosocial summary scores were significantly lower in HCV than non-HCV children (45.3 vs 49.6 and 44.0 vs 50.1, respectively). Nine out of 11 scale scores were significantly lower in children with HCV, most notably the General health (49.9 vs 77.1 P < 0.001) and Parent impact-emotional (45.6 vs 80.3 P < 0.001) scales. Children reported reduced physical functioning (82.8% vs 94.4%) but were otherwise less concerned than their parents about their future health. Despite being "asymptomatic" on routine medical history, children with early acquired HCV have significantly poorer health status than community controls. These findings suggest the need for services currently available for adult HCV patients to support families and children with HCV.
Publisher: Springer Science and Business Media LLC
Date: 12-12-2007
Abstract: To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting. Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey. Twenty nine general practices, Melbourne, Australia. (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002 (2) RCT: in idually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months-9 years 11 months (82 intervention, 81 control). Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials. Primary: BMI at 9 and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status child-reported health status, body satisfaction and appearance/self-worth. Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1 P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5 P=1.00) at 15 months. There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms. This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief in idualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient however, increasing either would have significant cost and resource implications at a population level.
Publisher: BMJ
Date: 31-01-2008
Publisher: American Academy of Pediatrics (AAP)
Date: 09-2008
Abstract: OBJECTIVES. Maternal depression is an established risk for adverse child development. Two thirds of clinically significant depressive symptoms occur in mothers reporting an infant sleep problem. We aimed to determine the long-term effects of a behavioral intervention for infant sleep problems on maternal depression and parenting style, as well as on child mental health and sleep, when the children reached 2 years of age. METHODS. We conducted a cluster-randomized trial in well-child centers across 6 government areas of Melbourne, Australia. Participants included 328 mothers reporting an infant sleep problem at 7 months, drawn from a population s le (N = 739) recruited at 4 months. We compared the usual well-child care (n = 154) versus a brief behavior-modification program designed to improve infant sleep (n = 174) delivered by well-child nurses at ages 8 to 10 months and measured maternal depression symptoms (Edinburgh Postnatal Depression Scale) parenting practices (Parent Behavior Checklist) child mental health (Child Behavior Checklist) and maternal report of a sleep problem (yes or no). RESULTS. At 2 years, mothers in the intervention group were less likely than control mothers to report clinical depression symptoms: 15.4% vs 26.4% (Edinburgh Postnatal Depression Scale community cut point) and 4.2% vs 13.2% (Edinburgh Postnatal Depression Scale clinical cut point). Neither parenting style nor child mental health differed markedly between the intervention and control groups. A total of 27.3% of children in the intervention group versus 32.6% of control children had a sleep problem. CONCLUSIONS. The sleep intervention in infancy resulted in sustained positive effects on maternal depression symptoms and found no evidence of longer-term adverse effects on either mothers' parenting practices or children's mental health. This intervention demonstrated the capacity of a functioning primary care system to deliver effective, universally offered secondary prevention.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.JAIP.2019.05.057
Abstract: Cashew is a common cause of tree nut allergy in children. To date there have been few studies of diagnostic tests for cashew allergy, and positive predictive values (PPVs) for cashew as well as other tree nuts are largely extrapolated from studies of peanut allergy. How relevant these cutoffs are for cashew has not been formally explored. We aimed to establish skin prick test (SPT) wheal sizes that correlated to 95% PPV for a positive food challenge for cashew. We included all cashew oral food challenges (OFCs) conducted as part of the HealthNuts (n = 108 age, 4-6 years) and SchoolNuts (n = 37 age, 10-14 years) studies, both recruited from the community (population cohort). A second cohort of all cashew OFCs conducted at the Royal Children's Hospital (RCH) allergy center (n = 343) (2011-2016) and a private allergy clinic based at RCH (n = 43) was included via electronic medical record review (clinic cohort). The 95% PPV for cashew SPT was calculated for both cohorts. Among the population cohort (n = 145), 62% of cashew OFCs were positive compared with 20% of the clinic cohort (n = 386). The SPT cutoff for 95% PPV derived from the population cohort was 10 mm (95% confidence interval [CI], 7.5-12.0). For the clinic cohort, the 95% PPV was 14 mm (95% CI, 9.5-unknown). An SPT wheal size of 8 mm had a PPV of 89% (95% CI, 79-95) in the population cohort and 62% (95% CI, 45-78) in the clinic cohort. A higher SPT wheal size may be more appropriate than the commonly used 8 mm cutoff to guide clinical decisions around when to perform OFC for cashew.
Publisher: Oxford University Press (OUP)
Date: 16-11-2020
DOI: 10.1093/SLEEP/ZSZ200
Abstract: Poor sleep patterns in older adults are associated with chromosomal telomere shortening, a marker of cellular senescence. However, studies have relied on self-reported sleep characteristics, with few data for younger in iduals. We investigated whether sleep measured via actigraphy was cross-sectionally associated with telomere length in children and midlife adults. A population-based s le of 1874 11–12 year olds and midlife adults (mean age 44 years, SD 5.1) had biological and physical assessments at centers across Australia in 2015–2016. Sleep characteristics, including duration, onset, offset, day-to-day variability, and efficiency, were derived from actigraphy. Relative telomere length (T/S ratio) was measured by quantitative polymerase chain reaction on genomic DNA from peripheral blood. Multivariable regression models estimated associations, adjusting for prespecified confounders. Both sleep and telomere data were available for 728 children and 1070 adults. Mean (SD) T/S ratio was 1.09 (0.55) in children and 0.81 (0.38) in adults. T/S ratio was not predicted by sleep duration (β 0.04, 95% confidence interval [CI] −0.02 to 0.09, p = .16, children β −0.004, 95% CI −0.03 to 0.02, p = .70, adults) or most other sleep metrics. The only exception was a weak association between later sleep timing (the midpoint of sleep onset and offset) and longer telomeres in adults (β 0.03, 95% CI 0.01 to 0.06, p = .01). Objective sleep characteristics show no convincing associations with telomere length in two largely healthy populations up to at least midlife. Sleep–telomere associations may be a late-life occurrence or may present only with a trigger such as presence of other morbidities.
Publisher: SAGE Publications
Date: 23-08-2017
Abstract: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically erse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2% adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0% adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014 symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2) adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.
Publisher: Springer Science and Business Media LLC
Date: 05-12-2007
Abstract: (1) To determine the prevalence of overweight and obesity in Australian 4-5-year-old children. (2) To investigate associations between socio-economic characteristics and (a) overweight/obesity and (b) waist circumference. Cross-sectional population survey. Wave 1 (2004) of the Longitudinal Study of Australian Children. Nationally representative s le of 4983 4-5-year-old children (2537 boys and 2446 girls mean age 56.9 months (s.d. 2.64 months range 51-67 months)). Prevalence of overweight and obesity (International Obesity TaskForce definitions) and waist circumference (cm). Prevalence estimates were obtained as weighted percentages. Uni- and multivariable ordinal logistic regression (using the proportional odds model) were used to assess associations between potential predictors and the risk of higher child body mass index status and a multivariable linear regression model to assess relationships between the same potential predictors and waist circumference. 15.2% of Australian preschoolers are estimated to be overweight and 5.5% obese. In univariate analyses, seven of the 12 variables were associated with higher odds of being in a heavier body mass index category. In a multivariable regression model, speaking a language other than English (particularly for boys), indigenous status and lower disadvantage quintile were the clearest independent predictors of higher body mass index status, with children in the lowest quintile of social disadvantage having 47% higher odds (95% CI 14, 92%) of being in a heavier body mass index category compared to those in the highest quintile. Waist circumference was not related to any socio-economic variable. This nationally representative survey confirms high rates of overweight and obesity in preschoolers throughout Australia. The recent emergence of a substantial socio-economic gradient should bring new urgency to public health measures to combat the obesity epidemic.
Publisher: BMJ
Date: 28-05-2011
Abstract: To determine in children aged 0-7 years (1) cross-sectional relationships between body mass index (BMI) and sleep duration, and whether (2) sleep duration predicts later BMI and/or (3) BMI predicts later sleep duration. Longitudinal Study of Australian Children, Waves 1 and 2. Infants aged 0-1 years (Wave 1), followed at age 2-3 years (Wave 2) children aged 4-5 years (Wave 1), followed at age 6-7 years (Wave 2). BMI, sleep duration by time-use diary, parent-reported sleep problems (none/mild vs moderate/severe). Cross-sectional, ANOVA (sleep duration) and χ(2) (sleep problems) longitudinal, linear regression. 3857 (76%) infants and 3844 (77%) children had BMI and sleep data. At every wave, approximately 15% and 5% of children were overweight and obese, respectively. Obesity was not associated with sleep duration at 0-1, 2-3 or 4-5 years, though obese 6-7-year olds slept approximately 30 min less (p<0.001). Sleep problems were similar across BMI categories at all ages. Wave 1 sleep duration did not predict Wave 2 BMI, nor did Wave 1 BMI predict Wave 2 sleep duration. In these large child population cohorts, sleep duration did not predict obesity up to age 6-7 years. Current trials of sleep interventions to prevent or manage obesity in young children may be premature.
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2021
Abstract: In this population-based cohort of 1179 children 11 to 12 years of age, equivalent benefits to adiposity and HRQoL were associated with different changes (trade-offs) in activities. Understanding equivalence of time-use trade-offs may inform tailored lifestyle choices. We explored which time reallocations were associated with equivalent changes in children’s health outcomes. Participants were from the cross-sectional Child Health CheckPoint Study (N = 1181 11–12 years 50% boys) nested within the population-based Longitudinal Study of Australian Children. Outcomes were adiposity (bioelectrical impedance analysis, BMI and waist girth), self-reported health-related quality of life (HRQoL Pediatric Quality of Life Inventory), and academic achievement (standardized national tests). Participants’ 24-hour time use (sleep, sedentary behavior, light physical activity, and moderate-to-vigorous physical activity [MVPA]) from 8-day 24-hour accelerometry was regressed against outcomes by using compositional log-ratio linear regression models. Children with lower adiposity and higher HRQoL had more MVPA (both P & .001) and sleep (P = .002 P = .008), and less sedentary time (P = .02 P = .001) and light physical activity (P & .001 P = .04), each relative to remaining activities. Children with better academic achievement had more sedentary time (P = .03) and less light physical activity (P = .006), each relative to remaining activities. A 0.1 standardized decrease in adiposity was associated with either 55 minutes more sleep, 89 minutes less sedentary time, 34 minutes less light physical activity, or 19 minutes more MVPA. A 0.1 standardized increase in HRQoL was associated with either 64 minutes more sleep, 65 minutes less sedentary time, 72 minutes less light physical activity, or 29 minutes more MVPA. Equivalent differences in outcomes were associated with several time reallocations. On a minute-for-minute basis, MVPA was 2 to 6 times as potent as sleep or sedentary time.
Publisher: BMJ
Date: 24-02-2017
DOI: 10.1136/ARCHDISCHILD-2016-311568
Abstract: To determine which of multiple early-life exposures predict onset or resolution of overweight/obesity during a 9-year period. On average, the 363 children (57% retention) were 6 and 15 years old at baseline and follow-up. Children were classified as 'never' overweight/obese (38%), 'resolving' overweight/obese (15%), 'becoming' overweight/obese (8%) or 'always' overweight/obese (39%). Compared with 'never overweight/obese' children, odds of 'becoming overweight/obese' were greater with higher child (OR 2.33, 95% CI 1.02 to 5.29) and maternal BMI (OR 1.18, CI 1.07 to 1.31), and lower with higher maternal education (OR 0.09, CI 0.02 to 0.34). Compared with 'always overweight/obese' children, odds of 'resolving overweight/obese' were lower with higher maternal BMI (OR 0.87, CI 0.78 to 0.97), and higher with better child physical health (OR 1.06, CI 1.02 to 1.10) and higher maternal age (OR 1.11, CI 1.01 to 1.22) and education (OR 4.07, CI 1.02 to 16.19). Readily available baseline information (child/maternal BMI, maternal age, education and child health) were the strongest predictors of both onset and resolution of overweight/obesity between the primary school and adolescent years. Perinatal, breastfeeding and lifestyle exposures were not strongly predictive. Results could stimulate development of algorithms identifying children most in need of targeted prevention or treatment.
Publisher: Wiley
Date: 11-2018
DOI: 10.1111/PPE.12519
Abstract: Childhood cancer is a rare but leading cause of morbidity and mortality. Established risk factors, accounting for <10% of incidence, have been identified primarily from case-control studies. However, recall, selection and other potential biases impact interpretations particularly, for modest associations. A consortium of pregnancy and birth cohorts (I4C) was established to utilise prospective, pre-diagnostic exposure assessments and biological s les. Eligibility criteria, follow-up methods and identification of paediatric cancer cases are described for cohorts currently participating or planning future participation. Also described are exposure assessments, harmonisation methods, biological s les potentially available for I4C research, the role of the I4C data and biospecimen coordinating centres and statistical approaches used in the pooled analyses. Currently, six cohorts recruited over six decades (1950s-2000s) contribute data on 388 120 mother-child pairs. Nine new cohorts from seven countries are anticipated to contribute data on 627 500 additional projected mother-child pairs within 5 years. Harmonised data currently includes over 20 "core" variables, with notable variability in mother/child characteristics within and across cohorts, reflecting in part, secular changes in pregnancy and birth characteristics over the decades. The I4C is the first cohort consortium to have published findings on paediatric cancer using harmonised variables across six pregnancy/birth cohorts. Projected increases in s le size, expanding sources of exposure data (eg, linkages to environmental and administrative databases), incorporation of biological measures to clarify exposures and underlying molecular mechanisms and forthcoming joint efforts to complement case-control studies offer the potential for breakthroughs in paediatric cancer aetiologic research.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2011
Abstract: To determine the feasibility of screening for child sleep problems and the efficacy of a behavioral sleep intervention in improving child and parent outcomes in the first year of schooling. A randomized controlled trial was nested in a population survey performed at 22 elementary schools in Melbourne, Australia. Intervention involved 2 to 3 consultations that covered behavioral sleep strategies for children whose screening results were positive for a moderate/severe sleep problem. Outcomes were parent-reported child sleep problem (primary outcome), sleep habits, psychosocial health-related quality of life, behavior, and parent mental health (all at 3, 6, and 12 months) and blinded, face-to-face learning assessment (at 6 months). The screening survey was completed by 1512 parents 161 (10.8%) reported a moderate/severe child sleep problem, and 108 of 136 (79.2% of those eligible) entered the trial. Sleep problems tended to resolve more rapidly in intervention children. Sleep problems affected 33% of 54 intervention children versus 43% of 54 control children at 3 months (P = .3), 25.5% vs 46.8% at 6 months (P = .03), and 32% vs 33% at 12 months (P = .8). Sustained sleep-habit improvements were evident at 3, 6, and 12 months (effect sizes: 0.33 [P = .03] 0.51 [P = .003] and 0.40 [P = .02] respectively), and there were initial marked improvements in psychosocial scores that diminished over time (effect sizes: 0.47 [P = .02] 0.41 [P = .09] and 0.26 [P = .3] respectively). Better prosocial behavior was evident at 12 months (effect size: 0.35 P = .03), and learning and parent outcomes were similar between groups. School-based screening for sleep problems followed by a targeted, brief behavioral sleep intervention is feasible and has benefits relevant to school transition.
Publisher: American Medical Association (AMA)
Date: 11-2012
DOI: 10.1001/ARCHPEDIATRICS.2012.1099
Abstract: To determine the emergent literacy and language effects of a low-intensity literacy promotion program (Let's Read) provided via universal well-child services to parents during the first 4 years of their child's life. Population-based, cluster randomized controlled trial performed between March 1, 2006, and December 10, 2010. Maternal and child health centers (clusters) in 5 relatively disadvantaged local government areas in Melbourne, Australia. All parents attending their 4-week well-child appointments in participating centers were invited to take part in the study. The Let's Read program was delivered at 4, 12, 18, and 42 months during universal well-child care visits. Child emergent literacy skills (intrasyllabic, phonemic, and sound/letter knowledge) and language (core, receptive, and expressive), measured at 4 years of age. A total of 630 parents participated, with 365 children in 32 intervention clusters and 265 children in 33 control clusters 563 children (89.4%) were retained in the study to 4 years of age. The adjusted mean differences (intervention minus control) for emergent literacy was 0.2 (95% CI, -0.2 to 0.6 P = .29) for intrasyllabic units, 0.05 (95% CI, -0.4 to 0.5 P = .85) for phonemic awareness, and 0.1 (95% CI, -1.5 to 1.6 P = .92) for letter knowledge. For language, the differences were 1.6 (95% CI, -1.1 to 4.3 P = .25) for core, 0.8 (95% CI, -2.0 to 3.7 P = .56) for receptive, and 1.4 (95% CI, -1.4 to 4.2 P = .32) for expressive scores. This population-wide primary care literacy promotion and book distribution program provided neither the anticipated benefits to literacy and language nor enhanced uptake of literacy activities at 4 years of age, even when targeted to relatively disadvantaged areas. isrctn.org Identifier: ISRCTN04602902.
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.INFBEH.2007.11.001
Abstract: Within a longitudinal study using a large representative, community s le of infants recruited at mean age 8 months, we examined influences on infant communication development at 24 months, including child gender, shy temperament, behavioural and emotional problems, and several variables relating to maternal psychosocial health. On most developmental measures girls were in advance of boys and they also showed shyer temperament. Child gender, shy temperament and maternal psychosocial indices were associated with both vocabulary development as measured by the MacArthur-Bates Communicative Development Inventory (CDI), and communication and symbolic development assessed via the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS) at 24 months. No prediction was found using scores at 8 or 12 months, although moderate stability between measures between 12 and 24 months was evident. Predictors of 24 month outcomes were all concurrently measured variables, and included temperamental shyness, but very little variance in communication outcomes was explained. Children whose mothers were experiencing clinical levels of depression and life difficulties reported more child behavioural problems.
Publisher: Springer Science and Business Media LLC
Date: 12-06-2013
DOI: 10.1038/IJO.2012.86
Abstract: No study has documented how symptomatic morbidity varies across the body mass index (BMI) spectrum (underweight, normal weight, overweight and obese) or across the entire child and adolescent age range. To (1) quantify physical and psychosocial morbidities experienced by 2-18-year-olds according to BMI status and (2) explore morbidity patterns by age. Cross-sectional data from two Australian population studies (the Longitudinal Study of Australian Children and the Health of Young Victorians Study) were collected during 2000-2006. Participants were grouped into five age bands: 2-3 (n=4606), 4-5 (n=4983), 6-7 (n=4464), 8-12 (n=1541) and 13-18 (n=928) years. Outcomes-Parent- and self-reported global health physical, psychosocial and mental health special health-care needs wheeze asthma and sleep problems. Exposure-measured BMI (kg m(-2)) categorised using standard international cutpoints. The variation in comorbidities across BMI categories within and between age bands was examined using linear and logistic regression models. Comorbidities varied with BMI category for all except sleep problems, generally showing the highest levels for the obese category. However, patterns differed markedly between age groups. In particular, poorer global health and special health-care needs were associated with underweight in young children, but obesity in older children. Prevalence of poorer physical health varied little by BMI in 2-5-year-olds, but from 6 to 7 years was increasingly associated with obesity. Normal-weight children tended to experience the best psychosocial and mental health, with little evidence that the U-shaped associations of these variables with BMI status varied by age. Wheeze and asthma increased slightly with BMI at all ages. Deviation from normal weight is associated with health differences in children and adolescents that vary by morbidity and age. As well as lowering risks for later disease, promoting normal body weight appears central to improving the health and well-being of the young.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.JADOHEALTH.2018.05.025
Abstract: Puberty marks a transition in risk for body image disturbance and disordered eating. Yet few studies have examined these symptoms across puberty and none have examined links with adrenarche, the earliest phase in the pubertal hormonal cascade. Levels of adrenal androgens (dehydroepiandrosterone, dehydroepiandrosterone sulphate, and testosterone) were measured in a population-based study of 8- to 9-year-old children (516 males and 621 females). Body dissatisfaction was measured using the Kids' Eating Disorder Scale Silhouettes. Covariates included body mass index, age, and socioeconomic status. There were significant associations between adrenal androgen levels and greater body dissatisfaction in both males and females. Specifically, females with more advanced levels of dehydroepiandrosterone and testosterone relative to peers, and males with more advanced levels of testosterone relative to peers, reported greater body dissatisfaction. However, after adjusting for covariates, hormones levels were no longer associated with body dissatisfaction, and only higher body mass index had a clear association with body dissatisfaction. The adrenarchal transition brings a heightened risk for body dissatisfaction. Whether this arises from the neuroendocrine effects of adrenal androgens or as a reaction to the greater body mass that accompanies adrenarche requires further exploration.
Publisher: Springer Science and Business Media LLC
Date: 17-12-2021
Publisher: SAGE Publications
Date: 09-09-2021
DOI: 10.1177/15562646211041492
Abstract: ‘Digital Mega-Studies’ are entirely or extensively digitised, longitudinal, population-scale initiatives, collecting, storing, and making available in idual-level research data of different types and from multiple sources, shaped by technological developments and unforeseeable risks over time. The Australian ‘Gen V’ project exemplifies this new research paradigm. In 2019, we undertook a multidisciplinary, multi-stakeholder process to map Digital Mega-Studies’ key characteristics, legal and governance challenges and likely solutions. We conducted large and small group processes within a one-day symposium and directed online synthesis and group prioritisation over subsequent weeks. We present our methods (including elicitation, affinity mapping and prioritisation processes) and findings, proposing six priority governance principles across three areas—data, participation, trust—to support future high-quality, large-scale digital research in health.
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2015
Publisher: Wiley
Date: 26-11-2004
Publisher: Wiley
Date: 24-03-2012
DOI: 10.1111/J.1365-2214.2011.01234.X
Abstract: Pre-school language impairment is common and greatly reduces educational performance. Population attempts to identify children who would benefit from appropriately timed intervention might be improved by greater knowledge about the typical profiles of language development. Specifically, this could be used to help with the early identification of children who will be impaired on school entry. This study applied longitudinal latent class analysis to assessments at 8, 12, 24, 36 and 48 months on 1113 children from a population-based study, in order to identify classes exhibiting distinct communicative developmental profiles. Five substantive classes were identified: Typical, i.e. development in the typical range at each age Precocious (late), i.e. typical development in infancy followed by high probabilities of precocity from 24 months onwards Impaired (early), i.e. high probabilities of impairment up to 12 months followed by typical language development thereafter Impaired (late), i.e. typical development in infancy but impairment from 24 months onwards Precocious (early), i.e. high probabilities of precocity in early life followed by typical language by 48 months. The entropy statistic (0.84) suggested classes were fairly well defined, although there was a non-trivial degree of uncertainty in classification of children. That half of the Impaired (late) class was expected to have typical language at 4 years and 6% of the numerically large Typical class was expected to be impaired at 4 years illustrates this. Characteristics indicative of social advantage were more commonly found in the classes with improving profiles. Developmental profiles show that some pre-schoolers' language is characterized by periods of accelerated development, slow development and catch-up growth. Given the uncertainty in classifying children into these profiles, use of this knowledge for identifying children who will be impaired on school entry is not straightforward. The findings do, however, indicate greater need for language enrichment programmes among disadvantaged children.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.ACAP.2019.01.010
Abstract: Better epidemiologic information on childhood hearing loss would inform research priorities and efforts to prevent its progression. To estimate prevalence and secular trends in children's hearing loss. We searched MEDLINE and Embase from January 1996 to August 2017. We included epidemiologic studies in English reporting hearing loss prevalence. The modified Leboeuf-Yde and Lauritsen tool was used to assess methodological quality. Meta-analyses combined study-specific estimates using random-effects models. Children 0 to 18 years of age. Among 88 eligible studies, 43.2% included audiometric measurement of speech frequencies. In meta-analyses, pooled prevalence estimates of slight or worse bilateral speech frequency losses >15 decibels hearing level (dB HL) were 13.1% (95% confidence interval [CI], 10.0-17.0). Using progressively more stringent cutpoints, pooled prevalence estimates were 8.1% (95% CI, 1.3-19.8) with >20 dB HL, 2.2% (95% CI, 1.4-3.0) with >25 dB HL, 1.8% (95% CI, 0.4-4.1) with >30 dB HL, and 0.9% (95% CI, 0.1-2.6) with >40 dB HL. Also, 8.9% (95% CI, 6.4-12.3) had likely sensorineural losses >15 dB HL in 1 or both ears, and 1.2% (95% CI, 0.5-2.1) had self-reported hearing loss. From 1990 to 2010, the prevalence of losses >15 dB HL in 1 or both ears rose substantially (all P for trend <.001). The studies had high heterogeneity and offered limited information for hearing loss types and secular trend. Childhood slight or worse hearing loss is prevalent and may be increasing. Advances in understanding hearing loss trajectories, causes, and prevention would require international repositories and longitudinal studies with audiometric data beginning in childhood. PROSPERO 2016 CRD42016034148.
Publisher: Wiley
Date: 10-07-2019
DOI: 10.1111/MICC.12557
Abstract: Intermediate phenotypes of microcirculation (retinal microvascular caliber) are associated with cardiovascular (CV) risk factors and independently predict CV events. However, the effect of microcirculation variation on the vascular system is unclear. We conducted a systematic review and meta-analysis of observational studies to quantify associations of retinal microvascular caliber (arteriolar, venular caliber, arteriole-to-venule ratio) and preclinical CV measures (large arterial function and structure). We identified studies in MEDLINE, EMBASE, and PubMed (1946 to March 2018) studying (a) general population s les and (b) patients with cardiometabolic disease. Study-specific correlation estimates were combined into meta-analysis where possible. Of 1294 studies identified, 26 met inclusion criteria (general population 16, patients 10), of which five studies were included in meta-analysis. Most studied middle-aged adults cross-sectionally, with one childhood study. Large arterial function and structure were predominantly assessed by pulse wave velocity and carotid intima-media thickness, respectively. Only arteriolar caliber was consistently associated with arterial function and structure, with stronger associations observed in cardiometabolic patients. Narrower (worse) arteriolar caliber was associated with faster (poorer) pulse wave velocity (correlation coefficient (r) -0.17, 95% CI -0.25 to -0.10) and greater (poorer) intima-media thickness (r -0.05, 95%CI -0.09 to -0.02) across all adult participants. Retinal arteriolar, but not venular caliber, was modestly associated with large arterial function and weakly associated with large arterial structure, with stronger evidence in patients with cardiometabolic disease. This suggests that preclinical changes in large arteries and the microcirculation have some shared but mainly unique pathways to associate with cardiovascular disease.
Publisher: Springer Science and Business Media LLC
Date: 24-09-2020
DOI: 10.1186/S12874-020-01111-X
Abstract: Very large cohorts that span an entire population raise new prospects for the conduct of multiple trials that speed up advances in prevention or treatment while reducing participant, financial and regulatory burden. However, a review of literature reveals no blueprint to guide this systematically in practice. This Statement of Intent proposes how erse trials may be integrated within or alongside Generation Victoria (GenV), a whole-of-state Australian birth cohort in planning, and delineates potential processes and opportunities. Parents of all newborns (estimated 160,000) in the state of Victoria, Australia, will be approached for two full years from 2021. The cohort design comprises four elements: (1) consent soon after birth to follow the child and parent/s until study end or withdrawal retrospective and prospective (2) linkage to clinical and administrative datasets and (3) banking of universal and clinical bios les and (4) GenV-collected bios les and data. GenV-collected data will focus on overarching outcome and phenotypic measures using low-burden, universal-capable electronic interfaces, with funding-dependent face-to-face assessments tailored to universal settings during the early childhood, school and/or adult years. For population or registry-type trials within GenV, GenV will provide all outcomes data and consent via traditional, waiver, or Trials Within Cohorts models. Trials alongside GenV consent their own participants born within the GenV window GenV may help identify potential participants via opt-in or opt-out expression of interest. Data sharing enriches trials with outcomes, prior data, and/or access to linked data contingent on custodian’s agreements, and supports modeling of causal effects to the population and between-trials comparisons of costs, benefits and utility. Data access will operate under the Findability, Accessibility, Interoperability, and Reusability (FAIR) and Care and Five Safes Principles. We consider governance, ethical and shared trial oversight, and expectations that trials will adhere to the best practice of the day. Children and younger adults can access fewer trials than older adults. Integrating trials into mega-cohorts should improve health and well-being by generating faster, larger-scale evidence on a longer and/or broader horizon than previously possible. GenV will explore the limits and details of this approach over the coming years.
Publisher: Wiley
Date: 23-05-2012
DOI: 10.1111/J.1440-1754.2012.02466.X
Abstract: To determine at school entry (i) the prevalence and types of child sleep problems (ii) sleep difficulties and hygiene practices associated with sleep problems and (iii) their associations with child health-related quality of life, mental health and parent mental health. We conducted a cross-sectional community-based study at 22 primary schools in Melbourne, Australia. One thousand five hundred and twelve (70%) parents of children in the first 6 months of the child's first year of primary school took part. Parent report of child sleep problems (none, mild, and moderate/severe) sleep difficulties pre-bedtime activities (television in bedroom, television or electronic games before bedtime, television or electronic games >2 h/day) and caffeine intake child mental health (Strengths and Difficulties Questionnaire), health-related quality of life (Pediatric Quality of Life Inventory) and parent mental health (Depression Anxiety Stress Scale-21). 38.6% of children had a parent-reported sleep problem (27.9% mild, 10.8% moderate/severe). Sleep problems were characterised by problematic sleep difficulties but not poor sleep hygiene practices. Moderate/severe sleep problems were associated with poorer child mental health (mean difference -0.8 95% confidence interval (CI) -1.1 to -0.5, P < 0.001), health-related quality of life (mean difference -9.9 95% CI -11.9 to -7.9, P < 0.001) and parent mental health (mean difference 9.8 95% CI 7.7-11.9, P < 0.001). In new school entrants, sleep problems are common and associated with poorer child mental health, health-related quality of life and parent mental health. Future research needs to determine if systematically addressing sleep problems improves these outcomes.
Publisher: Mary Ann Liebert Inc
Date: 10-2017
Abstract: A short sleep duration is associated with a higher obesity risk from midchildhood onward. However, whether sleep duration in early childhood is associated with body composition and cardiometabolic health remains unclear. This study aims to examine the prospective association of sleep duration in infancy and early childhood with body composition and cardiometabolic health at 6 years of age. Data were available for 5161 children from a population-based cohort in the Netherlands. Sleep duration was assessed at ages 2, 6, 24, and 36 months by parental reports. When children were 6 years old, measures of body composition (iDXA), blood pressure, insulin, and lipid levels were collected. Longitudinal associations among sleep duration, body composition, and cardiometabolic health were studied with multivariable linear regression analyses. In addition, potential bidirectional associations between sleep duration and BMI were studied by using cross-lagged modeling. Shorter sleep duration at 2 months predicted higher BMI and fat mass in 6-year-old children, accounting for confounders and BMI at 2 months (e.g., for BMI, per hour sleep, B = -0.018, 95% CI = -0.026 -0.009). No temporal relationships among sleep duration at other ages, later body composition, and cardiometabolic outcomes were found. The cross-lagged model indicated a bidirectional association between sleep duration and BMI in early life (2 to 6 months of age). Shorter sleep duration at 2 months, but not at later ages, predicted poorer body composition 6 years later. We found no clear evidence for an effect of sleep duration in early life on cardiometabolic health.
Publisher: American Academy of Pediatrics (AAP)
Date: 2007
Abstract: OBJECTIVE. In contrast to school-aged children, the impact of sleep problems in preschool-aged children is not well documented. We aimed to determine relationships between preschool-aged child sleep problems and child behavior health-related quality of life verbal, preliteracy, and early numeracy skills diagnosis of attention-deficit/hyperactivity disorder and injury. PARTICIPANTS AND METHODS. Participants included families (n = 4983) participating in the first wave of the Longitudinal Study of Australian Children, a nationally representative study of Australian children aged 4 to 5 years surveyed from March to November 2004. Measures consisted of a primary caregiver's report of whether their child had a sleep problem (none versus mild versus moderate/severe) specific sleep patterns occurring ≥4 nights per week health-related quality of life (by using the Pediatric Quality of Life Inventory 4.0) behavior (by using the Strengths and Difficulties Questionnaire) and parent-reported diagnosis of attention-deficit/hyperactivity disorder and injury requiring medical attention in the past 12 months. Tests of receptive vocabulary and preliteracy/numeracy skills (by using the Who Am I? developmental assessment and the adapted Peabody Picture Vocabulary Test, 3rd Edition) were directly administered to each child. RESULTS. Sleep problems were common, and compared with children without sleep problems, children with sleep problems had poorer child health-related quality of life, more behavior problems, and higher rates of attention-deficit/hyperactivity disorder. Difficulty going to sleep and morning tiredness had greater adverse associations than snoring or night waking. CONCLUSIONS. Given that sleep problems are very common, the adverse outcomes shown here could affect the transition to school for a very large number of preschoolers.
Publisher: Wiley
Date: 02-1999
DOI: 10.1046/J.1440-1754.1999.00338.X
Abstract: To describe the emotional and physical health concerns of young people, and identify the concerns for which young people are more likely to seek help. We surveyed a representative cross-sectional s les of students from 11 to 18 years of age from 24 Victorian secondary schools in late 1997 within the Health of Young Victorians Study. Included in this survey were items describing worries or concerns of physical and emotional health. Prevalence rates, Chi-square, and logistic regression analyses were used to describe relationships. 2361 questionnaires were completed (53% male, response rate 70%). Overall, most frequent reports concerned feelings of depression (40%), worries about weight (37%), worries about self confidence (34%), and trouble falling or staying asleep (30%). Females tended to report a greater range of health concerns. The most frequent reports, by gender, were worries about their weight (52% females), and feelings of depression (30% males). Feelings of being bullied (20%), and concerns about sex, drugs and alcohol (7-11%) were reported equally frequently by males and females. In contrast to the high levels of health concerns reported, few students also reported seeing someone about them other than parents or friends. This finding appeared consistent across ages and for both sexes with higher rates of seeking help for their physical rather than emotional health concerns. These results show that adolescents across Victoria are reporting high levels of concerns or worries about their health which differ across age and gender. They are more likely to report concerns about emotional health, but less likely to seek professional help than for physical concerns.
Publisher: Wiley
Date: 04-2017
DOI: 10.1111/JPC.13453
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2000
Abstract: Although there is clear evidence of the influence of parental factors on child health outcomes, the influence of parental perceptions of their health and illness on the reporting of child health remains primarily unknown. To examine relationships between parents' reporting of their own health and illness with the reporting of their children's health and illness. We surveyed parents of a representative population-based s le of children aged 5 to 18 years. One parent of each child completed a written questionnaire including the Child Health Questionnaire, a subjective measure of functional health and well-being, and an assessment of self-reported parental health and illness. Logistic regression models were used to examine relationships between parent and child health and illness. 5340 parents responded (86% mothers, 14% fathers). After adjusting for confounding effects, parents self-reporting poor health had increased odds of reporting their children with poor health (odds ratio: 7.5), although the effect was modified by parent gender. There were increased odds of mothers with self-reporting poor global health reporting their children with poor global health and illness (odds ratio: 9.0 and 2.5, respectively) that were not observed for fathers. A mother's self-reported health is strongly associated with her reporting of her child's health this was not observed for fathers. These results suggest that parental gender should be considered as a mediating factor in the reporting of child health.
Publisher: Springer Science and Business Media LLC
Date: 06-2000
Abstract: Childhood obesity is an important, potentially modifiable risk factor for a range of concurrent and later morbidities. Despite concerns about recent increases in children's body mass index (BMI), supporting data in Australia (as elsewhere) are scant. To seek anthropometric evidence of a recent secular increase in BMI in primary school children in Victoria, Australia. Data from two cross-sectional population-based surveys of primary school children (the Victorian subs le of the 1985 Australian Health and Fitness Survey and the 1997 Health of Young Victorians Study) were compared. Similar stratified random s ling and standardized measurement methods were employed in the two studies. Subjects were all children aged 7-12 y with complete height and weight data. Body mass index (BMI (weight/height2)) was used as the index of relative adiposity. Non-parametric and parametric methods were used to examine the pattern and magnitude of change in BMI over the 12 y interval. Data for 1421 children (50% male, 68% response) from the 1985 survey and 2277 children (51% male, 75% response) from the 1997 survey were analysed. At all ages, mean height and median weight were greater in 1997 than 1985 for both boys and girls. Median BMI was significantly higher in the 1997 s le for all but 12 y-old girls and for boys aged 7, 8 and 10 y (Mann-Whitney U test). The magnitude of the overall increase in BMI was estimated using analysis of covariance for log-transformed BMI adjusted for exact age, which indicated an increase of 1.03 kg/m2 for boys and 1.04 kg/m2 for girls (both P<0. 001). Plots of BMI against BMI percentile clearly showed a pattern of higher BMI at any given percentile, especially at the upper percentiles, for all ages and both genders. Primary school children in Victoria have become more obese over the last decade. Increases in BMI are most marked at the heavier end of the distribution. Lesser increases in median and mean BMI (confirmed by both parametric and non-parametric statistical models) may also have major public health implications.
Publisher: BMJ
Date: 04-2004
Abstract: To determine key themes from parents' comments on paths to diagnosis and intervention for their children with hearing loss, following introduction of at-risk neonatal hearing screening and modification of distraction test screening for infants not at-risk. Parents of children born in 1993 in Victoria, Australia, who were eligible for screening via the Victorian Infant Hearing Screening Program and who were subsequently diagnosed with a permanent congenital hearing loss and fitted with hearing aids prior to the year 2000 were asked to complete a semi-structured questionnaire shortly after aid fitting. Two researchers independently analysed parent comments using the constant comparative method. Parents of 82 children (61%) replied to the questionnaire. Themes analysis revealed a generally positive response to neonatal ABR screening, with a mixed response to the distraction test powerful emotions experienced by parents at diagnosis including denial and shock frustration arising from delays in diagnosis, and communication difficulties with providers. Special difficulties testing children with other medical and developmental problems, confusion about tympanostomy tube insertion, and difficulty with wearing hearing aids were also reported. Some children had experienced problems in the school setting. Experience of post-diagnostic services was generally positive. Parents need greater support both during the testing of screen failures and at the time of diagnosis. Providers need more training in how to communicate findings to parents, particularly at times when parents are experiencing strong emotions. Parents need more strategies to enable hearing aid wearing in very young children. Some children with additional medical, developmental, and behavioural problems need specialised approaches to testing.
Publisher: Oxford University Press (OUP)
Date: 14-06-2017
DOI: 10.1093/IJE/DYX079
Publisher: Center for Open Science
Date: 24-02-2023
Abstract: Early identification of language disorders ensures children in need receive support to improve development and quality of life outcomes. This study replicated methods from a previous study, drawing from the Longitudinal Study of Australian Children birth cohort. SuperLearner was used to estimate the accuracy of six parent-reported 24-36-month variables in predicting low 11-year language outcome. Of 5107 children at baseline, complete data was available for 523 (52.20% girls 27, 5.16%, had a low language score). The predictors yielded fair accuracy: 78% sensitivity (95% confidence interval, CI: [58,91]) and 71% specificity (95% CI: [67, 75]). These predictors relate to sentence complexity, vocabulary and behavior. Additional analyses did not improve accuracy. These results have now been replicated across two population-based cohorts.
Publisher: American Academy of Pediatrics (AAP)
Date: 08-2020
Abstract: To examine how overweight and obesity at specific ages and overall BMI growth patterns throughout childhood predict cardiometabolic phenotypes at 11 to 12 years. In a population-based s le of 5107 infants, BMI was measured every 2 years between ages 2 to 3 and 10 to 11 years. We identified 5 BMI trajectories using growth curve models. At ages 11 to 12 years, 1811 children completed assessments for metabolic syndrome risk scores, carotid-femoral pulse wave velocity, and carotid intima-media thickness. Multivariable regression models were used to estimate associations, adjusted for potential confounders (eg, age, sex, smoking exposure, and small for gestational age). Overweight and obesity from early childhood onward were strongly associated with higher cardiometabolic risk at 11 to 12 years of age. At age 6 to 7 years, compared with those with a healthy weight, children with overweight had higher metabolic syndrome risk scores by 0.23 SD units (95% confidence interval 0.05 to 0.41) and with obesity by 0.76 SD units (0.51–1.01), with associations almost doubling by age 10 to 11 years. Obese (but not overweight) children had higher outcome pulse wave velocity (0.64–0.73 SD units) from ages 6 to 7 years and slightly higher outcome carotid intima-media thickness (0.20–0.30 SD units) at all ages. Cumulative exposure to high BMI from 2 to 3 years of age carried the greatest cardiometabolic risk, with a gradient of risk across trajectories. High early-childhood BMI is already silently associated with the development of cardiometabolic risk by 11 to 12 years, highlighting the urgent need for effective action to reduce overweight and obesity in early childhood.
Publisher: Wiley
Date: 26-02-2013
DOI: 10.1111/JPC.12126
Abstract: To explore the link between pre-school children's general home computer use and their letter knowledge. As part of the Early Language in Victoria Study, a community cohort of 1539 four-year-old children was tested on letter knowledge as well as on non-verbal intelligence, oral language, articulation and phonological awareness. Performance on these measures was examined in relation to parent-questionnaire responses exploring home literacy environment and the amount of time children spent using the computer. A positive correlation between computer use and letter knowledge was found, and this association was still evident after controlling for other cognitive and environmental factors known to predict the development of letter knowledge in young children. Greater computer use in pre-school children appears to have a positive association with emerging literacy development. Future research needs to examine the nature of that association.
Publisher: Springer Science and Business Media LLC
Date: 26-02-2008
DOI: 10.1038/IJO.2008.12
Abstract: Though overweight is often established by school entry, not all mothers of such children report weight concerns. Enhancing concern might assist lifestyle change, but could lead to child body dissatisfaction. We investigated (i) perceived/desired body size and body dissatisfaction in mothers and their 6.5-year-old children, and (ii) the impact of earlier maternal concern about overweight on children's body mass index (BMI) status and body dissatisfaction. Prospective community study. Melbourne, Australia. 317 mother-child dyads. Child and maternal BMI (kg m(-2)) at 4.0 and 6.5 years maternal concern about child overweight at 4.0 years. Paired perceived and desired body size on 7-point figural rating scales self-reported by mothers and children, and reported by mothers regarding children dissatisfaction ('desired' minus 'perceived') score. For all three actual BMI perceived size pairings (mother self-report, mother's report on child and child self-report), BMI correlated with perceived body size (r=0.82 (mother self-report) r=0.65 (mother reporting on child) r=0.22 (child self-report) all P<0.001). Similarly, all three dissatisfaction scores were greater with increasing BMI status. Children's own dissatisfaction scores correlated with their actual BMI, but were not related to mothers' own body dissatisfaction scores or with mothers' dissatisfaction with children's body size. Maternal concern about overweight at the age of 4 years was not associated with BMI change, or child body dissatisfaction by the age of 6.5. Most mothers of overweight and obese children (88 and 90%, respectively) regarded their child as the middle figure (that is, 4) or thinner. Despite low rates of recognition of child overweight, maternal perceptions of the child's body correlated strongly with the child's actual BMI. Maternal concerns about child BMI did not appear to impact on child BMI change or child body dissatisfaction.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2009
Publisher: BMJ
Date: 03-09-2009
DOI: 10.1136/BMJ.B3308
Publisher: Wiley
Date: 17-05-2023
DOI: 10.1111/APA.16835
Publisher: BMJ
Date: 2003
DOI: 10.1136/ADC.88.1.20
Abstract: To assess short and longer term parent reported impacts of false positive referrals in the Victorian Infant Hearing Screening Program (VIHSP). Mailed retrospective case-control survey of infants consecutively referred to VIHSP between December 1998 and April 1999 for whom audiology did not confirm permanent hearing loss, comprising 137 infants screened with a neonatal risk factor questionnaire and 148 older infants screened with two consecutive behavioural (distraction) tests. The two control groups comprised non-referred screened infants matched by domicile, age, and gender. Main outcome measures were parent reported emotions experienced before and after child's audiology test, parent estimated impact of hearing loss, the Child Vulnerability Scale, audiology assessment satisfaction questionnaire, and questions relating to their child's hearing and language development. Final s le: at risk cases (AR) 108 (79% response), at risk controls 64 (51%) distraction test cases (DT) 103 (70%), distraction test controls 53 (41%). Parents across all groups believed that hearing loss would have major effects on a child's language (91-96%), schooling (81-91%), and employment opportunities (67-75%). Before audiology, 71% (AR) and 72% (DT) of case parents were anxious/worried, falling to 4% and 15% afterwards. After the test 82% (AR) and 79% (DT) reported relief, but 19% and 18% continued to feel worried. Ongoing concerns about hearing, language, development, and general health were comparable for AR cases compared to controls, and for DT cases compared to controls. Hearing screening tests are generally well received. Parents are realistic about the impact of childhood hearing loss and report a range of negative emotions when a false positive hearing screen requires referral. Although most are reassured by a normal test, a substantial number report continuing concern.
Publisher: Springer Science and Business Media LLC
Date: 29-08-2012
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2018
Abstract: Parents often do not accurately perceive overweight and/or obesity in their children. Changing this is widely considered an essential first step to reducing child overweight, but recent research suggests that, in fact, this could promote greater weight gain. We aimed to determine the directionality over time between higher child adiposity and parental perception of child overweight. Participants were from 2 cohorts of the population-based Longitudinal Study of Australian Children followed biennially since 2004. Repeated measures of BMI z scores and parental perceptions of overweight were available for the kindergarten cohort at 6 waves (ages 4–5, 6–7, 8–9, 10–11, 12–13, and 14–15 years n = 4632) and for the birth cohort at 4 waves (ages 2–3, 4–5, 8–9, and 10–11 years n = 4445). Bidirectionality between overweight perception and BMI z score was examined by using cross-lagged regression models. In both cohorts, wave-on-wave lagged effects were strong (all: P & .001) but much larger from BMI z score to parent perception. For every unit increase in the BMI z score, the odds of a child being perceived as overweight in the next wave ranged from 2.9 (birth cohort: age 2–3 years) to 10.4 (kindergarten cohort: age 6–7 years). These effects were ∼3 to 12 times larger than the reverse, whereby the perception of overweight predicted 0.2 to 0.5 higher BMI z score in the next wave. Higher child BMI z scores strikingly predicted a subsequent parental perception of child overweight. Parent-perceived overweight preceded rising (not falling) BMI, but these effects were small. Clinician efforts to make parents aware of overweight may not be harmful but seem unlikely to improve children’s BMI status.
Publisher: Elsevier BV
Date: 05-2012
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.ACAP.2014.06.021
Abstract: Poor sleep and working memory difficulties are both associated with learning difficulties, but it is not known whether they are linked with each other in childhood. We aimed to determine, in a population-based s le of grade 1 children, whether poor sleep is associated with reduced working memory capacity. Cross-sectional population-based study. All grade 1 children in 44 elementary schools in metropolitan Melbourne, Australia 1749 children were included (participation rate 65%, mean age 6.9 years). Parents completed a written questionnaire at home, after which researchers administered one-on-one child computerized assessments at school. Predictor measures were parent-reported 1) perceptions of poor sleep, 2) regularity of bedtime, 3) sleep duration, and 4) sleep onset latency. Outcome measures were backward digit recall (verbal working memory) and Mister X (visuospatial working memory) subtests of the Automated Working Memory Assessment (AWMA). Associations were examined using linear regression, adjusted for duration of schooling, gender, age, and social status. Increasing poor sleep (P = .03), less regularity of bedtime (P < .001), and shorter sleep duration (P = .03) were all associated with poorer verbal working memory, with effect sizes ranging from 0.3 to 1.2. Poor sleep was not associated with visuospatial working memory. At a population level, poor sleep in early school-age children is associated with poorer verbal working memory, an important predictor of academic difficulties.
Publisher: Elsevier BV
Date: 2023
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020900
Abstract: Nuclear magnetic resonance (NMR) metabolomics is high throughput and cost-effective, with the potential to improve the understanding of disease and risk. We examine the circulating metabolic profile by quantitative NMR metabolomics of a s le of Australian 11–12 year olds children and their parents, describe differences by age and sex, and explore the correlation of metabolites in parent–child dyads. The population-based cross-sectional Child Health CheckPoint study nested within the Longitudinal Study of Australian Children. Blood s les collected from CheckPoint participants at assessment centres in seven Australian cities and eight regional towns February 2015–March 2016. 1180 children and 1325 parents provided a blood s le and had metabolomics data available. This included 1133 parent–child dyads (518 mother–daughter, 469 mother–son, 68 father–daughter and 78 father–son). 228 metabolic measures were obtained for each participant. We focused on 74 biomarkers including amino acid species, lipoprotein subclass measures, lipids, fatty acids, measures related to fatty acid saturation, and composite markers of inflammation and energy homeostasis. We identified differences in the concentration of specific metabolites between childhood and adulthood and in metabolic profiles in children and adults by sex. In general, metabolite concentrations were higher in adults than children and sex differences were larger in adults than in children. Positive correlations were observed for the majority of metabolites including isoleucine (CC 0.33, 95% CI 0.27 to 0.38), total cholesterol (CC 0.30, 95% CI 0.24 to 0.35) and omega 6 fatty acids (CC 0.28, 95% CI 0.23 to 0.34) in parent–child comparisons. We describe the serum metabolite profiles from mid-childhood and adulthood in a population-based s le, together with a parent–child concordance. Differences in profiles by age and sex were observed. These data will be informative for investigation of the childhood origins of adult non-communicable diseases and for comparative studies in other populations.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2012
Abstract: Randomized trials have demonstrated the short- to medium-term effectiveness of behavioral infant sleep interventions. However, concerns persist that they may harm children’s emotional development and subsequent mental health. This study aimed to determine long-term harms and/or benefits of an infant behavioral sleep program at age 6 years on (1) child, (2) child-parent, and (3) maternal outcomes. Three hundred twenty-six children (173 intervention) with parent-reported sleep problems at age 7 months were selected from a population s le of 692 infants recruited from well-child centers. The study was a 5-year follow-up of a population-based cluster-randomized trial. Allocation was concealed and researchers (but not parents) were blinded to group allocation. Behavioral techniques were delivered over 1 to 3 in idual nurse consultations at infant age 8 to 10 months, versus usual care. The main outcomes measured were (1) child mental health, sleep, psychosocial functioning, stress regulation (2) child-parent relationship and (3) maternal mental health and parenting styles. Two hundred twenty-five families (69%) participated. There was no evidence of differences between intervention and control families for any outcome, including (1) children’s emotional (P = .8) and conduct behavior scores (P = .6), sleep problems (9% vs 7%, P = .2), sleep habits score (P = .4), parent- (P = .7) and child-reported (P = .8) psychosocial functioning, chronic stress (29% vs 22%, P = .4) (2) child-parent closeness (P = .1) and conflict (P = .4), global relationship (P = .9), disinhibited attachment (P = .3) and (3) parent depression, anxiety, and stress scores (P = .9) or authoritative parenting (63% vs 59%, P = .5). Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.
Publisher: Oxford University Press (OUP)
Date: 27-02-2019
DOI: 10.1093/IJE/DYZ023
Abstract: Lifelong inflammation – known to be associated with many non-communicable diseases – has not been thoroughly investigated in hearing. We aimed to determine if glycoprotein A (GlycA), a novel biomarker of chronic inflammation, is associated with hearing acuity in mid-childhood and mid-life. Population-based cross-sectional study within the Longitudinal Study of Australian Children with plasma GlycA and audiometry data (1169 children and 1316 parents). We calculated high Fletcher Index (mean threshold across 1, 2 and 4 kHz), defining hearing loss as threshold decibel hearing level (dB HL) (better ear). Linear/logistic regression quantified associations of GlycA with hearing threshold/loss. Mean [standard deviation (SD)] high Fletcher Indices (dB HL) were 8.0 (5.7) for children and 13.1 (6.9) for adults, with 8.7% and 26.1% respectively showing hearing loss. 1-SD rise in GlycA (children 0.13 mmol/L, adults 0.17 mmol/L) predicted higher hearing thresholds for the lower in idual frequencies [1 kHz: children β 0.8, 95% confidence interval (CI) 0.3–1.3 adults β 0.8, 95% CI 0.2–1.4]. This same pattern was evident for the high Fletcher Index (children β 0.7, 95% CI 0.3–1.1 adults β 0.8, 95% CI 0.3–1.4). This translated into 1-SD rise in GlycA predicting adult hearing loss [odds ratio (OR) 1.2, 95% CI 1.0–1.5] with similar but attenuated patterns in children. GlycA is associated with poorer hearing by mid-childhood. This potentially reframes hearing loss as a life-course condition with inflammatory antecedents common to other non-communicable diseases. Replication and mechanistic studies could inform causal inference and early prevention efforts.
Publisher: Public Library of Science (PLoS)
Date: 07-09-2022
DOI: 10.1371/JOURNAL.PONE.0272343
Abstract: Reallocations of time between daily activities such as sleep, sedentary behavior and physical activity are differentially associated with markers of physical, mental and social health. An in idual’s most desirable allocation of time may differ depending on which outcomes they value most, with these outcomes potentially competing with each other for reallocations. We aimed to develop an interactive app that translates how self-selected time reallocations are associated with multiple health measures. We used data from the Australian Child Health CheckPoint study ( n = 1685, 48% female, 11–12 y), with time spent in daily activities derived from a validated 24-h recall instrument, %body fat from bioelectric impedance, psychosocial health from the Pediatric Quality of Life Inventory and academic performance (writing) from national standardized tests. We created a user-interface to the compositional isotemporal substitution model with interactive sliders that can be manipulated to self-select time reallocations between activities. The time-use composition was significantly associated with body fat percentage (F = 2.66, P .001), psychosocial health (F = 4.02, P .001), and academic performance (F = 2.76, P .001). Dragging the sliders on the app shows how self-selected time reallocations are associated with the health measures. For ex le, reallocating 60 minutes from screen time to physical activity was associated with -0.8 [95% CI -1.0 to -0.5] %body fat, +1.9 [1.4 to 2.5] psychosocial score and +4.5 [1.8 to 7.2] academic performance. Our app allows the health associations of time reallocations to be compared against each other. Interactive interfaces provide flexibility in selecting which time reallocations to investigate, and may transform how research findings are disseminated.
Publisher: Wiley
Date: 21-07-2003
DOI: 10.1046/J.1464-5491.2003.00981.X
Abstract: To assess the validity of the Child Health Questionnaire (CHQ) as a screening tool for detecting 'at risk' emotional and behavioural maladjustment in children with diabetes, using the Behaviour Assessment System for Children (BASC) as a gold standard measure. CHQ and BASC were administered to 103 parents of children with Type 1 diabetes, aged 7-12 years. Sub-scales of the two measures were compared using Pearson's bivariate correlations. CHQ sensitivity and specificity cut-points were optimized against the BASC borderline category using receiver operating characteristic curves. The BASC Externalizing Problems scale correlated strongly with CHQ Behaviour, Global Behaviour, Mental Health, Family Activities and Family Cohesion scales (r-values -0.68, -0.54, -0.51, -0.59, and -0.42, respectively). BASC Internalizing Problems scale correlated strongly with CHQ Behaviour, Mental Health and Family Cohesion scales (r-values -0.40, -0.43 and -0.45, respectively). Using receiver operating characteristic curve analysis, the CHQ Mental Health scale most effectively identified children classified as borderline on the BASC Internalizing Problems scale (sensitivity 87%, specificity 78%), while the CHQ Global Behaviour scale most effectively identified children classified as borderline on the BASC Externalizing Problems scale (sensitivity 73%, specificity 82%). Significant correlations were seen between the CHQ Global Behaviour and Mental Health scales and the BASC Externalizing and Internalizing scales, respectively. Sequential use of the CHQ, as a screening tool, followed by an established mental health measure such as the BASC, may help identify children with diabetes 'at risk' for chronic maladjustment and poor health outcomes.
Publisher: Wiley
Date: 09-2005
DOI: 10.1111/J.1440-1754.2005.00689.X
Abstract: Background: General practitioners (GPs) could make an important contribution to management of childhood overweight. However, there are no efficacy data to support this, and the feasibility of this approach is unknown. Objectives: To determine if GPs and families can be recruited to a randomized controlled trial (RCT), and if GPs can successfully deliver an intervention to families with overweight/obese 5‐ to 9‐year‐old children. Methods: A convenience s le of 34 GPs from 29 family medical practices attended training sessions on management of childhood overweight. Practice staff trained in child anthropometry conducted a cross‐sectional body mass index (BMI) survey of 5‐ to 9‐year‐old children attending these practices. The intervention focused on achievable goals in nutrition, physical activity and sedentary behaviour, and was delivered in four solution‐focused behaviour change consultations over 12 weeks. Results: General practitioners were recruited from across the sociodemographic spectrum. All attended at least two of the three education sessions and were retained throughout the trial. Practice staff weighed and measured 2112 children in the BMI survey, of whom 28% were overweight/obese (17.5% overweight, 10.5% obese), with children drawn from all sociodemographic quintiles. Of the eligible overweight/obese children, 163 (40%) were recruited and retained in the LEAP RCT 96% of intervention families attended at least their first consultation. Conclusions: Many families are willing to tackle childhood overweight with their GP. In addition, GPs and families can participate successfully in the careful trials that are needed to determine whether an in idualized, family‐based primary care approach is beneficial, harmful or ineffective.
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2007
Abstract: OBJECTIVE. The purpose of this work was to determine relationships between BMI status at ages 4 to 5 years and mothers' and fathers' parenting dimensions and parenting styles. PARTICIPANTS AND METHODS. Participants were composed of all 4983 of the 4- to 5-year-old children in wave 1 of the nationally representative Longitudinal Study of Australian Children with complete BMI and maternal parenting data. Mothers and fathers self-reported their parenting behaviors on 3 multi-item continuous scales (warmth, control, and irritability) and were each categorized as having 1 of 4 parenting styles (authoritative, authoritarian, permissive, and disengaged) using internal warmth and control tertile cut points. Using a proportional odds model, odds ratios for children being in a higher BMI category were computed for mothers and fathers separately and together, after adjustment for factors associated with child BMI, including mothers' and fathers' BMI status. RESULTS. The s le was composed of 2537 boys and 2446 girls with a mean age 56.9 months 15% were overweight and 5% were obese (International Obesity Task Force criteria). Mothers' parenting behaviors and styles were not associated in any model with higher odds of children being in a heavier BMI category, with or without multiple imputation to account for missing maternal BMI data. Higher father control scores were associated with lower odds of the child being in a higher BMI category. Compared with the reference authoritative style, children of fathers with permissive and disengaged parenting styles had higher odds of being in a higher BMI category. CONCLUSIONS. This article is the first, to our knowledge, to examine the parenting of both parents in relation to preschoolers' BMI status while also adjusting for parental BMI status. Fathers' but not mothers' parenting behaviors and styles were associated with increased risks of preschooler overweight and obesity. Longitudinal impacts of parenting on BMI gain remain to be determined.
Publisher: American Academy of Pediatrics (AAP)
Date: 07-2017
Abstract: To describe 24-hour time-use patterns and their association with health-related quality of life (HRQoL) in early adolescence. The Child Health CheckPoint was a cross-sectional study nested between Waves 6 and 7 of the Longitudinal Study of Australian Children. The participants were 1455 11- to 12-year-olds (39% of Wave 6 51% boys). The exposure was 24-hour time use measured across 259 activities using the Multimedia Activity Recall for Children and Adolescents. “Average” days were generated from 1 school and 1 nonschool day. Time-use clusters were derived from cluster analysis with compositional inputs. The outcomes were self-reported HRQoL (Physical and Psychosocial Health [PedsQL] summary scores Child Health Utility 9D [CHU9D] health utility). Four time-use clusters emerged: “studious actives” (22% highest school-related time, low screen time), “techno-actives” (33% highest physical activity, lowest school-related time), “stay home screenies” (23% highest screen time, lowest passive transport), and “potterers” (21% low physical activity). Linear regression models, adjusted for a priori confounders, showed that compared with the healthiest “studious actives” (mean [SD]: CHU9D 0.84 [0.14], PedsQL physical 86.8 [10.8], PedsQL psychosocial 79.9 [12.6]), HRQoL in “potterers” was 0.2 to 0.5 SDs lower (mean differences [95% confidence interval]: CHU9D −0.03 [−0.05 to −0.00], PedsQL physical −5.5 [−7.4 to −3.5], PedsQL psychosocial −5.8 [−8.0 to −3.5]). Discrete time-use patterns exist in Australian young adolescents. The cluster characterized by low physical activity and moderate screen time was associated with the lowest HRQoL. Whether this pattern translates into precursors of noncommunicable diseases remains to be determined.
Publisher: BMJ
Date: 04-2014
DOI: 10.1136/BMJ.G2107
Publisher: MDPI AG
Date: 07-04-2021
Abstract: Health registries are critical to understanding, benchmarking and improving quality of care for specific diseases and conditions, but face hurdles including funding, bias towards clinical rather than population s les, lack of pre-morbid and outcomes data, and absent cross-registry harmonisation and coordination. Children are particularly under-represented in registry research. This paper lays out novel principles, methods and governance to integrate erse registries within or alongside a planned children’s mega-cohort to rapidly generate translatable evidence. GenV (Generation Victoria) will approach for recruitment parents of all newborns (estimated 150,000) over two years from mid-2021 in the state of Victoria (population 6.5 million), Australia. Its s le size and population denominator mean it will contain almost all children with uncommon or co-morbid conditions as they emerge over time. By design, it will include linked datasets, bios les (including from pregnancy), phenotypes and participant-reported measures, all of which will span pre-morbid to long-term outcomes. We provide a vignette of a planned new registry for high-risk pregnancies to illustrate the possibilities. To our knowledge, this is the first paper to describe such a methodology designed prospectively to enhance both the clinical relevance of a large multipurpose cohort and the value and inclusivity of registries in a population.
Publisher: Elsevier BV
Date: 07-2020
DOI: 10.1093/CDN/NZAA103
Publisher: BMJ
Date: 02-10-2018
DOI: 10.1136/ARCHDISCHILD-2018-315628
Abstract: Chronic conditions are the leading cause of mortality, morbidity and disability in children. However, children and caregivers are rarely involved in identifying research priorities, which may limit the value of research in supporting patient-centred practice and policy. To identify priorities of patients, caregivers and health professionals for research in childhood chronic conditions and describe the reason for their choices. An Australian paediatric hospital and health consumer organisations. Recruited participants (n=73) included patients aged 8 to 14 years with a chronic condition (n=3), parents/caregivers of children aged 0 to 18 years with a chronic condition (n=19), representatives from consumer organisations (n=13) and health professionals including clinicians, researches (n=38) identified and discussed research priorities. Transcripts were thematically analysed. Seventy-eight research questions were identified. Five themes underpinned participants’ priorities: maintaining a sense of normality (enabling participation in school, supporting social functioning, promoting understanding and acceptance), empowering self-management and partnership in care (overcoming communication barriers, gaining knowledge and skills, motivation for treatment adherence, making informed decisions, access and understanding of complementary and alternative therapies),strengthening ability to cope (learning to have a positive outlook, preparing for home care management, transitioning to adult services), broadening focus to family (supporting sibling well-being, parental resilience and financial loss, alleviating caregiver burden), and improving quality and scope of health and social care (readdressing variability and inequities, preventing disease complications and treatment side effects, identifying risk factors, improving long-term outcomes, harnessing technology, integrating multidisciplinary services). Research priorities identified by children, caregivers and health professionals emphasise a focus on life participation, psychosocial well-being, impact on family and quality of care. These priorities may be used by funding and policy organisations in establishing a paediatric research agenda.
Publisher: BMJ
Date: 03-2005
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/17477160701408783
Abstract: The level of body fat mass (BFM) in childhood that is associated with weight related morbidity is unclear. Bioelectrical impedance analysis (BIA) offers an inexpensive, acceptable and portable method for measuring body composition in children. However, different equations have been derived to estimate BFM, and relationships between equations have not been explored. To compare body mass index (BMI) and BIA as tools for estimating adiposity-related health risks in children. Height, weight and BIA were measured in a population based cross-sectional survey of 341 healthy 5-year-old Australian children. Percent BFM was estimated using four published BIA-based predictive equations for pre-school children. Ranking of children according to total BFM was compared for all equations. Each equation produced different estimates of percent BFM. In general, increasing BMI was associated with increasing BFM, but wide ranges of BFM estimates were produced for children of similar BMI. For all of the equations, females had a higher percent BFM compared with males of the same BMI (p<0.001). Percent BFM estimates rose rapidly in children classified as overweight/obese (1990 UK growth standard). The equations were highly correlated in their ranking of children from lowest to highest percent BFM. Results support concerns about the validity of BMI as an accurate measure of absolute BFM. Percent BFM estimates produced by the four BIA equations were highly correlated, indicating they rank children according to BFM in the same order. This suggests any single equation could provide a measure of relative BFM in children for population and longitudinal studies.
Publisher: Wiley
Date: 04-2007
DOI: 10.1111/J.1440-1754.2007.01056.X
Abstract: (i) To determine prevalence and rates of detection of overweight/obesity among general paediatric inpatients. (ii) To explore parental expectations regarding detection and management of overweight/obesity during admission. This is a cross-sectional survey conducted in the Royal Children's Hospital, Melbourne, Australia. A total of 102 children aged 2-12 years admitted to a general paediatric unit at the Royal Children's Hospital and their parents participated in the survey. The main outcome measures are body mass index (BMI) documentation of weight, height and BMI in patient notes parent description of child's weight, parent concern about child's weight, and parent opinion about detection and management of overweight. Twelve of 102 children (11.7%, 95% confidence intervals 6.2%, 19.7%) were overweight or obese. All children had a documented weight, two children (2.0%) had a documented height and none had BMI documented. Seven of 12 parents of overweight children described their child's weight as healthy five of 12 parents of overweight children were not concerned about their child's weight. Eight of 12 parents of overweight children believed all admitted children should have their BMI calculated. All parents thought the hospital should take action if a child was found to be overweight. Although prevalence of overweight was lower than expected, documentation of overweight did not occur for any patient in the study. Parents of overweight children with acute illnesses believed that the hospital should screen for overweight and discuss it with parents. Further studies are required to determine expectations among other patient populations.
Publisher: BMJ
Date: 12-2015
Publisher: Oxford University Press (OUP)
Date: 25-11-2021
Abstract: To investigate relationships between takeaway food and sugar-sweetened beverage (SSB) consumption with cardiometabolic phenotypes during childhood and mid-adulthood. Design: Cross-sectional Child Health CheckPoint within the national population-representative Longitudinal Study of Australian Children. Participants: 1838 children (mean age 11.5 years 49.1% female) and 1846 adults (mean age 43.7 years 87.6% female). Exposures: Self-reported takeaway food and SSB consumption (‘frequent’: ≥ weekly). Outcomes: Functional (pulse wave velocity (PWV), blood pressure (BP)) and structural (carotid intima-media thickness, retinal microvascular calibre) preclinical cardiovascular phenotypes lipids (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides). Analysis: Linear regression (exposure: takeaway or SSB consumption, in idually or together) adjusted for age, sex and socio-economic position and mediation analysis for body mass index (BMI). Associations were small among children (standardized mean difference (SMD) ≤0.15). In adults, associations were stronger with functional, but not structural, cardiovascular phenotypes and lipids, particularly for frequent takeaway food consumption (e.g. PWV (0.20 m/s 95% confidence interval (CI) 0.03 to 0.37) systolic (3.3 mmHg 95% CI 1.3 to 5.3) and diastolic BP (1.4 mmHg 95% CI 0.2 to 2.6) LDL (0.10 mmol/L 95% CI 0.02 to 0.18) HDL (−0.14 mmol/L 95% CI −0.19 to −0.10) and triglycerides (0.30 mmol/L 95% CI 0.12 to 0.48)]. BMI mediated associations between takeaway food consumption and PWV, BP, HDL and TG (proportion of mediation 34% to 75%), while mediation effects were smaller for SSB consumption. Frequent takeaway food consumption in adults was associated with adverse blood lipids and vascular function (mainly via BMI). Lack of strong associations in children highlights opportunities for prevention.
Publisher: Public Library of Science (PLoS)
Date: 19-01-2021
DOI: 10.1371/JOURNAL.PONE.0245501
Abstract: Daily time spent on one activity cannot change without compensatory changes in others, which themselves may impact on health outcomes. Optimal daily activity combinations may differ across outcomes. We estimated optimal daily activity durations for the highest fitness and lowest adiposity. Cross-sectional Child Health CheckPoint data (1182 11-12-year-olds 51% boys) from the population-based Longitudinal Study of Australian Children were used. Daily activity composition (sleep, sedentary time, light physical activity [LPA], moderate-to-vigorous physical activity [MVPA]) was from 8-day, 24-hour accelerometry. We created composite outcomes for fitness (VO 2max standing long jump) and adiposity (waist-to-height ratio body mass index fat-to-fat-free log-ratio). Adjusted compositional models regressed activity log-ratios against each outcome. Best activity compositions ( optimal time-use zones ) were plotted in quaternary tetrahedrons the overall optimal time-use composition was the center of the overlapping area. Time-use composition was associated with fitness and adiposity (all measures p .001). Optimal time use differed for fitness and adiposity. While both maximized MVPA and minimized sedentary time, optimal fitness days had higher LPA (3.4 h) and shorter sleep (8.25 h), but optimal adiposity days had lower LPA (1.0 h) and longer sleep (10.9 h). Balancing both outcomes, the overall optimal time-use composition was (mean [range]): 10.2 [9.5 10.5] h sleep, 9.9 [8.8 11.2] h sedentary time, 2.4 [1.8 3.2] h LPA and 1.5 [1.5 1.5] h MVPA. Optimal time use for children’s fitness and adiposity involves trade-offs. To best balance both outcomes, estimated activity durations for sleep and LPA align with, but for MVPA exceed, 24-h guidelines.
Publisher: Oxford University Press (OUP)
Date: 09-2000
Abstract: To improve the ability to describe and compare child health within and between countries, using standardized multidimensional child health measures. Data on population-specific psychometrics, the measurement structure, and norms are a vital prerequisite. These properties for the Child Health Questionnaire (CHQ) were examined for an Australian population and compared with the originating U.S. data. The CHQ 50-item parent-report was completed by 5,414 parents of children aged 5-18 years. Multi-item/multi-trait analysis tested convergent and discriminatory validity. Construct validity, test-retest reliability, comparative population mean scale scores, and the summary score factor structure were examined. Item and scale internal consistency and item discriminant validity results were good to excellent, and construct (concurrent) validity was supported. Australian children had higher scores than U.S. children except for Family Activities and Physical Functioning. The factor structure of the two summary scores for American children was not replicated in the normative s le but held for a subs le of children with one or more health conditions. The CHQ PF50 performed well in Australia at item and scale level. However, the physical and psychosocial summary scores are not supported for population-level analyses but may be of value for sub-groups of children with health problems.
Publisher: Springer Science and Business Media LLC
Date: 19-11-2019
DOI: 10.1007/S11136-019-02357-9
Abstract: The Paediatric Quality of Life Inventory To develop a mapping algorithm for converting the 23-item PedsQL instrument onto the CHU9D instrument and provide an external validation of two recently published algorithms that might be considered alternatives. Data from children in the Longitudinal Study of Australian Children (LSAC) were used (N = 1801). Six econometric methods were compared to identify the best algorithms, assessed against a series of goodness-of-fit criteria. The same data and goodness-of-fit criteria were used in the external validation exercise for previously published mapping algorithms. The optimal mapping algorithm was identified, which used PedsQL dimension scores to predict the CHU9D utilities. It performed well against standard goodness-of-fit tests. The external validation exercise revealed the recently published alternative algorithms also performed relatively well. The identified mapping algorithms can be used to facilitate cost-utility analysis in comparable populations when only the PedsQL instrument is available. Results from this population indicate the algorithms identified in this paper are well suited for estimating CHU9D self-report utilities when the full 23-item self-report PedsQL instrument has been used.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-11-2021
DOI: 10.1097/AUD.0000000000001153
Abstract: Hearing loss is one of the most prevalent congenital disorders among children. Many countries have implemented universal newborn hearing screening (UNHS) for the early diagnosis and treatment of hearing loss. Despite widespread implementation, the value for money of UNHS is unclear due to lack of cost and outcomes data from rigorous study designs. The objective of this research is to conduct a within-study cost-effectiveness analysis of UNHS compared with targeted screening (targeting children with risk factors of hearing loss) from the Australian healthcare system perspective. This evaluation is the first economic evaluation to assess the cost-effectiveness of UNHS compared to targeted screening using real-world data from a natural experiment. The evaluation assumed the Australian healthcare system perspective and considered a time horizon of 5 years. Utilities were estimated using responses to the Health Utilities Index Mark III. Screening costs were estimated based on the Victorian Infant Hearing Screening Program. Ongoing costs were estimated based on administrative data, while external data sources were used to estimate costs related to hearing services. Missing data were handled using the multiple imputation method. Outcome measures included quality-adjusted life years (QALYs) and four language and communication-related outcomes: Peabody Picture Vocabulary Test, Wechsler Nonverbal Scale of Ability, Progressive Achievement Test, and comprehensive, expressive, and total language scores based on the Preschool Language Scale. On average, the UNHS cost an extra Australian dollar (A$)22,000 per diagnosed child and was associated with 0.45 more QALYs per diagnosed child compared with targeted screening to 5 years, resulting in an incremental cost-effectiveness ratio (ICER) of A$48,000 per QALY gained. The ICERs for language outcomes lay between A$3,900 (for expressive language score) and A$83,500 per one-point improvement in language score (for Wechsler Nonverbal Scale of Ability). UNHS had a 69% probability of being more cost-effective compared to targeted screening at a willingness to pay threshold of A$60,000 per QALY gained. ICERs were most sensitive to the screening costs. The evaluation demonstrated the usefulness of a within-study economic evaluation to understand the value for money of the UNHS program in the Australian context. Findings from this evaluation suggested that screening costs were the key driver of cost-effectiveness results. Most outcomes were not significantly different between UNHS and targeted screening groups. The ICER may be overestimated due to the short follow-up period. Further research is warranted to include long-term resource use and outcome data, late diagnosis, transition and remission between severity levels, and timing of diagnosis and treatment.
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.EHB.2008.06.001
Abstract: To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children. The intervention was modelled on the LEAP (live, eat and play) trial, a randomised controlled trial conducted by the Centre for Community Child Health, Melbourne, Australia in 2002-2003. This study was undertaken as part of the assessing cost-effectiveness (ACE) in obesity project which evaluated, using consistent methods, 13 interventions targeting unhealthy weight gain in children and adolescents. A logic pathway was used to model the effects of the intervention compared to no intervention on body mass index (BMI) and health outcomes (disability-adjusted life years-DALYs). Disease costs and health benefits were tracked until the cohort of eligible children reached the age of 100 years or death. Simulation-modelling techniques were used to present a 95% uncertainty interval around the cost-effectiveness ratio. The intervention was also assessed against a series of filters ('equity', 'strength of evidence', 'acceptability', 'feasibility', sustainability' and 'side-effects') to incorporate additional factors that impact on resource allocation decisions. The intervention, as modelled, reached 9685 children aged 5-9 years with a BMI z-score of >or=3.0, and cost $AUD6.3M (or $AUD4.8M excluding time costs). It resulted in an incremental saving of 2300 BMI units which translated to 511 DALYs. The cost-offsets stemming from the intervention totalled $AUD3.6M, resulting in a net cost per DALY saved of $AUD4670 (dominated $0.1M) (dominated means intervention costs more for less effect). Compared to a 'no intervention' control group, the intervention was cost-effective under current assumptions, although the uncertainty intervals were wide. A key question related to the long-term sustainability of the small incremental weight loss reported, based on the 9-month follow-up results for LEAP.
Publisher: BMJ
Date: 22-03-2007
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.3109/17477166.2010.526226
Abstract: To determine longitudinal relationships between body mass index (BMI) and health-related quality of life (HRQoL) in an adolescent population s le. Design. Data collected in 2000 and 2005 within the Health of Young Victorians longitudinal cohort study. Originally a community s le of elementary school students in Victoria, Australia. Follow-up occurred in either secondary schools or in iduals homes. Cohort recruited in 1997 via a random s ling design from Victorian elementary schools. Originally comprising 1 943 children, 1 569 (80.8%) participated in 2000 (wave 2, 8-13 years) and 851 (54%) in 2005 (wave 3, 13-19 years). Main outcome measures. In both waves participants and their parents completed the PedsQL, a 23-item child HRQoL measure, and BMI z-scores and status (non-overweight, overweight or obese) were calculated from measured height and weight. Associations were tested cross-sectionally and longitudinally (linear regression, adjusted for baseline values) A total of 81.6% remained in the same BMI category, while 11.4% and 7.0% moved to higher and lower categories, respectively. Cross-sectional inverse associations between lower PedsQL and higher BMI categories were similar to those for elementary school children. Wave 2 BMI strongly predicted wave 3 BMI and wave 2 PedsQL strongly predicted wave 3 PedsQL. Only parent-reported Total PedsQL score predicted higher subsequent BMI, though this effect was small. Wave 2 BMI did not predict wave 3 PedsQL. This novel study confirmed previous cross-sectional associations, but did not provide convincing evidence that BMI is causally associated with falling HRQoL or vice versa across the transition from childhood to adolescence.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2011
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.JACI.2015.05.051
Abstract: There is evolving evidence that vitamin D insufficiency may contribute to food allergy, but findings vary between populations. Lower vitamin D-binding protein (DBP) levels increase the biological availability of serum vitamin D. Genetic polymorphisms explain almost 80% of the variation in binding protein levels. We sought to investigate whether polymorphisms that lower the DBP could compensate for adverse effects of low serum vitamin D on food allergy risk. From a population-based cohort study (n = 5276) we investigated the association between serum 25-hydroxyvitamin D3 (25[OH]D3) levels and food allergy at age 1 year (338 challenge-proven food-allergic and 269 control participants) and age 2 years (55 participants with persistent and 50 participants with resolved food allergy). 25(OH)D3 levels were measured using liquid chromatography-tandem mass spectrometry and adjusted for season of blood draw. Analyses were stratified by genotype at rs7041 as a proxy marker of DBP levels (low, the GT/TT genotype high, the GG genotype). Low serum 25(OH)D3 level (≤50 nM/L) at age 1 years was associated with food allergy, particularly among infants with the GG genotype (odds ratio [OR], 6.0 95% CI, 0.9-38.9) but not in those with GT/TT genotypes (OR, 0.7 95% CI, 0.2-2.0 P interaction = .014). Maternal antenatal vitamin D supplementation was associated with less food allergy, particularly in infants with the GT/TT genotype (OR, 0.10 95% CI, 0.03-0.41). Persistent vitamin D insufficiency increased the likelihood of persistent food allergy (OR, 12.6 95% CI, 1.5-106.6), particularly in those with the GG genotype. Polymorphisms associated with lower DBP level attenuated the association between low serum 25(OH)D3 level and food allergy, consistent with greater vitamin D bioavailability in those with a lower DBP level. This increases the biological plausibility of a role for vitamin D in the development of food allergy.
Publisher: BMJ
Date: 10-2013
Publisher: Wiley
Date: 14-06-2017
DOI: 10.1111/CCH.12477
Abstract: Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5-8 years with congenital mild-moderate hearing loss (ii) determine whether age of detection predicts outcomes and (iii) compare outcomes between children identified via well-established UNHS and the general population. Linear regression adjusted for potential confounding factors was used throughout. Via a quasi-experimental design, language and psychosocial outcomes were compared across four population-based Australian systems of hearing loss detection: opportunistic detection, born 1991-1993, n = 50 universal risk factor referral, born 2003-2005, n = 34 newly established UNHS, born 2003-2005, n = 41 and well-established UNHS, born 2007-2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well-established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217. Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild-moderate losses exposed to well-established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference -8.9 points, 95% CI -14.7 to -3.1). Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing losses. However, rigorous trials are needed to quantify benefits, versus costs and potential harms, of early aiding of children with mild losses.
Publisher: Informa UK Limited
Date: 12-2007
Publisher: Cambridge University Press (CUP)
Date: 30-10-2018
DOI: 10.1017/S0007114518003173
Abstract: This study investigates how dietary patterns and scores are associated with subsequent BMI and waist:height ratio (WHtR), and how BMI and WHtR are associated with subsequent dietary patterns or scores, from 2–3 to 10–11 and 4–5 to 14–15 years of age. In the Longitudinal Study of Australian Children, height, weight and waist circumference were measured biennially in children, yielding BMI z -score and WHtR. Parents, latterly children, reported frequency of child consumption of 12–16 food/drink items during the previous 24 h. At each wave, we empirically derived dietary patterns using factor analyses, and dietary scores based on the 2013 Australian Dietary Guidelines. We used structural-equation modelling to investigate cross-lagged associations ( n 1972–2882) between diet and body composition measures in univariable and multivariable analyses. Dietary scores atterns did not consistently predict WHtR and BMI z -score in the next wave, nor did BMI z -score and WHtR consistently predict diet in the next wave. The few associations seen were weak and often in the opposite direction to that hypothesised. The largest effect, associated with each standard deviation increase in BMI in wave 5 of the K cohort (age 12–13 years), was a 0·06 standard deviation estimated mean increase in dietary score (higher quality diet) in the subsequent wave (95 % CI 0·02, 0·11, P =0·003). Associations between dietary patterns/scores and body composition were not strongly evident in either direction. Better quantitative childhood dietary tools feasible for large-scale administration are needed to quantify how dietary patterns, energy intake and anthropometry co-develop.
Publisher: Elsevier BV
Date: 04-2001
DOI: 10.1111/J.1753-6405.2001.TB01840.X
Abstract: To determine the population prevalence of overweight and obesity among Australian children and adolescents, based on measured body mass index (BMI). To determine if overweight and obesity are distributed differentially across the population of young Australians. Data from three independent surveys were analysed. In each, height and weight were measured by trained surveyors using valid, comparable methods. BMI (kg/m2) was used as the index of adiposity and recently published international BMI cut-off values used to categorise each subject as non-overweight, overweight or obese. The population prevalence and distribution of overweight, obesity and overweight/obesity combined were generally consistent across datasets. The ranges of the prevalence of non-overweight, overweight, obesity and overweight/obesity combined were 79-81%, 14-16%, 5% and 19-21% (boys) respectively and 76-79%, 16-18%, 5-6% and 21-24% (girls). There were no consistent relationships between the prevalence of overweight/obesity and sex, age or SES. Their prevalence was up to 4% higher in urban than rural areas among boys, but there were no differences between urban and rural girls. The data suggest a higher prevalence of overweight/ obesity among students from European or Middle-Eastern cultural backgrounds. Some 19-23% of Australian children and adolescents are either overweight or obese. Although urban/rural, SES and cultural background differentials were noted, only the last warrants a targeted health promotion response. Overweight/obesity is a prevalent health risk factor among Australian children and adolescents. More information is needed to understand whether targeted approaches are required for specific ethnic groups in addition to broad, population-based approaches.
Publisher: Wiley
Date: 07-12-2022
DOI: 10.1111/JCPP.13733
Abstract: Language is foundational for neurodevelopment and quality of life, but an estimated 10% of children have a language disorder at age 5. Many children shift between classifications of typical and low language if assessed at multiple times in the early years, making it difficult to identify which children will have persisting difficulties and benefit most from support. This study aims to identify a parsimonious set of preschool indicators that predict language outcomes in late childhood, using data from the population‐based Early Language in Victoria Study ( n = 839). Parents completed surveys about their children at ages 8, 12, 24, and 36 months. At 11 years, children were assessed using the Clinical Evaluation of Language Fundamentals 4th Edition (CELF‐4). We used random forests to identify which of the 1990 parent‐reported questions best predict children's 11‐year language outcome (CELF‐4 score ≤81 representing low language) and used SuperLearner to estimate the accuracy of the constrained sets of questions. At 24 months, seven predictors relating to vocabulary, symbolic play, pragmatics and behavior yielded 73% sensitivity (95% CI: 57, 85) and 77% specificity (95% CI: 74, 80) for predicting low language at 11 years. [Corrections made on 5 May 2023, after first online publication: In the preceding sentence ‘motor skills’ has been corrected to ‘behavior’ in this version.] At 36 months, 7 predictors relating to morphosyntax, vocabulary, parent–child interactions, and parental stress yielded 75% sensitivity (95% CI: 58, 88) and 85% specificity (95% CI: 81, 87). Measures at 8 and 12 months yielded unsatisfactory accuracy. We identified two short sets of questions that predict language outcomes at age 11 with fair accuracy. Future research should seek to replicate results in a separate cohort.
Publisher: BMJ
Date: 06-2008
Abstract: To determine relationships between body mass index (BMI) status and indicators of health and morbidity in a nationally-representative population s le of preschool children. Data from the 4-5-year-old cohort in the first wave (2004) of the Longitudinal Study of Australian Children were studied. Main outcome measures were: measured child BMI, categorised as non-overweight, overweight and obese using International Obesity TaskForce cutpoints parent-reported child global health, health-related quality of life, mental health problems, asthma, sleep problems, injuries, special health care needs, and level of parental concern about the child's weight. Regression methods were used to assess associations with child's BMI status, adjusted for sociodemographic factors. BMI was available for 4934 (99%) children 756 (15.3%) were overweight and 258 (5.2%) obese. Compared to non-overweight children, parents of overweight and obese children reported a higher prevalence of special health care needs (adj OR 1.72, 95% CI 1.20 to 2.46), but other health outcomes were similar. Parental concern about the child's weight was low among the overweight (14.4%) and non-overweight (17.8%) children, but rose to 52.7% in the obese. However, parental concern was unrelated to any of the specific health problems studied. Despite a high prevalence of overweight/obesity, parents of overweight and obese children reported relatively few additional health burdens over and above those of the non-overweight preschoolers. These findings may shed light on the disparity between strong public concern and parents' expressed lack of concern about overweight/obesity in their own children around the time of school entry.
Publisher: Informa UK Limited
Date: 13-10-2019
DOI: 10.1080/02640414.2018.1523672
Abstract: Previous data have indicated relative stability over time of paediatric jumping performance, but few data exist since the early 2000s. This study quantified the 30-year secular changes in jumping performance of Australian children aged 11-12-years using data from the Australian Schools Health and Fitness Survey (1985, n = 1967) and Growing Up in Australia's Child Health CheckPoint (2015, n = 1765). Both cohorts measured jumping performance (standing long jump distance), anthropometric and demographic data. Secular changes in jumping performance means and quantiles were examined using multivariable linear and quantile regression. Between 1985 and 2015, jumping performance declined by 16.4 cm or by 11.2% (standardised change 0.66 SD, 95%CI 0.60 to 0.73). Adjustment for body mass reduced the effect by 32%, although the decline remained (absolute change - 11.1 cm, 95%CI -12.5 to -9.7 percent change 7.7%, 95%CI 6.7 to 8.6 standardised change 0.51 SD, 95%CI 0.44 to 0.57). This decline was evident across all quantiles. The jumping performance of Australian children aged 11-12-years has declined between 1985 and 2015, with body mass changes accounting for only part of the decline. Efforts should continue to promote paediatric muscular fitness, reduce adiposity, and aim to reverse this decline in jumping performance.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2003
Abstract: Objectives. In a community s le of children aged 3 to 4 years with previous infant sleep problems, we aimed to 1) establish proportions with recurring, persisting, and resolving sleep problems 2) identify early predictors of later sleep problems and 3) identify comorbidities of persistent or recurrent sleep problems at age 3 to 4 years. Methods. A follow-up community survey was conducted of mothers of children aged 3 to 4 years who had, as 8- to 10-month-old infants with identified sleep problems, participated in a community-based, randomized, controlled trial of a brief sleep intervention from 3 middle-class local government areas in Melbourne, Australia. Infant sleep problems (standardized maternal questionnaire), maternal well-being (Edinburgh Postnatal Depression Scale), child behavior problems (Child Behavior Check List for ages 1.5 to 5 years), marital satisfaction (Dyadic Adjustment Scale), and family functioning (General Functioning Scale, McMaster Family Assessment Device) were measured. Results. Seventy-three percent (114 of 156) of mothers responded, 36 (32%) of whom reported a current problem with their child’s sleep. Current sleep problems were similar regardless of infant sleep intervention. Twelve percent (14 of 114) reported that their child’s sleep problem had persisted, and 19% (21 of 113) reported that it had recurred. Children with current sleep problems were more likely still to be nursed to sleep by an adult and had slightly higher mean scores on Child Behavior Check List subscales for Aggressive Behavior (54 vs 52) and Somatic Problems (55 vs 53). Their mothers had higher Edinburgh Postnatal Depression Scale scores (median: 8 vs 5) and more difficulties with their partner undermining the management of their child. However, early depression did not predict current sleep problems. Families of children with sleep problems were functioning as well as those without sleep problems. Conclusions. Persistence or recurrence of infant sleep problems in the preschool years is common and is associated with slightly higher child behavior problems and maternal depression scores. Results suggest that depressive symptoms are a result rather than cause of sleep problems. Despite this, families of children with sleep problems are functioning well.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-06-2019
Abstract: Telomere length has been inversely associated with cardiovascular disease in adulthood, but its relationship to preclinical cardiovascular phenotypes across the life course remains unclear. We investigated associations of telomere length with vascular structure and function in children and midlife adults. Population‐based cross‐sectional CheckPoint (Child Health CheckPoint) study of 11‐ to 12‐year‐old children and their parents, nested within the LSAC (Longitudinal Study of Australian Children). Telomere length (telomeric genomic DNA [T]/β‐globin single‐copy gene [S] [T/S ratio]) was measured by quantitative polymerase chain reaction from blood‐derived genomic DNA. Vascular structure was assessed by carotid intima‐media thickness, and vascular function was assessed by carotid‐femoral pulse‐wave velocity and carotid elasticity. Mean (SD) T/S ratio was 1.09 (0.55) in children (n=1206 51% girls) and 0.81 (0.38) in adults (n=1343 87% women). Linear regression models, adjusted for potential confounders, revealed no evidence of an association between T/S ratio and carotid intima‐media thickness, carotid‐femoral pulse‐wave velocity, or carotid elasticity in children. In adults, longer telomeres were associated with greater carotid elasticity (0.14% per 10–mm Hg higher per unit of T/S ratio 95% CI, 0.04%–0.2% P =0.007), but not carotid intima‐media thickness (−0.9 μm 95% CI, −14 to 13 μm P =0.9) or carotid‐femoral pulse‐wave velocity (−0.10 m/s 95% CI, −0.3 to 0.07 m/s P =0.2). In logistic regression analysis, telomere length did not predict poorer vascular measures at either age. In midlife adults, but not children, there was some evidence that telomere length was associated with vascular elasticity but not thickness. Associations between telomere length and cardiovascular phenotypes may become more evident in later life, with advancing pathological changes.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-023698
Abstract: Overweight and obesity remain at historically high levels, cluster within families and are established risk factors for multiple diseases. We describe the epidemiology and cross-generational concordance of body composition among Australian children aged 11–12 years and their parents. The population-based cross-sectional Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children (LSAC). Assessment centres in seven major Australian cities and eight regional cities, or home visits February 2015–March 2016. Of all participating CheckPoint families (n=1874), body composition data were available for 1872 children (49% girls) and 1852 parents (mean age 43.7 years 88% mothers), including 1830 biological parent-child pairs. Height, weight, body mass index (BMI), waist circumference and waist-to-height ratio for all participants body fat and fat-free mass by four-limb bioimpedence analysis (BIA) at assessment centres, or body fat percentage by two-limb BIA at home visits. Analysis: parent-child concordance was assessed using (i) Pearson’s correlation coefficients, and (ii) partial correlation coefficients adjusted for age, sex and socioeconomic disadvantage. Survey weights and methods accounted for LSAC’s complex s le design. 20.7% of children were overweight and 6.2% obese, as were 33.5% and 31.6% of parents. Boys and girls showed similar distributions for all body composition measures but, despite similar BMI and waist-to-height ratio, mothers had higher proportions of total and truncal fat than fathers. Parent-child partial correlations were greatest for height (0.37, 95% CI 0.33 to 0.42). Other anthropometric and fat/lean measures showed strikingly similar partial correlations, ranging from 0.25 (95% CI 0.20 to 0.29) for waist circumference to 0.30 (95% CI 0.25 to 0.34) for fat-free percentage. Whole-s le and sex-specific percentile values are provided for all measures. Excess adiposity remains prevalent in Australian children and parents. Moderate cross-generational concordance across all measures of leanness and adiposity is already evident by late childhood.
Publisher: Cambridge University Press (CUP)
Date: 21-03-2018
DOI: 10.1017/S1368980018000563
Abstract: To determine which parental health behaviours early in childhood most strongly predict whole-of-childhood dietary trajectories. Population-based Longitudinal Study of Australian Children (LSAC, waves 1–6 2004–2014). Exposures were parents’ fruit/vegetable consumption, alcohol, smoking and physical activity at child age 0–1 years (B Cohort) or 4–5 years (K Cohort). Outcomes, from repeated biennial short diet diaries, were group-based trajectories of (i) dietary scores and empirically derived patterns of (ii) healthful and (iii) unhealthful foods consumed, spanning ages 2–3 to 10–11 years (B Cohort) and 4–5 to 14–15 years (K Cohort). We investigated associations of baseline parental health behaviours with child dietary trajectories using multinomial logistic regression. Australian homes. Of children, 4443 (87·0 %) from the B Cohort and 4620 (92·7 %) from the K Cohort were included in all trajectories. Multivariable analyses included 2719 to 2905 children and both parents. Children whose primary caregiver reported the lowest fruit/vegetable consumption had markedly higher odds of belonging to the least healthy score and pattern trajectories (K Cohort: OR=8·7, 95 % CI 5·0, 15·1 and OR=8·4, 95 % CI 4·8, 14·7, respectively) associations were weaker (K Cohort: OR=2·3, 95 % CI 1·0, 5·2) for the unhealthiest pattern trajectory. Secondary caregiver fruit/vegetable associations were smaller and inconsistent. Parental alcohol, smoking and physical activity were not predictive in multivariable analyses. Results were largely replicated for the B Cohort. Low primary caregiver fruit/vegetable consumption increased nearly ninefold the odds of children being in the lowest intake of healthy, but only weakly predicted unhealthy, food trajectories. Healthy and unhealthy food intake may have different determinants.
Publisher: Wiley
Date: 27-08-2019
DOI: 10.1002/PPUL.24489
Abstract: Telomere length is associated with poorer lung health in older adults, possibly from cumulative risk factor exposure, but data are lacking in pediatric and population-based cohorts. We examined associations of telomere length with lung function in children and mid-life adults. Data were drawn from a population-based cross-sectional study of 11 to 12 year-olds and mid-life adults. Lung function was assessed by spirometric FEV Mean T/S ratio was 1.09 (n = 1206 SD 0.55) in children and 0.81 (n = 1343 SD 0.38) in adults. In adults, for every additional unit in T/S ratio, FEV Shorter telomere length showed moderate associations with poorer airflow parameters, but not vital capacity (lung volume) in mid-life adults. However, there was no convincing evidence of associations in children.
Publisher: Elsevier BV
Date: 09-2004
DOI: 10.1367/A03-191R.1
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2015
Abstract: Outcomes for children with special health care needs (SHCN) can vary by their patterns and persistence over time. We aimed to empirically establish typical SHCN trajectories throughout childhood and their predictive relationships with child and parent outcomes. The 2 cohorts of the nationally representative Longitudinal Study of Australian Children were recruited in 2004 at ages 0 to 1 (n = 5107, B cohort) and 4 to 5 years (n = 4983, K cohort). The parent-reported Children With SHCN Screener (Short Form) was completed at each of 4 biennial waves. Wave 4 outcomes were parent-reported behavior and health-related quality of life, teacher-reported learning, and directly assessed cognition. Both parents self-reported mental distress. We derived intracohort trajectories by using latent class analysis in Mplus. We compared mean outcome scores across trajectories by using linear regression, adjusting for socioeconomic position. Four distinct SHCN trajectories were replicated in both cohorts: persistent (B 6.8%, K 8.7%), emerging (B 4.1%, K 11.5%), transient (B 7.9%, K 4.2%), and none (B 81.3%, K 75.6%). Every outcome was adversely affected except fathers’ mental health. From infancy to age 6 to 7 years, the persistent and emerging groups had similarly poor outcomes. From age 4 and 5 to 10 and 11 years, outcomes were incrementally poorer on moving from none to transient to emerging and to persistent SHCN. Effect sizes were largest for behavior, learning, and psychosocial outcomes. Adverse outcomes are shaped more by cumulative burden than point prevalence of SHCNs. In addition to providing care according to a child’s need at any given time, prioritizing care toward persistent SHCNs may have the biggest benefits for children and parents.
Publisher: BMJ
Date: 10-05-2017
Publisher: Wiley
Date: 18-03-2014
DOI: 10.1002/ICD.1863
Publisher: Hogrefe Publishing Group
Date: 06-2017
DOI: 10.1024/0301-1526/A000630
Abstract: Abstract. Background: Carotid intima-media thickness (CIMT), an ultrasonographic marker of cardiovascular risk, is increasingly used in adults and children. The choice of specific images used to quantify CIMT from a cine sequence is often based on image quality rather than on a consistent point in the cardiac cycle. This methodological study quantified the imprecision that may be introduced by variation of CIMT during the cardiac cycle. Probands and methods: Data from four-year-olds, 11 to 12-year-olds, and adults (n=30 each age group) were selected retrospectively from two population-derived studies. Far wall CIMT of the right common carotid artery was measured at end-diastole and peak systole using standardized protocols. All images were analysed using semi-automated edge-detection software. Results: In all age groups CIMT varied significantly during the cardiac cycle and was largest at end-diastole. The mean difference in CIMT between end-diastole and peak systole was greater in four-year-olds (38 μm 95 % confidence interval (CI) 33 to 43 μm) and 11 to 12-year-olds (31 μm CI 26 to 36 μm) than in adults (18 μm CI 16 to 22 μm). Carotid IMT increased by 8.8 % (CI 7.7 to 9.8 %), 6.9 % (CI 5.8 to 8.1 %), and 3.8 % (CI 3.1 to 4.5 %) between minimum and maximum arterial diameter in four-year-olds, 11 to 12-year-olds, and adults, respectively. The greatest variation in CIMT during the cardiac cycle was observed in children (up to 14 %). Conclusions: Inconsistent timing of CIMT measurement during the cardiac cycle is an avoidable source of imprecision, especially in children, in whom inter-in idual differences are smallest. As CIMT is largest at end-diastole, this is the most appropriate time point for consistent and comparable measurements to be made.
Publisher: American Medical Association (AMA)
Date: 02-2020
Publisher: Springer Science and Business Media LLC
Date: 18-07-2019
DOI: 10.1038/S41366-019-0407-Z
Abstract: Snacks contribute to overconsumption of energy-dense foods and thence obesity. Previous studies in this area are limited by self-reported data and small s les. In a large population-based cohort of parent-child dyads, we investigated how modification of pre-packaged snack food, i.e. (a) item quantity and variety, and (b) dishware (boxed container) size affected intake. Design: Randomized trial nested within the cross-sectional Child Health CheckPoint of the Longitudinal Study of Australian Children, clustered by day of visit. 1299 11-12 year olds, 1274 parents. 2 × 2 manipulation of snack box container size and item quantity/variety: (1) small box, few items, (2) large box, few items, (3) small box, more items, (4) large box, more items. Participants received a snack box during a 15 min break within their 3.5 h visit any snacks remaining were weighed. Consumed quantity (grams) and energy intake (kilojoules). Unadjusted linear regression. Children who were offered a greater quantity and variety of snack items consumed considerably more energy and a slightly higher food mass (main effect for energy intake: 349 kJ, 95% CI 282-416, standardized mean difference (effect size) 0.66 main effect for mass: 10 g, 95% CI 3-17, effect size 0.17). In contrast, manipulating box size had little effect on child consumption, and neither box size nor quantity/variety of items consistently affected adults' consumption. In children, reducing the number and variety of snack food items available may be a more fruitful intervention than focusing on container or dishware size. Effects observed among adults were small, although we could not exclude social desirability bias in adults aware of observation.
Publisher: Wiley
Date: 05-06-2008
DOI: 10.1111/J.1365-2214.2008.00825.X
Abstract: Understanding the impact of illnesses and morbidities experienced by children and adolescents is essential to clinical and population health programme decision making and intervention research. This study sought to: (1) examine the population prevalence of physical and mental health conditions for children and quantify their impact on multiple dimensions of children's health and well-being and (2) examine the cumulative effect of concurrent conditions. We conducted a cross-sectional school-based epidemiological study of 5414 children and adolescents aged 5-18 years, and examined parental reports of child health and well-being using the parent-report Child Health Questionnaire (CHQ) PF50 13 scales are scored on a 0-100 pt scale with clinically meaningful differences of five points and the presence of childhood conditions (illnesses and health problems). Asthma, dental, vision and allergies are the most commonly identified health problems for children and adolescents, followed by attention- and behaviour-related problems (asthma 17.9-23.2%, dental 11.9-22.7%, vision 7.2-14.7%, chronic allergies 8.8-13.9%, attention problems 5.1-13.8% and behaviour problems 5.7-12.0%). As the number of concurrent health problems increase, overall health and well-being decreases substantively with mean differences in CHQ scale scores of 14 points (-7.69 to -21.51) for physical health conditions, and 28 points (-5.15 to -33.81) for mental health conditions. Children's health and well-being decreases linearly with increasing presence and frequency of health problems. Having three or more conditions concurrently significantly burdens children's health and well-being, particularly for family-related CHQ domains, with a greater burden experienced for mental health conditions than physical health conditions.
Publisher: Springer Science and Business Media LLC
Date: 22-10-2018
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2000
Abstract: Many symptoms are attributed to teething in infants. There is little evidence to support these beliefs, despite their implications for clinical management. We investigated relationships between tooth eruption, fever, and teething symptoms. Prospective cohort study. Twenty-one children 6 to 24 months old attending 3 suburban long-day care centers ≥3 days/week. 1) Daily temperature recording and examination of alveolar ridges for tooth eruption (dental therapist). 2) Daily questionnaires—symptoms over preceding 24 hours (staff and parents independently). 3) Final questionnaire—beliefs/experiences related to teething (parents). Eruption day—the first day a tooth could be seen or felt. Non-toothdays–more than 28 days clear of any eruption day. Toothdays–the 5 days preceding eruption days. Data were collected for 236 toothdays and 895 non-toothdays pertaining to 90 teeth. Child temperatures were similar on toothdays and non-toothdays (36.21 vs 36.18, paired ttest). Logistic regression adjusted for age did not show an association between toothdays and temperature (odds ratio [OR] = 1.35, 95% confidence interval [CI] = 0.80, 2.27 for high fever OR = 1.34, 95% CI = 0.48, 3.77 for low fever). Logistic regression models allowing for within-child cluster effects and age were fitted to daily staff and parent reports of mood, wellness/illness, drooling/dribbling, sleep, diarrhea, strong diapers, red cheeks, and rashes/flushing. Only parent-reported (but not staff-reported) loose stools were significantly associated with tooth eruption (OR = 1.86, 95% CI = 1.26, 2.73). When the toothday definition was varied to 10 days preceding or 5 days surrounding tooth eruption, this single significant association was no longer apparent (OR = 1.42, 95% CI = 0.98, 2.05 and OR = 1.47, 95% CI = 0.97, 2.21, respectively). All parents retrospectively reported that their own children had suffered a range of teething symptoms. This study did not confirm the expected strong associations between tooth eruption and a range of teething symptoms in children 6 to 30 months old, although we cannot rule out the possibility that weak associations may exist (Type II error). These findings contrast with strong parent and professional beliefs to the contrary. Such beliefs may preclude optimal management of common patterns of illness and behavior in young children.teething, infants, symptoms, tooth eruption, illness.
Publisher: Oxford University Press (OUP)
Date: 19-03-2018
DOI: 10.1093/IJE/DYY034
Publisher: Informa UK Limited
Date: 14-05-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2020
Publisher: Elsevier BV
Date: 05-2005
DOI: 10.1367/A04-162R.1
Publisher: Springer Science and Business Media LLC
Date: 20-06-2011
Publisher: Swansea University
Date: 15-06-2023
Abstract: IntroductionNewborn babies who require admission for specialist care can experience immediate and sometimes lasting impacts. For babies admitted to special care nurseries (SCN), there is no dataset comparable to that of the Australian and New Zealand Neonatal Network (ANZNN), which has helped improve the quality and consistency of neonatal intensive care through standardised data collection. ObjectivesWe aim to establish a proof-of-concept, Victoria-wide registry of babies admitted to SCN, embedded within the whole-of-Victoria Generation Victoria (GenV) cohort. MethodsThis prototype registry is a depth sub-cohort nested within GenV, targeting all babies born in Victoria from Oct-2021 to Oct-2023. Infants admitted to SCN are eligible. The minimum dataset will be harmonised with ANZNN for common constructs but also include SCN-only items, and will cover maternal, antenatal, newborn, respiratory/respiratory support, cardiac, infection, nutrition, feeding, cerebral and other items. As well as the dataset, this protocol outlines the anticipated cohort, timeline for this registry, and how this will serve as a resource for longitudinal research through its integration with the GenV longitudinal cohort and linked datasets. ConclusionThe registry will provide the opportunity to better understand the health and future outcomes of the large and growing cohort of children that require specialist care after birth. The data would generate translatable evidence and could lay the groundwork for a stand-alone ongoing clinical quality registry post-GenV.
Publisher: Wiley
Date: 14-09-2021
DOI: 10.1111/JPC.15705
Abstract: This study aimed to determine the feasibility and parental acceptability of screening for congenital cytomegalovirus (cCMV) through saliva polymerase chain reaction in infants who did not pass their newborn hearing screening. Additionally, the utility (i.e. time to diagnosis and treatment) of this enhanced clinical pathway was evaluated. The study was conducted through the Victorian Infant Hearing Screening Programme (VIHSP) across four maternity hospitals in Melbourne, Australia, during June 2019–March 2020. Parents were approached by VIHSP staff about obtaining a test for cytomegalovirus (CMV) at the time of their baby's second positive (‘refer’) result on the VIHSP screen. Participating parents collected a saliva swab for CMV polymerase chain reaction from their infants. Feasibility was determined by the proportion of ‘referred’ infants whose parents completed the salivary CMV screening test ≤21 days of life. Acceptability was measured through parent survey. Of 126 eligible families, 96 (76.0%) had salivary screening swabs taken ≤21 days of life. Most families ( .0%) indicated that screening was acceptable, straightforward and thought testing their baby for cCMV was a good idea. One infant screened positive on day 30, was diagnosed with cCMV via confirmatory testing by day 31 and commenced valganciclovir on day 32. Obtaining a saliva s le to screen for cCMV in infants who do not pass their newborn hearing screen is feasible and appears acceptable to parents. This targeted cCMV screening method could be an option where mothers are rapidly discharged from hospital, especially in the context of the COVID‐19 pandemic.
Publisher: JMIR Publications Inc.
Date: 14-05-2021
DOI: 10.2196/23499
Abstract: Many current research needs can only be addressed using very large cohorts. In such studies, traditional one-on-one phone, face-to-face, or paper-based engagement may not be feasible. The only realistic mechanism for maintaining engagement and participation at this scale is via digital methods. Given the substantial investment being made into very large birth cohort studies, evidence for optimal methods of participant engagement, participation, and retention over sustained periods without in-person contact from researchers is paramount. This study aims to provide an overview of systematic reviews and meta-analyses evaluating alternative strategies for maximizing participant engagement and retention rates in large-scale studies using digital methods. We used a rapid review method by searching PubMed and Ovid MEDLINE databases from January 2012 to December 2019. Studies evaluating at least 1 e-engagement, participation, or retention strategy were eligible. Articles were screened for relevance based on preset inclusion and exclusion criteria. The methodological quality of the included reviews was assessed using the AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews 2) measurement tool, and a narrative synthesis of the data was conducted. The literature search yielded 19 eligible reviews. Overall, 63% (n=12) of these reviews reported on the effectiveness of e-engagement or participation promotion strategies. These evaluations were generally not conducted within very large observational digital cohorts. Most of the contributing reviews included multipurpose cohort studies (with both observational and interventional elements) conducted in clinical and research settings. Email or SMS text message reminders, SMS text messages or voice notifications, and incentives were the most commonly used design features to engage and retain participants. For parental outcomes, engagement-facilitation interventions influenced uptake and behavior change, including video feedback, goal setting, and intensive human facilitation and support. Participant-stated preferences for content included new knowledge, reminders, solutions, and suggestions about health issues presented in a clear, short, and personalized way. Perinatal and postpartum women valued self-monitoring and personalized feedback. Digital reminders and multiple SMS text messages were specific strategies that were found to increase adherence to medication and clinic attendance, respectively. This review adds to the growing literature evaluating methods to optimize engagement and participation that may apply to large-scale studies using digital methods it is promising that most e-engagement and participation promotion strategies appear to be effective. However, these reviews canvassed relatively few strategies, suggesting that few alternative strategies have been experimentally evaluated. The reviews also revealed a dearth of experimental evidence generated within very large observational digital cohort studies, which may reflect the small number of such studies worldwide. Thus, very large studies may need to proactively build in experimental opportunities to test engagement and retention approaches to enhance the success of their own and other large digital contact studies.
Publisher: Springer Science and Business Media LLC
Date: 20-07-2005
Abstract: Population health information, collected using soundly-designed methodologies, is essential to inform policy, research, and intervention programs. This study aimed to derive policy-oriented recommendations for the content of a health and wellbeing population survey of children 0–12 years living in Victoria, Australia. Qualitative interviews were conducted with 54 academic and policy stakeholders, selected to encompass a wide breadth of expertise in areas of public health and inter-sectoral organisations relevant to child health outcomes, including universities, government and non-government agencies across Victoria. These stakeholders were asked to provide advice on strategic priorities for child health information (data) using a structured interview technique. Their comments were summarised and the major themes were extracted. The priority areas of health and wellbeing recommended for regular collection include obesity and its determinants, pregnancy and breastfeeding, oral health, injury, social and emotional health and wellbeing, family environment, community, health service utilisation, illness, and socioeconomic position. Population policy questions for each area were identified. In contrast to previous population survey programs nationally and internationally, this study sought to extract contemporary policy-oriented domains for inclusion in a strategic program of child health data collection, using a stakeholder consultation process to identify key domains and policy information needs. The outcomes are a rich and relevant set of recommendations which will now be taken forward into a regular statewide child health survey program.
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/17477160701369274
Abstract: To conduct an exploratory study of time-use patterns in Australian 5-year-old children, and to pilot the novel Children's Light Time-Use Diary as a potential tool for investigating relationships between children's time-use and weight status. Subjects for the present cross-sectional study were drawn from an established longitudinal cohort and included eighty-four 5-year-old Australian children (36 males) originally recruited as infants in three local government areas of Melbourne. Children were weighed and measured, and body mass index (BMI kg/m(2)) calculated. Over three to four complete 24-hour periods, parents completed the Children's Light Time-Use Diary to record their child's activities in 15-minute blocks and details about the context in which the activities took place, selecting from a list of predetermined options. The children studied were largely sedentary, with television viewing the most time-consuming activity outside sleep. Only 49% of children spent any time walking for transport or pleasure. Children spent a median of 71% of their time in activities that were likely to be physically active when outdoors, compared with 3% when indoors, but averaged only 110 minutes/day outdoors (excluding passive transport). The 11 overweight/obese children watched significantly more television than non-overweight children. The Children's Light Time-Use Diary appears to be a practical and informative tool, which may complement accelerometry as a tool relevant to future studies of the determinants of child overweight/obesity. Further validation studies and larger research trials seem warranted.
Publisher: BMJ
Date: 19-10-2012
Abstract: Early and persistent exposure to socioeconomic disadvantage impairs children's health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0-1, 2-3, 4-5 and 6-7 years. 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2019-030833
Abstract: In an ambitious undertaking, Growing Up in Australia’s Child Health CheckPoint streamlined and implemented wide-ranging population phenotypes and bios les relevant to non-communicable diseases in nearly 1900 parent–child dyads throughout Australia at child aged 11–12 years. This BMJ Open Special Issue describes the methodology, epidemiology and parent–child concordance of 14 of these phenotypes, spanning cardiovascular, respiratory, bone, kidney, hearing and language, body composition, metabolic profiles, telomere length, sleep, physical activity, snack choice and health-related quality of life. The Special Issue also includes a cohort summary and study methodology paper.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.JACI.2013.11.019
Abstract: It is unknown whether population infant feeding practices have changed since recently revised Australian allergy guidelines removed recommendations to delay allergenic solids. We sought to determine whether updated 2008 guidelines were associated with changes in feeding practice and to determine whether sociodemographic factors influenced this response. In a population-based, cross-sectional study (HealthNuts) of 5276 infants recruited between 2007 and 2011 in Melbourne, Australia, parents reported on infant feeding practices. Multinomial logistic regression was used to investigate the associations between recruitment year and feeding practices and whether these associations were modified by sociodemographic factors. Compared with participants recruited in 2007-2009, those recruited in 2009-2011 were more likely to introduce solids at age 4 months (adjusted multinomial odds ratio [aMOR], 1.21 95% CI, 1.02-1.45 P = .032) and less likely to introduce solids at age 6 months (aMOR, 0.80 95% CI, 0.69-0.92 P = .002), egg after 6 months (aMOR, 0.82 95% CI, 0.71-0.94 P = .004), and peanut after 12 months (aMOR, 0.70 95% CI, 0.49-0.98 P = .037). Although parents recruited in 2009-2011 were less likely to formula feed (aMOR, 0.84 95% CI, 0.72-0.98 P = .023), formula-fed infants were more likely to be given a partially hydrolyzed formula (aMOR, 1.37 95% CI, 1.12-1.70 P = .003). These changes were significantly stronger among families with a higher socioeconomic status and those without a family history of allergies. Updated national allergy guidelines are associated with reduced delay in introduction of solids, egg, and peanut and an increase in partially hydrolyzed formula use among formula-fed infants. Higher socioeconomic status and absence of family history of allergies were associated with better uptake of feeding guidelines.
Publisher: BMJ
Date: 12-10-2002
Publisher: Wiley
Date: 10-03-2021
DOI: 10.1111/APA.15813
Abstract: To examine associations between patterns of language use and early adolescent well‐being. Participants were 1763 Australian 11‐ to 12‐year‐olds in the Child Health CheckPoint. Six patterns of language use were identified from a writing activity using Linguistic Inquiry and Word Count and factor analysis: Acting in the present and future , Positive emotion , Gender and relationships , Self‐aware, Inquisitive and time focused, and Confident . Well‐being measures represented a spectrum from negatively to positively framed psychosocial health. Associations between language use and well‐being were estimated using linear regression adjusted for age, sex and social disadvantage. Positive emotion (high emotional tone, positive emotion) was associated with better general well‐being (standardised regression coefficient (SRC) 0.05 95% confidence interval 0.00 to 0.11 p = 0.04), life satisfaction (0.06 0.01 to 0.11 p = 0.03), psychosocial health (0.07 0.02 to 0.12 p = 0.01) and quality of life (QoL) (0.06 0.01 to 0.11 p = 0.02). Similarly, Self‐aware (high first person singular pronouns, authentic, low clout) was associated with better general well‐being, life satisfaction and psychosocial health (SRC 0.05, 0.09, 0.08), but Confident (high clout, first person plural pronouns, affiliation) was associated with worse life satisfaction, psychosocial health and QoL (SRC −0.06, −0.09, −0.06). If replicated in ‘real‐world’ settings (e.g., social media), language patterns could provide naturalistic insights into early adolescents’ well‐being.
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA11.10254
Publisher: Springer Science and Business Media LLC
Date: 05-01-2011
Publisher: Cambridge University Press (CUP)
Date: 21-06-2018
DOI: 10.1017/S030500091800017X
Abstract: We explored whether supported (SJE) or coordinated joint engagement (CJE) between mothers recruited from the community and their 24-month-old children who were slow-to-talk at 18 months old were associated with child language scores at ages 24, 36, and 48 months ( n = 197). We further explored whether SJE or CJE modified the concurrent positive associations between maternal responsive behaviours and language scores. Previous research has shown that SJE, maternal expansions, imitations, and responsive questions were associated with better language scores. Our main finding was that SJE but not CJE was consistently positively associated with 24- and 36-month-old expressive and receptive language scores, but not with 48-month-old language scores. SJE modified how expansions and imitations, but not responsive questions, were associated with language scores the associations were evident in all but the highest levels of SJE. Further research is necessary to test these findings in other s les before clinical recommendations can be made.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2014
Publisher: Elsevier BV
Date: 02-2011
Publisher: Frontiers Media SA
Date: 24-04-2020
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.SLEEP.2015.08.013
Abstract: Using national Australian time-diary data, we aimed to empirically determine sleep duration thresholds beyond which children have poorer health, learning, quality of life, and weight status and parents have poorer mental health. Cross-sectional data from the first three waves of the Longitudinal Study of Australian Children. A nationally representative s le of 4983 4-5-year-olds, recruited in 2004 from the Australian Medicare database and followed biennially 3631 had analyzable sleep information and a concurrent measure of health and well-being for at least one wave. At each wave, a parent completed 24-h time-use diaries for one randomly selected weekday and one weekend day, including a "sleeping/napping" category. Parent-reported child mental health, health-related quality of life, and maternal aternal mental health teacher-reported child language, literacy, mathematical thinking, and approach to learning and assessed child body mass index and girth. Linear regression analyses revealed weak, inconsistent relationships between sleep duration and outcomes at every wave. For ex le, children with versus without psychosocial health-related quality of life problems slept slightly less at 6-7 years (adjusted mean difference 0.12 h 95% confidence interval 0.01-0.22, p = 0.03), but not at 4-5 (0.00 -0.10 to 0.11, p = 1.0) or 8-9 years (0.09 -0.02 to 0.22, p = 0.1). Empirical exploration using fractional polynomials demonstrated no clear thresholds for sleep duration and any adverse outcome at any wave. Present guidelines in terms of children's short sleep duration appear misguided. Other parameters such as sleep timing may be more meaningful for understanding optimal child sleep.
Publisher: Wiley
Date: 10-2000
DOI: 10.1046/J.1464-5491.2000.00360.X
Abstract: To study parent and adolescent-reported physical, psychosocial and family wellbeing in children aged 5-18 years with diabetes. 5-18-year-olds attending a diabetes clinic at a tertiary children's hospital. (1) Child Health Questionnaire (CHQ) PF-50, a functional heath status measure for children aged 5-18 years (parents) (2) CHQ CF-80, a similar self-report measure (adolescents aged 12-18 years) (3) 11 study-designed questions related to diabetes-specific concerns (parents) (4) global ratings of physical and psychosocial health (clinicians) (5) HbA1c level (all subjects). CHQ data were compared with Australian normative data collected six months earlier. Reports were obtained from 128 parents and 71 adolescents (90 and 92% response). The CHQ demonstrated good psychometric properties in this s le of children with diabetes. Parents reported children with diabetes to have generally poorer health than children in the normative s le, especially on psychosocial and parent/family scales. Psychosocial health was markedly lower in 5-11-year-olds with HbA1c > 8.8%, but not in 12-18-year-olds. Presence of diabetes-related symptoms and concerns correlated with lower physical and psychosocial functioning. Parents and clinicians concurred in their ratings of health for 12-18-year-olds but not 5-11-year-olds. Adolescents reported their own health similarly to adolescents in the normative s le. Parents report children aged 5-18 years with diabetes to have poorer health than children in the normative s le across all domains. Clinicians may underrate the impact of diabetes for younger children, with possible therapeutic implications. In providing an overall description of health, instruments like the CHQ may add another dimension to the care of children with diabetes and can feasibly be used within clinical settings.
Publisher: Springer Science and Business Media LLC
Date: 17-08-2004
Publisher: BMJ
Date: 16-12-2014
DOI: 10.1136/ARCHDISCHILD-2013-304150
Abstract: To provide accurate population normative data documenting cross-sectional, age-specific sleep patterns in Australian children aged 0-9 years. The first three waves of the nationally representative Longitudinal Study of Australian Children, comprising two cohorts recruited in 2004 at ages 0-1 years (n=5107) and 4-5 years (n=4983), and assessed biennially. Children with analysable sleep data for at least one wave. At every wave, parents prospectively completed 24-h time-use diaries for a randomly selected week or weekend day. 'Sleeping, napping' was one of the 26 precoded activities recorded in 15-min time intervals. From 0 to 9 years of age, 24-h sleep duration fell from a mean peak of 14 (SD 2.2) h at 4-6 months to 10 (SD 1.9) h at 9 years, mainly due to progressively later mean sleep onset time from 20:00 (SD 75 min) to 21:00 (SD 60 min) and declining length of day sleep from 3.0 (SD 1.7) h to 0.03 (SD 0.2) h. Number and duration of night wakings also fell. By primary school, wake and sleep onset times were markedly later on weekend days. The most striking feature of the centile charts is the huge variation at all ages in sleep duration, sleep onset time and, especially, wake time in this normal population. Parents and professionals can use these new centile charts to judge normalcy of children's sleep. In future research, these population parameters will now be used to empirically determine optimal child sleep patterns for child and parent outcomes like mental and physical health.
Publisher: Mary Ann Liebert Inc
Date: 18-10-2023
Publisher: Wiley
Date: 2007
DOI: 10.1111/J.1440-1754.2007.01005.X
Abstract: Aim: Sleep problems in the second 6 months of life are common and associated with maternal depression. This paper extends previous research to (i) establish the prevalence of sleep problems in younger infants from a broader socio‐economic spectrum, (ii) examine the relationship between infant sleep problems and maternal physical, as well as mental, health, and (iii) explore mothers’ sleep quality as a potential mediator of this relationship. Methods: Design: Cross‐sectional, community survey in Melbourne, Australia. S le: Mothers of 3‐ to 6‐month‐old infants (mean 4.6 months) recruited from well‐child clinics in six sociodemographically erse metropolitan local government areas. Outcome measures: Maternal mental and physical health standardised questionnaire on infant sleep patterns maternal report of an infant sleep problem (yes/no). Results: The survey was completed by 692 mothers 237 (34%) reported an infant sleep problem, of whom 73 (31%) rated the problem as severe. Sleep patterns characterising a problem included the infant waking seven nights per week, nursing the infant to sleep at the beginning of the night, the infant sleeping in the parent’s room, and parental disagreement regarding managing infant sleep. There was no relationship between sleep problems and socio‐economic levels. Mothers reporting infant sleep problems had poorer mental and physical health compared with those not reporting sleep problems. Conclusion: Sleep problems are common in early infancy across metropolitan socio‐economic levels and are associated with poorer maternal health and well‐being. Preventive strategies for infant sleep problems need to begin early in primary care to improve mothers’ health.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2015
Abstract: We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial’s definitive 6-year outcomes. Randomized trial nested in a population-based ascertainment. Children with language scores & .25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills parent-reported pragmatic language, behavior, and health-related quality of life costs of intervention and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. Of 1464 children assessed at age 4, 266 were eligible and 200 randomized 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3 95% confidence interval [CI] –1.2 to 5.7 P = .20) or expressive (0.8 95% CI –1.6 to 3.2 P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36 95% CI 0.08–0.65 P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276 95% CI: $3424 to $5128). Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2007
Publisher: Springer Science and Business Media LLC
Date: 28-03-2012
Publisher: Springer Science and Business Media LLC
Date: 18-01-2023
DOI: 10.1186/S12916-022-02711-8
Abstract: Common pregnancy and perinatal complications are associated with offspring cardiometabolic risk factors. These complications may influence multiple metabolic traits in the offspring and these associations might differ with offspring age. We used data from eight population-based cohort studies to examine and compare associations of pre-ecl sia (PE), gestational hypertension (GH), gestational diabetes (GD), preterm birth (PTB), small (SGA) and large (LGA) for gestational age (vs. appropriate size for gestational age (AGA)) with up to 167 plasma/serum-based nuclear magnetic resonance-derived metabolic traits encompassing lipids, lipoproteins, fatty acids, amino acids, ketones, glycerides hospholipids, glycolysis, fluid balance, and inflammation. Confounder-adjusted regression models were used to examine associations (adjusted for maternal education, parity age at pregnancy, ethnicity, pre/early pregnancy body mass index and smoking, and offspring sex and age at metabolic trait assessment), and results were combined using meta-analysis by five age categories representing different periods of the offspring life course: neonates (cord blood), infancy (mean ages: 1.1–1.6 years), childhood (4.2–7.5 years) adolescence (12.0–16.0 years), and adulthood (22.0–67.8 years). Offspring numbers for each age category/analysis varied from 8925 adults (441 PTB) to 1181 infants (135 GD) 48.4% to 60.0% were females. Pregnancy complications (PE, GH, GD) were each associated with up to three metabolic traits in neonates ( P ≤0.001) with some evidence of persistence to older ages. PTB and SGA were associated with 32 and 12 metabolic traits in neonates respectively, which included an adjusted standardised mean difference of −0.89 standard deviation (SD) units for albumin with PTB (95% CI: −1.10 to −0.69, P =1.3×10 −17 ) and −0.41 SD for total lipids in medium HDL with SGA (95% CI: −0.56 to −0.25, P =2.6×10 −7 ), with some evidence of persistence to older ages. LGA was inversely associated with 19 metabolic traits including lower levels of cholesterol, lipoproteins, fatty acids, and amino acids, with associations emerging in adolescence, (e.g. −0.11 SD total fatty acids , 95% CI: −0.18 to −0.05, P =0.0009), and attenuating with older age across adulthood. These reassuring findings suggest little evidence of wide-spread and long-term impact of common pregnancy and perinatal complications on offspring metabolic traits, with most associations only observed for newborns rather than older ages, and for perinatal rather than pregnancy complications.
Publisher: BMJ
Date: 04-2000
DOI: 10.1136/ADC.82.4.297
Abstract: To examine the relation between a child's height and grade progression in primary school. Height was measured in a representative cross sectional s le of children from 24 primary schools in Victoria in late 1997. Height measurements were transformed to standardised scores using Cole's "LMS" method to allow for comparison across ages and genders. Children within each grade were ided into three equal groups based on age (youngest third, middle third, oldest third), again to allow for cross age comparison. A total of 2848 children aged 5-12 years (51% male) were included, with approximately 400 children in each of the seven grades from preparatory to grade 6. Analysis of variance showed a significant relation overall between age and height, with a sequential decrease in height from the youngest to the oldest third. When genders were considered separately, the relation remained significant for boys but not for girls. A total of 133 children (66% male) repeated a grade in primary school. When this group of grade repeaters was removed from the s le, analysis of variance showed no significant relation between standardised height score and age tertile for boys. Although birth weight category and maternal education were independent predictors of height scores overall, they did not appear to influence decisions to retain pupils in grades. Older boys within grades, notably those who have repeated a grade, are shorter than their peers. Decisions to retain pupils, particularly boys who are experiencing school difficulties, may be influenced by their height.
Publisher: Wiley
Date: 11-05-2022
DOI: 10.1111/AJO.13540
Abstract: Pregnancy represents a time of increased morbidity and mortality for women and their infants. Clinical quality registries (CQRs) collect, analyse and report key healthcare quality indicators for patient cohorts to improve patient care. There are limited data regarding existing CQRs in pregnancy. This scoping review aimed to: (1) identify Australian CQRs specific to pregnancy care and describe their general characteristics and (2) outline their aims and measured outcomes The scoping review was undertaken according to Joanna Briggs Institute guidelines. CQRs were identified using a systematic approach from publications (Ovid MEDLINE, PubMed, Google Scholar), peer consultation, the Australian register of clinical registries and web searches. Details surrounding general characteristics, aims and outcomes were collated. We identified two primary sources of information about pregnancy care. (1) Six CQRs are specific to pregnancy (Australia and New Zealand twin‐twin transfusion syndrome registry, Australian Pregnancy Register for women with epilepsy and those taking anti‐epileptic drugs, National Register of Antipsychotic Medication in Pregnancy, Australasian Maternity Outcomes Surveillance System, Neonatal Alloimmune Thrombocytopaenia Registry and the Diabetes in Pregnancy clinical register). (2) Fourteen observational cohort studies were facilitated by non‐pregnancy‐specific CQRs where a subsection of patients underwent pregnancy. Australian CQRs currently report varied information regarding some selected conditions during pregnancy and offer therapeutic and epidemiological insight into their care. Further research into their effectiveness is warranted. We note the lack of a CQR spanning the common problems of pregnancy in general, where significant health, service and economic gains are possible.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2017
Abstract: To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non–English speaking background,family history of speech/language difficulties) maternal factors (mental health, vocabulary, education, and age) and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life). Almost 19% of children (22/1204 .9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68–0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85–0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning. Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties.
Publisher: Elsevier BV
Date: 02-2009
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2010
Publisher: Wiley
Date: 08-2019
DOI: 10.1111/OBR.12798
Abstract: findings from systematic reviews into infant feeding and later adiposity are largely negative. World Health Organization (WHO) is auspicing Healthy Life Trajectories Initiative (HeLTI), a suite of trials aiming to prevent overweight/obesity in childhood. To inform planning, this narrative review sought to detail potentially effective components of nutrition-related interventions involving children aged 0 to 2 years. Systematic searches of PubMed and the Cochrane Library (2006-2016) identified 108 systematic reviews. These included 31 randomized trials in the age group of interest. Of these, 11 reported greater than or equal to 1 statistically significant (P < 0.05) benefit on body weight and/or composition. Six multicomponent trials whose interventions incorporated education to promote breastfeeding (four trials), responsive feeding (two trials), and healthy diet (eg, increasing fruit and vegetables and limiting unhealthy snack foods five trials), delivered through home visits or at baby health clinics, reported relative reductions in body mass index (BMI) at the end of intervention. Early benefits were not maintained in the two trials reporting follow-up 1 to 3 years later. Other potentially effective approaches included lower protein formulas in formula-fed infants and education around reducing sugar-sweetened beverages. There is some evidence that infant feeding interventions can have a transient positive impact on a child's BMI. It is not known whether ongoing intervention can avoid the subsequent expected wash-out.
Publisher: Wiley
Date: 25-06-2020
DOI: 10.1111/MICC.12642
Publisher: Wiley
Date: 15-06-2010
DOI: 10.1111/J.1365-2923.2010.03686.X
Abstract: This study aimed to describe the application, feasibility and outcomes of using simulated patients (SPs) to increase the skills of general practitioners (GPs) delivering a behavioural intervention to reduce childhood overweight and mild obesity. Five female actors were trained as SPs. A total of 67 GPs from 46 general practices in Melbourne, Victoria, Australia, conducted two simulated consultation visits regarding healthy lifestyle family behaviour change, during which they practised their skills and received formative feedback. The GPs and SPs rated GP performance immediately after each consultation. Subsequently, 139 parents of overweight or obese 5-9-year-old children rated GP performance during real-life consultations. Other measures included child body mass index (BMI) Z-scores (at baseline and at a 9-month follow-up) and GP-reported levels of comfort and competence and the perceived value of SP visits. Simulated patient ratings, but not GP self-ratings, of GP performance predicted both parent ratings of real-life consultations (Spearman's rho 0.39 for correlation with SP rating at Visit 1) and subsequent reductions in BMI Z-scores between baseline and follow-up (Visit 1, rho-0.45 Visit 2, rho-0.46). GP levels of comfort and competence were maintained during and after the SP visits. A total of 95% of GPs rated simulated consultations as useful, although only 18% said they would pay for them. Simulated patient assessment may predict real patient feedback and clinical outcomes, helping to identify doctors who require further training in behaviour change techniques. Randomised controlled trials may establish whether SPs actually raise skills or improve outcomes.
Publisher: BMJ
Date: 04-05-2002
DOI: 10.1136/BMJ.324.7345.1062
Abstract: To compare the effect of a behavioural sleep intervention with written information about normal sleep on infant sleep problems and maternal depression. Randomised controlled trial. Well child clinics, Melbourne, Australia. 156 mothers of infants aged 6-12 months with severe sleep problems according to the parents. Maternal report of infant sleep problem scores on Edinburgh postnatal depression scale at two and four months. Discussion on behavioural infant sleep intervention (controlled crying) delivered over three consultations. At two months more sleep problems had resolved in the intervention group than in the control group (53/76 v 36/76, P=0.005). Overall depression scores fell further in the intervention group than in the control group (mean change -3.7, 95% confidence interval -4.7 to -2.7, v -2.5, -1.7 to -3.4, P=0.06). For the subgroup of mothers with depression scores of 10 and over more sleep problems had resolved in the intervention group than in the control group (26/33 v 13/33, P=0.001). In this subgroup depression scores also fell further for intervention mothers than control mothers at two months (-6.0, -7.5 to -4.0, v -3.7, -4.9 to -2.6, P=0.01) and at four months (-6.5, -7.9 to 5.1 v -4.2, -5.9 to -2.5, P=0.04). By four months, changes in sleep problems and depression scores were similar. Behavioural intervention significantly reduces infant sleep problems at two but not four months. Maternal report of symptoms of depression decreased significantly at two months, and this was sustained at four months for mothers with high depression scores.
Publisher: BMJ
Date: 04-2002
DOI: 10.1136/ADC.86.4.245
Abstract: To determine whether a two tier universal infant hearing screening programme (population based risk factor ascertainment and universal distraction testing) lowered median age of diagnosis of bilateral congenital hearing impairment (CHI) >40 dB HL in Victoria, Australia. Comparison of whole population birth cohorts pre and post introduction of the Victorian Infant Hearing Screening Program (VIHSP). All babies surviving the neonatal period born in Victoria in 1989 (pre-VIHSP) and 1993 (post-VIHSP) were studied. (1) Pre-1992: distraction test at 7-9 months. (2) Post-1992: infants with risk factors for CHI referred for auditory brain stem evoked response (ABR) assessment all others screened by modified distraction test at 7-9 months. Of the 1989 cohort (n = 63 454), 1.65/1000 were fitted with hearing aids for CHI by end 1995, compared with 2.09/1000 of the 1993 cohort (n = 64 116) by end 1999. Of these, 79 cases from the 1989 cohort (1.24/1000) and 72 cases from the 1993 cohort (1.12/1000) had CHI >40 dB HL. Median age at diagnosis of CHI >40 dB HL for the 1989 birth cohort was 20.3 months, and for the 1993 cohort was 14.2 months. Median age at diagnosis fell significantly for severe CHI but not for moderate or profound CHI. Significantly more babies with CHI >40 dB HL were diagnosed by 6 months of age in 1993 than in 1989 (21.7% v 6.3%). Compared to the six years pre-VIHSP, numbers aided by six months were consistently higher in the six years post-VIHSP (1.05 per 100 000 births versus 13.4 per 100 000 births per year). VIHSP resulted in very early diagnosis for more infants and lowered median age of diagnosis of severe CHI. However, overall results were disappointing.
Publisher: American Medical Association (AMA)
Date: 03-10-2016
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JACI.2017.02.019
Abstract: The HealthNuts study previously reported interim prevalence data showing the highest prevalence of challenge-confirmed food allergy in infants internationally. However, population-derived prevalence data on challenge-confirmed food allergy and other allergic diseases in preschool-aged children remain sparse. This study aimed to report the updated prevalence of food allergy at age 1 year from the whole cohort, and to report the prevalence of food allergy, asthma, eczema, and allergic rhinitis at age 4 years. HealthNuts is a population-based cohort study with baseline recruitment of 5276 one-year-old children who underwent skin prick test (SPT) to 4 food allergens and those with detectable SPT results had formal food challenges. At age 4 years, parents completed a questionnaire (81.3% completed) and those who previously attended the HealthNuts clinic at age 1 year or reported symptoms of a new food allergy were invited for an assessment that included SPT and oral food challenges. Data on asthma, eczema, and allergic rhinitis were captured by validated International Study of Asthma and Allergies in Childhood questionnaires. The prevalence of challenge-confirmed food allergy at age 1 and 4 years was 11.0% and 3.8%, respectively. At age 4 years, peanut allergy prevalence was 1.9% (95% CI, 1.6% to 2.3%), egg allergy was 1.2% (95% CI, 0.9% to 1.6%), and sesame allergy was 0.4% (95% CI, 0.3% to 0.6%). Late-onset peanut allergy at age 4 years was rare (0.2%). The prevalence of current asthma was 10.8% (95% CI, 9.7% to 12.1%), current eczema was 16.0% (95% CI, 14.7% to 17.4%), and current allergic rhinitis was 8.3% (95% CI, 7.2% to 9.4%). Forty percent to 50% of this population-based cohort experienced symptoms of an allergic disease in the first 4 years of their life. Although the prevalence of food allergy decreased between age 1 year and age 4 years in this population-based cohort, the prevalence of any allergic disease among 4-year-old children in Melbourne, Australia, is remarkably high.
Publisher: Elsevier BV
Date: 03-2011
DOI: 10.1016/J.JADOHEALTH.2010.06.019
Abstract: To assess changes in overweight and obesity between adolescence and young adulthood. Prospective 8-wave cohort study in Victoria, Australia, with 1,520 adolescents tracked from the age of 14 for a period of 10 years. Participants aged 18 years overweight was defined as a body mass index (BMI) ≥ 25 and obesity as a BMI ≥ 30. The proportion of overweight in iduals increased from 20% in mid-adolescence to 33% at the age of 24 years. Obesity increased from 3.6% to 6.7%. Approximately 40% of young adults with a BMI ≥ 25 had been persistently at normal weights during adolescence and approximately 80% had been at a normal weight at some point. Around half of obese young adults had never been classified as obese as adolescents. No in idual with persistent obesity in adolescence had a BMI <25 at 24 years. A total of 31% of females and 59% of males who had been overweight for only one or two waves of adolescent data collection had a BMI ≥ 25 at 24 years. Substantial shifts in overweight and obesity occur between adolescence and young adulthood the extent of continuity depends on both the severity and persistence of adiposity in adolescence. Few adolescents who peak into obesity or are persistently overweight achieve a normal weight in young adulthood. Resolution is more common in those who are less persistently overweight as teenagers, suggesting scope for lifestyle interventions in this subgroup.
Publisher: Wiley
Date: 26-02-2020
DOI: 10.1111/JPC.14835
Publisher: BMJ
Date: 11-05-2019
DOI: 10.1136/ARCHDISCHILD-2019-316917
Abstract: To investigate the associations of hearing thresholds and slight to mild hearing loss with academic, behavioural and quality of life outcomes in children at a population level. Design and participants: children aged 11–12 years in the population-based cross-sectional Child Health CheckPoint study within the Longitudinal Study of Australian Children. Audiometry: mean hearing threshold across 1, 2 and 4 kHz (better and worse ear) slight/mild hearing loss (threshold of 16–40 decibels hearing loss (dB HL)). Outcomes: National Assessment Program – Literacy and Numeracy, language, teacher-reported learning, parent and teacher reported behaviour and self-reported quality of life. Analysis: linear regression quantified associations of hearing threshold/loss with outcomes. Of 1483 children (mean age 11.5 years), 9.2% and 13.1% had slight/mild bilateral and unilateral hearing loss, respectively. Per SD increment in better ear threshold (5.7 dB HL), scores were worse on several academic outcomes (eg, reading 0.11 SD, 95% CI 0.05 to 0.16), parent-reported behaviour (0.06 SD, 95% CI 0.01 to 0.11) and physical (0.09 SD, 95% CI 0.04 to 0.14) and psychosocial (0.06 SD, 95% CI 0.01 to 0.11) Pediatric Quality of Life Inventory (PedsQL). Compared with normally hearing children, children with bilateral slight/mild losses scored 0.2–0.3 SDs lower in sentence repetition, teacher-reported learning and physical PedsQL but not other outcomes. Similar but attenuated patterns were seen in unilateral slight/mild losses. Hearing thresholds and slight/mild hearing loss showed small but important associations with some child outcomes at 11–12 years. Justifying hearing screening or intervention at this age would require better understanding of its longitudinal and indirect effects, alongside effective management and appropriate early identification programmes.
Publisher: American Academy of Pediatrics (AAP)
Date: 06-2001
Abstract: To describe infant sleep patterns and investigate relationships between infant sleep problems and maternal well-being in the community setting. Cross-sectional community survey. Maternal and Child Health Centers in 3 middle-class local government areas in Melbourne, Australia. Mothers of infants 6 to 12 months of age. Maternal well-being (Edinburgh Postnatal Depression Scale) and infant sleep problems (standardized maternal questionnaire). The survey was completed by 738 mothers (94% response rate), of whom 46% reported their infant's sleep as a problem. In the univariate analyses, sleep patterns characterizing a sleep problem included the infant sleeping in the parent's bed, being nursed to sleep, taking longer to fall asleep, waking more often and for longer periods overnight, and taking shorter naps. The same sleep patterns were associated with high depression scores and tended to increase as depression scores increased. Because of positive skew, the Edinburgh Postnatal Depression Score was analyzed in 3 categories (& , 10–12, and & ) using validated cutoff scores from community and clinical studies. Fifteen percent of mothers scored above 12 on the depression scale, indicating probable clinical depression, and 18% scored between 10 and 12, indicating possible clinical depression. After adjusting for potential confounders and factors significant in the univariate analyses, maternal report of an infant sleep problem remained a significant predictor of a depression score & (odds ratio: 2.13 95% confidence interval: 1.27,3.56) and & (odds ratio: 2.88 95% confidence interval: 1.93,4.31). However, mothers reporting good sleep quality, despite an infant sleep problem, were not more likely to suffer depression. Maternal report of infant sleep problems and depression symptoms are common in middle-class Australian communities. There is a strong association between the 2, even when known depression risk factors are taken into account. Maternal report of good sleep quality attenuates this relationship. Appropriate anticipatory guidance addressing infant sleep could potentially decrease maternal report of depressive symptoms.
Publisher: Wiley
Date: 30-10-2014
DOI: 10.1111/JPC.12415
Abstract: Glycosylated haemoglobin (HbA1c), a marker of diabetic glycemic control, is associated with chronic psychosocial stress in non-diabetic adults. This study aimed to determine whether HbA1c also acts as a biomarker of psychosocial stress in healthy 6-year-olds. Eligible participants were 326 children recruited from 6 socio-economically erse areas in Melbourne, Australia, who took part in an earlier randomised trial for sleep problems at age 7 months. At 6 years, they participated in a follow-up assessment. HbA1c collected by finger-prick. Exposures (collected simultaneously): proxy measures of child stress including: (i) child mental health (ii) maternal mental health (depression, anxiety, stress), negative life events in the preceding year, life stresses and coping and (iii) family socioeconomic status and financial stress. linear regressions, adjusted for original randomisation status and clustering. Sixty percent (134/225) of children retained at 6 years provided HbA1c data, which ranged from 3.9%-5.8% (SD 0.3%). No child or family variable was associated with HbA1c. Of the maternal variables, only anxiety predicted HbA1c (adjusted difference per point increase: -0.01, 95% CI: -0.003 to 0.02, P = 0.01) this association was in the opposite direction to that hypothesised and clinically insignificant. HbA1c was not associated with psychosocial stress in healthy 6-year-olds. This suggests that any link between HbA1c and psychosocial stress emerges after this age, and that HbA1c is unlikely to be a reliable biomarker for stress in early childhood or over the transition to school.
Publisher: Wiley
Date: 13-05-2004
Publisher: Wiley
Date: 18-11-2014
DOI: 10.1111/DMCN.12635
Abstract: The epidemiology of preschool speech sound disorder is poorly understood. Our aims were to determine: the prevalence of idiopathic speech sound disorder the comorbidity of speech sound disorder with language and pre-literacy difficulties and the factors contributing to speech outcome at 4 years. One thousand four hundred and ninety-four participants from an Australian longitudinal cohort completed speech, language, and pre-literacy assessments at 4 years. Prevalence of speech sound disorder (SSD) was defined by standard score performance of ≤79 on a speech assessment. Logistic regression examined predictors of SSD within four domains: child and family parent-reported speech cognitive-linguistic and parent-reported motor skills. At 4 years the prevalence of speech disorder in an Australian cohort was 3.4%. Comorbidity with SSD was 40.8% for language disorder and 20.8% for poor pre-literacy skills. Sex, maternal vocabulary, socio-economic status, and family history of speech and language difficulties predicted SSD, as did 2-year speech, language, and motor skills. Together these variables provided good discrimination of SSD (area under the curve=0.78). This is the first epidemiological study to demonstrate prevalence of SSD at 4 years of age that was consistent with previous clinical studies. Early detection of SSD at 4 years should focus on family variables and speech, language, and motor skills measured at 2 years.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020896
Abstract: To describe the epidemiology and parent–child concordance of vascular function in a population-based s le of Australian parent–child dyads at child age 11–12 years. Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC). Assessment centres in seven major Australian cities and eight regional towns or home visits, February 2015–March 2016. Of all participating CheckPoint families (n=1874), 1840 children (49% girls) and 1802 parents (88% mothers) provided vascular function data. Survey weights and methods were applied to account for LSAC’s complex s le design and clustering within postcodes and strata. The SphygmoCor XCEL assessed vascular function, generating estimates of brachial and central systolic blood pressure and diastolic blood pressure, central pulse pressure, augmentation index and carotid–femoral pulse wave velocity. Pearson’s correlation coefficients and multivariable linear regression models estimated parent–child concordance. Hypertension was present in 3.9% of children and 9.0% of parents. Mean child and parent values for augmentation index were 4.5% (SD 11.6) and 21.3% (SD 12.3), respectively, and those for carotid–femoral pulse wave velocity were 4.48 m/s (SD 0.59) and 6.85 m/s (SD 1.14), respectively. Parent–child correlation for brachial systolic blood pressure was 0.20 (95% CI 0.15 to 0.24), brachial diastolic blood pressure 0.21 (95% CI 0.16 to 0.26), central systolic blood pressure 0.21 (95% CI 0.16 to 0.25), central diastolic blood pressure 0.21 (95% CI0.17 to 0.26), central pulse pressure 0.19 (95% CI 0.14 to 0.24), augmentation index 0.28 (95% CI 0.23 to 0.32) and pulse wave velocity 0.22 (95% CI 0.18 to 0.27). We report Australian values for traditional and more novel vascular function markers, providing a reference for future population studies. Cross-generational concordance in multiple vascular function markers is already established by age 11–12 years, with mechanisms of heritability remaining to be explored.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020895
Abstract: To describe objectively measured sleep characteristics in children aged 11–12 years and in parents and to examine intergenerational concordance of sleep characteristics. Population-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. Data were collected between February 2015 and March 2016 across assessment centres in Australian major cities and selected regional towns. Of the participating CheckPoint families (n=1874), sleep data were available for 1261 children (mean age 12 years, 50% girls), 1358 parents (mean age 43.8 years 88% mothers) and 1077 biological parent–child pairs. Survey weights were applied and statistical methods accounted for the complex s le design, stratification and clustering within postcodes. Parents and children were asked to wear a GENEActive wrist-worn accelerometer for 8 days to collect objective sleep data. Primary outcomes were average sleep duration, onset, offset, day-to-day variability and efficiency. All sleep characteristics were weighted 5:2 to account for weekdays versus weekends. Biological parent–child concordance was quantified using Pearson’s correlation coefficients in unadjusted models and regression coefficients in adjusted models. The mean sleep duration of parents and children was 501 min (SD 56) and 565 min (SD 44), respectively the mean sleep onset was 22:42 and 22:02, the mean sleep offset was 07:07 and 07:27, efficiency was 85.4% and 84.1%, and day-to-day variability was 9.9% and 7.4%, respectively. Parent–child correlation for sleep duration was 0.22 (95% CI 0.10 to 0.28), sleep onset was 0.42 (0.19 to 0.46), sleep offset was 0.58 (0.49 to 0.64), day-to-day variability was 0.25 (0.09 to 0.34) and sleep efficiency was 0.23 (0.10 to 0.27). These normative values for objective sleep characteristics suggest that, while most parents and children show adequate sleep duration, poor-quality (low efficiency) sleep is common. Parent–child concordance was strongest for sleep onset/offset, most likely reflecting shared environments, and modest for duration, variability and efficiency.
Publisher: SAGE Publications
Date: 29-05-2013
Abstract: Childhood mental health difficulties affect one in every seven children in Australia, posing a potential financial burden to society. This paper reports on the early lifetime in idual and population non-hospital healthcare costs to the Australian Federal Government for children experiencing mental health difficulties. It also reports on the use and cost of particular categories of service use, including the Medicare Benefits Schedule (MBS) mental health items introduced in 2006. Data from the Longitudinal Study of Australian Children (LSAC) were used to calculate total Medicare costs (government subsidised healthcare attendances and prescription medications) from birth to the 8th birthday associated with childhood mental health difficulties measured to 8–9 years of age. Costs were higher among children with mental health difficulties than those without difficulties. While in idual costs increased with the persistence of difficulties, population-level costs were highest for those with transient mental health difficulties. Although attenuated, these patterns persisted after child, parent and family characteristics were taken into account. Use of the MBS-reimbursed mental health services among children with a mental health difficulty was very low (around 2%). Australian healthcare costs for young children with mental health difficulties are substantial and provide further justification for early intervention and prevention. The current provision of Medicare-rebated mental health services does not appear to be reaching young children with mental health difficulties.
Publisher: SAGE Publications
Date: 31-05-2012
Abstract: Mental health problems are an international public health issue affecting a substantial proportion of youth. This study aimed to identify groups of young children exhibiting distinct internalising and externalising symptom trajectories across early childhood compared to existing norms. Linear regression then identified child, parenting and family predictors from infancy in the development of internalising and externalising behaviours at age 5 years. This consisted of a follow-up of 5-year-old children from a longitudinal, population-based study with earlier surveys having been completed by primary caregivers when the children were aged 7, 12, 18, 24 and 36 months. Five hundred 5-year-olds (68% retention) were included from 733 children recruited at age 6–7 months from routine well-child appointments across six socio-economically erse government areas in Victoria, Australia. Mothers then completed a further questionnaire when their children reached 5 years of age, repeating the instruments included in previous waves. The primary outcomes were the Child Behavior Checklist (CBCL), 1.5–5 internalising and externalising symptoms (T-scores in relation to norms) and behaviours (raw scores). Across early childhood, three distinct profiles for each of the internalising and externalising symptoms (T-scores) were identified and compared to CBCL norms. Around 20% of this Australian child population exhibited consistently elevated symptoms for each problem. Regarding aetiology, longitudinally the strongest predictors of internalising behaviours at 5 years of age were harsh discipline, maternal stress, having no older siblings, single parenthood and maternal substance misuse. The strongest predictors of externalising behaviours at 5 years of age were male sex, harsh discipline and maternal stress. The predictors explained 22% of the variation in internalising behaviours and 24% of the variation in externalising behaviours at 5 years. Starting as early as the toddler period, effective population approaches to preventing mental health problems are needed. Randomised trials of preventive interventions focused on improving parenting practices and reducing maternal stress are under way.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/17477160802191122
Abstract: To assess associations between multiple potential predictors and change in child body mass index (BMI). In the 1997 Health of Young Victorians Study, children in Grades preparatory to three (aged 5-10 years) had their height and weight measured. Parents provided information on potential predictors of childhood overweight across six domains (children's diet, children's activity level, family composition, sociodemographic factors, prenatal factors and parental adiposity). Measures were repeated three years later in 2000/1. BMI was transformed to standardised (z) scores using the US 2000 Growth Chart data and children were classified as non-overweight or overweight according to international cut-points. Regression analyses, including baseline BMI z-score as a covariate, assessed the contribution of each potential predictor to change in BMI z-score, development of overweight and spontaneous resolution of overweight in 1,373 children. BMI z-score change was positively associated with frequency of take-away food, food quantity, total weekly screen time, non-Australian paternal country of birth, maternal smoking during pregnancy, and maternal and paternal BMI. Inverse associations were noted for the presence of siblings and rural residence (all p<0.05). Predictors of categorical change (development and resolution of overweight) were less clearly identified, apart from an association between maternal BMI and overweight development (p=0.02). Multivariable models suggested in idual determinants have a cumulative effect on BMI change. Strong short-term tracking of BMI makes it difficult to identify predictors of change. Nonetheless, putative determinants across all domains assessed were independently associated with adiposity change. Multi-faceted solutions are likely to be required to successfully deal with the complexities of childhood overweight.
Publisher: Elsevier BV
Date: 02-2011
Publisher: Wiley
Date: 2012
DOI: 10.1111/J.1440-1754.2010.01772.X
Abstract: In late 2007, we established the Australian Paediatric Research Network (APRN) - a 350 member strong research network - which aims to facilitate high quality research into common, child health conditions seen in secondary care settings. Through this network we hope to engage paediatricians working at 'the coal face' to generate research ideas, take part in projects and ultimately contribute to better health care and policy for Australian children. As for adults, tertiary institutions remain the predominant site of paediatric research. Tertiary research however, is biased towards severe illness, isolated conditions, highly selected patients and single interventions. This is not always relevant to the real world that paediatricians confront every day. The APRN is off to a strong start. We have worked with members to establish their research priorities and conducted a prospective audit of their caseload to inform the relevance, feasibility and design of future APRN studies. We have developed a website (www.aprn.org.au) which will house useful tools for conducting research including child health measures and project design needs. We plan to call for member-initiated research proposals on an annual basis and to conduct a 'multi-topic' survey addressing up to six research topics at any one time. Although conducting research in secondary care settings poses time, cost and process challenges, all of these are firmly within the APRN's sights.
Publisher: Cambridge University Press (CUP)
Date: 04-2004
DOI: 10.1079/PHN2003537
Abstract: To investigate the prevalence and incidence of overweight and obesity, the frequency of overweight resolution and the influence of parental adiposity during middle childhood. As part of a prospective cohort study, height and weight were measured in 1997 and 2000/2001. Children were classified as non-overweight, overweight or obese based on standard international definitions. Body mass index (BMI) was transformed into age- and gender-specific Z -scores employing the LMS method and 2000 growth chart data of the Centers for Disease Control and Prevention. Parents self-reported height and weight, and were classified as underweight, healthy weight, overweight or obese based on World Health Organization definitions. Primary schools in Victoria, Australia. In total, 1438 children aged 5–10 years at baseline. The prevalence of overweight and obesity increased between baseline (15.0 and 4.3%, respectively) and follow-up (19.7 and 4.8%, respectively P 0.001 for increase in overweight and obesity combined). There were 140 incident cases of overweight (9.7% of the cohort) and 24 of obesity (1.7% of the cohort) only 3.8% of the cohort (19.8% of overweight/obese children) resolved to a healthy weight. The stability of child adiposity as measured by BMI category (84.8% remained in the same category) and BMI Z -score ( r = 0.84 mean change = −0.05) was extremely high. Mean change in BMI Z -score decreased with age (linear trend β = 0.03, 95% confidence interval 0.01–0.05). The influence of parental adiposity largely disappeared when children's baseline BMI was adjusted for. During middle childhood, the incidence of overweight/obesity exceeds the proportion of children resolving to non-overweight. However, for most children adiposity remains stable, and stability appears to increase with age. Prevention strategies targeting children in early childhood are required.
Publisher: Wiley
Date: 10-07-2017
DOI: 10.1111/APA.13929
Abstract: Time use could profoundly affect adolescents' health-related quality of life (HRQL). Ideally, overall time use patterns would be considered, because activities within a 24-hour day are inherently correlated (more in one activity means less in another). This review focused on the associations of (i) overall time use patterns and (ii) components of time use patterns with HRQL in adolescents. More physical activity, less screen time and more/adequate sleep, in isolation, are associated with better profile-based HRQL subscales. Greater understanding of adolescents' overall time use patterns and HRQL is, therefore, a priority for policy development.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020898
Abstract: Snack foods—typically high in salt, sugar, fat and/or energy—are likely important to the obesity epidemic. In the context of a population-based health assessment involving parent–child dyads at child age 11–12 years, we report cross-generational concordance in intake at a controlled snack food observation. Cross-sectional study (Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. Assessment centres in seven Australian cities, February 2015–March 2016. Of all participating CheckPoint families (n=1874), 1299 children (50.3% girls) and 1274 parents (85.9% mothers) with snack data were included. Survey weights and methods were applied to account for the clustered multistage s le design. Partway through the 3.5-hour assessment, parents and children attended Food Stop separately for a timed 15 min ‘snack break’. One of four standardised box size/content combinations was randomly provided to all participants on any given day. Total food mass, energy, nutrients and sodium consumed was measured to the nearest 1 g. Pearson’s correlation coefficients and adjusted multivariable linear regression models assessed parent–child concordance in each variable. Children consumed less grams (151 g [SD 80] vs 165 g [SD 79]) but more energy (1393 kJ [SD 537] vs 1290 kJ [SD 658]) than parents. Parent–child concordance coefficients were small, ranging from 0.07 for sodium intake to 0.17 for carbohydrate intake. Compared with children with parents’ energy intake on the 10th centile, children whose parents were on the 90th centile ate on average 227 kJ more. If extrapolated to one similar unsupervised snack on a daily basis, this equates to an additional 83 050 kJ per year, which could have a cumulative impact on additional body fat. Although modest at an in idual level, this measured parent-child concordance in unsupervised daily snack situations could account for substantial annual population differences in energy, fat and sodium intake for children aged 11–12 years. ISRCTN12538380 .
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.AMBP.2008.06.006
Abstract: A common policy response to the childhood obesity epidemic is to recommend that primary care physicians screen for and offer counseling to the overweight/obese. As the literature suggests, this approach may be ineffective it is important to document the opportunity costs incurred by brief primary care obesity interventions that ultimately may not alter body mass index (BMI) trajectory. Live, Eat and Play (LEAP) was a randomized controlled trial of a brief secondary prevention intervention delivered by family physicians in 2002-2003 that targeted overweight/mildly obese children aged 5 to 9 years. Primary care utilization was prospectively audited via medical records, and parents reported family resource use by written questionnaire. Outcome measures were BMI (primary) and parent-reported physical activity and dietary habits (secondary) in intervention compared with control children. The cost of LEAP per intervention family was AU $4094 greater than for control families, mainly due to increased family resources devoted to child physical activity. Total health sector costs were AU $873 per intervention family and AU $64 per control, a difference of AU $809 (P < .001). At 15 months, intervention children did not differ significantly in adjusted BMI or daily physical activity scores compared with the control group, but dietary habits had improved. This brief intervention resulted in higher costs to families and the health care sector, which could have been devoted to other uses that do create benefits to health and/or family well-being. This has implications for countries such as the United States, the United Kingdom, and Australia, whose current guidelines recommend routine surveillance and counseling for high child BMI in the primary care sector.
Publisher: Wiley
Date: 03-2013
DOI: 10.1002/OBY.20050
Abstract: This study aimed to determine whether (1) initial and/or (2) changes in psychosocial functioning predict body mass index (BMI) z-score change over 4 years in overweight/mildly obese 5- to 9-year old children presenting to primary care. Eligible participants (n = 258) were overweight/mildly obese children (IOTF criteria) recruited into the LEAP2 trial (ISRCTN52511065) from 3,958 children visiting general practitioners in Melbourne, Australia from May 2005 to July 2006. Predictors were change scores calculated from repeated measures of parent- and child-reported child health-related quality of life (PedsQL) and self-esteem child-reported desire to be thinner and parent-reported child weight concern. Outcome was measured BMI z-score change from baseline to 4 years. The 189 respondents (61% female 73% retention) showed little mean change in BMI z-score (-0.08) but wide variation (standard deviation 0.50, range -1.32 to 1.20). Only one baseline measure (better parent-reported PedsQL School Functioning) predicted improving BMI z-score. However, parents and children consistently reported that changes in psychosocial functioning (i.e., PedsQL Social and Global Self-esteem) were inversely related to BMI z-score change scores. The strongest predictors of decreases in BMI z-scores were changes in child-reported body-image variables, i.e., improvements in Physical Appearance Self-esteem (β =0.40, 95% CI -0.98 to -0.15, P < 0.01) and declines in Desire to be Thinner (β = 0.33, 95% CI 0.04 to 0.23, P < 0.01). At presentation to primary care, it seems unlikely that targeting the psychosocial factors measured in this study would influence BMI z-score change in overweight/mildly obese children. Subsequent change in psychosocial well-being covaries with BMI z-score change and may have important adolescent ramifications the causal directions for these associations require further research.
Publisher: BMJ
Date: 09-10-2017
Abstract: Social patterning of dietary-related diseases may partly be explained by population disparities in children's diets. This study aimed to determine which early life socioeconomic factors best predict dietary trajectories across childhood. For waves 2-6 of the Baby (B) Cohort (ages 2-3 to 10-11 years) and waves 1-6 of the Kindergarten (K) Cohort (ages 4-5 to 14-15 years) of the Longitudinal Study of Australian Children, we constructed trajectories of dietary scores and of empirically derived dietary patterns. Dietary scores, based on the Australian Dietary Guidelines, summed children's consumption frequencies of seven groups of foods or drinks over the last 24 hours. Dietary patterns at each wave were derived using factor analyses of 12-16 food or drink items. Using multinomial logistic regression analyses, we examined associations of baseline single (parental education, remoteness area, parental employment, income, food security and home ownership) and composite (socioeconomic position and neighbourhood disadvantage) factors with adherence to dietary trajectories. All dietary trajectory outcomes across both cohorts showed profound gradients by composite socioeconomic position but not by neighbourhood disadvantage. For ex le, odds for children in the lowest relative to highest socioeconomic position quintile being in the 'never healthy' relative to the 'always healthy' score trajectory were OR=16.40, 95% CI 9.40 to 28.61 (B Cohort). Among the single variables, only parental education consistently predicted dietary trajectories. Child dietary trajectories vary profoundly by family socioeconomic position. If causal, reducing dietary inequities may require researching underlying pathways, tackling socioeconomic inequities and targeting health promoting interventions to less educated families.
Publisher: Wiley
Date: 08-07-2008
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.ACAP.2009.08.007
Abstract: To describe the extent to which parent- and teacher-reported child mental health problems vary by different indicators of socioeconomic status. Participants were 4-5-year-old children in the Longitudinal Study of Australian Children (LSAC). Parents (N = 4968) and teacher (N = 3245) completed the 3-4-year-old version of Strengths and Difficulties Questionnaire (SDQ). Parents also reported the socioeconomic indicators of income, education, employment, and family composition (1- vs 2-parent families). Logistic regression models were used to predict SDQ total difficulties and each of the 4 SDQ subscales problems, as reported by parents and by teacher, and considered all putative socioeconomic status (SES) predictor variables simultaneously. The proportions of children scoring in the abnormal range varied according to SES indicator and mental health subscale. All of the SES indicators independently predicted parent-reported child mental health problems, although odds ratios were generally small to moderate (1.2 to 2.4), and not all reached statistical significance. Low income and parent education showed larger associations than sole parenthood or unemployment. The pattern for teachers was similar, though less consistent. Behavioral problems showed stronger associations with social disadvantage than emotional problems. Research examining pathways to young children's mental health should include erse measures of SES, particularly of family income and education. The fact that mental health problems were most strongly associated with parent education and income should be of interest to policy makers because education and income reflect investments in the lives of our participants' parents during their own childhood and adolescence.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2022
DOI: 10.1038/S41366-022-01130-2
Abstract: Modelling genetic pre-disposition may identify children at risk of obesity. However, most polygenic scores (PGSs) have been derived in adults, and lack validation during childhood. This study compared the utility of existing large-scale adult-derived PGSs to predict common anthropometric traits (body mass index (BMI), waist circumference, and body fat) in children and adults, and examined whether childhood BMI prediction could be improved by combining PGSs and non-genetic factors (maternal and earlier child BMI). Participants (n = 1365 children, and n = 2094 adults made up of their parents) were drawn from the Longitudinal Study of Australian Children. Children were weighed and measured every two years from 0-1 to 12-13 years, and adults were measured or self-reported measurements were obtained concurrently (average analysed). Participants were genotyped from blood or oral s les, and PGSs were derived based on published genome-wide association studies. We used linear regression to compare the relative utility of these PGSs to predict their respective traits at different ages. BMI PGSs explained up to 12% of child BMI z-score variance in 10-13 year olds, compared with up to 15% in adults. PGSs for waist circumference and body fat explained less variance (up to 8%). An interaction between BMI PGSs and puberty (p = 0.001-0.002) suggests the effect of some variants may differ across the life course. In idual BMI measures across childhood predicted 10-60% of the variance in BMI at 12-13 years, and maternal BMI and BMI PGS each added 1-9% above this. Adult-derived PGSs for BMI, particularly those derived by modelling between-variant interactions, may be useful for predicting BMI during adolescence with similar accuracy to that obtained in adulthood. The level of precision presented here to predict BMI during childhood may be relevant to public health, but is likely to be less useful for in idual clinical purposes.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-08-2017
Abstract: Lower socioeconomic position ( SEP ) predicts higher cardiovascular risk in adults. Few studies differentiate between neighborhood and family SEP or have repeated measures through childhood, which would inform understanding of potential mechanisms and the timing of interventions. We investigated whether neighborhood and family SEP , measured biennially from ages 0 to 1 year onward, was associated with carotid intima–media thickness ( IMT ) at ages 11 to 12 years. Data were obtained from 1477 families participating in the Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children. Disadvantaged family and neighborhood SEP was cross‐sectionally associated with thicker maximum carotid IMT in separate univariable linear regression models. Associations with family SEP were not attenuated in multivariable analyses, and associations with neighborhood SEP were attenuated only in models adjusted for family SEP . The difference in maximum carotid IMT between the highest and lowest family SEP quartile measured at ages 10 to 11 years was 10.7 μm (95% CI , 3.4–18.0 P =0.004), adjusted for age, sex, pubertal status, passive smoking exposure, body mass index, blood pressure, and arterial lumen diameter. In longitudinal analyses, family SEP measured as early as age 2 to 3 years was associated with maximum carotid IMT at ages 11 to 12 years (difference between highest and lowest quartile: 8.5 μm 95% CI , 1.3–15.8 P =0.02). No associations were observed between SEP and mean carotid IMT . We report a robust association between lower SEP in early childhood and carotid IMT in mid‐childhood. Further investigation of mechanisms may inform pediatric cardiovascular risk assessment and prevention strategies.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JPEDS.2018.12.030
Abstract: To evaluate how the reallocation of time between sleep, sedentary time, light, and moderate-vigorous activities is associated with children's body composition. Population-based cross-sectional Child Health CheckPoint within the Longitudinal Study of Australian Children (n = 938 11-12 year-olds, 50% boys). Twenty-four hour activity composition via accelerometry (minutes/day of sleep, sedentary time, light, and moderate-to-vigorous physical activity [MVPA]) and 3-part body composition (percentage truncal fat, percentage nontruncal fat, and percentage fat-free mass) via bioelectrical impedance analysis were measured. We estimated differences in 3-part body composition associated with the incremental reallocation of time between activities, using dual-compositional regression models adjusted for sex, age, puberty, and socioeconomic position. Reallocation of time between MVPA and any other activity was strongly associated with differences in body composition. Adverse body composition differences were larger for a given MVPA decrease than were the beneficial differences for an equivalent MVPA increase. For ex le, 15 minutes less MVPA (relative to remaining activities) was associated with absolute percentage differences of +1.7% (95% CI 1.2 2.4) for truncal fat, +0.8% (0.6 1.2) for nontruncal fat, and -2.6% (-3.5 -1.9) for fat-free mass, and a 15-minute increase was associated with -0.7% (-0.9 -0.5) truncal fat, -0.4% (-0.5 -0.3) nontruncal fat, and +1.1% (0.9 1.5) fat-free mass. Reallocations between sleep, sedentary time, and light physical activity were not associated with differences in body composition. Preventing declines in MVPA during inactive periods (eg, holidays) may be an important intervention goal. More MVPA, instead of other activities, may benefit body composition.
Publisher: Springer Science and Business Media LLC
Date: 2007
Publisher: Wiley
Date: 15-02-2021
DOI: 10.1111/JPC.15371
Abstract: Most prescribed medicines during pregnancy are antibiotics, with unknown effects on a fetus and on the infant's acquired microbiome. This study investigates associations between in utero antibiotic exposure and ear infection trajectories over the first decade of life, hypothesising effects on early or persistent, rather than later‐developing, ear infections. Design and participants: The Longitudinal Study of Australian Children birth cohort recruited a nationally‐representative s le of 5107 infants in 2004. Measures: Mothers reported antibiotic use in pregnancy when a child was 3–21 months old (wave 1), and ongoing problems with ear infection every 2 years spanning ages 0–1 to 10–11 years (waves 1–6). Analysis: Latent class models identified ear infection trajectories, and univariable and multivariable multinomial logistic regression determined odds of adverse trajectories by antibiotic exposure. A total of 4500 (88.1% of original s le) children contributed (mean baseline age 0.7 years 51.3% boys) 10.4% of mothers reported antibiotic use in pregnancy. Four probability trajectories for ear infection emerged: ‘consistently low’ (86.2%), ‘moderate to low’ (5.6%), ‘low to moderate’ (6.7%) and ‘consistently high’ (1.4%). Antibiotic use in pregnancy was associated with children following ‘consistently high’ (adjusted odds ratio 2.04, 95% confidence interval 1.08–3.88, P = 0.03) and ‘moderate to low’ (adjusted odds ratio 1.78, 95% confidence interval 1.25–2.53, P = 0.001) trajectories. Antibiotic use in pregnancy is associated with an increased risk of persistent and early childhood ear infections. This highlights the wisdom of cautious antibiotic use during pregnancy, and the need for the study of potential mechanisms underlying these associations.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1093/CDN/NZAA179
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2013
Abstract: Targeting physical activity (PA) is a mainstay in obesity treatment, but its BMI benefits are poorly quantified. We studied long-term predictive PA-BMI relationships in overweight/obese children presenting to primary care. Three-year follow-up of 182 overweight/obese 5- to 10-year-olds recruited from 45 Melbourne general practices. Predictor: 7-day accelerometry (counts per minute, cpm). Outcomes: change in BMI z score, BMI category, and clinically significant BMI improvement (z score change ≥0.5). Analysis: Linear and logistic regression. Mean (SD) baseline and 3-year BMI z scores were 1.8 (0.6) and 1.8 (0.7), and mean (SD) activity scores 334 (111) and 284 (104) cpm, respectively. Baseline activity did not predict BMI change. However, for every 100 cpm increase in change in activity over 3 years, BMI z score fell by 0.11 (95% confidence interval [CI] 0.03–0.20 P = .006). There were also trends toward greater odds of staying in the same, versus moving to a higher, BMI category (odds ratio 1.85, 95% CI 0.99–3.46) and clinically significant BMI improvement (odds ratio 1.96, 95% CI 0.90–4.27 P = .09). Change in percentage time spent in moderate-vigorous (P = .01), but not sedentary (P = .39) or light (P = .59), activity predicted reduced BMI z score. Sustained increase in moderate-vigorous PA predicts reducing BMI z score over 3 years in overweight/obese children presenting to primary care. However, the small BMI change associated with even the largest activity changes may explain disappointing BMI outcomes of brief primary care interventions targeting PA.
Publisher: CSIRO Publishing
Date: 12-02-2020
DOI: 10.1071/AH19177
Abstract: Objective The aim of this study was to assess the acceptability of a novel, integrated general practitioner (GP)–paediatrician model of care, aiming to reduce referrals to hospitals and improve primary care quality. Methods A pre-post study was conducted with five general practice clinics in north-west Melbourne. Over 12 months, 49 GPs and 896 families participated in the intervention that included weekly to fortnightly paediatrician–GP co-consultation sessions at the general practice, monthly case discussions and telephone or email clinical support for GPs. GPs and families completed surveys or interviews at three time points (before the intervention, after running the model for 4 months and at the end of the implementation). Non-identifiable consultation data were extracted from general practice medical records. Results All GPs found the model acceptable. Although not significant, there was a trend towards a lower proportion of referrals to private paediatricians after the intervention (from 34% to 20%) and emergency departments (from 19% to 12%). Outpatient clinic referrals remained steady, and then increased as the paediatrician left the clinics (31% vs 47% before and after the intervention respectively). Unnecessary prescribing of acid suppression medications decreased by 20% (from 29% to 9%). GPs reported improved confidence in paediatric care (88% vs 100% before and after the intervention respectively). Families reported increased confidence in GP care (78% vs 94% before and after the intervention respectively). Model cost estimates were A$172 above usual care per child seen in the co-consultations. Conclusions This novel model of care is acceptable to GPs and families and may improve access and quality of paediatric care. What is known about the topic? A GP–paediatrician integrated model of care appears effective in reducing hospital burden in England, but has not been implemented in Australia. What does this paper add? This pilot, an Australian first, found that a GP–paediatrician integrated model of care is feasible and acceptable in Australia’s primary healthcare system, improves GP confidence and quality of paediatric care, may reduce paediatric referrals to outpatient clinics and emergency departments and improves family confidence in, and preference for, GP care. What are the implications for practitioners? This model may reduce hospital burden and improve quality in GP paediatric care while potentially producing cost savings for families and the healthcare system.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.ACAP.2012.12.005
Abstract: In many countries, pediatricians offer skilled secondary care for children with conditions more challenging than can readily be managed in the primary care sector, but the extent to which this sector engages with the detection and management of obesity remains largely unexplored. This study aimed to audit the prevalence, diagnosis, patient, and consultation characteristics of obesity in Australian pediatric practices. This was a national prospective patient audit in Australia. During the course of 2 weeks, members of the Australian Paediatric Research Network prospectively recorded consecutive outpatient consultations by using a brief standardized data collection form. Measures included height, weight, demographics, child and parent health ratings, diagnoses, referrals, investigations, and consultation characteristics. We compared the prevalence of pediatrician-diagnosed and measured obesity (body mass index ≥95th percentile) and top-ranked diagnoses, patient, and consultation characteristics in (a) obese and nonobese children, and (b) obese children with and without a diagnosis. A total of 198 pediatricians recorded 5466 consultations with 2-17 year olds, with body mass index z-scores calculated for 3436 (62.9%). Of the 12.6% obese children, only one-third received an "overweight/obese" diagnosis. Obese children diagnosed as overweight/obese were heavier, older, and in poorer health than those not diagnosed and incurred more Medicare (government-funded health system) cost and referrals. Obesity is infrequently clinically diagnosed by Australian pediatricians and measurement practices vary widely. Further research could focus on supporting and normalizing clinical obesity activities from which pediatricians and parents could see clear benefits.
Publisher: Informa UK Limited
Date: 21-09-2022
Publisher: Oxford University Press (OUP)
Date: 30-01-2021
Abstract: Sleep plays an important role in cardiometabolic health. Although the importance of considering sleep as a multidimensional construct is widely appreciated, studies have largely focused on in idual sleep characteristics. The association between actigraphy-derived sleep profiles and cardiometabolic health in healthy adults and children has not been examined. This study used actigraphy-measured sleep data collected between February 2015 and March 2016 in the Child Health CheckPoint study. Participants wore actigraphy monitors (GENEActiv Original, Cambs, UK) on their nondominant wrist for 7 days and sleep characteristics (period, efficiency, timing, and variability) were derived from raw actigraphy data. Actigraphy-derived sleep profiles of 1,043 Australian children aged 11–12 years and 1,337 adults were determined using K-means cluster analysis. The association between cluster membership and biomarkers of cardiometabolic health (blood pressure, body mass index, apolipoproteins, glycoprotein acetyls, composite metabolic syndrome severity score) were assessed using Generalized Estimating Equations, adjusting for geographic clustering, with sex, socioeconomic status, maturity stage (age for adults, pubertal status for children), and season of data collection as covariates. Four actigraphy-derived sleep profiles were identified in both children and adults: short sleepers, late to bed, long sleepers, and overall good sleepers. The overall good sleeper pattern (characterized by adequate sleep period time, high efficiency, early bedtime, and low day-to-day variability) was associated with better cardiometabolic health in the majority of comparisons (80%). Actigraphy-derived sleep profiles are associated with cardiometabolic health in adults and children. The overall good sleeper pattern is associated with more favorable cardiometabolic health.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.ACAP.2012.12.001
Abstract: To investigate timing and strength of associations between mental health and overweight in childhood to investigate how the cumulative burden of each of these problems affects the other. Participants were 3197 children in the population-based Longitudinal Study of Australian Children. At 4 biennial waves spanning ages 4-5 to 10-11 years, parents and teachers reported child mental health on the Strengths and Difficulties Questionnaire, and researchers measured body mass index (BMI). Outcomes were analyzed both continuously and dichotomized (clinical vs no mental health problems overweight vs not overweight). Approximately 30% of participants had overweight and/or mental health problems at some point between ages 4-5 and 10-11 years. Small positive cross-sectional mental health-BMI associations emerged at 8-9 years and strengthened by 10-11 years. In longitudinal analyses, more episodes of overweight predicted higher Total Difficulties scores by 10-11 years, mainly reflecting greater Peer Problems and, to a lesser degree, Emotional Symptoms than never-overweight children though modest, these associations were robust to a range of sensitivity analyses. In post hoc analyses, overweight in late childhood was more strongly associated with poorer mental health at 10-11 years than early and fluctuating childhood overweight. Associations were smaller and less robust for mental health problems prospectively predicting higher BMI. Relationships between poorer mental health and higher BMI emerged then strengthened in middle to late childhood. In childhood, it appears that overweight precedes mental health problems, particularly peer problems and-on a lower level-emotional problems, rather than the reverse.
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.JACI.2012.01.056
Abstract: Measurement of whole peanut-specific IgE (sIgE) is often used to confirm sensitization but does not reliably predict allergy. Ara h 2 is the dominant peanut allergen detected in 90% to 100% of patients with peanut allergy and could help improve diagnosis. We sought to determine whether Ara h 2 testing might improve the accuracy of diagnosing peanut allergy and therefore circumvent the need for an oral food challenge (OFC). Infants from the population-based HealthNuts study underwent skin prick tests to determine peanut sensitization and subsequently underwent a peanut OFC to confirm allergy status. In a stratified random s le of 200 infants (100 with peanut allergy and 100 with peanut tolerance), whole peanut sIgE and Ara h 2 sIgE levels were quantified by using fluorescence enzyme immunoassay. By using the previously published 95% positive predictive value of 15 kU(A)/L for whole peanut sIgE, a corresponding specificity of 98% (95% CI, 93% to 100%) was found in this study cohort. At the equivalent specificity of 98%, the sensitivity of Ara h 2 sIgE is 60% (95% CI, 50% to 70%), correctly identifying 60% of subjects with true peanut allergy compared with only 26% correctly identified by using whole peanut sIgE. We report that when using a combined approach of plasma sIgE testing for whole peanut followed by Ara h 2 for the diagnosis of peanut allergy, the number of OFCs required is reduced by almost two thirds. Ara h 2 plasma sIgE test levels provide higher diagnostic accuracy than whole peanut plasma sIgE levels and could be considered a new diagnostic tool to distinguish peanut allergy from peanut tolerance, which might reduce the need for an OFC.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.BONE.2018.04.011
Abstract: To examine cross-sectional associations of children's bone health (size, density, strength) with moderate-vigorous physical activity (MVPA) and sedentary behaviour by considering: (1) duration of activity, (2) fragmentation, and (3) duration/fragmentation combined. Design: Population-based cross-sectional study. 11-12 year-olds in the Longitudinal Study of Australian Children's Child Health CheckPoint. Exposures: MVPA and sedentary behaviour (7-day accelerometry), yielding (1) daily average durations (min/day) and (2) fragmentations (the parameter alpha, representing the relationship between activity bout frequency and bout length). Tibial peripheral quantitative computed tomography (bone density, geometry, strength). Multivariable regression models including activity durations and fragmentations separately and combined. Of 1357 children attending the CheckPoint, 864 (64%) provided both bone and accelerometry data (mean age 11.4 years (standard deviation (SD) 0.5) 49% male). Mean daily MVPA and sedentary behaviour durations were 34.4 min/day (SD 28.3) and 667.9 min/day (SD 71.9) respectively for boys and girls combined. Each additional daily hour of MVPA was associated with small bone health benefits comprising greater periosteal and endosteal circumference (standardised effect sizes 0.25, 95% CI 0.10 to 0.40 and 0.21, 95% CI 0.03 to 0.39, respectively) and bone strength (0.26, 95% CI 0.14 to 0.38). Sedentary duration and fragmentation of either MVPA or sedentary behaviour showed little association with bone health. In early adolescence, MVPA duration showed associations with better bone health that, while modest, could be of population-level importance. MVPA fragmentation and sedentary behaviour duration and fragmentation seemed less important.
Publisher: Informa UK Limited
Date: 10-2011
DOI: 10.3109/17477166.2011.575159
Abstract: Many parents do not recognize that their young children are overweight or obese, possibly because epidemiological cutpoints may not reflect parent perceptions of overweight. We determined whether any Body mass index (BMI) cutpoint reliably triggers parent concern, drawing on the first wave (2004) of the Longitudinal Study of Australian Children (LSAC). BMI (kg/m(2)) and parent concern about their child's weight categorized in three different ways (any, moderately or greater, very) were available for 4,983 children aged 4-5. We used logistic regression to assess the relationship between BMI and parent concern, and receiver operating characteristic (ROC) curves to determine BMI cutpoints that best discriminate parent concern. Parent concern about their pre-schoolers' weight related only modestly to body mass and was not triggered by any definable BMI threshold. This may partly explain why current childhood obesity policies are ineffective, as they typically require in idual concern leading to family behavioural change.
Publisher: BMJ
Date: 14-05-2015
DOI: 10.1136/BMJ.H2318
Publisher: Heighten Science Publications Corporation
Date: 16-06-2023
DOI: 10.29328/JOURNAL.IJCV.1001053
Abstract: Targeted screening for Cytomegalovirus (CMV) in Deaf and Hard of Hearing (DHH) children is now internationally recommended. With newborn genomic screening for DHH children a future possibility, the commercially-available human genomic DNA collection kit (ORACollect, Oragene OCR-100) could enable one single s le to screen for CMV and genetic causes of deafness at scale with minimal additional costs. Our pilot study validated ORACollect against Copan FLOQswabs® (gold standard clinical procedure) for detecting CMV using 15 sets of saliva s les from 14 infants/children, comparing CMV PCR results using different testing protocols. ORACollect stored at room temperature had high sensitivity (up to 89%), specificity (up to 80%) and percent agreement (up to 86%) in detecting CMV DNA compared to FLOQswabs®. This suggests that ORACollect is an appropriate alternative to FLOQswabs® for collecting viral CMV DNA for PCR testing, independent of the DNA extraction approach. This could be revolutionary in facilitating dual genomic and viral screening in newborns and would enable CMV screening in non-tertiary hospital settings where laboratory facilities are not available.
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2021
Abstract: To examine the contribution of early life factors and preschool- and school-aged language abilities to children’s 11-year language and academic outcomes. Participants (N = 839) were from a prospective community cohort study of 1910 infants recruited at 8 to 10 months of age. Early life factors included a combination of child (prematurity, birth weight), family (socioeconomic disadvantage, family history of language difficulties), and maternal factors (education, vocabulary, and age). Language (standardized assessment of receptive and expressive skills) and academic (national assessment) outcomes at 11 years were predicted by using a series of multivariable regression models. Early life factors explained 11% to 12% of variance in language scores at 11 years. The variance explained increased to 47% to 64% when language scores from 2 to 7 years were included. The largest increase in variance explained was with 4-year language scores. The same early life factors explained 13% to 14% of academic scores at 11 years, with increases to 43% to 54% when language scores from 2 to 11 years were included. Early life factors adequately discriminated between children with typical and low language scores but were much better discriminators of children with typical and low academic scores. When earlier language scores were added to models then the area under the curve increased to 0.9 and above. Children’s language outcomes at 11 years are accurately predicted by their 4-year language ability and their academic outcomes at 11 years are predicted by early family and home environment factors. Children with low language abilities at 11 years consistently performed more poorly on national assessments of literacy and numeracy.
Publisher: Elsevier BV
Date: 2008
DOI: 10.2139/SSRN.1703265
Publisher: BMJ
Date: 09-06-2012
DOI: 10.1136/ARCHDISCHILD-2011-301305
Abstract: Higher adult blood pressure, even without hypertension, predicts cardiovascular outcomes, and is predicted by childhood blood pressure. Regular dark chocolate intake lowers blood pressure in adults, but effects in children are unknown. To examine the feasibility of school-based provision of dark chocolate and its short-term efficacy in reducing mean group blood pressure. 194 children (aged 10–12 years) were randomised by class to intervention (7 g dark chocolate daily for 7 weeks, n=124) or control (n=70) groups 98% and 93% provided baseline and follow-up measurements, respectively. Intervention and control students had similar systolic (mean difference 1.7 mm Hg, 95% CI −0.6 to 4.1) and diastolic (−1.2 mm Hg, 95% CI −3.6 to 1.3) blood pressure, anthropometry and well-being at outcome. Results show that providing dark chocolate is feasible and acceptable in the school setting. For a definitive trial, the authors recommend a larger s le, endovascular function measures, and consideration of higher antioxidant ‘dose’ by virtue of duration and/or content.
Publisher: Elsevier BV
Date: 02-2011
Publisher: Informa UK Limited
Date: 09-2015
DOI: 10.1111/AJPY.12072
Publisher: Elsevier BV
Date: 12-2022
Publisher: Elsevier BV
Date: 02-2009
Publisher: Elsevier BV
Date: 02-2019
Publisher: Informa UK Limited
Date: 2003
DOI: 10.3109/14992020309080047
Abstract: The aim of this study was to report the incidence, prevalence and clinical characteristics of congenital hearing loss sufficient to require hearing aid fitting in the first 6 years of life for the 1993 birth cohort of the state of Victoria (population 4.4 million), Australia. In 1993, 64,116 infants born in the state of Victoria survived the neonatal period. Subjects included all children with congenital hearing loss for which hearing aids were fitted, at any time up to and including 31 December 1999, when the youngest member of the cohort reached 6 years of age. Data on the degree, type and etiology of hearing loss were available from the Australian Hearing database for all subjects. Sociodemographic and health data were available from the Victorian Infant Hearing Screening Program (VIHSP) and parent questionnaires. The known prevalence of identified congenital hearing loss increased as the cohort aged. By the time the youngest member had reached the age of 6 years, 134 children (78 boys, 56 girls) had been fitted with hearing aids for permanent congenital hearing loss of any degree (2.09/1000). Fifty-four (40%) of these had known mild losses (20-40 dB HL). The prevalence of known moderate or greater loss (> 40 dB HL) was 1.12/1000 the data suggest that over 90% could have been detectable by neonatal hearing screening. A further seven children from the birth cohort were fitted with hearing aids due to acquired forms of hearing loss (0.11/1000). The etiology was known in only 57 (43%) congenital cases, with known non-syndromal genetic causes accounting for 21 (37%) of these. This study reports on the prevalence of congenital hearing loss requiring hearing aid fitting for an entire birth cohort. These data indicate the possible yield from neonatal screening, and hence the likely benefit of such screening. For a large proportion of cases, the etiology remains unknown. These data have implications for health service delivery and illustrate the usefulness of a population database in monitoring the prevalence of congenital hearing loss.
Publisher: Wiley
Date: 27-10-2008
DOI: 10.1111/J.1469-7610.2008.01943.X
Abstract: Mental health problems comprise an international public health issue affecting up to 20% of children and show considerable stability. We aimed to identify child, parenting, and family predictors from infancy in the development of externalising and internalising behaviour problems by age 3 years. Design Longitudinal, population-based survey completed by primary caregivers when children were 7, 12, 18, 24 and 36 months old. Participants 733 children sequentially recruited at 6-7 months from routine well-child appointments (August-September 2004) across six socio-economically and culturally erse government areas in Victoria, Australia 589 (80%) retained at 3 years. Measures 7 months: sociodemographic characteristics, maternal mental health (Depression Anxiety Stress Scale (DASS)), substance misuse, home violence, social isolation, infant temperament 12 months: partner relationship, parenting (Parent Behavior Checklist (PBC)) 18, 24 and 36 months: child behaviour (Child Behavior Checklist 1(1/2)-5 (CBCL)), PBC, DASS. Sixty-nine percent of all families attending well-child clinics took part. The consistent and cumulative predictors of externalising behaviours were parent stress and harsh discipline. Predictors of internalising behaviours included small family size, parent distress, and parenting. Twenty-five percent of variation in early externalising behaviour and 17% of variation in early internalising behaviour was explained. Effective and cost-efficient population approaches to preventing mental health problems early in childhood are urgently needed. Programmes must support parents in reducing personal stress as well as negative parenting practices.
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670903001893
Abstract: In childhood, mental health problems primarily consist of behaviour and emotional problems. These affect one in every seven children (i.e. 200 000 in Australia). Left untreated, up to 50% of preschool problems continue through the childhood years. Because of their high prevalence, population-based approaches will be needed to reduce their associated burden. The aim of the present study was therefore to identify evidence-based preventive interventions for behavioural and emotional problems of children aged 0–8 years. Randomized controlled trials of preventive interventions for behavioural and emotional problems were located by searching standard clinical databases and systematic reviews. The authors determined which programmes were effective and ineffective, iding the effective programmes into those with high or low risk of trial bias. Among effective programmes, the most promising for delivery in Australian contexts were identified, selected for their strength of evidence, s le comparability to Australia's population, and programme compatibility with Australia's service system. Around 50 preventive interventions have been evaluated in randomized controlled trials. Most targeted children's behavioural problems, and a few targeted emotional problems. Three US programmes have the best balance of evidence: in infancy, the in idual Nurse Home Visitation Programme at preschool age, the in idual Family Check Up at school age, the Good Behaviour Game class programme. Three parenting programmes in England and Australia are also worthy of highlight: the Incredible Years group format, Triple P in idual format, and Parent Education Programme group format. Effective preventive interventions exist primarily for behaviour and, to a lesser extent, emotional problems, and could be disseminated from research to mainstream in Australia, ensuring fidelity to original programmes. Future research should develop programmes targeting emotional problems, and replicate effective programmes for behaviour problems in quality population translation trials. Randomized trial methods in staged roll-outs can determine population cost–benefits for children's mental health without delaying dissemination.
Publisher: Springer Science and Business Media LLC
Date: 09-07-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2015
Publisher: Wiley
Date: 11-12-2017
DOI: 10.1111/CCH.12543
Publisher: Elsevier BV
Date: 11-2019
Publisher: Elsevier BV
Date: 02-2011
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JAIP.2017.10.019
Abstract: The risk of developing asthma in those with early food allergy is unknown, particularly when early life food allergy has resolved. To understand whether challenge-proven food allergy in infancy increases the risk of asthma at age 4 years, using data from a population-based cohort. A total of 5,276 12-month-old infants were recruited using a population-based s ling frame. Infants underwent skin prick test to egg, peanut, and sesame and those with a detectable skin prick test result had oral food challenges. At age 4 years, food challenges were repeated to determine persistence or resolution of food allergy. The association between food allergy and doctor-diagnosed asthma was examined using binomial regression in 2,789 participants. Children with food allergy at age 1 year had an increased risk of asthma (1 food allergy: relative risk [RR], 1.69 95% CI, 1.29-2.21 2 or more food allergies: RR, 2.76 95% CI, 1.94-3.92). The risk of asthma was highest in children with food allergy and coexistent eczema in infancy (RR, 2.87 95% CI, 2.22-3.70). Transient food allergy and persistent food allergy were both associated with an increased risk of asthma (transient egg allergy: RR, 1.92 95% CI, 1.46-2.51 persistent egg allergy: RR, 2.60 95% CI, 1.76-3.85). Asthma at age 4 years is twice as common in those with challenge-proven food allergy at age 1 year, irrespective of whether the food allergy subsequently resolves. Children with 2 or more food allergies and those with coexistent eczema were almost 3 times as likely to develop asthma compared with those with no food allergies.
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.JADOHEALTH.2012.12.018
Abstract: Early puberty has been linked to higher rates of mental health problems in adolescence. However, previous studies commencing after the initiation of puberty have been unable to explore whether early puberty is preceded by higher rates of these problems. In a large national study, we aimed to determine whether difficulties in behavior and psychosocial adjustment are evident before as well as during the early pubertal transition. The Longitudinal Study of Australian Children recruited a nationally representative cohort of 4,983 children at age 4-5 years in 2004. This analysis includes 3,491 of these children (70.1%) followed up at ages 6-7, 8-9, and 10-11 years, with a completed parent report of stage of pubertal maturation at age 8-9 years. Parents reported behavior difficulties (Strengths and Difficulties Questionnaire) and psychosocial adjustment (Pediatric Quality of Life Inventory) at all four waves from ages 4-5 to 10-11 years. Both boys and girls who entered puberty early (i.e., by age 8-9 years) also experienced poorer psychosocial adjustment at this age. These psychosocial differences were already evident at ages 4-5 and 6-7 years, and persisted to at least age 10-11 years. Similar patterns were evident for behavior difficulties, but only for boys early puberty was not related to behavior difficulties in girls. Children with early puberty have different patterns of behavior and social adjustment from the preschool years through early adolescence. At least in part, the association between early-onset puberty and poor mental health appears to result from processes under way well before the onset of puberty.
Publisher: Elsevier BV
Date: 11-2014
Abstract: Parental feeding practices are associated with children's body mass index (BMI). It has been generally assumed that parental feeding determines children's eating behaviors and weight gain, but feeding practices could equally be a parent's response to child weight. In longitudinal analyses, we assessed the directionality in the relation between selected controlling feeding practices and BMI in early childhood. Participants were 4166 children from the population-based Generation R Study. BMI was measured at ages 2 and 6 y. With the use of the Child Feeding Questionnaire, parents reported on restriction, monitoring, and pressure to eat (child age: 4 y). BMI and feeding-behavior scales were transformed to SD scores. With the use of linear regression analyses, there was an indication that a higher BMI at age 2 y predicted higher levels of parental restriction (adjusted β = 0.07 95% CI: 0.04, 0.10) and lower levels of pressure to eat (adjusted β = -0.20 95% CI: -0.23, -0.17) 2 y later. Restriction at age 4 y positively predicted child BMI at 6 y of age, although this association attenuated to statistical nonsignificance after accounting for BMI at age 4 y (β = 0.01 95% CI: -0.01, 0.03). Pressure to eat predicted lower BMI independently of BMI at age 4 y (β = -0.02 95% CI: -0.04, -0.01). For both restriction and pressure to eat, the relation from BMI to parenting was stronger than the reverse (Wald's test for comparison: P = 0.03 and < 0.001, respectively). Monitoring predicted a lower child BMI, but this relation was explained by confounding factors. Although the feeding-BMI relation is bidirectional, the main direction of observed effects suggests that parents tend to adapt their controlling feeding practices in response to their child's BMI rather than the reverse. Therefore, some components of current programs aimed at preventing or treating unhealthy child weight may need to be carefully scrutinized, especially those targeting parental food-related restriction and pressure to eat.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2011
Abstract: Early shared reading and literacy promotion benefits have stimulated international interest in the development of early-years literacy-promotion programs despite limited evidence of effectiveness at a broader population level. To determine whether a population-based primary care literacy promotion intervention during the first 2 years of life improves early markers of subsequent literacy by 2 years of age. This cluster randomized controlled trial took place in 5 relatively disadvantaged areas in Melbourne, Australia. Infants attending their maternal and child health centers were recruited at age 1–2 months. The intervention (4–8, 12, and 18 months) comprised maternal and child health nurses modelling shared reading activities to parents, supported by parent information and free books. Outcomes (at 2 years) included expressive vocabulary (MacArthur Bates Communicative Development Inventory), communication (Communication and Symbolic Behavior Scales), and home literacy environment (StimQ-Toddler). We analyzed the outcomes using random-effects (linear regression) models allowing for clustering. A total of 552 families (87.6% 324 intervention and 228 control families) of 630 recruited families (66.5% response) were retained to outcome. A total of 97.3% of intervention parents received some (93.7% to all) of the intervention. At 2 years, the trial arms had similar vocabulary (adjusted mean difference: −2.0 [95% confidence interval: −6.2 to 2.2] P = .36), communication (adjusted mean difference: 0.2 [95% confidence interval: −2.3 to 2.7] P = .87), and home literacy (adjusted mean difference: −0.4 [95% confidence interval: −1.0 to 0.2] P = .21). This universal literacy-promotion program was not beneficial in relatively disadvantaged communities by the age of 2 years and may be ineffective. Alternative interpretations may relate to program intensity, reach and/or sleeper effects. Definitive outcomes at 4 years are awaited.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.ATHEROSCLEROSIS.2019.04.212
Abstract: Pro-inflammatory diet may be a modifiable risk factor for cardiovascular disease. We examine associations of two inflammatory diet scores with preclinical cardiovascular phenotypes at two life course stages. Participants: 1771 children (49% girls) aged 11-12 years and 1793 parents (87% mothers, mean age 43.7 (standard deviation 5.2) years) in the Child Health CheckPoint Study. 23 items in the Australian National Secondary Students' Diet and Activity (NaSSDA) survey were used to derive two inflammatory diet scores based on: 1) published evidence of associations with C-reactive protein (literature-derived score), and 2) empirical associations with CheckPoint's inflammatory biomarker (glycoprotein acetyls, GlycA-derived score). Cardiovascular phenotypes assessed vascular structure (carotid intima-media thickness, retinal vessel calibre) and function (pulse wave velocity, blood pressure). Linear regression models were conducted, adjusted for age, sex, socioeconomic position and child pubertal status, plus a sensitivity analysis also including BMI (z-score for children). In adults, both inflammatory diet scores showed small associations with adverse cardiovascular function and microvascular structure. Per standard deviation higher GlycA-derived diet score, pulse wave velocity was 0.17 m/s faster (95% CI 0.11 to 0.22), mean arterial pressure was 1.85 mmHg (1.34-2.37) higher, and retinal arteriolar calibre was 1.29 μm narrower (-2.10 to -0.49). Adding BMI to models attenuated associations towards null. There was little evidence of associations in children. Our findings support cumulative adverse effects of a pro-inflammatory diet on preclinical cardiovascular phenotypes across the life course. Associations evident by mid-life were not present in childhood, when preventive measures should be instituted.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JAIP.2016.12.021
Abstract: Oral food challenge is the main tool for diagnosing food allergy, but there is little data on the reaction profiles of young children undergoing challenges, nor how these reactions compare to reactions on accidental ingestion in the community. To compare reaction profiles from food challenges and parent-reported reactions on accidental ingestion, and assess predictors of severe reactions. HealthNuts is a longitudinal population-based cohort study of 5276 1-year-old infants. Infants underwent skin prick tests and those with identifiable wheals were offered food challenges. Food challenges were repeated at age 4 years in those with previous food allergy or reporting new food allergies. Community-reported reactions were ascertained from parent questionnaires. Food challenges were undertaken in 916 children at age 1 year and 357 children at age 4 years (a total of 2047 peanut, egg, or sesame challenges). Urticaria was the most common sign in positive challenges at both ages (age 1 year, 88.7%, and age 4 years, 71.2%) although angioedema was significantly more common at age 4 years (40.1%) than at age 1 year (12.9%). Anaphylaxis was equally uncommon at both ages (2.1% and 2.8% of positive challenges at ages 1 and 4 years, respectively) but more common for peanut than for egg (4.5% and 1.2% of positive challenges at ages 1 and 4 years, respectively). The patterns of presenting signs reported during community reactions were similar to those observed in formal food challenges. Serum food-specific IgE levels of 15 kU/L or more were associated with moderate to severe reactions but skin prick test was not. There was a shift from the most common presenting reaction of urticaria during food challenges toward more angioedema in older children. Serum food-specific IgE levels were associated with reaction severity.
Publisher: Elsevier BV
Date: 04-2000
DOI: 10.1111/J.1467-842X.2000.TB00145.X
Abstract: To provide reliability, validity and population means for the Australian Authorized Adaptation of the parent-report Child Health Questionnaire (CHQ). We surveyed a representative s le of Australian parents of school-aged children (5-18 years) in Victoria between July and December 1997, using a school-based cluster s le design stratified by educational sector and age. Some 5,414 parents responded (72%). Good psychometric performance was observed for the CHQ in Australia. Population means demonstrated differences in health on domains of functioning and well-being by age and gender. This population-derived s le demonstrated high ceiling values on Physical Functioning and Social Role scales. The CHQ appears to be a reliable and valid measure of child and adolescent functional health and well-being for the Australian population. Child health outcomes of children and adolescents with particular conditions or within population subgroups can be compared with these age and gender benchmarks. Appropriate uses for the CHQ may be to discriminate between children who are generally healthy and children with health problems, or in population surveys partnered with measures that extend the range of physical functioning and social functioning.
Publisher: Cambridge University Press (CUP)
Date: 30-10-2009
DOI: 10.1017/S030500090999016X
Abstract: This study examines potential predictors of ‘precocious talking’ (expressive language ⩾90th percentile) at one and two years of age, and of ‘stability’ in precocious talking across both time periods, drawing on data from a prospective community cohort comprising over 1,800 children. Logistic regression was used to examine the relationship between precocious talking and the following potential predictors: gender, birth order, birth weight, non-English speaking background, socioeconomic status, maternal age, maternal mental health scores, and vocabulary and educational attainment of parents. The strongest predictors of precocity (being female and having a younger mother) warrant further exploration. Overall, however, it appears that precocity in early vocabulary development is not strongly influenced by the variables examined, which together explained just 2·6% and 1% of the variation at 1 0 and 2 0 respectively.
Publisher: BMJ
Date: 14-03-2011
Abstract: Short sleep duration may contribute to childhood obesity. Amenable to intervention, sleep thus provides a potential path for prevention. The authors aimed to determine the impact of a behavioural intervention that successfully reduced parent-reported infant sleep problems on adiposity at age 6. 5-year follow-up of a previously reported population-based cluster randomised trial. Participant allocation was concealed to researchers and data collection blinded. Recruitment from well-child centres in Melbourne, Australia. 328 children (174 intervention) with parent-reported sleep problems at age 7-8 months drawn from 49 centres (clusters). Behavioural sleep strategies delivered over one to three structured in idual nurse consultations from 8 to 10 months, versus usual care. MAIN OUTCOMES AT AGE 6 YEARS: Body mass index (BMI) z-score, percentage overweight/obese and waist circumference. Intention-to-treat regression analyses adjusted for potential confounders. Anthropometric data were available for 193 children (59% retention) at age 6. There was no evidence of a difference between intervention (N=101) and control (N=92) children for BMI z-score (adjusted mean difference 0.2, 95% CI -0.1 to 0.4), overweight/obese status (20% vs 17% adjusted OR 1.4, 95% CI 0.7 to 2.8) and waist circumference (adjusted mean difference -0.3, 95% CI -1.6 to 1.1). In posthoc analyses, neither infant nor childhood sleep duration were associated with anthropometric outcomes. A brief infant sleep intervention did not reduce overweight/obesity at 6 years. Population-based primary care sleep services seem unlikely to reduce the early childhood obesity epidemic.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2011
Abstract: To determine predictors of child externalizing (behavioral) and internalizing (emotional) symptoms in a national population s le. Data were collected in 3 biennial waves (2004, 2006, and 2008) from 2 cohorts in the Longitudinal Study of Australian Children, initially including 5107 children 0 to 1 year of age and 4983 children 4 to 5 years of age. The primary outcomes were child externalizing and internalizing symptoms. Relationships between potential risk factors and child mental health outcomes were described by using linear regression. In unadjusted analyses, children's mental health symptoms were predicted by a large number of risk factors. In multivariate models, early childhood factors (birth through 5 years) explained 30% and 18% of variations in externalizing and internalizing symptoms, respectively, at 4 to 5 years of age. Middle childhood (5–9 years of age) factors explained 20% and 23% of variations in externalizing and internalizing symptoms, respectively, at 8 to 9 years of age. Harsh discipline was a strong consistent predictor of externalizing symptoms in both age groups, whereas poorer child physical health, maternal emotional distress, harsh discipline, and overinvolved rotective parenting (younger cohort only) predicted internalizing symptoms consistently. National data on predictors of child mental health symptoms highlighted a small number of significant risk factors, situated in the family context and present from a very young age. This knowledge is informing population-level, randomized, prevention trials of family support programs.
Publisher: Cambridge University Press (CUP)
Date: 18-01-2021
DOI: 10.1017/S2040174420001245
Abstract: While birth cohorts are shaped by underpinning life course frameworks, few if any report how they select them. This review aimed to (1) summarise publicly available frameworks relevant to planning and communicating large new early-life cohorts and (2) help select frameworks to guide and communicate Generation Victoria (GenV), a whole-of-state birth and parent cohort in planning in the state of Victoria, Australia. We identified potential frameworks from prior knowledge, networks and a pragmatic literature search in 2019. We considered for inclusion only frameworks with an existing visual graphic. We summarised each framework’s concept, then judged it on a seven-item matrix (Scope, Dimensions, Outcomes, Life course, Mechanisms, Multi-age, and Visual Clarity) to be of high, intermediate or low relevance to GenV. We presented and evaluated 14 life course frameworks across research and policy. Two, nine and three frameworks, respectively, were ranked as high, intermediate and low relevance to GenV, although none totally communicated its scope and intent. Shonkoff’s biodevelopmental framework was selected as GenV’s primary framework, adapted to include ongoing feedback loops through the life course and influence of an in idual’s outcomes on the next generation. Because conceptual simplicity precluded the primary framework from capturing the wide range of relevant exposures, we selected the Australian Institute of Health and Welfare’s person-centred model as a secondary framework. This summary of existing life course frameworks may prove helpful to other cohorts in planning. Our transparent process and focus on visual communication are already assisting in explaining and selecting measures for GenV. The feasibility, comprehension and validity of these frameworks could be further tested at implementation.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2007
Abstract: OBJECTIVE. Infant sleep problems are strongly associated with poorer maternal mental health. It is not known whether they are also associated with poorer paternal mental health, nor whether sleep problems in older children are associated with maternal or paternal mental health. We aimed to examine relationships between child sleep problems and maternal and paternal mental health and general well-being in each of the infant and preschool-aged groups. METHODS. Participants of this cross-sectional survey included families of infants (n = 5107) and preschool-aged children (n = 4983) participating in the first wave of the nationally representative Longitudinal Study of Australian Children, surveyed March through November 2004. The primary outcomes were mother and father serious psychological distress (measured by the Kessler-6) and general health (parent report of general health taken from the 12-item Short Form Health Survey and dichotomized into poor versus good health). A primary caregiver's report of the child's sleep problem was dichotomized into moderate/severe versus none/mild. RESULTS. The prevalence of severe psychological distress ranged from 3% to 5%, and prevalence of poor general health ranged from 8% to 11%. Moderate to severe sleep problems affected 17% of infants and 14% of preschool-aged children. Infant sleep problems were associated with poor general health in mothers and with poor general health in fathers. Preschool sleep problems were associated with poor maternal general health. In mothers with no past history of depression, infant sleep problems had a greater effect on severe psychological distress compared with mothers with a past history of depression. CONCLUSIONS. Sleep problems are common in infants and preschool-aged children. Infant sleep problems, in particular, are associated with poorer health in both parents, especially the mental health of mothers with no past history of depression.
Publisher: JMIR Publications Inc.
Date: 14-08-2020
Abstract: any current research needs can only be addressed using very large cohorts. In such studies, traditional one-on-one phone, face-to-face, or paper-based engagement may not be feasible. The only realistic mechanism for maintaining engagement and participation at this scale is via digital methods. Given the substantial investment being made into very large birth cohort studies, evidence for optimal methods of participant engagement, participation, and retention over sustained periods without in-person contact from researchers is paramount. his study aims to provide an overview of systematic reviews and meta-analyses evaluating alternative strategies for maximizing participant engagement and retention rates in large-scale studies using digital methods. e used a rapid review method by searching PubMed and Ovid MEDLINE databases from January 2012 to December 2019. Studies evaluating at least 1 e-engagement, participation, or retention strategy were eligible. Articles were screened for relevance based on preset inclusion and exclusion criteria. The methodological quality of the included reviews was assessed using the AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews 2) measurement tool, and a narrative synthesis of the data was conducted. he literature search yielded 19 eligible reviews. Overall, 63% (n=12) of these reviews reported on the effectiveness of e-engagement or participation promotion strategies. These evaluations were generally not conducted within very large observational digital cohorts. Most of the contributing reviews included multipurpose cohort studies (with both observational and interventional elements) conducted in clinical and research settings. Email or SMS text message reminders, SMS text messages or voice notifications, and incentives were the most commonly used design features to engage and retain participants. For parental outcomes, engagement-facilitation interventions influenced uptake and behavior change, including video feedback, goal setting, and intensive human facilitation and support. Participant-stated preferences for content included new knowledge, reminders, solutions, and suggestions about health issues presented in a clear, short, and personalized way. Perinatal and postpartum women valued self-monitoring and personalized feedback. Digital reminders and multiple SMS text messages were specific strategies that were found to increase adherence to medication and clinic attendance, respectively. his review adds to the growing literature evaluating methods to optimize engagement and participation that may apply to large-scale studies using digital methods it is promising that most e-engagement and participation promotion strategies appear to be effective. However, these reviews canvassed relatively few strategies, suggesting that few alternative strategies have been experimentally evaluated. The reviews also revealed a dearth of experimental evidence generated within very large observational digital cohort studies, which may reflect the small number of such studies worldwide. Thus, very large studies may need to proactively build in experimental opportunities to test engagement and retention approaches to enhance the success of their own and other large digital contact studies.
Publisher: Springer Science and Business Media LLC
Date: 2007
Publisher: SAGE Publications
Date: 23-05-2020
Abstract: Poorer mental health in adulthood is associated with increased risk of cardiovascular disease and reduced life expectancy. However, little is known of the molecular pathways underpinning this relationship and how early in life adverse metabolite profiles relate to self-reported variation in mental health. We examined cross-sectional associations between mental health and serum metabolites indicative of cardiovascular health, in large Australian population-based cohorts at two stages of the life-course. We characterised cross-sectional serum nuclear magnetic resonance metabolite profiles of positively and negatively framed mental health in a large population-based s le of Australian 11- to 12-year-olds ( n = 1172 51% girls) and mid-life adults (n = 1322 mean age 45 years 87% women). We examined multiple standard self-report mental health scales, spanning psychosocial health, general well-being, life satisfaction, and health-related quality of life. Linear regression was used to investigate the cross-sectional association between mental health and each metabolite (n = 73) in children and adults separately, unadjusted and adjusted for age, sex, socioeconomic position and body mass index. Better child and adult mental health were associated with lower levels of the inflammatory marker glycoprotein acetyls, and a favourable, less atherogenic lipid/lipoprotein profile. Patterns of association in children were generally weaker than in adults. Associations were generally modest and partially attenuated when adjusted for body mass index. In general, metabolite profiles associated with better child and adult mental health closely aligned with those predictive of better cardiovascular health in adults. Our findings support previous evidence for the likely bidirectional relationship between mental health and cardiovascular disease risk, by extending this evidence base to the molecular level and in children.
Publisher: Springer Science and Business Media LLC
Date: 05-2002
Abstract: Childhood overweight/obesity is associated with poor physical and psychosocial health in clinical s les. However, there is little information on the health status of overweight and obese children in the community, who now represent a large proportion of the child population. We examined parent-reported child health and well-being and parent concern about child weight by body mass index (BMI) category in a population s le of primary school children. A stratified two-stage random cluster s le of 24 primary schools representative of the state of Victoria, Australia. BMI (weight/height(2)) transformed to normalised Z-scores using the 1990 UK Growth Reference the Child Health Questionnaire (CHQ), a 13-scale 50-item parent-completed measure of health and well-being parent self-reported height and weight parent concern about child's weight. Data were available for 2863 children aged 5-13 y (50.5% male), of whom 17% were overweight and 5.7% obese. Using logistic regression analyses with 'normal weight' as the referent category, obese boys were at greater risk of poor health (ie <15th centile) on seven of the 12 CHQ scales: Physical Functioning (odds ratio (OR) 2.8), Bodily Pain (OR 1.8), General Health (OR 3.5), Mental Health (OR 2.8), Self Esteem (OR 1.8), Parent Impact-Emotional (OR 1.7) and Parent Impact-Time (OR 1.9). Obese girls were at greater risk of poor health on only two scales: General Health (OR 2.1) and Self Esteem (OR 1.8). Forty-two percent of parents with obese children and 81% with overweight children did not report concern about their child's weight. Parents were more likely to report concern if the child was obese (OR 21.3), overweight (OR 3.5) or underweight (OR 5.4) than normal weight (P<0.05). Concern was not related to child gender, parental BMI or parental education after controlling for child BMI. Perceived health and well-being of overweight/obese children varied little by weight category of the reporting parent (overweight vs non-overweight). Parents were more likely to report poorer health and well-being for overweight and obese children (particularly obese boys). Parental concern about their child's weight was strongly associated with their child's actual BMI. Despite this, most parents of overweight and obese children did not report poor health or well-being, and a high proportion did not report concern. This has implications for the early identification of such children and the success of prevention and intervention efforts. DOI:10.1038/sj/ijo/0801974
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.ACAP.2009.04.003
Abstract: To describe time adolescents spend using electronic media (television, computer, video games, and telephone) and to examine associations between self-reported health/well-being and daily time spent using electronic media overall and each type of electronic media. Design-Cross-sectional data from the third (2005) wave of the Health of Young Victorians Study, an Australian school-based population study. Outcome Measures-Global health, health-related quality of life (HRQoL KIDSCREEN), health status (Pediatric Quality of Life Inventory 4.0 PedsQL), depression/anxiety (Kessler-10), and behavior problems (Strengths and Difficulties Questionnaire). Exposure Measures-Duration of electronic media use averaged over 1 to 4 days recalled with the Multimedia Activity Recall for Children and Adolescents (MARCA) computerized time-use diary. Analysis-Linear and logistic regression adjusted for demographic variables and body mass index z score. A total of 925 adolescents (mean +/- standard deviation age, 16.1+/-1.2 years) spent, on average, 3 hours 16 minutes per day using electronic media (television, 128 minutes per day video games, 35 computers, 19 telephone, 13). High overall electronic media use was associated with poorer behavior, health status, and HRQoL. Associations with duration of specific media exposures were mixed there was a favorable association between computer use (typing/Internet) and psychological distress, whereas high video game use was associated with poorer health status, HRQoL, global health, and depression/anxiety. Television and telephone durations were not associated with any outcome measure. Despite television's associations with obesity, time spent in other forms of media use appear more strongly related to adolescent health and well-being. This study supports efforts to reduce high video game use and further exploration of the role of computers in health enhancement.
Publisher: Wiley
Date: 12-11-2015
DOI: 10.1111/JPC.12760
Abstract: To report the cumulative incidence, health-seeking behaviour and medical intervention of infants with gastro-oesophageal reflux (GOR) in the first year of life. The HealthNuts study is a longitudinal, population-based study. At 12 months of age, infants underwent skin prick testing to food allergens, including cows milk. Parents completed a questionnaire on GOR symptoms, food allergy and treatments. Factors associated with seeking health care for infants with GOR were modelled using logistic regression. Of 4674 infants, parents reported GOR in 1054 (23% 95% confidence interval (CI) 21.4-23.8). Parents consulted a medical practitioner in 662 (64%) cases. Symptoms commenced in the first month in 411 (48%) and resolved within 6 months in 703 (75%) infants. Factors associated with doctor consultation for GOR were prematurity (adjusted odds ratio (aOR) 1.94 95% CI 1.43-2.63) and family history of atopy (aOR 1.64 95% CI 1.1-2.43). Eight per cent of infants (371/4674 95% CI 7.2-8.7) received anti-reflux medication and 6% (296/4674 95% CI 5.7-7.1) changed formula. Parents were more likely to seek treatment if they perceived their infant to be unsettled (aOR 2.55 95% CI 1.26-5.17) and if the duration of GOR was prolonged (aOR 3.36 for symptoms >6 months 95% CI 1.83-6.17). In the first year of life, approximately 14% of the population seek medical advice for GOR symptoms. The use of anti-reflux medication in the general community remains high, despite the absence of evidence that it is appropriate or effective for uncomplicated GOR.
Publisher: Wiley
Date: 21-11-2003
DOI: 10.1002/IJC.10815
Abstract: The improving prognosis for children with cancer refocuses attention to long-term outcomes with an emphasis on quality of life. Few studies have examined relationships and differences in reported results between the parent, child and clinician. We examined parent-proxy and clinician-reported functional status and health-related quality of life for children and adolescents with acute lymphoblastic leukemia (ALL). Children and adolescents, 5-18 years, in the maintenance phase of treatment for ALL attending the Haematology/Oncology outpatient clinic at the Royal Children's Hospital, Melbourne, were eligible. Measures included: 1) parent-reported functional health and well-being (Child Health Questionnaire [CHQ]) 2) parent-reported condition specific quality of life (Pediatric Cancer Quality of Life inventory [PCQL]) 3) clinician ratings of physical and psychosocial health and 4) clinical indicators. Insufficient numbers of older patients prohibited collection of adolescent self-reports. We had a 94% response and 31 participants. Mean time since diagnosis: 1.5 (SD 0.4) years. Parents reported significantly lower functioning and well-being than population norms for all CHQ scales, whereas cancer-specific quality of life was comparable to PCQL norms. Clinician reports of the child's global physical and psychosocial health were moderately associated with each other (r(s) = 0.56, p < 0.001), and with the parent-reported physical (r(s) = 0.47, p < 0.01) and psychosocial (r(s) = 0.56, p < 0.001) CHQ summary scores. Clinician reports of the child's psychosocial health were not associated with any clinical indicators reported regularly. The results demonstrate that the social, physical and emotional health and well-being of children with ALL is significantly poorer than the health of their community-based peers. Routinely collected indicators of clinical progress conceal the psychosocial burden of ALL. Data on health, well-being and quality of life can easily be incorporated into clinical care.
Publisher: Informa UK Limited
Date: 2009
Publisher: Walter de Gruyter GmbH
Date: 08-06-2022
Abstract: Newborn screening (NBS) programs operate in many countries, processing millions of dried bloodspot (DBS) s les annually. In addition to early identification of various adverse health outcomes, these s les have considerable potential as a resource for population-based research that could address key questions related to child health. The feasibility of archival DBS s les for emerging targeted and untargeted multi-omics analysis has not been previously explored in the literature. This review aims to critically evaluate the latest advances to identify opportunities and challenges of applying omics analyses to NBS cards in a research setting. Medline, Embase and PubMed databases were searched to identify studies utilizing DBS for genomic, proteomic and metabolomic assays. A total of 800 records were identified after removing duplicates, of which 23 records were included in this review. These papers consisted of one combined genomic/metabolomic, four genomic, three epigenomic, four proteomic and 11 metabolomic studies. Together they demonstrate that the increasing sensitivity of multi-omic analytical techniques makes the broad use of NBS s les achievable for large cohort studies. Maintaining the pre-analytical integrity of the DBS s le through storage at temperatures below −20 °C will enable this important resource to be fully realized in a research capacity.
Publisher: Elsevier BV
Date: 09-2007
Publisher: Springer Science and Business Media LLC
Date: 07-10-2019
DOI: 10.1038/S41366-019-0457-2
Abstract: We examined how combinations of clinical indicators at various ages predict overweight/obesity development, as well as resolution, by 10-11 and 14-15 years of age. Data were derived from Birth (N = 3469) and Kinder (N = 3276) cohorts of the Longitudinal Study of Australian Children, followed from ages 2-3 and 4-5 years, respectively. Every two years, 25 potential obesity-relevant clinical indicators were quantified. Overweight/obesity was defined using International Obesity Taskforce cutpoints at 10-11 years and 14-15 years. In both cohorts, three factors predicted both development and resolution of overweight/obesity in multivariable models. Among normal weight children, increased odds of developing overweight/obesity were associated with higher child (odd ratio (OR) 1.67-3.35 across different study waves) and maternal (OR 1.05-1.09) BMI, and inversely with higher maternal education (OR 0.60-0.62, when assessed at age 2-7 years). Lower odds of resolving existing overweight/obesity were related with higher child (OR 0.51-0.79) and maternal (OR 0.89-0.95) BMI, and inversely with higher maternal education (OR 1.62-1.92, when assessed at age 2-5 years). The prevalence of overweight/obesity at the age of 14-15 years was 13% among children with none of these risk factors at age 6-7 years, compared with 71% among those with all 3 risk factors (P < 0.001). From early childhood onwards, child and maternal BMI and maternal education predict overweight/obesity onset and resolution by adolescence. A simple risk score, easily available to child health clinicians, could help target treatment or prevention.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.JPEDS.2016.08.064
Abstract: To evaluate the associations between breastfeeding duration, age at solids introduction, and their interaction in relation to infant (age 9-15 months) above normal body mass index (BMI). Cross-sectional, population-based study with 3153 infants from Melbourne (2007-2011). Above normal BMI (z score > 2, equivalent to >97.7th percentile) defined using the World Health Organization standard. Both longer duration of full and any (full or partial) breastfeeding were associated with lower odds of above normal BMI (eg, aOR, 0.37 [95% CI, 0.22-0.60] for full breastfeeding 4-5 months versus 0-1 months). Compared with introduction of solids at 5-6 months, both early and delayed introduction were associated with increased odds of above normal BMI (aOR for 4 months, 1.75 [95% CI, 1.10-2.80] and for ≥7 months, 2.64 [95% CI, 1.26-5.54] versus 6 months). Such associations differ by breastfeeding status at 4 months (interaction P = .08). Early introduction of solids was associated with increased odds of above normal BMI in both infants fully or partially breastfed for ≥4 months (aOR, 3.66 95% CI, 1.41-9.51) and those breastfed for <4 months (aOR, 3.11 95% CI, 1.39-6.97). Introduction of solids at ≥7 months was associated with increased odds of above normal BMI (aOR, 5.79 95% CI, 1.91-17.49) among infants breastfed for <4 months only. Introduction of solids at 5-6 months, compared with either early or delayed introduction, is associated with decreased odds of above normal BMI at 1 year of age, regardless of infants' breastfeeding status at 4 months. These results may have implications for public health guidelines with regard to recommendations about the optimal timing of the introduction of solid foods in infancy.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-03-2021
Publisher: Public Library of Science (PLoS)
Date: 31-07-2013
DOI: 10.1371/ANNOTATION/F7E5E1F3-77F6-4C56-B0BA-53B54A86DF14
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.ACAP.2017.10.001
Abstract: Maternal shared reading practices predict emergent literacy, but fathers' contributions are less certain. We examined whether fathers' shared home reading activities at 2 years predict language and emergent literacy at age 4 years, when controlling for maternal contributions and whether this differentially benefits these outcomes in disadvantaged children. Two-parent families were recruited from 5 relatively disadvantaged communities for the universal Let's Read literacy promotion population-based trial (ISRCTN 04602902) in Melbourne, Australia. For exposure at 2 years, home reading practices were recorded via self-reported maternal and paternal StimQ-Toddler questionnaires and dichotomized at study median (high vs low). At 4 years, outcomes assessed included receptive and expressive language (Clinical Evaluation of Language Fundamentals 4) and emergent literacy (Sunderland Phonological Awareness Test-Revised). Linear regression, adjusted for mothers' home reading, was performed to assess 2-year-old vocabulary and communication skills and family disadvantage. Interaction of disadvantage (yes vs no) with high home reading by fathers and at least one parent was assessed. Data were available for 405 families (64.3%). High father reading at 2 years (reference: low) predicted better expressive (mean difference, 4.7 95% confidence interval, 1.5 to 8.0) and receptive (mean difference, 5.0 95% confidence interval, 1.8 to 8.2) language at 4 years (both P < .001), but not emergent literacy skills. Similar patterns were observed in families with at least one parent with high home reading. Fathers' reading did not differentially benefit outcomes in disadvantaged children. Fathers' involvement in reading at 2 years predicted better language but not emergent literacy at 4 years, and it did not protect against adverse effects of socioeconomic disadvantage.
Publisher: BMJ
Date: 18-08-2011
DOI: 10.1136/BMJ.D4741
Publisher: Wiley
Date: 11-2010
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-023194
Abstract: To describe the epidemiology and parent–child concordance of objectively measured physical activity in a population-based s le of Australian parent–child dyads. Cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children. Assessment centres in seven Australian cities and eight regional towns or home visits February 2015–March 2016. Of all CheckPoint families (n=1874), 1261 children (50% girls) and 1358 parent (88% mothers) provided objectively measured activity data, comprising 1077 parent–child dyads. Activity behaviour was assessed by GENEActiv accelerometer. Duration of moderate-to-vigorous physical activity (MVPA) and vigorous physical activity and sedentary behaviour (SB) were derived using Cobra custom software, along with MVPA/SB fragmentation and mean daily activity. Pearson’s correlation coefficients and linear regression estimated parent–child concordance. Survey weights and methods accounted for the complex s le design and clustering. Although parents had average lower accelerometry counts than children (mean [SD] 209 [46] vs 284 [71] g.min), 93% of parents met MVPA daily duration guidelines on published cutpoints (mean [SD] 125 [63] min/day MVPA), compared with only 15% of children (mean 32 [27] min). Parents showed less daily SB duration (parents: 540 [101], children: 681 [69] minutes) and less fragmented accumulation of MVPA (parents: α=1.85, children: α=2.00). Parent–child correlation coefficients were 0.16 (95% CI 0.11 to 0.22) for MVPA duration, 0.10 (95% CI 0.04 to 0.16) for MVPA fragmentation, 0.16 (95% CI 0.11 to 0.22) for SB duration and 0.18 (95% CI 0.12 to 0.23) for SB fragmentation. Standardised cutpoints are needed for objective activity measures to inform activity guidelines across the lifecourse. This may reflect large amounts of time in non-shared environments (school and work).
Publisher: Wiley
Date: 23-02-2004
Publisher: Wiley
Date: 13-06-2014
DOI: 10.1111/JPC.12649
Abstract: We studied infants and children with and without special health care needs (SHCN) during the first 8 years of life to compare the (i) types and costs to the government's Medicare system of non-hospital health-care services and prescription medication in each year and (ii) cumulative costs according to persistence of SHCN. Data from the first two biennial waves of the nationally representative Longitudinal Study of Australian Children, comprising two independent cohorts recruited in 2004, at ages 0-1 (n = 5107) and 4-5 (n = 4983) years. Exposure condition: parent-reported Children with Special Health Care Needs Screener at both waves, spanning ages 0-7 years. Federal Government Medicare expenditure, via data linkage to the Medicare database, on non-hospital health-care attendances and prescriptions from birth to 8 years. At both waves and in both cohorts, >92% of children had complete SHCN and Medicare data. The proportion of children with SHCN increased from 6.1% at age 0-1 years to 15.0% at age 6-7 years. Their additional Medicare costs ranged from $491 per child at 6-7 years to $1202 at 0-1 year. This equates to an additional $161.8 million annual cost or 0.8% of federal funding for non-hospital-based health care. In both cohorts, costs were highest for children with persistent SHCNs. SHCNs incur substantial non-hospital costs to Medicare, and no doubt other sources of care, from early childhood. This suggests that economic evaluations of early prevention and intervention services for SHCNs should consider impacts on not only the child and family but also the health-care system.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-023196
Abstract: To describe the epidemiology and parent-child concordance of hearing, speech reception, vocabulary and language in Australian parent-child dyads at child age 11 to 12 years. Population-based cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children. Assessment centres in seven Australian cities and eight regional towns or home visits around Australia, February 2015 to March 2016. Of all participating CheckPoint families (n=1874), 1516 children (50% female) and 1520 parents (87% mothers, mean age 43.8 years) undertook at least one of four measurements of hearing and language. Hearing threshold (better ear mean of 1, 2 and 4 kHz) from pure-tone audiometry, speech reception threshold, receptive vocabulary, expressive and receptive languages using a sentence repetition task. Parent-child concordance was examined using Pearson’s correlation coefficients and adjusted linear regression models. Survey weights and methods accounted for Longitudinal Study of Australian Children’s complex s ling and stratification. Children had a similar speech reception threshold to parents (children mean −14.3, SD 2.4 parents −14.9, SD 3.2 dB) but better hearing acuity (children 8.3, SD 6.3 parents 13.4, SD 7.0 decibels hearing level). Standardised sentence repetition scores were similar (children 9.8, SD 2.9 parents 9.1, SD 3.3) but, as expected, parents had superior receptive vocabularies. Parent-child correlations were higher for the cognitively-based language measures (vocabulary 0.31, 95% CI 0.26 to 0.36 sentence repetition 0.29, 95% CI 0.24 to 0.34) than the auditory measures (hearing 0.18, 95% CI 0.13 to 0.23 speech reception threshold 0.18, 95% CI 0.13 to 0.22). Mother-child and father-child concordances were similar for all measures. We provide population reference values for multiple measures spanning auditory and verbal communication systems in children and mid-life adults. Concordance values aligned with previous twin studies and offspring studies in adults, in keeping with polygenic heritability that is modest for audition but around 60% for language by late childhood.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-07-2019
Abstract: High‐throughput nuclear magnetic resonance profiling of circulating metabolites is suggested as an adjunct for cardiovascular risk evaluation. The relationship between metabolites and subclinical atherosclerosis remains unclear, particularly among children. Therefore, we examined the associations of metabolites with carotid intima‐media thickness ( cIMT ) and arterial pulse wave velocity ( PWV ). Data from two independent population‐based studies was examined (1) cross‐sectional associations with cIMT and PWV in 1178 children (age 11–12 years, 51% female) and 1316 parents (mean age 45 years, 87% female) from the CheckPoint study (Australia) and (2) longitudinal associations in 4249 children (metabolites at 7–8 years, PWV at 10–11 years, 52% female), and cross‐sectional associations in 4171 of their mothers (mean age 48 years, cIMT data) from ALSPAC (The Avon Longitudinal Study of Parents and Children UK ). Metabolites were measured by the same nuclear magnetic resonance platform in both studies, comprising of 69 biomarkers. Biophysical assessments included body mass index, blood pressure, cIMT and PWV . In linear regression analyses adjusted for age, sex, body mass index, and blood pressure, there was no evidence of metabolite associations in either children or adults for cIMT at a 10% false discovery threshold. In CheckPoint adults, glucose was positively, and some high‐density lipoprotein‐cholesterol derived measures and amino acids (glutamine, histidine, tyrosine) inversely associated with PWV. These data suggest that in children circulating metabolites have no consistent association with cIMT and PWV once adjusted for body mass index and blood pressure. In their middle‐aged parents, some evidence of metabolite associations with PWV were identified that warrant further investigation.
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.MVR.2019.103966
Abstract: Traditional retinal microvascular parameters (smaller arteriolar and greater venular caliber) are associated with cardiovascular risk factors, pre-clinical vascular phenotypes and clinical cardiovascular events in adults. Although novel retinal microvascular geometric parameters showed analogous associations in adults, less is known whether these parameters are associated with cardiovascular health from childhood. In a population-based cross-sectional study in children (n = 1126, mean age 11.4 years, 50.3% girls), we examined associations of cardiovascular risk factors and pre-clinical arterial phenotypes with retinal geometric parameters. Cardiovascular parameters included body mass index (BMI), an inflammatory marker (GlycA), low-density lipoprotein and high-density lipoprotein (HDL) cholesterol, systolic (SBP) and diastolic blood pressure, large artery functional (pulse wave velocity, PWV and carotid arterial elasticity) and structural (carotid intima-media thickness) phenotypes. Retinal geometric parameters (fractal dimension (D
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2004
Publisher: BMJ
Date: 16-02-2018
DOI: 10.1136/ARCHDISCHILD-2017-313191
Abstract: To estimate prevalence and persistence of 19 common paediatric conditions from infancy to 14–15 years. Population-based prospective cohort study. Australia. Parallel cohorts assessed biennially from 2004 to 2014 from ages 0–1 and 4–5 years to 10–11 and 14–15 years, respectively, in the Longitudinal Study of Australian Children. 19 health conditions: 17 parent-reported, 2 (overweight/obesity, obesity) directly assessed. Two general measures: health status, special health care needs. Analysis: (1) prevalence estimated in 2-year age-bands and (2) persistence rates calculated at each subsequent time point for each condition among affected children. 10 090 children participated in Wave 1 and 6717 in all waves. From age 2, more than 60% of children were experiencing at least one health condition at any age. Distinct prevalence patterns by age-bands comprised eight conditions that steadily rose (overweight/obesity, obesity, injury, anxiety/depression, frequent headaches, abdominal pain, autism spectrum disorder, attention-deficit hyperactivity disorder). Six conditions fell with age (eczema, sleep problems, day-wetting, soiling, constipation, recurrent tonsillitis), three remained stable (asthma, diabetes, epilepsy) and two peaked in mid-childhood (dental decay, recurrent ear infections). Conditions were more likely to persist if present for 2 years persistence was especially high for obesity beyond 6–7 (91.3%–95.1% persisting at 14–15). Beyond infancy, most Australian children are experiencing at least one ongoing health condition at any given time. This study’s age-specific estimates of prevalence and persistence should assist families and clinicians to plan care. Conditions showing little resolution (obesity, asthma, attention-deficit hyperactivity disorder) require long-term planning and management.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.SLEH.2018.05.004
Abstract: Sleep is important for the physical, social and mental well-being of both children and adults. In this paper, we discuss the need to consider sleep as a multidimensional construct and as a component of total 24-hour activity. First, we make a case for considering sleep as a multidimensional construct, whereby all characteristics of sleep (including duration, quality, timing, and variability) and their links with health are examined. Second, we argue that sleep should also be conceptualized as part of the daily spectrum of time-use, along with other types of activity. We propose novel statistical models, in particular compositional data analysis (CoDA), as appropriate analytical methods for a new sleep paradigm.
Publisher: Wiley
Date: 04-2005
DOI: 10.1111/J.1440-1754.2005.00587.X
Abstract: Universal Newborn Hearing Screening (UNHS) programmes have been widely implemented, but their costs, benefits and long-term logistics remain to be clearly defined. There are few rigorous evaluations of alternative strategies. In this paper, we evaluate the performance of the distraction test component of the two-tiered Victorian Infant Hearing Screening Program (VIHSP). All babies born in the State of Victoria, Australia in 1993 who survived the neonatal period were screened for the presence of risk factors for hearing loss. Those at-risk were referred for Auditory Brainstem Evoked Response (ABR) screening by a professional audiologist. All others were screened by modified distraction test at age 7-9 months. This birth cohort was followed through age 6 for diagnoses of congenital hearing loss resulting in fitting of hearing aids. Estimates of false-positives, false-negatives, sensitivity, specificity and positive predictive values were determined for the distraction test as a population screen. Ages at diagnosis and aid fitting for screen failures with hearing loss were compared with current goals. For targeted (moderate or greater-aided) losses, the distraction test yielded eight (0.02%) documented false-negatives (one severe and seven moderate) and an estimated 4265 (99%) false-positives. Distraction test sensitivity was 65%, specificity 91% and PPV 0.3%. Mean age at diagnosis for distraction test failures across all severities, including mild losses, was 23 (SD 18) months with a mean age at aid fitting of 26 (SD 20) months. The distraction test screen generated large numbers of false-positives and a significant number of false-negatives, performing particularly poorly with moderate losses. Ages at diagnosis and aid fitting for screen failures were far older than currently accepted goals. There is little evidence that the distraction test can be made to work acceptably as a population-based screen.
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.3109/17477166.2010.549491
Abstract: We aimed to systematically review current literature on temporal relationships between psychological factors and subsequent adiposity gain and obesity onset within childhood/adolescence. Databases were searched for longitudinal, population-based studies assessing psychological predictors and adiposity-related outcomes ≥ 1 year later. Study characteristics were synthesised into descriptive Tables and quality evaluated. Fifteen papers met inclusion criteria. Predictors broadly related to psychological symptoms or self-esteem. Evidence was mixed as to whether depressive symptoms and other negative emotional states may increase risk for adiposity gain and obesity onset within adolescence. There was some evidence for low self-esteem predicting obesity onset. Among obese adolescents, depressive symptoms exacerbated obesity, while physical appearance self-esteem exerted gender-specific adiposity changes. The literature had substantial limitations and inconsistencies. This review provides some support for psychological components in obesity prevention/intervention programs as part of a multifactorial approach to tackling childhood obesity. Further good-quality longitudinal research would strengthen the sparse literature and clarify inconsistencies.
Publisher: American Medical Association (AMA)
Date: 05-01-2005
Abstract: The negative effects of childhood overweight and obesity on quality of life (QOL) have been shown in clinical s les but not yet in population-based community s les. To determine relationships between weight and health-related QOL reported by parent-proxy and child self-report in a population s le of elementary school children. Cross-sectional data collected in 2000 within the Health of Young Victorians Study, a longitudinal cohort study commenced in 1997. In iduals were recruited via a random 2-stage s ling design from primary schools in Victoria, Australia. Of the 1943 children in the original cohort, 1569 (80.8%) were resurveyed 3 years later at a mean age of 10.4 years. Health-related QOL using the PedsQL 4.0 survey completed by both parent-proxy and by child self-report. Summary scores for children's total, physical, and psychosocial health and subscale scores for emotional, social, and school functioning were compared by weight category based on International Obesity Task Force cut points. Of 1456 participants, 1099 (75.5%) children were classified as not overweight 294 (20.2%) overweight and 63 (4.3%) obese. Parent-proxy and child self-reported PedsQL scores decreased with increasing child weight. The parent-proxy total PedsQL mean (SD) score for children who were not overweight was 83.1 (12.5) overweight, 80.0 (13.6) and obese, 75.0 (14.5) P<.001. The respective child self-reported total PedsQL mean (SD) scores were 80.5 (12.2), 79.3 (12.8), and 74.0 (14.2) P<.001. At the subscale level, child and parent-proxy reported scores were similar, showing decreases in physical and social functioning for obese children compared with children who were not overweight (all P<.001). Decreases in emotional and school functioning scores by weight category were not significant. The effects of child overweight and obesity on health-related QOL in this community-based s le were significant but smaller than in a clinical s le using the same measure.
Publisher: Wiley
Date: 07-09-2012
DOI: 10.1111/ALL.12015
Abstract: Although egg allergy is the most common food allergy in infants and young children, risk factors for egg allergy remain largely unknown. This study examined the relationship between environmental and demographic factors and egg allergy in a population-based infant cohort. In a study of 5276 infants (HealthNuts), infants underwent skin prick testing (SPT) to egg white at 12 months of age. Questionnaire data on relevant exposures were obtained. 699/873 (80%) infants eligible for oral food challenge (detectable wheal on SPT) attended for formal assessment of egg allergy status 453 had confirmed egg allergy (positive challenge and SPT ≥ 2 mm). Associations between environmental and demographic factors and egg allergy were investigated using multivariable logistic regression. Children with older siblings and those with a pet dog at home were less likely to develop egg allergy by 1 year of age (adjusted OR [aOR], 0.72 95% CI, 0.62, 0.83 per sibling and aOR, 0.72 95% CI, 0.52, 0.99, respectively). Caesarean section delivery, antibiotic use in infancy, childcare attendance and maternal age were not associated with egg allergy. History of allergic disease in an immediate family member and having parents born in East Asia were strong risk factors for infantile egg allergy (aOR, 1.82 95% CI, 1.40, 2.36 and aOR, 3.30 95% CI, 2.45, 4.45, respectively). Exposure in the first year of life to siblings and dogs may decrease the risk of subsequent egg allergy. Infants with a family history of allergy and those with parents born in East Asia are at increased risk of egg allergy.
Publisher: Springer Science and Business Media LLC
Date: 09-11-2020
DOI: 10.1038/S41440-020-00576-Z
Abstract: Reservoir pressure parameters (i.e., reservoir pressure [RP] and excess pressure [XSP]) independently predict cardiovascular events in adults, but this has not been investigated in children. This study aimed to determine (1) the association of reservoir pressure parameters with carotid intima-media thickness (carotid IMT), a preclinical vascular phenotype, and (2) whether a multivariable regression model with or without reservoir pressure parameters fits better for estimating carotid IMT in children. Study participants were 11-12-year-old children (n = 1231, 50% male) from the Child Health CheckPoint study, a cross-sectional substudy of the population-based Longitudinal Study of Australian Children. RP and XSP were obtained using brachial-cuff oscillometry (SphygmoCor XCEL, AtCor, Sydney). Carotid IMT was quantified by vascular ultrasonography. XSP was associated with carotid IMT after adjusting for confounders including age, sex, BMI z-score, heart rate, pubertal stage, moderate-to-vigorous physical activity, and mean arterial pressure (β = 0.93 µm, 95% CI 0.30-1.56 for XSP peak and β = 0.04 µm, 95% CI 0.01-0.08 for XSP integral). The results of the likelihood ratio test indicated a trend that the model with XSP and the above confounders fit better than a similar model without XSP for estimating carotid IMT. Our findings indicate that brachial-cuff device-measured XSP is associated with carotid IMT independent of conventional cardiovascular risk factors, including standard BP. This implies that a clinically convenient cuff approach could provide meaningful information for the early assessment of cardiovascular risk among children.
Publisher: Public Library of Science (PLoS)
Date: 23-07-2013
Publisher: American Academy of Pediatrics (AAP)
Date: 2016
Publisher: BMJ
Date: 31-01-2018
DOI: 10.1136/ARCHDISCHILD-2017-313505
Abstract: In a national study of Australian children aged 11–12 years old, we examined the (1) prevalence and characteristics of hearing loss, (2) its demographic risk factors and (3) evidence for secular increases since 1990. This is a cross-sectional CheckPoint wave within the Longitudinal Study of Australian Children. 1485 children (49.8% retention 49.7% boys) underwent air-conduction audiometry. Aim 1: hearing loss (≥16 decibels hearing level (dB HL)) was defined in four ways to enable prior/future comparisons: high Fletcher Index (mean of 1, 2 and 4 kHz primary outcome relevant to speech perception), four-frequency (1, 2, 4 and 8 kHz), lower frequency (1 and 2 kHz) and higher frequency (4 and 8 kHz) aim 2: logistic regression of hearing loss by age, gender and disadvantage index and aim 3: P for trend examining CheckPoint and reported prevalence in studies arranged by date since 1990. For high Fletcher Index, the prevalence of bilateral and unilateral hearing loss ≥16 dB HL was 9.3% and 13.3%, respectively. Slight losses (16–25 dB HL) were more prevalent than mild or greater (≥26 dB HL) losses (bilateral 8.5% vs 0.8% unilateral 12.5% vs 0.9%), and lower frequency more prevalent than higher frequency losses (bilateral 11.0% vs 6.9% unilateral 15.4% vs 11.5%). Demographic characteristics did not convincingly predict hearing loss. Prevalence of bilateral/unilateral lower and higher frequency losses ≥16 dB HL has risen since 1990 (all P for trend .001). Childhood hearing loss is prevalent and has risen since 1990. Future research should investigate the causes, course and impact of these changes.
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2011
Abstract: To investigate prospectively the relationship between BMI and the mental health and health-related quality of life (HRQoL) of young children. In this study we used data from the Longitudinal Study of Australian Children obtained when children were 4 to 5 and 8 to 9 years old. BMI was available for 3363 children at both waves. Mental health problems were assessed by using the Strengths and Difficulties Questionnaire (SDQ), which was completed by parents and teachers. HRQoL was assessed by using the Pediatric Quality of Life Inventory (PedsQL), which was completed by the parents. Logistic regression models were adjusted for children's age, gender, baseline SDQ or PedsQL scores, and maternal characteristics. A 1-SD increase in BMI in children aged 4 to 5 years was associated with increased odds of scoring in the abnormal range of the SDQ peer problems scale of 1.15 (95% confidence interval [CI]: 1.03–1.28) for parent reports and 1.20 (95% CI: 1.04–1.37) for teacher reports when these children were aged 8 to 9 years. The odds ratio for children who scored above the at-risk cutoff on the parent-reported PedsQL social problems scale was 1.17 (95% CI: 1.06–1.28) for each 1-SD increase at 4 to 5 years of age. There were also increased odds for teacher reports of childhood emotional problems. Higher BMI in children aged 4 to 5 years was positively related to poorer peer relationships and teacher-reported emotional problems but not to other childhood mental health problems, in these children at 8 to 9 years of age. Prospective studies are needed to determine if peer problems experienced by children with higher BMI predict subsequent mental health problems in other areas.
Publisher: Oxford University Press (OUP)
Date: 10-05-2022
DOI: 10.1093/IJE/DYAC086
Publisher: Wiley
Date: 20-05-2018
DOI: 10.1111/JPC.13943
Abstract: Cardiovascular disease and mental illness commonly co-occur in later life, but it is unknown how early these associations arise. We aimed to determine the extent to which: (i) childhood mental health is associated with functional and structural cardiovascular risk phenotypes and adiposity in late childhood/adolescence, and (ii) associations between mental health and cardiovascular phenotypes may be explained by differential body mass index. This cross-sectional study drew on three longitudinal community-based cohort studies (two enriched for overweight/obesity) in metropolitan Melbourne, Australia, with harmonized follow-up in 2014. Mental health exposures included emotional and behavioural problems (Strength and Difficulties Questionnaire) and psychosocial health and general well-being (Pediatric Quality of Life Inventory (PedsQL)), which were assessed by self- and parent-proxy report. Cardiovascular risk phenotypes and adiposity measures included mean arterial pressure, pulse wave velocity, carotid artery intima-media thickness, retinal arterioleto-venule ratio, waist circumference, % body fat, and BMI z-score. We used multivariable linear regression models, adjusting for age, sex and neighbourhood disadvantage, to examine associations. Of the 364 participants (mean age 14.7, standard deviation 2.0, years), 30% were overweight and 16% obese. All adiposity indicators were positively associated with higher behavioural/emotional problems and poorer psychosocial health and negatively associated with better ratings of positive general well-being, as reported by parents and children (all P ≤ 0.03). However, there was little evidence that cardiovascular functional or structural phenotypes varied by mental health. By late childhood/adolescence, mental health is strongly associated with adiposity but not with cardiovascular structure or function. This suggests that the known relationship between these constructs may not develop until early or mid-adulthood.
Publisher: Springer Science and Business Media LLC
Date: 19-07-2018
DOI: 10.1038/S41366-018-0170-6
Abstract: Hearing loss is a disabling condition whose prevalence rises with age. Obesity-a risk factor common to many non-communicable diseases-now appears to be implicated. We aimed to determine: (1) cross-sectional associations of body composition measures with hearing in mid-childhood and mid-life and (2) its longitudinal associations with 10-year body mass index (BMI) trajectories. Design & Participants: There were 1481 11-12-year-old children and 1266 mothers in the population-based cross-sectional CheckPoint study nested within the Longitudinal Study of Australian Children (LSAC). Anthropometry (CheckPoint): BMI, fat/fat-free mass indices, waist-to-height ratio LSAC wave 2-6-biennial measured BMI. Audiometry (CheckPoint): Mean hearing threshold across 1, 2 and 4 kHz hearing loss (threshold > 15 dB HL, better ear). Latent class models identifying BMI trajectories linear/logistic regression quantifying associations of body composition/trajectories with hearing threshold/loss. Measures of adiposity, but not fat-free mass, were cross-sectionally associated with hearing. Fat mass index predicted the hearing threshold and loss in children (β 0.6, 95% confidence interval (CI) 0.3-0.8, P < 0.001 , odds ratio (OR) 1.2, 95% CI 1.0-1.4, P = 0.05) and mothers (β 0.8, 95% CI 0.5-1.2, P < 0.001 OR 1.2, 95% CI 1.1-1.4, P = 0.003). Concurrent obesity (OR 1.5, 95% CI 1.1-2.1, P = 0.02) and waist-to-height ratio (WHtR) ≥ 0.6 (OR 1.6, 95% CI 1.2-2.3, P = 0.01) predicted maternal hearing, with similar but attenuated patterns in children. In longitudinal analyses, mothers', but not children's, BMI trajectories predicted hearing (OR for severely obese 3.0, 95% CI 1.4-6.6, P = 0.01). Concurrent adiposity and decade-long BMI trajectories showed small, but clear, associations with poor hearing in mid-life women, with emergent patterns by mid-childhood. This suggests that obesity may play a role in the rising global burden of hearing loss. Replication and mechanistic and body compositional studies could elucidate possible causal relationships.
Publisher: Springer Science and Business Media LLC
Date: 18-05-2020
Publisher: Wiley
Date: 02-2013
DOI: 10.1111/COB.12014
Abstract: In 2010, the Management Stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN) undertook a Delphi survey asking 'What research questions remain to be addressed in the effective management of child and adolescent obesity?' Members of ACAORN, the Child and Adolescent Obesity Clinics of Australasia Network (CAOCOA-Net) and attendees at the Child Obesity symposium at the annual scientific meeting for the Australian and New Zealand Obesity Society (ANZOS) contributed to three rounds of survey development. Although reasonable concordance in ratings was evident for all 10 questions, 'determining the best strategies for long-term weight management' and 'how best to support the primary healthcare system to achieve these strategies' were clearly identified as the highest research priorities. Other priorities included 'how best to identify the right children with whom to intervene' and 'managing factors which impact on service delivery'. Identifying priority research areas from those working in the field offers the opportunity to stimulate research collaboration and provide justification for funding applications.
Publisher: Wiley
Date: 14-10-2001
Publisher: American Academy of Pediatrics (AAP)
Date: 09-2013
Abstract: To document the natural history of stuttering by age 4 years, including (1) cumulative incidence of onset, (2) 12-month recovery status, (3) predictors of stuttering onset and recovery, and (4) potential comorbidities. The study cohort was a prospective community-ascertained cohort (the Early Language in Victoria Study) from Melbourne, Australia, of 4-year-old children (n = 1619 recruited at age 8 months) and their mothers. Outcome was stuttering onset by age 4 years and recovery within 12 months of onset, defined using concurrent monthly parent and speech pathologist ratings. Potential predictors: child gender, birth weight, birth order, prematurity, and twinning maternal mental health and education socioeconomic status and family history of stuttering. Potential comorbidities: preonset and concurrent temperament, language, nonverbal cognition, and health-related quality of life. By age 4 years, the cumulative incidence of stuttering onset was 11.2% (95% confidence interval [CI]: 9.7% to 12.8%). Higher maternal education (P = .004), male gender (P = .02), and twinning (P = .005) predicted stuttering onset. At outcome, stuttering children had stronger language (mean [SD]: 105.0 [13.0] vs 99.6 [14.6] mean difference 5.5, 95% CI: 3.1 to 7.8 P & .001) and nonverbal cognition (mean [SD]: 106.5 [11.4] vs 103.9 [13.7], mean difference 2.6, 95% CI: 0.4 to 4.8 P = .02) and better health-related quality of life but were otherwise similar to their nonstuttering peers. Only 9 of 142 children (6.3% 95% CI: 2.9% to 11.7%) recovered within 12 months of onset. Although stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset.
Publisher: Wiley
Date: 2007
Publisher: Wiley
Date: 05-10-1999
DOI: 10.1046/J.1440-1754.1999.355395.X
Abstract: Parents ascribe many infant symptoms to teething, despite little evidence to support such an attribution. We report current parental beliefs about teething and its management in a suburban Australian setting. A written questionnaire was given to all English-speaking parents consecutively attending infant hearing testing sessions in one Melbourne municipality between August and October 1997. Approximately 90% of Victorian infants attend these sessions. Parents of 92 infants (mean age 9.9 months) completed questionnaires (97% response rate). Only one believed that teething causes no problems. Most (70-85%) believed that teething causes fever, pain, irritability, sleep disturbance, mouthing/biting, drooling and red cheeks 35-55% reported nappy rash, 'sooking', ear pulling, feeding problems, runny nose, loose stools, and infections and a few (< 15%) reported smelly urine, constipation, colic or convulsions. Symptoms reported for a parent's own infant correlated almost perfectly with symptoms believed to be experienced by infants generally (r = 0.97, P < 0.001). Amount of infant distress when teething correlated with more 'difficult' infant temperament (r = 0.25, P < 0.05), and longer duration of symptoms per tooth correlated with parent distress (r = 0.26, P < 0. 05). Paracetamol (60%) and topical analgesia (55%) were commonly used remedies. Parents diagnose teething more by the presence of 'teething symptoms' (65%) than by palpable (43%) or visible (36%) tooth eruption. Teething is a distressing but ill-defined phenomenon reported by almost all parents of young children, and most use some form of medication to manage it. Most symptoms are minor and relate to discomfort rather than physical illness, but a substantial minority still ascribes potentially serious symptoms to teething.
Publisher: Wiley
Date: 04-06-2013
DOI: 10.1111/OBR.12047
Abstract: To evaluate the effectiveness of school-based physical activity interventions on fitness, adiposity and cardiometabolic outcomes among schoolchildren. Medline, Embase, EBSCOhost CINAHL and ERIC databases were searched up to October 2012. intervention delivered at school with controls having no intervention or usual physical education classes participants aged 5-18 years outcomes spanning some or all of the above. We assessed levels of evidence for identified trials based on methodological quality and s le size. Dose of the interventions (a total summary measure of intensity, frequency and duration) were considered. Eighteen randomized controlled trials (RCTs, total participants = 6,207) were included, of which six were large, higher quality trials with high dose of the intervention. The intervention was consistent in increasing fitness with large, higher quality studies and high dose of intervention providing strong evidence. Dose of school-based physical activity is an important determinant of trial efficiency. Some large, higher quality RCTs provided strong evidence for interventions to decrease skin-fold thickness, increase fitness and high-density lipoprotein cholesterol. Evidence for body mass index, body fat and waist circumference, blood pressure and triglycerides, low-density lipoprotein cholesterol and total cholesterol remain inconclusive and require additional higher quality studies with high dose of interventions to provide conclusive evidence.
Publisher: BMJ
Date: 12-11-2015
Publisher: BMJ
Date: 11-2006
Publisher: Cambridge University Press (CUP)
Date: 28-04-2017
DOI: 10.1017/S0007114517000897
Abstract: This study aimed to derive and compare longitudinal trajectories of dietary scores and patterns from 2–3 to 10–11 years and from 4–5 to 14–15 years of age. In waves two to six of the Baby (B) Cohort and one to six of the Kindergarten (K) Cohort of the population-based Longitudinal Study of Australian Children, parents or children reported biennially on the study child’s consumption of twelve to sixteen healthy and less healthy food or drink items for the previous 24 h. For each wave, we derived a dietary score from 0 to 14, based on the 2013 Australian Dietary Guidelines (higher scores indicating healthier diet). We then used factor analyses to empirically derive dietary patterns for separate waves. Using group-based trajectory modelling, we generated trajectories of dietary scores and empirical patterns in 4504 B and 4640 K Cohort children. Four similar trajectories of dietary scores emerged for the B and K Cohorts, containing comparable proportions of children in each cohort: ‘never healthy’ (8·8 and 11·9 %, respectively), ‘moderately healthy’ (24·0 and 20·7 %), ‘becoming less healthy’ (16·6 and 27·3 %) and ‘always healthy’ (50·7 and 40·2 %). Deriving trajectories based on dietary patterns, rather than dietary scores, produced similar findings. For ‘becoming less healthy’ trajectories, dietary quality appeared to worsen from 7 years of age in both cohorts. In conclusion, a brief dietary measure administered repeatedly across childhood generated robust, nuanced dietary trajectories that were replicable across two cohorts and two methodologies. These trajectories appear ideal for future research into dietary determinants and health outcomes.
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.SLEEP.2012.04.014
Abstract: To examine whether infant sleep problems predict (1) sleep problems and (2) poorer outcomes at the age of six years. We studied a community-based cohort of 326 six-year-olds recruited to a randomized trial of a behavioral sleep intervention for sleep problems at age seven months. Predictors were parent-reported child sleep problems at ages 4, 12, and 24 months ("yes" vs. "no"). There were a number of parent reported six-year-old outcomes: (1) Child sleep problem ("moderate/large" vs. "none/small") and Child Sleep Habits Questionnaire (CSHQ) (2) child and maternal mental and global health, child health-related quality of life (HRQoL, also child-reported), and child-parent relationship. The analyses were composed of multivariable models, adjusting for potential confounders and six-year sleep problems, examining whether each outcome was predicted by each infant sleep problem entered simultaneously. In a second set of analyses the predictor was the count of the number of waves with a sleep problem. A total of 225 (69%) families participated at six years. The CSHQ Total increased 0.5 points (95% CI: 0.4 to 2.4, p=0.006) with each additional infant sleep problem, but there was little evidence that sleep problems at one or more time points during early childhood predicted other child, maternal, or child-parent outcomes at six years. Infant sleep problems, whether transient, recurring, or persistent, do not predict long-term outcomes. Clinicians should focus on reducing child sleep problems and their considerable short-to-medium term impacts as they arise during childhood.
Publisher: Springer Science and Business Media LLC
Date: 08-06-2012
Publisher: Wiley
Date: 03-09-2010
DOI: 10.1111/J.1440-1754.2010.01830.X
Abstract: To determine whether adolescent health and well-being are associated with having a pet in the household (any pet, or specifically dogs, cats or horses onies) or average daily time spent caring for laying with pet(s). Design, setting and participants--Cross-sectional data from the third wave of the Health of Young Victorians Study (HOYVS), a school-based population study in Victoria, Australia. Predictors--Adolescent-reported pet ownership and average daily time spent caring for laying with pet(s). Outcomes--Self-reported quality of life (KIDSCREEN) average 4-day daily physical activity level from a computerised diary parent-proxy and self-reported physical and psychosocial health status (PedsQL) measured BMI status (not overweight, overweight, obese) and blood pressure. Statistical Analysis--Regression methods, adjusted for socio-demographic factors, and non-parametric methods. Household pet data were available for 928 adolescents (466 boys mean age of 15.9 (SD 1.2) years). Most adolescents (88.7%) reported having a pet in their household. Of these, 75.1% reported no activity involving pets over the surveyed days. It appeared that neither owning a pet nor time spent caring for laying with a pet was related, positively or negatively, to adolescent health or well-being. Despite high rates of pet ownership, adolescents had little interaction with pets. It appears that owning a pet and time spent caring for laying with a pet was not clearly associated with adolescents' health or well-being.
Publisher: Springer Science and Business Media LLC
Date: 14-05-2013
DOI: 10.1038/IJO.2013.71
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: American Academy of Pediatrics (AAP)
Date: 11-2006
Abstract: OBJECTIVE. The goal was to determine the prevalence and effects of slight/mild bilateral sensorineural hearing loss among children in elementary school. METHODS. A cross-sectional, cluster-s le survey of 6581 children (response: 85% grade 1: n = 3367 grade 5: n = 3214) in 89 schools in Melbourne, Australia, was performed. Slight/mild bilateral sensorineural hearing loss was defined as a low-frequency pure-tone average across 0.5, 1, and 2 kHz and/or a high-frequency pure-tone average across 3, 4, and 6 kHz of 16 to 40 dB hearing level in the better ear, with air/bone-conduction gaps of & dB. Parents reported children's health-related quality of life and behavior. Each child with slight/mild bilateral sensorineural hearing loss, matched to 2 normally hearing children (low-frequency pure-tone average and high-frequency pure-tone average of ≤15 dB hearing level in both ears), completed standardized assessments. Whole-s le comparisons were adjusted for type of school, grade level, and gender, and matched-s le comparisons were adjusted for nonverbal IQ scores. RESULTS. Fifty-five children (0.88%) had slight/mild bilateral sensorineural hearing loss. Children with and without sensorineural hearing loss scored similarly in language (mean: 97.2 vs 99.7), reading (101.1 vs 102.8), behavior (8.4 vs 7.0), and parent- and child-reported child health-related quality of life (77.6 vs 80.0 and 76.1 vs 77.0, respectively), but phonologic short-term memory was poorer (91.0 vs 102.8) in the sensorineural hearing loss group. CONCLUSIONS. The prevalence of slight/mild bilateral sensorineural hearing loss was lower than reported in previous studies. There was no strong evidence that slight/mild bilateral sensorineural hearing loss affects adversely language, reading, behavior, or health-related quality of life in children who are otherwise healthy and of normal intelligence.
Publisher: Informa UK Limited
Date: 16-03-2020
Publisher: Elsevier BV
Date: 08-2001
DOI: 10.1016/S1054-139X(01)00211-7
Abstract: To evaluate a new generic measure of adolescent health status, the self-report version of the Child Health Questionnaire (CHQ), and provide population-based data. Furthermore, we aimed to examine the impact of common adolescent illness and health concerns on their health and well-being. A stratified, two-stage, random cluster s ling design was used to obtain a cross-sectional s le of subjects through schools. A written questionnaire included the 80-item 12-scale self-report CHQ and items measuring health concerns, illnesses/health conditions, and sociodemographics. A total of 2361 adolescents participated (response rate of 70%). Reliability was high: Tests of internal consistency and discriminant validity reported 90% of item-scale correlations >.4 all scales had Cronbach alpha coefficients >.7. Adolescents with illnesses/conditions or health concerns reported lower scores and larger differences for content-related scales, supporting content and construct validity. Statistically significant age and gender trends were observed for Mental Health, Self-Esteem, General Health, and Family Cohesion scales. Health status worsened as health concerns increased (X(2) linear trend, p =.00) with deterioration in health of 5-20% on all scales for emotional health concerns (40% of s le). The self-report CHQ is a reliable and seemingly valid measure of health and well-being for adolescent health research, although additional measures may be required where scales have high ceiling values. The significantly lower scores reported by adolescents with illness and/or health concerns lend support to the use of standardized health measures and longitudinal research to further examine the impact of adolescent comorbidities and their causal determinants.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-022400
Abstract: To describe the epidemiology and concordance of bone health in a population-based s le of Australian parent-child dyads at child age 11–12 years. Population-based cross-sectional study (the Child Health CheckPoint) nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC). Assessment centres in seven cities around Australia, February 2015–March 2016. Participants: of all participating CheckPoint families (n=1874), bone data were available for 1222 dyads (1271 children, 50% girls 1250 parents, 86% mothers). Peripheral quantitative CT (pQCT) of the non-dominant leg scanned at the 4% (distal) and 66% (mid-calf) tibial sites. Stratec XCT 2000 software generated estimates of bone density, geometry and polar stress-strain index. Parent-child concordance were assessed using Pearson’s correlation coefficients and multivariable linear regression models. Percentiles were determined using survey weights. Survey weights and methods accounted for LSAC’s complex s ling, stratification and clustering within postcodes. Concordances were greater for the geometric pQCT parameters (periosteal circumference 0.38, 95% CI 0.33 to 0.43 endosteal circumference 0.42, 95% CI 0.37 to 0.47 total cross-sectional area 0.37, 95% CI 0.32 to 0.42) than density (cortical density 0.25, 95% CI 0.19 to 0.30). Mother-child and father-child values were similar. Relationships attenuated only slightly on adjustment for age, sex and body mass index. Percentiles and concordance are presented for the whole s le and by sex. There is strong parent-child concordance in bone geometry and, to a lesser extent, density even before the period of peak adolescent bone deposition. This geometrical concordance suggests that future intergenerational bone studies could consider using pQCT rather than the more commonly used dual X-ray absorptiometry (DXA).
Publisher: Elsevier BV
Date: 06-2023
Publisher: BMJ
Date: 07-02-2018
DOI: 10.1136/BMJ.K507
Publisher: BMJ
Date: 09-2006
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.ACAP.2017.03.002
Abstract: We aimed to determine whether the accumulation of physical, psychosocial, and combined health adversities measured at age 8 to 9 years predicts worsening of academic scores cross-sectionally at 8 to 9 and longitudinally at 10 to 11 years. Design: Longitudinal data from Waves 3 and 4 in the Longitudinal Study of Australian Children (83% of 4983 retained). Exposures (8-9 years): Physical health adversities (yes/no summed range, 0-5): overweight, special health care needs, chronic illness, PedsQL Physical, and global health. Psychosocial health adversities (yes/no summed range, 0-4): parent- and teacher-reported behavior, PedsQL Psychosocial, sleep problems. Combined health adversities (range 0-9). Outcomes (8-9, and 10-11 years): National academic standardized test scores. Generalized estimating equations, accounting for multiple academic domains in each year and socioeconomic position and cognition. At 8 to 9 years, 23.9%, 9.9%, and 5.3% had 1, 2, or ≥3 physical health adversities, respectively, while 27.2%, 9.5%, and 4.9% had 1, 2, or ≥3 psychosocial health adversities. For each additional health adversity at 8 to 9 years, academic scores fell incrementally in year 3 and year 5 (both P < .001), with reductions of at least 0.4 SDs for ≥3 health adversities. Number was more important than type (physical, psychosocial) of adversity. The accumulation of health adversities predicts poorer academic achievement up to 2 years later. Interventions might need to address multiple domains to improve child academic outcomes and be delivered across the health-education interface.
Publisher: MDPI AG
Date: 14-07-2023
Abstract: Through a cross-sectional community study of 2044 children aged 2 years, we (1) examine the impact of hearing loss on early spoken expressive vocabulary outcomes and (2) investigate how early intervention-related factors impact expressive vocabulary outcomes in children with hearing loss predominantly identified through universal newborn hearing screening. We used validated parent/caregiver-reported checklists from two longitudinal cohorts (302 children with unilateral or bilateral hearing loss, 1742 children without hearing loss) representing the same population in Victoria, Australia. The impact of hearing loss and lification-related factors on vocabulary was estimated using g-computation and multivariable linear regression. Children with versus without hearing loss had poorer expressive vocabulary scores, with mean scores for bilateral loss 0.5 (mild loss) to 0.9 (profound loss) standard deviations lower and for unilateral loss marginally (0.1 to 0.3 standard deviations) lower. For children with hearing loss, early intervention and lification by 3 months, rather than by 6 months or older, resulted in higher expressive vocabulary scores. Children with hearing loss demonstrated delayed spoken expressive vocabulary despite whole-state systems of early detection and intervention. Our findings align with calls to achieve a 1-2-3 month timeline for early hearing detection and intervention benchmarks for screening, identification, and intervention.
Publisher: American Academy of Pediatrics (AAP)
Date: 2009
Abstract: OBJECTIVES. Our goals were to document (1) the onset of stuttering and (2) whether specific child, family, or environmental factors predict stuttering onset in children aged up to 3 years. METHODS. Participants included a community-ascertained cohort of 1619 2-year-old Australian children recruited at 8 months of age to study the longitudinal development of early language. The main outcome measure was parental telephone report of stuttering onset, verified by face-to-face expert diagnosis. Preonset continuous measures of the child's temperament (approach/withdrawal) and language development were available. Information on a range of predictor measures hypothesized to be associated with stuttering onset was obtained (maternal mental health and education levels, gender, premature birth status, birth weight, birth order, twinning, socioeconomic status, family history of stuttering). RESULTS. By 3 years of age, the cumulative incidence of stuttering onset was 8.5%. Onset often occurred suddenly over 1 to 3 days (49.6%) and involved the use of word combinations (97.1%). Children who stuttered were not more shy or withdrawn. Male gender, twin birth status, higher vocabulary scores at 2 years of age, and high maternal education were associated with stuttering onset. The multivariable model, however, had low predictive strength just 3.7% of the total variation in stuttering onset was accounted for. CONCLUSIONS. The cumulative incidence of stuttering onset was much higher than reported previously. The hypothesized risk factors for stuttering onset together explained little of the variation in stuttering onset up to 3 years of age. Early onset was not associated with language delay, social and environmental factors, or preonset shyness/withdrawal. Health professionals can reassure parents that onset is not unusual up to 3 years of age and seems to be associated with rapid growth in language development.
Publisher: BMJ
Date: 24-01-2020
DOI: 10.1136/ARCHDISCHILD-2019-317485
Abstract: As caesarean delivery and childhood allergy continue to rise, their inter-relationships may change. We examined whether caesarean delivery predicts allergic disease and impaired lung function in two contemporary harmonised population-based cohorts. Parent-reported asthma and eczema data were drawn from two prospective Australian infant cohorts, HealthNuts (n=5276, born 2006–2010) and the Longitudinal Study of Australian Children (LSAC, n=5107, born 2003–2004) at age 6–7 years, and spirometric lung function from LSAC’s Child Health CheckPoint (n=1756) at age 11–12 years. Logistic regression estimated associations between delivery mode and current asthma and eczema at 6–7 years, and linear regression examined lung function at 11–12 years. Models were adjusted for potential confounding factors. Complete case analysis included 3135 HealthNuts and 3654 LSAC children (32.2% and 30.9% born by caesarean, respectively). An association was evident between caesarean delivery and asthma at age 6–7 years in HealthNuts (adjusted OR (aOR) 1.25, 95% CI 1.00 to 1.57) but not in LSAC (aOR 1.05, 95% CI 0.86 to 1.28), while neither study showed clear associations with eczema (HealthNuts: aOR 1.09, 95% CI 0.88 to 1.35 LSAC: aOR 0.89, 95% CI 0.69 to 1.15). Spirometric lung function parameters at age 11–12 years were similar by delivery mode. Associations were not modified by duration of breast feeding, maternal history of asthma/eczema, childcare attendance, number of older siblings or pet exposure. In two unselected populations using harmonised protocols, the likely association of caesarean delivery with developing childhood allergy was small.
Publisher: Elsevier BV
Date: 04-2012
Publisher: Springer Science and Business Media LLC
Date: 06-04-2021
DOI: 10.1038/S41366-021-00800-X
Abstract: To investigate associations between early-life diet trajectories and preclinical cardiovascular phenotypes and metabolic risk by age 12 years. Participants were 1861 children (51% male) from the Longitudinal Study of Australian Children. At five biennial waves from 2-3 to 10-11 years: Every 2 years from 2006 to 2014, diet quality scores were collected from brief 24-h parent/self-reported dietary recalls and then classified using group-based trajectory modeling as 'never healthy' (7%), 'becoming less healthy' (17%), 'moderately healthy' (21%), and 'always healthy' (56%). At 11-12 years: During children's physical health Child Health CheckPoint (2015-2016), we measured cardiovascular functional (resting heart rate, blood pressure, pulse wave velocity, carotid elasticity/distensibility) and structural (carotid intima-media thickness, retinal microvasculature) phenotypes, and metabolic risk score (composite of body mass index z-score, systolic blood pressure, high-density lipoproteins cholesterol, triglycerides, and glucose). Associations were estimated using linear regression models (n = 1100-1800) adjusted for age, sex, and socioeconomic position. Compared to 'always healthy', the 'never healthy' trajectory had higher resting heart rate (2.6 bpm, 95% CI 0.4, 4.7) and metabolic risk score (0.23, 95% CI 0.01, 0.45), and lower arterial elasticity (-0.3% per 10 mmHg, 95% CI -0.6, -0.1) and distensibility (-1.2%, 95% CI -1.9, -0.5) (all effect sizes 0.3-0.4). Heart rate, distensibility, and diastolic blood pressure were progressively poorer for less healthy diet trajectories (linear trends p ≤ 0.02). Effects for systolic blood pressure, pulse wave velocity, and structural phenotypes were less evident. Children following the least healthy diet trajectory had poorer functional cardiovascular phenotypes and metabolic syndrome risk, including higher resting heart rate, one of the strongest precursors of all-cause mortality. Structural phenotypes were not associated with diet trajectories, suggesting the window to prevent permanent changes remains open to at least late childhood.
Publisher: American Diabetes Association
Date: 02-2004
Abstract: OBJECTIVE—To assess change in health-related quality of life (HRQOL) in children with diabetes over 2 years and determine its relationship to change in metabolic control. RESEARCH DESIGN AND METHODS—In 1998, parents of children aged 5–18 years attending a tertiary diabetes clinic reported their child’s HRQOL using the Child Health Questionnaire PF-50. Those aged 12–18 years also self-reported their HRQOL using the analogous Child Health Questionnaire CF-80. HbA1c levels were recorded. In 2000, identical measures were collected for those who were aged ≤18 years and still attending the clinic. RESULTS—Of 117 eligible subjects, 83 (71%) participated. Parents reported no significant difference in children’s HRQOL at baseline and follow-up. However, adolescents reported significant improvements on the Family Activities (P & 0.001), Bodily Pain (P = 0.04), and General Health Perceptions (P = 0.001) scales and worsening on the Behavior (P = 0.04) scale. HbA1c at baseline and follow-up were strongly correlated (r = 0.57). HbA1c increased significantly (mean 7.8% in 1998 vs. 8.5% in 2000 P & 0.001), with lower baseline HbA1c strongly predicting an increase in HbA1c over the 2 years (r2 = 0.25, P & 0.001). Lower parent-reported Physical Summary and adolescent-reported Physical Functioning scores at baseline also predicted increasing HbA1c. Poorer parent-reported Psychosocial Summary scores were related to higher HbA1c at both times but did not predict change in HbA1c. CONCLUSIONS—Changes in parent and adolescent reports of HRQOL differ. Better physical functioning may protect against deteriorating HbA1c, at least in the medium term. While the HRQOL of children with diabetes does not appear to deteriorate over time, we should not be complacent, as it is consistently poorer than that of their healthy peers.
Publisher: Wiley
Date: 2003
DOI: 10.1046/J.1440-1754.2003.00084.X
Abstract: To trial the Parents' Evaluation of Developmental Status (PEDS) as an instrument for reporting developmental concerns for Australian preschool children. A cross-sectional survey of parents and carers of 262 children attending five day-care centres and two kindergartens in Melbourne was conducted between October and November 1999. Parents and carers completed the written PEDS questionnaire, comprising 10 questions eliciting concerns about learning, development and behaviour, and answered questions about the acceptability and use of the PEDS. Of 445 children, 389 were eligible for inclusion. Complete parent and carer PEDS data were available for 262 children (67% response: 47% boys 53% girls) aged from 18 months to 5 years, 9 months. Most parents found the PEDS questionnaire easy to complete (98%) and likely to be useful to health professionals (89%). Twenty-four children (9%) were classified as being at high-risk of disabilities and 49 (19%) were classified as being at medium-risk of disabilities. Parents of 125 children (48%) reported no concerns. The prevalence of parental concerns was similar to the USA norming s le. Carers reported similar prevalences of concerns. Although overall agreement was high, parent/carer kappa-values were modest, being highest for the gross motor (kappa = 0.40) and social-emotional (kappa = 0.37) domains. The PEDS is acceptable to parents of Australian preschool children, with a prevalence of significant concerns (i.e. children at high- and medium-risk of developmental problems) that is similar to those in the USA. Further research is needed to assess what factors differentially influence whether a concern is felt in a particular domain for a particular child.
Publisher: Springer Science and Business Media LLC
Date: 26-02-2022
DOI: 10.1038/S41366-022-01080-9
Abstract: Obesity is characterized by heightened inflammation, and both phenotypes are associated with hearing loss. We aimed to determine if inflammation mediates the associations between obesity and hearing ability in mid-childhood and mid-life. Participants: 1165 11- to 12-year-old children and 1316 parents in the population-based cross-sectional Child Health CheckPoint within the Longitudinal Study of Australian Children. Adiposity measures: Body mass index (BMI) classified as normal, overweight and obesity waist-to-height ratio (WHtR) classified as <0.5 and ≥0.5 fat mass index. Inflammatory biomarkers: Serum glycoprotein A (GlycA) high-sensitivity C-reactive protein (hsCRP). Audiometry: Composite high Fletcher Index (mean threshold of 1, 2, 4 kHz) in the better ear. Causal mediation analysis decomposed a 'total effect' (obesity on hearing status) into 'indirect' effect via a mediator (eg GlycA, hsCRP) and 'direct' effect via other pathways, adjusting for age, sex and socioeconomic position. Compared to adults with BMI within the normal range, those with obesity had hearing thresholds 1.9 dB HL (95% CI 1.0-2.8) higher on the high Fletcher Index 40% of the total effect was mediated via GlycA (indirect effect: 0.8 dB HL, 95% CI 0.1-1.4). Children with obesity had hearing thresholds 1.3 dB HL (95% CI 0.2-2.5) higher than those with normal BMI, of which 67% (indirect effect: 0.9 dB HL, 95% CI 0.4-1.4) was mediated via GlycA. Similar mediation effects were noted using other adiposity measures. Similar but less marked mediation effects were observed when hsCRP was used as the inflammatory biomarker (6-23% in adults and 23-33% in children). Inflammation may play an important mediating role in the modest hearing reductions associated with obesity, particularly in children. These findings offer insights into possible mechanisms and early prevention strategies for hearing loss.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/17477160701830796
Abstract: In 2005, the Australian Child and Adolescent Obesity Research Network (ACAORN) addressed the question, "What childhood and adolescent obesity research questions remain to be addressed through longitudinal research?" Using the Delphi Technique, ACAORN members in idually generated then refined and prioritised a set of research ideas. When delegates to a national child obesity symposium repeated the final (prioritisation) step, a strong concordance in rankings was evident. The highest-priority questions related to modifiable environmental risk rotective factors parental and family factors longitudinal relationships between development of obesity and physical, social and mental health predisposing prenatal and early childhood patterns of growth and nutrition identification of stronger early markers of later chronic disease risk and better understanding of the natural course of overweight in childhood. These prioritised research questions could be proactively provided to funding bodies, quoted to support research applications, and used to stimulate secondary data analysis and collaborations between research groups.
Publisher: Wiley
Date: 2004
DOI: 10.1111/J.1440-1754.2004.00282.X
Abstract: Abstract: Although slight/mild sensorineural hearing loss affects about 3% of the school‐aged population, with many more children having such impairments at single frequencies or in only one ear, little is known about its impacts on language, learning, and quality of life. This annotation explores what is known about prevalence and impact of this condition and argues for large‐scale research to better address these issues.
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.3109/17477166.2010.526613
Abstract: Early adiposity rebound ([AR], when body mass index [BMI] rises after reaching a nadir) strongly predicts later obesity. We investigated whether the upswing in BMI at AR is accompanied by an increase in body fat. Community-based cohort study. A total of 299 first-born children (49% male). Measurements. Six-monthly anthropometry and bioelectrical impedance, 4-6.5 years lean and fat mass index (kg/m(2)) for direct comparison with BMI. Supplementary (0-2 years) weight and length measures (needed for growth curve modelling) were drawn from subjects' child health records. AR was estimated from in idually modelled BMI curves from birth to 6.5 years. Two main analyses were performed: 1) cross-sectional comparisons of BMI, fat mass index (FMI), lean mass index (LMI) and percent body fat in children with early ( 5 years) rebound and 2) investigation of linear trends in BMI, FMI, LMI and percent body fat before and after AR. Results. The 81 children (27%) experiencing early AR had higher BMI, FMI, LMI and percent fat at 6.5 years. Overall, FMI decreased steeply pre-AR, at -0.56 (0.02) kg/m(2) per year (mean [Standard Error]), then flattened post-AR to 0.07 (0.05) kg/m(2) per year. In contrast, LMI increased pre-AR (0.34 [0.01]) and steepened post-AR (0.47 [0.03] kg/m(2) per year). The 'adiposity rebound' is characterised by increasing lean mass index, coupled with cessation of the decline in fat mass index. Understanding what controls the dynamics of childhood body composition and mechanisms that delay AR could help prevent obesity.
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.JADOHEALTH.2008.05.003
Abstract: A knowledge of how young people use their time could be instrumental in informing health interventions, modeling consumer behaviors, and planning service delivery. The aim of the present study was to describe age- and gender-related patterns in the self-reported use of time on school days in a large s le of Australian children and adolescents aged between 10 and 18 years. A single, detailed use-of-time diary for a school day was collected from 6024 Australians aged 10-18 from several state and regional surveys conducted in the states of South Australia (SA) and Victoria between 2001 and 2006. Time-use profiles were analyzed for a range of active and sedentary state behaviors. Boys reported higher physical activity levels (PALs), moderate-to-vigorous physical activity (MVPA), and sports than girls. There were no differences in free play, and girls used more active transport. All activity-related variables decreased with age, except active transport, which peaked at 14-15 years. Boys exhibited higher levels of screen time, whereas girls had higher levels of passive transport. Screen time and its components (television, videogames, and computer use) peaked in the peripubertal years. Age- and gender-related patterns of time use vary greatly within adolescence. This may reflect a mix of biological and social factors.
Publisher: Elsevier BV
Date: 10-2021
Publisher: American Medical Association (AMA)
Date: 04-2020
Publisher: American Academy of Pediatrics (AAP)
Date: 2016
Abstract: Universal newborn hearing screening was implemented worldwide largely on modeled, not measured, long-term benefits. Comparative quantification of population benefits would justify its high cost. Natural experiment comparing 3 population approaches to detecting bilateral congenital hearing loss (& dB, better ear) in Australian states with similar demographics and services: (1) universal newborn hearing screening, New South Wales 2003–2005, n = 69 (2) Risk factor screening (neonatal intensive care screening + universal risk factor referral), Victoria 2003–2005, n = 65 and (3) largely opportunistic detection, Victoria 1991–1993, n = 86. Children in (1) and (2) were followed at age 5 to 6 years and in (3) at 7 to 8 years. Outcomes were compared between states using adjusted linear regression. Children were diagnosed younger with universal than risk factor screening (adjusted mean difference –8.0 months, 95% confidence interval –12.3 to –3.7). For children without intellectual disability, moving from opportunistic to risk factor to universal screening incrementally improved age of diagnosis (22.5 vs 16.2 vs 8.1 months, P & .001), receptive (81.8 vs 83.0 vs 88.9, P = .05) and expressive (74.9 vs 80.7 vs 89.3, P & .001) language and receptive vocabulary (79.4 vs 83.8 vs 91.5, P & .001) these nonetheless remained well short of cognition (mean 103.4, SD 15.2). Behavior and health-related quality of life were unaffected. With new randomized trials unlikely, this may represent the most definitive population-based evidence supporting universal newborn hearing screening. Although outperforming risk factor screening, school entry language still lagged cognitive abilities by nearly a SD. Prompt intervention and efficacy research are needed for children to reach their potential.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JACI.2018.07.038
Abstract: Longitudinal population-based data regarding tree nut allergy are limited. We sought to determine the population prevalence of tree nut allergy at age 6 years and explore the relationship between egg and peanut allergy at age 1 year and development of tree nut allergy at age 6 years. A population-based s le of 5276 children was recruited at age 1 year and followed up at age 6 years. At age 1 year, allergies to egg and peanut were determined by means of oral food challenge, and parents reported their child's history of reaction to tree nuts. Challenge-confirmed tree nut allergy was assessed at age 6 years. At age 1 year, the prevalence of parent-reported tree nut allergy was 0.1% (95% CI, 0.04% to 0.2%). Only 18.5% of infants had consumed tree nuts in the first year of life. At age 6 years, challenge-confirmed tree nut allergy prevalence was 3.3% (95% CI, 2.8% to 4.0%), with cashew the most common (2.7% 95% CI, 2.2% to 3.3%). Of children with peanut allergy only at age 1 year, 27% (95% CI, 16.1% to 39.7%) had tree nut allergy at age 6 years compared with 14% (95% CI, 10.4% to 17.9%) of those with egg allergy only and 37% (95% CI, 27.2% to 47.4%) of those with both peanut and egg allergy. Tree nut allergy is uncommon in the first year of life, likely because of limited tree nut consumption. At age 6 years, tree nut allergy prevalence is similar to peanut allergy prevalence. More than a third of children with both peanut and egg allergy in infancy have tree nut allergy at age 6 years. Understanding how to prevent tree nut allergy should be an urgent priority for future research.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: BMJ
Date: 21-10-2010
Abstract: To determine whether a structured programme of parent anticipatory guidance 'Toddlers Without Tears,' delivered in universal primary care, can prevent preschool child behaviour problems. Cluster randomised controlled trial. 40 primary care nursing centres (clusters) in metropolitan Melbourne, Australia. 733 English-speaking mothers of 6- to 7-month-old infants consecutively recruited from well-child appointments 589 (80%) retained at age 3 years. Parenting programme from age 8 to 15 months, with two group sessions co-led by well-child providers and a parenting expert. The programme addressed normal behaviour development and offered strategies to increase desired and reduce unwanted behaviour. While 93% of intervention parents received at least some of the programme, only 49% completed all components. Control Usual primary care. Maternal report of child externalising behaviour (Child Behaviour Checklist), parenting (Parent Behaviour Checklist) and maternal mental health (Depression Anxiety Stress Scales) when children were aged 3 years. Behaviour scores in the intervention and control groups were similar (mean (SD)) 11.4 (7.1) versus 12.4 (7.6) adjusted mean difference -0.8, 95% CI -2.2 to 0.6, p=0.26). On the parenting subscale scores, intervention parents reported fewer unreasonable expectations of child development (37.3 (10.9) vs 39.9 (10.2), adjusted mean difference -3.1, 95% CI -4.9 to -1.4, p=0.001). The mean scores for harsh/abusive and nurturing parenting, and maternal mental health, were similar between the two groups. A brief universal parenting programme in primary care is insufficient to prevent development of preschool externalising problems. A new population trial targeting more intensive prevention to distressed parents with toddler behaviour problems is now under way, aiming to prevent externalising and internalising problems before school entry. ISRCTN77531789.
Publisher: MDPI AG
Date: 02-03-2021
DOI: 10.3390/NU13030821
Abstract: Scope: B vitamers are co-enzymes involved in key physiological processes including energy production, one-carbon, and macronutrient metabolism. Studies profiling B vitamers simultaneously in parent–child dyads are scarce. Profiling B vitamers in parent–child dyads enables an insightful determination of gene–environment contributions to their circulating concentrations. We aimed to characterise: (a) parent–child dyad concordance, (b) generation (children versus adults), (c) age (within the adult subgroup (age range 28–71 years)) and (d) sex differences in plasma B vitamer concentrations in the CheckPoint study of Australian children. Methods and Results: 1166 children (11 ± 0.5 years, 51% female) and 1324 parents (44 ± 5.1 years, 87% female) took part in a biomedical assessment of a population-derived longitudinal cohort study: The Growing Up in Australia’s Child Health CheckPoint. B vitamer levels were quantified by UHPLC/MS-MS. B vitamer levels were weakly concordant between parent–child pairs (10–31% of variability explained). All B vitamer concentrations exhibited generation-specificity, except for flavin mononucleotide (FMN). The levels of thiamine, pantothenic acid, and 4-pyridoxic acid were higher in male children, and those of pantothenic acid were higher in male adults compared to their female counterparts. Conclusion: Family, age, and sex contribute to variations in the concentrations of plasma B vitamers in Australian children and adults.
Publisher: BMJ
Date: 11-04-2018
DOI: 10.1136/ARCHDISCHILD-2017-314631
Abstract: To evaluate research priority setting approaches in childhood chronic diseases and to describe the priorities of stakeholders including patients, caregivers/families and health professionals. We conducted a systematic review of MEDLINE, Embase, PsycINFO and CINAHL from inception to 16 October 2016. Studies that elicited stakeholder priorities for paediatric chronic disease research were eligible for inclusion. Data on the prioritisation process were extracted using an appraisal checklist. Generated priorities were collated into common topic areas. We identified 83 studies (n=15 722). Twenty (24%) studies involved parents/caregivers and four (5%) children. The top three health areas were cancer (11%), neurology (8%) and endocrine/metabolism (8%). Priority topic areas were treatment (78%), disease trajectory (48%), quality of life sychosocial impact (48%), disease onset revention (43%), knowledge/self-management (33%), prevalence (30%), diagnostic methods (28%), access to healthcare (25%) and transition to adulthood (12%). The methods included workshops, Delphi techniques, surveys and focus groups/interviews. Specific methods for collecting and prioritising research topics were described in only 60% of studies. Most reviewed studies were conducted in high-income nations. Research priority setting activities in paediatric chronic disease cover many discipline areas and have elicited a broad range of topics. However, child/caregiver involvement is uncommon, and the methods often lack clarity. A systematic and explicit process that involves patients and families in partnership may help to inform a more patient and family-relevant research agenda in paediatric chronic disease.
Publisher: Wiley
Date: 2007
Publisher: Wiley
Date: 07-2014
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2020
Abstract: Subgroups of children may benefit more from working memory training than others. In this study, we aimed to examine whether response to the Cogmed Working Memory Training program differed for children with low IQ and elevated attention-deficit/hyperactivity disorder, emotional and behavioral symptoms, special health care needs, or by sex. We used data from the Memory Maestros trial, a population-based randomized controlled trial of the Cogmed program delivered at school (n = 226) compared to usual teaching (n = 226) in grade 1 children (mean age 6.9 years SD 0.4) with low working memory. Cogmed comprises 20 to 25 sessions of 45-minute duration over 5 to 7 weeks. Children completed subtests from the Automated Working Memory Assessment to measure change in working memory from baseline to 6 months postrandomization. After training, improved working memory standard scores (& SD) from baseline to 6 months were observed for approximately one-third of the children, with more than half maintaining stable scores (within 1 SD). However, similar outcomes were observed for children receiving usual teaching. Differential effect of Cogmed versus usual teaching was evident for children with elevated hyperactivity and/or inattention, who were less likely to show improved visuospatial working memory, but not for other subgroups studied. Children with elevated hyperactivity and/or inattention were less likely to show clinically meaningful improvement after Cogmed however, differential effects were not evident for children with low IQ and elevated emotional and behavioral symptoms, special health care needs, or by sex. More research is needed to determine if training can improve working memory and, if so, for whom.
Publisher: Wiley
Date: 19-08-2018
DOI: 10.1111/CCH.12615
Abstract: There is growing evidence that specific styles of parent-child interaction benefit child development, particularly child language development. Direct observational techniques help clarify the behaviours and styles within parent-child interactions that may influence child language outcomes however, these techniques tend to be labour-intensive and costly. We report on the development of a replicable, low-burden mechanism for observing and coding specific maternal linguistic behaviours in a population-based cohort of 2-year-olds. The coding scheme was developed as part of a prospective, longitudinal study examining the associations between maternal responsive behaviours and child language outcomes in slow-to-talk toddlers. In the first phase of the study, three coding systems were tested by coding five s le parent-toddler interactions and then comparing them based on (a) the ease of method and thus likely intrarater and interrater reliability and (b) the number of data points. The second phase was to demonstrate how the chosen method could be used in practice with a large at-risk group of toddlers. Of the three coding systems explored, the Observer® XT software was selected for ease of use and because detailed coding of free-play videos could be achieved in close to real time. Intrarater and interrater reliability were established in 251 mother-child free-play videos, producing high intraclass correlation coefficients of 0.95 to 0.99 for the six behaviours. The study provides evidence that numerous parent-child interactions can be rigourously yet efficiently coded without substantial information loss. The observational mechanism in the current study has been fully developed and is shown to be feasible for research purposes focusing on parent-toddler interactions. However, further testing of the observational mechanism is required to examine whether the same results could be produced if coding was conducted "live" and for shorter duration thereby making it readily useable for clinicians.
Publisher: Wiley
Date: 23-09-2020
DOI: 10.1002/JBMR.4143
Publisher: Wiley
Date: 06-02-2003
DOI: 10.1017/S0012162203000379
Abstract: The aim of this study was to describe child health and well-being across the spectrum of cerebral palsy (CP) and to report on psychometric properties of the Child Health Questionnaire (CHQ) in this population. Parents of 80 in iduals (45 males, 35 females mean age 11 years 4 months, SD 3 years 6 months range 5 to 18 years) attending a CP clinic in Victoria, Australia were surveyed. Measures included the CHQ PF-50, a 50-item parent-reported heath status measure severity of CP, based on the Gross Motor Function Classification System and cognitive status and presence of epilepsy. CHQ data were compared with normative data collected in Victoria two years earlier. The CHQ demonstrated good psychometric properties for children with CP. Children with CP had markedly poorer health on every CHQ scale than those in the normative s le. Health status did not vary by cognitive status or epilepsy. Children with severe CP had the poorest physical health, but psychosocial health and emotional impact on parents were similar for mild and severe CP showing that these should not be assumed to be less prevalent when CP is mild.
Publisher: Springer Science and Business Media LLC
Date: 10-2018
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JAIP.2017.11.018
Abstract: Although food allergy has probably risen over recent decades, recent reports suggest that the prevalence of food sensitization in the general population has not changed. However, this has not been analyzed in infants at high risk of food allergy. The objective of this study was to compare the prevalence of food sensitization in high-risk infants from 2 cohorts recruited 15 years apart in the same region. This study includes 620 high-risk infants with a family history of allergy (Melbourne Atopy Cohort Study [MACS]) born 1990-1994, and a subgroup of high-risk infants from the population-based HealthNuts study (n = 3,661/5,276), born 2006-2010. Both studies undertook skin prick tests (SPT) to peanut, egg, and milk at age 12 months. A logistic regression model generated adjusted prevalences to account for differences in s ling frame. SPT ≥ 95% positive predictive values (PPVs) for food allergy were used as proxies for food allergy. The adjusted prevalence of sensitization in MACS was similar to the observed prevalence of sensitization in the high-risk subgroup of HealthNuts: 7.9% (95% confidence interval 6.8-8.9) and 7.9% (7.0-8.8) respectively for peanut, 15.0% (13.4-16.6) and 14.5% (13.4-15.7) respectively for egg, and 2.4% (1.6-3.1) and 2.6% (2.0-3.4) respectively for cow's milk. The prevalence of SPT ≥ 95% PPVs was similar between the 2 studies. The prevalence of food sensitization among high-risk infants has remained stable in Australia since the 1990s, despite the reported increase in food-related anaphylaxis in the same period. This discrepancy could be due to increased food allergy in the low-risk population, increased conversion of food sensitization to allergy, or increased number of high-risk infants. Alternatively, increased awareness or severity of reactions may have led to an apparent increase in food allergy.
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2013
Abstract: Research suggests that general parenting dimensions and styles are associated with children’s BMI, but directionality in this relationship remains unknown. Moreover, there has been little attention to the influences of both mothers’ and fathers’ parenting. We aimed to examine reciprocal relationships between maternal and paternal parenting consistency and child BMI. Participants were 4002 children and their parents in the population-based Longitudinal Study of Australian Children. Mothers and fathers self-reported parenting consistency, and children’s BMI was measured at 4 biennial waves starting at age 4 to 5 years in 2004. Bidirectionality between parenting and child BMI was examined by using regression analyses in cross-lagged models. The best-fitting models indicated a modest influence from parenting to child BMI, whereas no support was found for bidirectional influences. For mothers, higher levels of parenting consistency predicted lower BMI in children from Waves 1 to 2 and 3 to 4 for ex le, for every SD increase in mothers’ parenting consistency at Wave 1, child BMIz fell by 0.025 in Wave 2 (95% confidence interval: −0.05 to −0.003). For fathers, higher levels of parenting consistency were associated with lower child BMI from Waves 1 to 2 and 2 to 3. Parenting inconsistency of mothers and fathers prospectively predicted small increases in offspring BMI over 2-year periods across middle childhood. However, child BMI did not appear to influence parenting behavior. These findings support recent calls for expanding childhood overweight interventions to address the broad parenting context while involving both mothers and fathers.
Publisher: Wiley
Date: 04-07-2015
DOI: 10.1111/CCH.12174
Abstract: Maternal responsiveness is important in early language development, but its measurement by direct observation has to date been unrealistic in community settings because of training and time constraints. We report on the development and cross-sectional comparison of a global rating of maternal responsiveness against a detailed measure of responsiveness at age 24 months. The community-based s le comprised 246 toddlers and their mothers, identified as being slow-to-talk at age 18 months within the Let's Learn Language population-based randomized controlled trial. At age 24 months, mother-child dyads were videotaped during 15 minutes of free-play and children undertook a standardized language assessment. Videos were blindly rated on both the new global measure, comprising a single rating of responsiveness on a five-point Likert scale, and a detailed rating of responsiveness known to predict language outcomes, comprising a sum of specific maternal responsive behaviours. The global rating scale required relatively little training and ratings could be conducted in real time. The global and detailed ratings of maternal responsiveness showed moderate correlation (r = 0.44 P < 0.001). Small positive correlations were found between the global rating and expressive (r = 0.23 P < 0.001), receptive (r = 0.28, P < 0.001) and total language (r = 0.28 P < 0.001) at age 24 months. The global rating scale was efficient and moderately effective as a measure of maternal responsiveness. It is possible that, combined with other risk measures including concurrent language skills, it could strengthen prediction of which children will and will not go on to experience lasting language difficulties.
Publisher: Wiley
Date: 26-02-2020
Publisher: Mary Ann Liebert Inc
Date: 04-2017
Abstract: Adult BMI trajectories outperform single BMI measurements as predictors of cardiovascular mortality however, it is unknown whether this also holds in childhood. We aimed to identify BMI trajectory categories from birth to adolescence, and examine their associations with adolescent cardiovascular function and structure. Adolescents from a community-based prospective birth cohort completed 11-16 BMI measurements between birth and adolescence. BMI trajectory categories were identified using latent class analysis. Associations between trajectories and cardiovascular outcomes (14 years) were assessed using adjusted linear regression models (n = 187). Cardiovascular outcomes included systolic/diastolic blood pressure, augmentation index, pulse wave velocity, carotid intima-media thickness, and retinal arteriole-to-venule ratio. Regression models were adjusted for child age, gender, height, socioeconomic status, and puberty status at outcome. Three BMI trajectories emerged that erged sharply by the age of 1 year. BMI increments were thereafter roughly parallel for those in the low normal (39%) and high normal (51%) groups, but steeper in the consistently overweight (10%) group, which was notable for lack of an obvious adiposity rebound. Cardiovascular function and structure were similar across the three trajectory groups. The only exception was augmentation index, which was 7.8% (95% CI: 2.6 to 13.0) higher in the consistently overweight in iduals than the low normal in iduals. We found little evidence that those with consistently higher BMI from infancy experienced poorer cardiovascular function or structure by the age of 14 years. Nonetheless, childhood BMI trajectories track strongly, meaning resolution of risky BMI, while essential to decrease later cardiovascular risk, is unlikely without intervention.
Publisher: Cambridge University Press (CUP)
Date: 17-05-2021
DOI: 10.1017/S0007114521001616
Abstract: Inflammatory diets are increasingly recognised as a modifiable determinant of mental illness. However, there is a dearth of studies in early life and across the full mental well-being spectrum (mental illness to positive well-being) at the population level. This is a critical gap given that inflammatory diet patterns and mental well-being trajectories typically establish by adolescence. We examined the associations of inflammatory diet scores with mental well-being in 11–12-year-olds and mid-life adults. Throughout Australia, 1759 11–12-year-olds (49 % girls) and 1812 parents (88 % mothers) contributed cross-sectional population-based data. Alternate inflammatory diet scores were calculated from a twenty-six-item FFQ, based on the prior literature and prediction of inflammatory markers. Participants reported negatively and positively framed mental well-being via psychosocial health, quality of life and life satisfaction surveys. We used causal inference modelling techniques via generalised linear regression models (mean differences and risk ratios (RR)) to examine how inflammatory diets might influence mental well-being. In children and adults, respectively, a 1 sd higher literature-derived inflammatory diet score conferred between a 44 % (RR 95 % CI 1·2, 1·8) to 57 % (RR 95 % CI 1·3, 2·0) and 54 % (95 % CI 1·2, 2·0) to 86 % (RR 95 % CI 1·4, 2·4) higher risk of being in the worst mental well-being category (i.e. th percentile) across outcome measures. Results for inflammation-derived scores were similar. BMI mediated effects (21–39 %) in adults. Inflammatory diet patterns were cross-sectionally associated with mental well-being at age 11–12 years, with similar effects observed in mid-adulthood. Reducing inflammatory dietary components in childhood could improve population-level mental well-being across the life course.
Publisher: Elsevier BV
Date: 09-2020
Publisher: American Academy of Pediatrics (AAP)
Date: 12-2007
Abstract: OBJECTIVE. This article responds to evidence gaps regarding language impairment identified by the US Preventive Services Task Force in 2006. We examine the contributions of putative child, family, and environmental risk factors to language outcomes at 24 months of age. METHODS. A community-ascertained s le of 1720 infants who were recruited at 8 months of age were followed at ages 12 and 24 months in a prospective, longitudinal study in metropolitan Melbourne, Australia. Outcomes at 24 months were parent-reported infant communication (Communication and Symbolic Behavior Scales and MacArthur-Bates Communicative Development Inventories vocabulary production score). Putative risk factors were gender, preterm birth, birth weight, multiple birth, birth order, socioeconomic status, maternal mental health, maternal vocabulary and education, maternal age at birth of child, non–English-speaking background, and family history of speech-language difficulties. Linear regression models were fitted to total standardized Communication and Symbolic Behavior Scales and Communicative Development Inventories vocabulary production scores a logistic regression model was fitted to late-talking status at 24 months. RESULTS. The regression models accounted for 4.3% and 7.0% of the variation in the 24-month Communication and Symbolic Behavior Scales and Communicative Development Inventories scores, respectively. Male gender and family history were strongly associated with poorer outcomes on both instruments. Lower Communication and Symbolic Behavior Scales scores were also associated with lower maternal vocabulary and older maternal age. Lower vocabulary production scores were associated with birth order and non–English-speaking background. When the 12-month Communication and Symbolic Behavior Scales Total score was added as a covariate in the linear regression of 24-month Communication and Symbolic Behavior Scales Total score, it was by far the strongest predictor. CONCLUSIONS. These early risk factors explained no more than 7% of the variation in language at 24 months. They seem unlikely to be helpful in screening for early language delay.
Publisher: American Medical Association (AMA)
Date: 11-2022
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2006
Abstract: OBJECTIVE. To report the prevalence and stability of cry-fuss problems during the first 4 months of life and sleep problems from 2 to 24 months and relationships between the persistence of cry-fuss and sleep problems and outcomes at 24 months. METHODS. The study was a prospective cohort study in maternal and child health centers in 3 local government areas in Melbourne, Australia. A total of 483 first-born infants were monitored prospectively from 2 weeks through 2, 4, 8, 12, 18, and 24 months. Child behavior, maternal depression, parenting stress, and marital quality were assessed. Predictor variables were parent reports of moderate or greater cry-fuss problems (2 and 4 months) and sleep problems (8, 12, 18, and 24 months) and parent-reported, 24-hour, sleep/cry-fuss diaries (2, 4, and 12 months). RESULTS. The response rate was 68% (483 of 710 infants) the attrition rate was & %. The prevalence of cry-fuss problems decreased from 19.1% at 2 months to 12.8% at 4 months, with 5.6% of mothers reporting cry-fuss problems at both ages. Prevalence rates of sleep problems were 21.2%, 16.2%, 10.0%, and 12.1% at 8, 12, 18, and 24 months, respectively 6.4% had a problem at ≥3 of these ages. In multivariate analyses, cry-fuss/sleep problems at ≥3 previous time points (but not 1 or 2 time points) contributed significantly to depression (2.8% of variance), total behavior (1.4% of variance), and total stress (4.6% of variance) scores. Repeated problems had a greater impact than a concurrent sleep problem on depression and stress scores, whereas the reverse was true for behavior scores. CONCLUSIONS. Most cry-fuss and sleep problems in the first 2 years of life are transient. Persistent, rather than transient, problems contribute to maternal depression, parenting stress, and subsequent child behavior problems.
Publisher: Wiley
Date: 28-05-2022
DOI: 10.1111/CDOE.12662
Abstract: Studying parent‐child pair health provides the opportunity to identify risk factors and opportunities for oral health prevention and intervention focusing on the family context. The aim of this study was to describe the oral health of children aged 11‐12 years and their parents in a national s le of parent‐child dyads in Australia. The Child Health CheckPoint is a study of 11 to 12‐year‐old children and one parent nested within the Longitudinal Study of Australian Children, a nationally representative cohort study. In 2015‐16, the study collected two‐dimensional photographic intra‐oral images and was scored using visual assessments of the teeth, oral hygiene and malocclusion. Of the 1874 CheckPoint families, 1396 biological parent‐child pairs had at least one oral health measure recorded. Over two‐thirds of children had moderate to severe gingival inflammation (69.7%, 95%CI 64.7‐74.9). Parents had a lower proportion of poor oral hygiene (2.1%, 95% CI 1.4‐3.0) than children (13.0%, 95% CI 11.3‐14.9). High concordance was seen in the Modified Gingival Index correlation coefficient 0.49 (95%CI 0.44‐0.53). The high concordance in gingival health between child‐parent pairs supports the familial and behavioural links established in previous studies. Children had poorer oral hygiene but fewer visible dental caries lesions than their parents. As dental caries is a chronic and cumulative disease, preventive interventions targeting children's oral hygiene are needed.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020261
Abstract: ‘Growing Up in Australia: The Longitudinal Study of Australian Children’ (LSAC) is Australia's only nationally representative children’s longitudinal study, focusing on social, economic, physical and cultural impacts on health, learning, social and cognitive development. LSAC's first decade collected wide-ranging repeated psychosocial and administrative data here, we describe the Child Health CheckPoint, LSAC’s dedicated biophysical module. LSAC recruited a cross-sequential s le of 5107 infants aged 0–1 year and a s le of 4983 children aged 4–5 years in 2004, since completing seven biennial visits. CheckPoint was a cross-sectional wave that travelled Australia in 2015–2016 to reach LSAC’s younger cohort at ages 11–12 years between LSAC waves 6 and 7. Parent–child pairs participated in comprehensive assessments at 15 Assessment Centres nationwide or, if unable to attend, a shorter home visit. CheckPoint’s intergenerational, multidimensional measures were prioritised to show meaningful variation within normal ranges and capture non-communicable disease (NCD) phenotype precursors. These included anthropometry, physical activity, fitness, time use, vision, hearing, and cardiovascular, respiratory and bone health. Biospecimens included blood, saliva, buccal swabs (also from second parent), urine, hair and toenails. The epidemiology and parent–child concordance of many measures are described in separate papers. 1874 (54% of eligible) parent–child pairs and 1051 second parents participated. Participants' geographical distribution mirrored the broader Australian population however, mean socioeconomic position and parental education were higher and fewer reported non-English-speaking or Indigenous backgrounds. Application of survey weights partially mitigates that the achieved s le is less population representative than previous waves of LSAC due to non-random attrition. Completeness was uniformly high for phenotypic data ( % of eligible), biospecimens (74%–97%) and consent (genetic analyses 98%, accessing neonatal blood spots 97%, sharing 96%). CheckPoint enriches LSAC to study how NCDs develop at the molecular and phenotypic levels before overt disease emerges, and clarify the underlying dimensionality of health in childhood and mid-adulthood.
Publisher: BMJ
Date: 15-06-2010
Abstract: Adolescent obesity is linked to metabolic and cardiovascular risk, but its associations with adolescents' experienced health and morbidity are less clear. Morbidities experienced by overweight/obese adolescents and associations between morbidities and timing of overweight/obesity were examined. Data were from the Health of Young Victorians Study (HOYVS 1997, 2000, 2005), a school-based longitudinal study. Outcomes were blood pressure, health status (Pediatric Quality of Life Inventory 4.0 (PedsQL), global health), mental health (Strengths and Difficulties Questionnaire), psychological distress (Kessler-10), physical symptoms, sleep, asthma, dieting, and healthcare needs and visits. Regression methods assessed associations with body mass index status and timing of overweight/obesity. Of the 923 adolescents (20.2% overweight, 6.1% obese), 63.5% were classified as "never" overweight/obese, 8.5% as "childhood only", 7.3% as "adolescence only" and 20.8% as "persistent". Compared to non-overweight, current obesity was associated with lower PedsQL physical summary scores (mean -6.58, 95% CI -9.52 to -3.63) and good/fair oor global health (OR 3.52, 95% CI 1.95 to 6.36), hypertension (systolic 8.86, 95% CI 4.70 to 16.71 diastolic 5.29, 95% CI 2.74 to 10.20) and dieting (OR 5.79, 95% CI 3.28 to 10.23), with intermediate associations for overweight. Associations with psychosocial morbidity were weaker and inconsistent and there were few associations with health symptoms and problems. Only dieting (OR 2.30, 95% CI 1.36 to 3.89) was associated with resolved childhood overweight/obesity. Despite poorer overall health, overweight/obese adolescents were not more likely to report specific problems that might prompt health intervention. Morbidity was mainly associated with concurrent, rather than earlier, overweight/obesity.
Publisher: Cambridge University Press (CUP)
Date: 27-06-2018
DOI: 10.1017/S1368980018001398
Abstract: With the intention to inform future public health initiatives, we aimed to determine the extent to which typical childhood dietary trajectories predict adolescent cardiovascular phenotypes. Longitudinal study. Exposure was determined by a 4 d food diary repeated over eight waves (ages 4–15 years), coded by Australian Dietary Guidelines and summed into a continuous diet score (0–14). Outcomes were adolescent (Wave 8, age 15 years) blood pressure, resting heart rate, pulse wave velocity, carotid intima-media thickness, retinal arteriole-to-venule ratio. Latent class analysis identified ‘typical’ dietary trajectories from childhood to adolescence. Adjusted linear regression models assessed relationships between trajectories and cardiovascular outcomes, adjusted for a priori potential confounders. Community s le, Melbourne, Australia. Children ( n 188) followed from age 4 to 15 years. Four dietary trajectories were identified: unhealthy (8 %) moderately unhealthy (25 %) moderately healthy (46 %) healthy (21 %). There was little evidence that vascular phenotypes associated with the trajectories. However, resting heart rate (beats/min) increased ( β 95 % CI) across the healthy (reference), moderately healthy (4·1 −0·6, 8·9 P =0·08), moderately unhealthy (4·5 −0·7, 9·7 P =0·09) and unhealthy (10·5 2·9, 18·0 P =0·01) trajectories. Decade-long dietary trajectories did not appear to influence macro- or microvascular structure or stiffness by mid-adolescence, but were associated with resting heart rate, suggesting an early-life window for prevention. Larger studies are needed to confirm these findings, the threshold of diet quality associated with these physiological changes and whether functional changes in heart rate are followed by phenotypic change.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: MDPI AG
Date: 25-08-2021
Abstract: Parental preconception exposures to built and natural outdoor environments could influence pregnancy and birth outcomes either directly, or via a range of health-related behaviours and conditions. However, there is no existing review summarising the evidence linking natural and built characteristics, such as air and noise pollution, walkability, greenness with pregnancy and birth outcomes. Therefore, the planned scoping review aims to collate and map the published literature on parental preconception exposures to built and natural outdoor environments and adverse pregnancy and birth outcomes. We will search electronic databases (MEDLINE, EMBASE, Scopus) to identify studies for inclusion. Studies will be included if they empirically assess the relationship between maternal and paternal preconception exposures to physical natural and built environment features that occur outdoors in the residential neighbourhood and adverse pregnancy and birth outcomes. Two reviewers will independently screen titles and abstracts, and then the full text. Data extraction and assessment of study quality will be performed by one researcher and checked by a second researcher. Results will be summarised in a narrative synthesis, with additional summaries presented as tables and figures. The scoping review will be disseminated via a peer-reviewed publication, at academic conferences, and published on a website.
Publisher: Wiley
Date: 03-10-2018
DOI: 10.1111/CCH.12601
Publisher: Wiley
Date: 07-12-2018
Abstract: Identifying risk and protective factors for language development informs interventions for children with developmental language disorder (DLD). Maternal responsive and intrusive communicative behaviours are associated with language development. Mother-child interaction quality may influence how children use these behaviours in language learning. To identify (1) communicative behaviours and interaction quality associated with language outcomes (2) whether the association between a maternal intrusive behaviour (directive) and child language scores changed alongside a maternal responsive behaviour (expansion) and (3) whether interaction quality modified these associations. Language skills were assessed at 24, 36 and 48 months in 197 community-recruited children who were slow to talk at 18 months. Mothers and 24-month-olds were video-recorded playing at home. Maternal praise, missed opportunities, and successful and unsuccessful directives (i.e., whether followed by the child) were coded during a 10-min segment. Interaction quality was rated using a seven-point fluency and connectedness (FC) scale, during a 5-min segment. Linear regressions examined associations between these behaviours/rating and language scores. Interaction analysis and simple slopes explored effect modification by FC. There was no evidence that missed opportunities or praise were associated with language scores. Higher rates of successful directives in the unadjusted model and unsuccessful directives in the adjusted model were associated with lower 24-month-old receptive language scores (e.g., unsuccessful directives effect size (ES) = -0.41). The association between unsuccessful directives and receptive language was weaker when adjusting for co-occurring expansions (ES = -0.34). Both types of directives were associated with poorer receptive and expressive language scores in adjusted models at 36 and 48 months (e.g., unsuccessful directive and 48-month receptive language, ES = -0.66). FC was positively associated with 24-, 36- and 48-month language scores in adjusted models (e.g., receptive language at 24 months, ES = 0.21, at 48 months, ES = 0.18). Interaction analysis showed the negative association between successful directives and 24-month receptive language existed primarily in poorly connected dyads with low FC levels. These findings illustrate the effects of the combined interaction between different maternal communicative behaviours and features of the interaction itself on child language development, and the need to consider both in research and practice. Whilst more intrusive directives were associated with poorer language scores, this association attenuated when adjusting for co-occurring responsive expansions, and the association was strongest for children in lower quality interactions. This work may inform clinical practice by helping clinicians target the most appropriate communicative behaviours for specific mother-child dyads.
Publisher: Informa UK Limited
Date: 05-03-2013
DOI: 10.3109/14015439.2013.775332
Abstract: Assessment for the purpose of monitoring change over time requires a different practical and statistical approach to that of assessment for diagnosing impairment. Sophisticated methods exist for identifying strengths and weaknesses in a patient's voice/speech profile, yet our understanding of the impact of repeated assessment is limited. Monitoring change necessitates that stimuli are stable in the absence of any true change in functioning, while remaining sensitive to influences that are considered to alter functioning (degeneration, therapy). The current paper discusses the issues relating to stimuli selection, identifying error within the s le and appropriate statistical models for identifying intra-in idual change in the context of clinical and experimental speech or voice examinations.
Publisher: Elsevier BV
Date: 03-2020
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020264
Abstract: To describe a well-established marker of cardiovascular risk, carotid intima–media thickness (IMT) and related measures (artery distensibility and elasticity) in children aged 11–12 years old and mid-life adults, and examine associations within parent–child dyads. Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC). Assessment centres in seven Australian major cities and eight selected regional towns, February 2015 to March 2016. Of all participating CheckPoint families (n=1874), 1489 children (50.0% girls) and 1476 parents (86.8% mothers) with carotid IMT data were included. Survey weights and methods were applied to account for LSAC’s complex s le design and clustering within postcodes and strata. Ultrasound of the right carotid artery was performed using standardised protocols. Primary outcomes were mean and maximum far-wall carotid IMT, quantified using semiautomated edge detection software. Secondary outcomes were carotid artery distensibility and elasticity. Pearson’s correlation coefficients and multivariable linear regression models were used to assess parent–child concordance. Random effects modelling on a subset of ultrasounds (with repeated measurements) was used to assess reliability of the child carotid IMT measure. The average mean and maximum child carotid IMT were 0.50 mm (SD 0.06) and 0.58 mm (SD 0.05), respectively. In adults, average mean and maximum carotid IMT were 0.57 mm (SD 0.07) and 0.66 mm (SD 0.10), respectively. Mother–child correlations for mean and maximum carotid IMT were 0.12 (95% CI 0.05 to 0.23) and 0.10 (95% CI 0.03 to 0.21), respectively. For carotid artery distensibility and elasticity, mother–child correlations were 0.19 (95% CI 0.10 to 0.25) and 0.11 (95% CI 0.02 to 0.18), respectively. There was no strong evidence of father–child correlation in any measure. We provide Australian values for carotid vascular measures and report a modest mother–child concordance. Both genetic and environmental exposures are likely to contribute to carotid IMT.
Publisher: BMJ
Date: 12-08-2021
Abstract: One size rarely fits all in population health. Differing outcomes may compete for best allocations of time. Among children aged 11–12 years, we aimed to (1) describe optimal 24-hour time use for erse physical, cognitive/academic and well-being outcomes, (2) pinpoint the ‘Goldilocks Day’ that optimises all outcomes and (3) develop a tool to customise time-use recommendations. In 2004, the Longitudinal Study of Australian Children recruited a nationally-representative cohort of 5107 infants with biennial follow-up waves. We used data from the cross-sectional Child Health CheckPoint module (2015–2016, n=1874, 11–12 years, 51% males). Time use was from 7-day 24-hour accelerometry. Outcomes included life satisfaction, psychosocial health, depressive symptoms, emotional problems, non-verbal IQ vocabulary, academic performance, adiposity, fitness, blood pressure, inflammatory biomarkers, bone strength. Relationships between time use and outcomes were modelled using compositional regression. Optimal daily durations varied widely for different health outcomes (sleep: 8.3–11.4 hours sedentary: 7.3–12.2 hours light physical activity: 1.7–5.1 hours moderate-to-vigorous physical activity (MVPA): 0.3–2.7 hours, all models p≤0.04). In general, days with highest physical activity (predominantly MVPA) and low sedentary time were optimal for physical health, while days with highest sleep and lowest sedentary time were optimal for mental health. Days with highest sedentary time and lowest physical activity were optimal for cognitive health. The overall Goldilocks Day had 10 hours 21 min sleep, 9 hours 44 min sedentary time, 2 hours 26 min light physical activity and 1 hour 29 min MVPA. Our interactive interface allows personalisation of Goldilocks Days to an in idual’s outcome priorities. ‘Goldilocks Days’ necessitate compromises based on hierarchies of priorities for health, social and economic outcomes.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020263
Abstract: To (1) describe the epidemiology of child and adult telomere length, and (2) investigate parent–child telomere length concordance. Population-based cross-sectional study within the Longitudinal Study of Australian Children. Assessment centres in seven major Australian cities and eight selected regional towns February 2015 to March 2016. Of 1874 participating families, telomere data were available for analysis for 1206 children and 1343 parents, of whom 1143 were parent–child pairs. There were 589 boys and 617 girls 175 fathers and 1168 mothers. Relative telomere length (T/S ratio), calculated by comparing telomeric DNA (T) level with the single copy (S) beta-globin gene in venous blood-derived genomic DNA by quantitative real-time PCR. Mean T/S ratio for all children, boys and girls was 1.09 (SD 0.56), 1.05 (SD 0.53) and 1.13 (SD 0.59), respectively. Mean T/S ratio for all parents, fathers and mothers was 0.81 (SD 0.37), 0.82 (SD 0.36) and 0.81 (SD 0.38), respectively. Parent–child T/S ratio concordance was moderate (correlation 0.24). In adjusted regression models, one unit higher parent T/S ratio was associated with 0.36 (estimated linear regression coefficient (β) 95% CI 0.28 to 0.45) higher child T/S ratio. Concordance was higher in the youngest parent-age tertile (β 0.49 95% CI 0.34 to 0.64) compared with the middle (β 0.35 95% CI 0.21 to 0.48) and oldest tertile (β 0.26 95% CI 0.11 to 0.41 p-trend 0.04). Father–child concordance was 0.34 (95% CI 0.18 to 0.48), while mother–child was 0.22 (95% CI 0.17 to 0.28). We provide telomere length population values for children aged 11–12 years and their mid-life parents. Relative telomere length was shorter in adults than children, as expected. There was modest evidence of parent–child concordance, which diminished with increasing parent age.
Publisher: Elsevier BV
Date: 03-2012
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2013
Abstract: Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years. A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals – Preschool, 2nd Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention − control, 2.0 95% confidence interval [CI] −0.5 to 4.4 P = .12) but not receptive (0.6 95% CI −2.5 to 3.8 P = .69) language. The intervention improved phonological awareness skills (5.0 95% CI 2.2 to 7.8 P & .001) and letter knowledge (2.4 95% CI 0.3 to 4.5 P = .03), but not other secondary outcomes. A standardized yet flexible 18-session language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020262
Abstract: To describe the distribution of albuminuria among Australian children aged 11–12 years and their parents, and assess its intergenerational concordance within parent–child dyads. Population-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. Assessment centres (seven Australian cities and eight regional towns) and home visits across Australia, February 2015 to March 2016. Of all participating CheckPoint families (n=1874), 1557 children (46.2% girls) and 1454 parents (85.5% mothers) provided random urine s les at the visit s les from menstruating females were excluded. Urine albumin-to-creatinine ratio (ACR) and its components (urine albumin and creatinine concentration) albuminuria was defined as an ACR ≥3.4 mg/mmol. Pearson’s correlation coefficients and multivariable linear regression models assessed parent–child concordance, using log-transformed data due to skewing. Survey weights and methods were applied to account for the complex s le design. The median ACR for children was 1.03 mg/mmol (IQR 0.65–1.97) and 1.01 mg/mmol (IQR 0.60–2.09) for adults. The median ACR was higher in girls (1.20, IQR 0.71–2.65) than boys (0.90, IQR 0.61–1.65) and in mothers (1.13, IQR 0.63–2.33) than fathers (0.66, IQR 0.41–1.05). Albuminuria was detected in 15.1% of children (girls 20.8%, boys 10.1%) and 13.5% of adults (15.1% mothers, 4.0% fathers) had albuminuria. There was a small correlation between parent and child ACR (Pearson correlation coefficient 0.06, 95% CI 0.01 to 0.12). Albuminuria is common among Australian children and adults, which is of concern because it predicts risk for kidney and cardiovascular disease, and mortality. The weak concordance among intergenerational pairs for urine ACR suggests either that genetic heritability is low or that it becomes evident only at later offspring life stages.
Publisher: Cold Spring Harbor Laboratory
Date: 06-2022
DOI: 10.1101/2022.06.01.494306
Abstract: The number of words children produce (expressive vocabulary) and understand (receptive vocabulary) changes rapidly during early development, partially due to genetic factors, although mechanisms are not well understood. Here, we performed a meta-genome-wide association study within the EAGLE consortium and investigated polygenic overlap with later-life traits, including Attention-Deficit/Hyperactivity Disorder (ADHD) and cognition. We studied 37,913 parent-reported vocabulary size measures (English, Dutch, Danish) for 17,298 children of European descent. Meta-analyses were performed for early-phase expressive (infancy, 15-18 months), late-phase expressive (toddlerhood, 24-38 months) and late-phase receptive (toddlerhood, 24-38 months) vocabulary. Subsequently, we estimated Single-Nucleotide Polymorphism heritability (SNP-h 2 ), genetic correlations (r g ) and modelled underlying genetic factor structures with multivariate models. Contributions of common genetic variation to early-life vocabulary were modest (SNP-h 2 : 0.08(SE=0.01) to 0.24(SE=0.03)) and multi-factorial. Genetic overlap between infant expressive and toddler receptive vocabulary was near zero (r g =0.07(SE=0.10)), although both measures were genetically related to toddler expressive vocabulary (r g =0.69(SE=0.14) and r g =0.67(SE=0.16), respectively). Consistently, polygenic association patterns with later-life traits differed: Genetic links with cognition emerged only in toddlerhood (e.g. toddler receptive vocabulary and intelligence: r g =0.36(SE=0.12)), despite comparable study power for infant measures. Furthermore, increased polygenic ADHD risk was associated with larger infant expressive vocabulary (r g =0.23(SE=0.08)), as confirmed by ADHD-symptom-based follow-up analyses in the Avon Longitudinal Study of Parents and Children (ALSPAC-r g =0.54(SE=0.26)). Genetic relationships with toddler receptive vocabulary were, however, opposite (ALSPAC-r g =-0.74(SE=0.23)), highlighting developmental changes in genetic architectures. Multiple genetic components contribute to early-life vocabulary development, shaping polygenic association patterns with later-life ADHD symptoms and cognition.
Publisher: Wiley
Date: 05-03-2013
DOI: 10.1111/CCH.12040
Abstract: Children born low birthweight, preterm and/or small for gestational age (SGA) sustain substantially increased costs for hospital-based health care and additional educational support in the first few years of life. This is the first study internationally to investigate costs beyond hospital care, to community-based health care and prescription medicines across early and middle childhood with actual cost data, and to examine these costs according to the severity of perinatal risk. In the prospective Longitudinal Study of Australian Children, we followed two cohorts of children from age of 0 to 5 years (no increased perinatal risk, n = 3973 mild risk, n = 442 and moderate-to-high risk, n = 297), and from age of 4 to 9 years (no increased perinatal risk, n = 3629 mild risk, n = 465 and moderate-to-high risk, n = 361). Children were defined as mild risk if born 32-36 weeks, with birthweight 1500-2499 g, and/or SGA (<5-9th percentile), and moderate-to-high risk if born <32 weeks, birthweight <1500 g and/or extremely SGA (<5th percentile). Federal government expenditure (2011 $AUD) on healthcare attendances and prescription medication from birth to 9 years were calculated via data linkage to the Australian Medicare records. Mean costs per child were A$362 higher (95% CI $156 568) from 0 to 5 years and A$306 higher (95% CI $137 475) from 4 to 9 years, for children with any compared with no increased perinatal risk (P < 0.001). At the population level, an additional A$32m was spent per year for children 0-9 years with any relative to no increased perinatal risk. Perinatal risk is a major public health issue conferring considerable additional expense to community-based health care, most marked in the first year of life but persisting up to at least 10 years. Even without additionally considering burden, these findings add to the urgency of identifying effective mechanisms to reduce perinatal risk across its full spectrum.
Publisher: Informa UK Limited
Date: 06-05-2014
DOI: 10.3109/17549507.2014.898095
Abstract: This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative s les of children. Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme. It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311 p = .002) for each additional wave of language difficulties. Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.
Publisher: Wiley
Date: 30-03-2006
DOI: 10.1111/J.1440-1754.2006.00831.X
Abstract: To ascertain the extent to which general practitioners (GPs) routinely weigh, measure and calculate body mass index (BMI) in children, and to assess the accuracy and accessibility of their anthropometric equipment. A convenience s le of 34 GPs from 29 primary care family medical practices in Melbourne, Australia, completed a questionnaire regarding their routine anthropometric practice for 5-10-year-old children and perceived role in managing childhood overweight and obesity. Practice audits (April-June 2002) assessed the accuracy and accessibility of anthropometric equipment. Forty-four per cent of GPs reported regularly weighing children 38% regularly measured children's height. Only one regularly calculated children's BMI. Formal training in child anthropometry and servicing of anthropometric equipment was rare. The majority of equipment was accessible. Stadiometers on average measured the height of a 'short' pole (true height 92.68 cm) as 92.52 cm (SD = 0.8), and measured the height of a 'tall' pole (true height 157.64 cm) as 157.55 cm (SD = 0.9). On average, calibration weights of 20 kg and 80 kg were recorded as 19.7 kg (SD = 0.6) and 79.2 kg (SD = 1.5) respectively. Despite these shortcomings, these GPs generally felt they played a key role in managing overweight in children. Self-reported practice by these GPs falls well short of 2003 National Health and Medical Research Council guidelines recommending bi-annual measuring of all children in the primary care setting. The variability of anthropometric equipment audited could result in widely discrepant BMI values, leading to serious misclassification of many children's weight status.
Publisher: Wiley
Date: 24-07-2018
DOI: 10.1111/CCH.12600
Abstract: In a community s le of slow-to-talk toddlers, we aimed to (a) quantify how well maternal responsive behaviors at age 2 years predict language ability at age 4 and (b) examine whether maternal responsive behaviors more accurately predict low language status at age 4 than does expressive vocabulary measured at age 2 years. Prospective community-based longitudinal study. At child age 18 months, 1,138 parents completed a 100-word expressive vocabulary checklist within a population survey 251 (22.1%) children scored ≤20th percentile and were eligible for the current study. Potential predictors at 2 years were (a) responsive language behaviors derived from videotaped parent-child free-play s les and (b) late-talker status. Outcomes were (a) Clinical Evaluation of Language Fundamentals-Preschool Second Edition receptive and expressive language standard score at 4 years and (b) low language status (standard score > 1.25 standard deviations below the mean on expressive or receptive language). Two hundred eight (82.9% of 251) participants were retained to age 4. In adjusted linear regression analyses, maternal expansions predicted higher receptive (p < 0.001, partial R A combination of short measures of different dimensions, such as parent responsive behaviors, in addition to a child's earlier language skills increases the ability to predict language outcomes at age 4 to a precision that is approaching clinical value. Research to further enhance predictive values should be a priority, enabling health professionals to identify which slow-to-talk toddlers most likely will or will not experience later poorer language.
Publisher: Wiley
Date: 12-2009
DOI: 10.1111/J.1440-1754.2009.01598.X
Abstract: The newly formed Australian Paediatric Research Network (APRN) aims to facilitate general paediatricians' participation in research in secondary care settings. This (its first) project aimed to identify Australian paediatricians' top research priorities and preferred research designs. All Australian general paediatricians were invited into a national Delphi process survey. In Stage 1, they were asked 'Thinking about your clinical practice, what are the most important research questions which need addressing?'. Using qualitative methods, a 'top 20' list of the most common, feasible research questions was generated. In Stage 2, respondents prioritised these 'top 20' research questions in terms of perceived importance to their practice, and rated their interest in participating in various types of research. A total of 685 (68%) of 1006 paediatricians completed the baseline survey, with 209 paediatricians contributing 430 Stage 1 research questions. Of these, 128 (30%) had not been addressed in the literature and were researchable in the secondary care outpatient setting. The top five questions ranked in Stage 2 by 348 paediatricians were obesity management (two questions), long-term ADHD educational outcomes, autism spectrum outcomes, and prophylactic antibiotics in preventing urinary tract infections. Paediatricians were willing to participate in research designs, including longitudinal research (75%) and randomised trials (64%). Australian paediatricians are interested in research, and their ideas can provide direction for APRN and potentially other networks in Australia. Many of the questions generated could not be easily answered by traditional biomedical and clinical research methods, highlighting the potential benefit of practice-based research networks.
Publisher: Wiley
Date: 25-04-2013
DOI: 10.1111/J.1440-1754.2012.02472.X
Abstract: Targeted newborn hearing screening for infants in neonatal intensive care units (NICUs) may be considered when resources preclude universal newborn hearing screening (UNHS). However, process outcomes have not been compared between stand-alone NICU hearing screening programs and NICU screening within a full UNHS program. Comparison of two consecutive hearing screening programs delivered under similar conditions in the four NICUs in Victoria, Australia. All NICU infants were eligible for pre-discharge automated auditory brainstem response (AABR) hearing screening. Capture, referral and diagnostic data were collected for all NICU infants during the NICU-only (April 2003-February 2005) and subsequent UNHS (April 2005-June 2006) programs. 4704 eligible infants were admitted during the 23-month NICU-only period, and 3160 during the 15-month UNHS period. Double AABR using ALGO 3i equipment was planned for both programs but, due to clinician concern about this high-risk clinical population, the NICU-only protocol was amended to single AABR using AccuScreen equipment. Capture rates were 71.1% (NICU-only) vs. 95.4% (UNHS) (P < 0.001), successful follow-up rates were 85.8% vs. 96% (P= 0.004), and mean corrected age at the first audiology appointment was 51.5 vs. 40.2 days (P= 0.05). NICU screening offered within a larger UNHS program outperformed the stand-alone NICU hearing screening program on all measured parameters. Greater resourcing might address shortcomings of the stand-alone program but would also reduce its potential savings. The high loss to follow-up also argues against the often-advocated approach of referring all NICU infants for diagnostic audiologic testing, bypassing hearing screening altogether.
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2009
End Date: 2011
Funder: Australian Research Council
View Funded ActivityStart Date: 2004
End Date: 2005
Funder: Financial Markets Foundation for Children
View Funded ActivityStart Date: 2006
End Date: 2007
Funder: Telstra Foundation
View Funded ActivityStart Date: 2007
End Date: 2009
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2003
End Date: 2005
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2012
End Date: 2017
Funder: National Health and Medical Research Council
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End Date: 2007
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2016
End Date: 2020
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2011
End Date: 2015
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2003
End Date: 2007
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2009
End Date: 2011
Funder: Australian Research Council
View Funded ActivityStart Date: 2007
End Date: 2011
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2014
End Date: 2018
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2008
Funder: Australian Research Council
View Funded ActivityStart Date: 2008
End Date: 2010
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2007
End Date: 2009
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2010
Funder: Australian Research Council
View Funded ActivityStart Date: 2010
End Date: 2014
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2008
End Date: 2010
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2010
End Date: 2013
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2010
End Date: 2015
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2009
End Date: 2014
Funder: Australian Research Council
View Funded ActivityStart Date: 2012
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2011
End Date: 2014
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2007
End Date: 2010
Funder: National Health and Medical Research Council
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