Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index

BackgroundWhile much cross-sectional data is available, there have been few longitudinal investigations of patterns of electronic media use in children. Further, the possibility of a bi-directional relationship between electronic media use and body mass index in children has not been considered. This study aimed to describe longitudinal patterns of television viewing and electronic game/computer use, and investigate relationships with body mass index (BMI).MethodsThis prospective cohort study was conducted in elementary schools in Victoria, Australia. 1278 children aged 5&ndash;10 years at baseline and 8&ndash;13 years at follow-up had their BMI calculated, from measured height and weight, and transformed to z-scores based on US 2000 growth data. Weight status (non-overweight, overweight and obese) was based on international BMI cut-off points. Weekly television viewing and electronic game/computer use were reported by parents, these were summed to generate total weekly screen time. Children were classified as meeting electronic media use guidelines if their total screen time was &le;14 hrs/wk.ResultsElectronic media use increased over the course of the study; 40% met guidelines at baseline but only 18% three years later. Television viewing and electronic game/computer use tracked moderately and total screen time was positively associated with adiposity cross-sectionally. While weaker relationships with adiposity were observed longitudinally, baseline z-BMI and weight status were positively associated with follow-up screen time and baseline screen time was positively associated with z-BMI and weight status at follow-up. Children who did not meet guidelines at baseline had significantly higher z-BMI and were more likely to be classified as overweight/obese at follow-up.ConclusionElectronic media use in Australian elementary school children is high, increases with age and tracks over time. There appears to be a bi-directional association suggesting that interventions targeting reductions in either screen time or adiposity may have a positive effect on both screen time and adiposity.<br /

Improving infant sleep and maternal mental health: a cluster randomised trial

Objectives: To determine whether a community-delivered intervention targeting infant sleep problems improves infant sleep and maternal well-being and to report the costs of this approach to the healthcare system. Design: Cluster randomised trial. Setting: 49 Maternal and Child Health (MCH) centres (clusters) in Melbourne, Australia. Participants: 328 mothers reporting an infant sleep problem at 7 months recruited during October&ndash;November 2003. Intervention: Behavioural strategies delivered over individual structured MCH consultations versus usual care. Main outcome measures: Maternal report of infant sleep problem, depression symptoms (Edinburgh Postnatal Depression Scale (EPDS)), and SF-12 mental and physical health scores when infants were 10 and 12 months old. Costs included MCH sleep consultations, other healthcare services and intervention costs. Results: Prevalence of infant sleep problems was lower in the intervention than control group at 10 months (56% vs 68%; adjusted OR 0.58 (95% CI: 0.36 to 0.94)) and 12 months (39% vs 55%; adjusted OR 0.50 (0.31 to 0.80)). EPDS scores indicated less depression at 10 months (adjusted mean difference &ndash;1.4 (&ndash;2.3 to &ndash;0.4) and 12 months (&ndash;1.7 (&ndash;2.6 to &ndash;0.7)). SF-12 mental health scores indicated better health at 10 months (adjusted mean difference 3.7 (1.5 to 5.8)) and 12 months (3.9 (1.8 to 6.1)). Total mean costs including intervention design, delivery and use of non-MCH nurse services were &pound;96.93 and &pound;116.79 per intervention and control family, respectively. Conclusions: Implementing this sleep intervention may lead to health gains for infants and mothers and resource savings for the healthcare system.<br /

Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

These findings from a community-ascertained cohort refute long-held views suggesting that developmental stuttering is associated with a range of poorer outcomes. If anything, the reverse was true, with stuttering predicting subsequently better language,nonverbal skills, and psychosocial health-related quality of life at 4 years of age.Future research with this cohort will support a more complete longitudinal understanding of when and in whom recovery occurs. Current best practice recommends waiting for 12 monthsbefore commencing treatment, unlessthe child is distressed, there is parental concern, or the child becomes reluctant to communicate. It may be that for many children treatment could be deferred even longer. Treatment is efficacious15 but is both intensive (median of 15.4o ne-hour clinical sessions followedby 10 one-hour clinical maintenance sessions) and expensive; this "watchful waiting" recommendation would therefore help target allocation of scarce resources to the small number of children who do not resolve and experience adverse outcomes, secure in the knowledge that delaying treatment by a year or more has been shown not to compromise treatment efficac

Tackling the big questions: What research matters to Australian paediatricians?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136534/1/jpc13453.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136534/2/jpc13453_am.pd

DETERIORO DEL LENGUAJE, DEL HABLA Y TRASTORNOS DE LA FLUIDEZ, MANEJO DE LOS TRASTORNOS DEL LENGUAJE Y EL HABLA EN LA INFANCIA. - SPEECH IMPAIRMENT, SPEECH AND FLUENCY DISORDERS, MANAGING LANGUAGE DISORDERS AND SPEECH IN CHILDHOOD.

Una guía para identificar los problemas más comunes, entender su evolución clínica, decidir cuándo y para qué se consultan los servicios, y entender qué mejoras se pueden esperar.Aprender a hablar es uno de los logros más importantes de la vida. El lenguaje, por lo general adquirido con tan poco esfuerzo, sustenta el aprendizaje y la capacidad de interactuar con los demás y establece las relaciones de cada niño. La mala comunicación tiene profundas implicancias para el empleo, la salud, la alfabetización, la crianza de la siguiente generación, y las desigualdades sociales. Por lo tanto es de gran preocupación social que el lenguaje, el habla, y los desórdenes de la fluidez sean algunos de los trastornos más comunes del desarrollo.El objetivo de esta revisión clínica es resumir la información actual sobre los deterioros del lenguaje y del habla para ayudar a los médicos generales, servicios universales de salud del niño y pediatras a identificar los problemas más comunes, entender su evolución clínica, decidir cuándo y para qué se consultan los servicios, y entender qué mejoras se pueden esperar

A Grounded Analysis of Player-Described Board Game Immersion

Substantial research has explored the experience of immersion in digital games, but it is unclear whether this phenomenon extends to other game genres such as board games. Immersion is a concept widely discussed in the board game community by both developers and players and yet there is relatively little research in the area. This paper presents a grounded theory analysis of board game players’ online discussions of immersion. This data is augmented by interviews with five board game players describing their experiences of immersion. The resultant analysis highlights that board game players discuss immersion in terms of both engrossment in the challenge of the game, and submergence within the game world the board game creates. We also focus on elements of game play which players reported in helping and hindering their immersion; importantly these elements do not always come from the game itself. We conclude that board game immersion shares similarities with the literature on immersion in digital games, despite the lack of multimedia interactio

How well are Australian infants and children aged 4 to 5 years doing?

This report presents an analysis of the data from the first wave of the Longitudinal Study of Australian Children (LSAC) to explore the wellbeing of over 10,000 Australian infants and children. This report presents an analysis of the data from the first wave of the Longitudinal Study of Australian Children (LSAC) to explore the wellbeing of 5,107 children in the infant cohort of the study and the 4,983 children, aged 4 to 5 years, in the child cohort. Wave 1 of LSAC includes measures of multiple aspects of children\u27s early development. These developmental measures are summarised in the LSAC Outcome Index, a composite measure which includes an overall index as well as three separate domain scores, tapping physical development, social and emotional functioning, and learning and cognitive development. This report explores five specific aspects of infants\u27 and children\u27s experiences, exposures and environments in relation to their Outcome Index scores: * key sociodemographic characteristics covering the child, mother, family and neighbourhood * non-parental care experiences * child health—prenatal and postnatal experiences and exposures * maternal physical and mental health * the early educational experiences of the child cohort in the home and out-of-home contexts. This paper is by Melissa Wake, Ann Sanson, Donna Berthelsen, Pollyanna Hardy, Sebastian Misson, Katherine Smith, Judy Ungerer and the LSAC Research Consortium

Can improving working memory prevent academic difficulties? a school based randomised controlled trial

Background: Low academic achievement is common and is associated with adverse outcomes such as grade repetition, behavioural disorders and unemployment. The ability to accurately identify these children and intervene before they experience academic failure would be a major advance over the current &lsquo;wait to fail&rsquo; model. Recent research suggests that a possible modifiable factor for low academic achievement is working memory, the ability to temporarily store and manipulate information in a &lsquo;mental workspace&rsquo;. Children with working memory difficulties are at high risk of academic failure. It has recently been demonstrated that working memory can be improved with adaptive training tasks that encourage improvements in working memory capacity. Our trial will determine whether the intervention is efficacious as a selective prevention strategy for young children at risk of academic difficulties and is cost-effective.Methods/Design: This randomised controlled trial aims to recruit 440 children with low working memory after a school-based screening of 2880 children in Grade one. We will approach caregivers of all children from 48 participating primary schools in metropolitan Melbourne for consent. Children with low working memory will be randomised to usual care or the intervention. The intervention will consist of 25 computerised working memory training sessions, which take approximately 35 minutes each to complete. Follow-up of children will be conducted at 6, 12 and 24 months post-randomisation through child face-to-face assessment, parent and teacher surveys and data from government authorities. The primary outcome is academic achievement at 12 and 24 months, and other outcomes include child behaviour, attention, health-related quality of life, working memory, and health and educational serviceutilisation.Discussion: A successful start to formal learning in school sets the stage for future academic, psychological and economic well-being. If this preventive intervention can be shown to be efficacious, then we will have the potential to prevent academic underachievement in large numbers of at-risk children, to offer a ready-to-use intervention to the Australian school system and to build international research partnerships along the health education interface, in order to carry our further studies of effectiveness and generalisability.<br /