Affluent Children Research Articles

Differences in perceived causes of childhood obesity between migrant and local communities in China: A qualitative study.

In developing countries, obesity traditionally affectsmore affluent children, butis spreading to a wider social group. Understanding the perceivedcontributors can provide valuable insights to plan preventive interventions. We exploreddifferences in the perceived causes of childhood obesity between local and migrant communities in a major Chinese city. We conducted 20 focus groups (137 parents, grandparents, school teachers) and 11semi-structured interviews with school Principals from migrant and local communities in Guangzhou. Data were transcribed and analysed using a thematic approach. We found that Lack of influence from grandparents, who were perceived to promote obesogenic behaviorin local children, fewer opportunities for unhealthy snacking and less pressure for academic attainment leading to moreactive play were interpreted as potential “protective” factors among migrant children. Nevertheless, two perceived causes of obesity were more pronounced in migrant than local children: lack of parental monitoring after-school andunsafe neighborhoods limiting physical-activity. Two barriers that restricted child physical activity were only found in the migrant community: limited home space, and cultural differences, inhabitinginteractive play with local children. Future interventions should consider uniquedeterminants of obesity in children from different social backgrounds, with tailored strategies to prevent further rise of the epidemic.

Short-Term Intervention Effects of the PATHS Curriculum in Young Low-Income Children: Capitalizing on Plasticity.

Deficits in behavioral and cognitive regulation are prevalent in children reared in poverty relative to more affluent children due to the effects of adverse conditions on the developmental underpinnings of these skills. Despite evidence to suggest that these emergent processes are susceptible to environmental inputs, research documenting short-term intervention program influences on these regulatory domains in young impoverished children is limited. We sought to determine the proximal effects of a universal school-based intervention (the PATHS Curriculum) on social, emotional, relational, and cognitive outcomes in urban poor kindergarten children. Four schools in high-poverty neighborhoods with similar demographic characteristics were randomly assigned to either PATHS or an attentional control. Teacher-reported measures of behavior (e.g., attention, concentration, aggression), peer nominations (e.g., likability, aggression, acceptance), and tasks gauging inhibitory control were administered in the fall of kindergarten and again in the spring after one academic year (about 6months) of PATHS. Children who received PATHS exhibited significantly greater improvements than control students across all teacher-rated behavioral measures of social competence (i.e., emotion regulation, prosocial behavior, peer relations) and behavioral problems (i.e., aggression, internalizing behaviors, impulsivity and hyperactivity) at post-test as well as improvements in motor inhibition. This line of research constitutes an important frontier for prevention research given the implications for improving ultimate outcomes for otherwise disadvantaged children.

Vitamin N For the Soul

Vitamin N For the Soul

Differences in perceived causes of childhood obesity between migrant and local communities in China: a qualitative study

BackgroundIn China, obesity has traditionally affected the more affluent urban children, but the problem is spreading to a wider social group, including children who have migrated from rural to urban areas. Customised interventions are needed to prevent further growth in the prevalence of obesity among these migrant children. Exploring the perceptions of key stakeholders regarding the causes of childhood obesity can provide valuable insights, but no qualitative studies have addressed this issue. We investigated the differences in the perceived causes of childhood obesity between local and migrant communities living in a major city in China. MethodsWe conducted 20 focus groups (six in migrant communities) involving 137 participants (including parents, grandparents, and school teachers) and 11 semi-structured interviews with school principals (two from schools for migrants) in Guangzhou. Audio data were transcribed verbatim and analysed with a thematic approach. Ethics approval was obtained from the Life and Health Sciences Ethical Review Committee at the University of Birmingham (reference ERN_13-1519). Local ethics approval was also granted by the Ethical Committee of Guangzhou Center for Disease Control and Prevention. FindingsThree potential protective factors for obesity among migrant children were interpreted (theme one). Grandparents remaining in the hometown of migrant families were not believed to influence child care that often promotes obesity among local children. Migrant children might be exposed to fewer opportunities for unhealthy snacking and had more opportunity for active play, as they were reportedly under less pressure for academic attainment compared with local children. Nevertheless, two perceived causes were more pronounced for migrant children than for local children (theme two): a lack of parental care and monitoring for after-school health behaviours; and unsafe neighbourhoods with insufficient space for physical activity. Two further barriers that restricted children's physical activity were only found in the migrant community (theme three): limited home space for physical activity, and cultural differences that made interactive play with local children challenging. InterpretationAlthough migrant children might have benefited from some protective factors in relation to the development of childhood obesity, several perceived causes were either more pronounced or unique in relation to this group. Future research should deepen knowledge of the modifiable determinants of obesity in migrant children and develop appropriate intervention strategies to prevent further rise of the epidemic in this population while continuing current efforts to control obesity in local children. FundingThe study was funded by the Guangzhou Medical Foundation (20131A031001).

Urban Telemedicine Enables Equity in Access to Acute Illness Care.

Children with care for acute illness available through the Health-e-Access telemedicine model at childcare and schools were previously found to have 22% less emergency department (ED) use than counterparts without this service, but they also had 24% greater acute care use overall. We assessed the hypothesis that increased utilization reflected improved access among impoverished inner-city children to a level experienced by more affluent suburban children. This observational study compared utilization among children without and with telemedicine access, beginning in 1993, ending in 2007, and based on 84,287 child-months of billing claims-based observation. Health-e-Access Telemedicine was initiated in stepwise manner over 187 study-months among 74 access sites (childcare, schools, community centers), beginning in month 105. Children dwelled in inner city, rest-of-city Rochester, NY, or in surrounding suburbs. Rate of total acute care visits (office, ED, telemedicine) was measured as visits per 100 child-years. Observed utilization rates were adjusted in multivariate analysis for age, sex, insurance type, and season of year. When both suburban and inner-city children lacked telemedicine access, overall acute illness visits were 75% greater among suburban than inner-city children (suburban:inner-city rate ratio 1.75, p < 0.0001). After telemedicine became available to inner-city children, their overall acute visits approximated those of suburban children (suburban:inner-city rate ratio 0.80, p = 0.07), whereas acute visits among suburban children remained at least (worst-case comparison) 56% greater than inner-city children without telemedicine (rate ratio 1.56, p < 0.0001). At baseline, overall acute illness utilization of suburban children exceeded that of inner-city children. Overall utilization for inner-city children increased with telemedicine to that of suburban children at baseline. Without telemedicine, however, inner-city use remained substantially less than for suburban counterparts. Health-e-Access Telemedicine redressed socioeconomic disparities in acute care access in the Rochester area, thus contributing to a more equitable community.

Association between overweight and academic achievement among affluent school children in Allahabad

Psychological and social health problems related to overweight may affect academic achievement of overweight children. The purpose of the present study was to assess the relationship between overweight and academic achievement in school children. A total of 330, school children studying between 6 th and 10 th standard aged between 11 to 16 years were studied from two affluent schools of Allahabad city- Maharshi Patanjali Vidya Mandir and Tagore Public School. Children with BMI between 85 th and 95 th percentile were considered as overweight. 165 identified overweight children as cases and 165 normal weight children as controls were selected. While selecting controls, it was kept in mind to maintain the similarity of age, gender and standard between case and control. Cumulative Grade Point Average (CGPA) along with Math and English grades were recorded from the school register to evaluate the academic achievement of children. Chi square test was used for statistical analysis. Findings of the study reveal that there is no significant difference (p>0.05) between cases and controls with respect to grades achieved in CGPA, Math and English in both boys and girls. Overall, overweight was not found significantly associated to children's academic achievement. More research studies are required to further explore the relationship between excess body weight and academic achievement.

Teachers’ dispositions towards the role of digital devices in play-based pedagogy in early childhood education

A body of research is emerging on early childhood education teachers’ views on the integration of digital technologies in their practice. Despite evidence of the digitalisation of homes in affluent societies and children’s interactions in highly mediated digital environments, few teachers so far have integrated digital devices into a play-based pedagogy. Thus, this project aimed to examine the attitudes and aptitudes towards digital devices of teachers in their personal lives and professional practice in five countries (England, Luxemburg, Malta, Greece and Kuwait). An online survey designed to collect broad-scale data was followed by focus group interviews. The findings demonstrated that although teachers are digitally competent in their personal lives, there is a dominant ideology regarding the nature of play-based pedagogy that hinders the integration of digital devices into their practice.

Prevalence and determinants of overweight/obesity among affluent school children

Prevalence and determinants of overweight/obesity among affluent school children

The association of body height, height variability and inequality.

Body height is associated with environmental conditions. It has been suggested that under poor conditions when inequality within a population increases, also the variability in height tends to increase. We studied the association of body height, within-country variability in height and geographic and historic origin in 767 growth studies carried out in 80 countries, published between 1794 and 2013, with data on N = 78,184 infants age 2 years, and N = 2,130,729 juveniles age 7 years. The studies represent almost the whole spectrum of economic diversity in human societies since the end-18(th) century. 207 studies contained data for both infants and juveniles with 50,819 subjects (age 2), and 123,078 subjects (age 7). Multiple linear regressions showed significant interactions between height, sex, historic year of the study, geographic origin, and within-study standard deviation for height with multiple R-squared = 0.527, p < 0.001, at age 2, and multiple R-squared = 0.436, p < 0.001, at age 7. Yet, the two age groups differed in respect to within-study standard deviation for height. We found a significant association between body height and within-study standard deviation for height only at age 2: tall infant populations are less variable in height (r = -0.27, p < 0.01). There was no such association in children aged 7 years. Tall children from affluent and short children from less affluent countries do not differ in the variability of body height. The data suggest that the 'environmental adversity' hypothesis for variation in growth: small mean values for height go along with large standard deviations for height, does not apply for children at age 7.

It still takes a village: an epidemiological study of the role of social supports in understanding unexpected health states in young people.

BackgroundThis study of adolescent Canadians examines two groups who are anomalous in their health experiences: (1) those with perceived low affluence yet who perceive themselves to have excellent general health status; (2) those of perceived high affluence but who are reporting poor health status. Our hope was to explore the role of social supports in explaining such anomalies. We hypothesized that cumulative levels of social support available to these young people would have an influence on their perceived health status, with more support being associated with better self reported health.MethodsYoung people (n = 26,078 from 436 schools) aged 11–15 years were administered a general health survey in classroom settings during the 2009–10 academic school year. Descriptive and regression-based cross-sectional analyses (with an affluence-social support interaction term) were used to relate both individual and cumulative levels of social support in homes, neighborhoods, schools, and peer groups to self-reported health status.ResultsSocial supports and their cumulative availability indeed were strongly related to perceived health, with more supports being associated with better self-perceived health. Less affluent children were much more likely to report excellent health in the presence of numerous social supports. More affluent children were much more likely to report poor health in the absence of such supports. The strength and dose-dependent nature of the findings were consistent and striking.ConclusionsStudy findings from this large, contemporary and national analysis affirm the importance of social supports as potential determinants of health for young people from both high and low affluent groups. Conceptually, findings affirm the wisdom of the ancient principle: “it takes a village to raise a child”.

Prevalence of obesity in affluent school children of Greater Noida, Uttar Pradesh

Background: Childhood obesity is a state of over nutrition with long term complications such as hypertension, coronary artery disease and Type-2 diabetes. It also adversely affects psychological development causing poor body image and low self-esteem. Objective: The aim of this study was to know the prevalence of obesity in affluent school children of Greater Noida, Uttar Pradesh. Methods: This study was carried out in affluent school children of four private schools in Greater Noida, Uttar Pradesh. Height and weight of each child weremeasured, and body mass index was determined according to Quetelet’s index. Results: Totally 816 school children of 6-11 years were examined with 528 boys and 288 girls. The overall prevalence of obesity was 7.4% without significant difference in boys (7.3%) and girls (7.6%). Prevalence of obesity was high at the age of 11 years both in boys (12.2%) and girls (11.5%). Conclusion: The present study revealed that obesity has a high prevalence reaching to epidemic proportions in the affluent school children of Greater Noida, Uttar Pradesh.

Overweight and Obesity among Children of Affluent Public School in Allahabad, Uttar Pradesh

In developing countries such as India, especially in urban population and affluent children, obesity is emerging as a major health problem. The magnitude of overweight ranges from 9% to 27.5% and obesity ranges from 1% to 12.9% among Indian children. To know the prevalence of overweight & obesity in affluent school children aged between 11–16 years and to analyze the association between overweight/obesity with physical activity. A cross sectional study was carried out in 2 affluent schools of Allahabad city –Maharshi Patanjali Vidya Mandir and Tagore Public School. A total of 1146, school children studying between 6th and 11th standard aged between 11 to 16 years were studied and data regarding time spent on television viewing, sleeping, playing computer/video games, indoor games, outdoor games and physical exercises was recorded in a pre designed and pre tested questionnaire. Out of 1146 school children 223 (19.5%) and 119 (10.4%) were overweight and obese respectively. The overall prevalence of overweight and obesity in affluent school children of 11–16 years was estimated to be 29.9%. Proportion of overweight and obesity was more in boys (20.7% and 12.2%) than girls (17.8% and 8.0%).

Revised Indian Academy of Pediatrics 2015 growth charts for height, weight and body mass index for 5-18-year-old Indian children.

Growth chart committee of Indian Academy of Pediatrics (IAP) has revised growth charts for 5–18-year-old Indian children in Jan 2015. The last IAP growth charts (2007) were based on data collected in 1989–92 which is now >2 decades old. India is in an economic and nutrition transition and hence growth pattern of Indian children has changed over last few years. Thus, it was necessary to produce contemporary, updated growth references for Indian children. The new IAP charts were prepared by collating data from nine groups who had published studies in indexed journals on growth from India in the last decade. Growth charts were constructed from a total of 87022 middle and upper socioeconomic class children (m 54086, f 32936) from all five zones of India. Data from middle and upper socioeconomic class children are likely to have higher prevalence of overweight and obesity and hence growth charts produced on such populations are likely to “normalize” obesity. To remove such unhealthy weights form the data, method suggested by World Health Organization was used to produce weight charts. Thus, the new IAP weight charts are much lower than the recently published studies on affluent Indian children. Since Indian's are at a higher risk of obesity-related cardiometabolic complications at lower body mass index (BMI), BMI charts adjusted for 23, and 27 adult equivalent cut-offs as per International obesity task force guidelines were constructed. IAP now recommends use of these new charts to replace the 2007 IAP charts.

Assessing immunization interventions in the Women, Infants, and Children (WIC) program.

Vaccination promotion strategies are recommended in Women, Infants, and Children (WIC) settings for eligible children at risk for under-immunization due to their low-income status. To determine coverage levels of WIC and non-WIC participants and assess effectiveness of immunization intervention strategies. The 2007-2011 National Immunization Surveys were used to analyze vaccination histories and WIC participation among children aged 24-35 months. Grantee data on immunization activities in WIC settings were collected from the 2010 WIC Linkage Annual Report Survey. Coverage by WIC eligibility and participation status and grantee-specific coverage by intervention strategy were determined at 24 months for select antigens. Data were collected 2007-2011 and analyzed in 2013. Of 13,183 age-eligible children, 5,699 (61%, weighted) had participated in WIC, of which 3,404 (62%, weighted) were current participants. In 2011, differences in four or more doses of the diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine by WIC participation status were observed: 86% (ineligible); 84% (current); 77% (previous); and 69% (never-eligible). Children in WIC exposed to an immunization intervention strategy had higher coverage levels than WIC-eligible children who never participated, with differences as great as 15% (DTaP). Children who never participated in WIC, but were eligible, had the lowest vaccination coverage. Current WIC participants had vaccination coverage comparable to more affluent children, and higher coverage than previous WIC participants.

National Trends in Tongue Reduction Surgery for Macroglossia in Children

Objectives: (1) Examine the frequency of partial glossectomy performed for the indication of macroglossia in the United States, assessing for any differences in rates of intervention across various demographics. (2) Identify potential morbidities associated with partial glossectomy in this population and determine how such factors may influence length of stay (LOS) and cost of admission following tongue reduction surgery. Methods: Retrospective cross-sectional study using the 2006 and 2009 KidsTM Inpatient Databases (KID). During the 2-year study period, partial glossectomy was performed in 80 children under 5 years with macroglossia. Results: A disproportionately higher rate of intervention was seen in whites ( P = .001) and patients in the highest socioeconomic quartile ( P = .007). Conversely, a lower rate of intervention was observed in black children ( P = .011). The average age at the time of partial glossectomy was 23 months (mode, 12 months). Patients were classified as isolated (n = 16, 20%) or syndromic macroglossia (n = 64, 80%) based on associated diagnoses. The average length of stay after partial glossectomy for macroglossia ranged from 5 to 11 days. Differences in LOS (mean, 9.5 days) and cost (mean, $9.8k) between isolated and syndromic macroglossia groups were not significant. Conclusions: Partial glossectomy for macroglossia is typically performed prior to age 2 years in the United States. Syndromic comorbidities do not seem to contribute to increased LOS or cost of admission. White children and affluent children appear to be undergoing partial glossectomy at a higher rate than their peers.

Alternative Entrances: Phillip Noyce and Sydney’s Counterculture

[Extract] Phillip Noyce is one of Australia's most prominent film makers - a successful feature film director with both iconic Australian narratives and many a Hollywood blockbuster under his belt. Still, his beginnings were quite humble and far from his role today when he grew up in the midst of the counterculture of the late sixties. Millions of young people his age joined the various 'movements' of the day after experiences that changed their lives-mostly music but also drugs or fashion. The counterculture was a turbulent time in Sydney artistic circles as elsewhere. Everything looked possible, you simply had to "Do It!" - and Noyce did. He dived head-on into these times and with a voracious appetite for its many aspects-film, theatre, rallies, music, art and politics in general. In fact he often was the driving force behind such activities.

Prevalence of overweight and obesity among children and adolescents of the Indian subcontinent: a meta-analysis.

In order to examine the prevalence of overweight and obesity in childhood within the Indian subcontinent, a meta-analysis of studies was conducted. Within the data sets analyzed, six homogeneous statistical subgroups were observed and three levels of prevalence were discernible (low, intermediate, and high). The pooled estimates of the prevalence of overweight and obesity in children were 2% (95% confidence interval [CI], 2-3%) to 6% (95% CI, 6-7%) for the low-prevalence group, 11% (95% CI, 11-12%) to 18% (95% CI, 17-18%) for the intermediate-prevalence group, and 23% (95% CI, 22-24%) to 36% (95% CI, 34-37%) for the high-prevalence group. Data on subjects in the low-prevalence group were obtained from national-level data and from data sets in which urban and rural subjects were combined. Neither the intermediate- nor the high-prevalence category contained any data from the rural or national level. The intermediate group largely included urban children, whereas the high-prevalence group generally included affluent children within major urban centers. Most of the data sets reported the prevalence of overweight and obesity among children in the 10-18-year age range. The prevalence of overweight and obesity was higher among boys than girls, and had increased among urban dwellers during the last decade.

Height of South Asian children in the Netherlands aged 0–20 years: secular trends and comparisons with current Asian Indian, Dutch and WHO references

Background: People from Asian populations are generally shorter than other ethnic groups. It is unknown if current universal height references are suitable for affluent South Asian children in the Netherlands.Aims: To develop height-for-age charts for contemporary South Asian children aged 0–20 years living in the Netherlands, to evaluate secular trends, and to compare the charts with current Asian Indian, Dutch and WHO references.Subjects and methods: A population-based study measured 3315 South Asian children aged 0–20 years between 2007–2010. Among this cohort, 6876 measurements were taken. Another 7388 measurements were taken of a historical cohort of 1078 children born between 1974–1976 (aged 0–18 years).Results: An upward trend in height was observed for South Asian children living in the Netherlands between 1992–2010. The height-for-age charts of the South Asian historical cohort were similar to current Asian Indian charts. South Asian children in the Netherlands were shorter than their Dutch contemporaries at every age; and these differences increased further during adolescence. Compared to the WHO height-for-age references, there were considerable discrepancies in height, with curves intersecting twice.Conclusion: The discrepancies between the South Asian and Dutch and WHO height-for-age references indicate differences in growth patterns between the source populations.

Boosting family income to promote child development.

Families who live in poverty face disadvantages that can hinder their children's development in many ways, write Greg Duncan, Katherine Magnuson, and Elizabeth Votruba-Drzal. As they struggle to get by economically, and as they cope with substandard housing, unsafe neighborhoods, and inadequate schools, poor families experience more stress in their daily lives than more affluent families do, with a host of psychological and developmental consequences. Poor families also lack the resources to invest in things like high-quality child care and enriched learning experiences that give more affluent children a leg up. Often, poor parents also lack the time that wealthier parents have to invest in their children, because poor parents are more likely to be raising children alone or to work nonstandard hours and have inflexible work schedules. Can increasing poor parents' incomes, independent of any other sort of assistance, help their children succeed in school and in life? The theoretical case is strong, and Duncan, Magnuson, and Votruba-Drzal find solid evidence that the answer is yes--children from poor families that see a boost in income do better in school and complete more years of schooling, for example. But if boosting poor parents' incomes can help their children, a crucial question remains: Does it matter when in a child's life the additional income appears? Developmental neurobiology strongly suggests that increased income should have the greatest effect during children's early years, when their brains and other systems are developing rapidly, though we need more evidence to prove this conclusively. The authors offer examples of how policy makers could incorporate the findings they present to create more effective programs for families living in poverty. And they conclude with a warning: if a boost in income can help poor children, then a drop in income--for example, through cuts to social safety net programs like food stamps--can surely harm them.

A cross-sectional study of childhood and adolescent obesity in affluent school children from western suburb of Mumbai 2001-2002 and 2013-2014

Introduction: Change in lifestyle patterns associated with genetic factors is causing increasing prevalence of childhood and adolescent obesity in India. Obesity during childhood and adolescence puts these children at a high risk for adult cardio-metabolic disorders and other chronic diseases. It is important that this avalanche is prevented in time by comprehensive school health education programmes and other timely interventions. An observational cross-sectional study, as a part of the School Health Education and Enlightened Living (SHEEL) project, was conducted to assess the prevalence in childhood overweight and obesity during the academic years 2000-2001 and 2013-2014 at a private school. Materials and Methods: As a part of the SHEEL project, a total of 2421 children consists of 1346 boys and 1075 girls (age ranged, 4 -15 years) were evaluated for their height (stadiometer), weight (electronic weighing scale) and body mass index (BMI) during the academic year 2000-2001 (stage 1 study). We approached the same school again in the academic year 2013-14 (stage 2 study). In this stage, a total of 2056 children (1067 boys and 989 girls; age range 5-15 years) were measured for the same parameters to evaluate in childhood and adolescent obesity when compared with that observed in 2000-2001.The measurements were plotted on gender specific BMI charts (Center for Disease Control and Prevention [CDC] charts) for obtaining percentiles. Identification of overweight and obesity was arrived at by CDC centile charts. Results: The stage 1 study done during the academic year 2000-2001 in school children from an affluent class of society showed a prevalence of overweight, in girls as 16.7% (180/1075) and in boys, 13.7% (185/1346). The prevalence of obesity for the total number of children was 15.3% (14.2% in 1075 girls and 16.1% in 1346 boys). In stage 2 study done during the academic year 2013-2014 in the same school, prevalence of overweight in girls was 16% (158/989) and in boys, 15.3% (163/1067) and the prevalence of obesity was 11.1% (9.1% in 989 girls and 12.9% in 1067 boys). If children at risk for obesity (overweight) and obese were clubbed together, nearly 1/3 of the children, 30.4% in 2001 and 26.7% in 2013, had above-normal BMI percentiles. In this study, the percentage of children showing overweight/obesity increased from the age groups 7 to 8 years and above as compared to the younger age groups. Conclusions: The current cross-sectional study shows that the prevalence of childhood and adolescent overweight and obesity amongst children from a upper-socio-economic stratum of society has remained high at 25-30% during both the periods of the school-based study. However, the trend for the prevalence of overweight and obesity in this >10 years has shown a definite decline of 5.8% in girls, while the decline of 1.6% in boys was not as remarkable.