New Zealand Children Research Articles

Household crowding associated with childhood otitis media hospitalisations in New Zealand.

To examine the association between hospitalisations for otitis media and area-level measures of household crowding among children in New Zealand. Counts of hospital admissions for otitis media by census area unit were offset against population data from the 2006 national census. Area-level household crowding, exposure to tobacco smoke in the home, equivalised income and individual-level characteristics age and sex were adjusted for. To examine effect modification by ethnicity, three separate poisson models were examined for the total, Māori and non-Māori populations. Household crowding was significantly associated with hospital admissions for otitis media after adjustment in all three models. Neighbourhoods with the highest compared to the lowest proportion of crowded homes exhibited incidence rate ratios of 1.25 (95%CI 1.12-1.37) in the total population, 1.59 (95%CI 1.21-2.04) in the Māori restricted model and 1.17 (95%CI 1.06-1.32) in the non-Māori restricted model. Otitis media hospitalisations are associated with area-level measures of household crowding and other risk factors in this ecological study. The largest increase in otitis media incidence relative to neighbourhood rates of household crowding was exhibited among Māori cases of otitis media. This study adds weight to the growing body of literature linking infectious disease risk to overcrowding in the home.

The Socialization of Families Away from Home: Group Dynamics and Family Functioning on Holiday

The focus on individuals in tourism research has led to limited and fragmented research on family groups and their leisure experiences away from home. This article extends conceptual and theoretical understandings within family tourism research by offering a three-dimensional framework inclusive of group perspectives. A whole-family methodology was used with 10 families (10 fathers, 10 mothers, and 20 children) in New Zealand as a more critical and holistic approach to tourism concepts. Empirical findings illustrate group dynamics along with the underrepresented generational perspectives of children and gender perspectives of fathers to provide insights into family functioning. This resulted in a three-layered model of family holiday experiences inclusive of group sociality. The collective intentionality of family togetherness on holiday is contrasted with more balanced modes in own time, highlighting the complexity of socialization within tourism theory and practice.

Pupil–teacher relationships: perceptions of boys with social, emotional and behavioural difficulties

This article is derived from a study of pupils with social, emotional and behavioural difficulties’ (SEBD) perceptions of their schooling experiences both in mainstream and residential schools. It is based on the accounts of 29 boys with severe SEBD who were attending a residential special school for children in New Zealand. Through in-depth, semi-structured and focus group interviews, a number of salient features of their schooling experiences were raised. One of these features was the pupils’ relationship with teachers. This article reports on pupils with SEBD’s perceptions of mainstream and residential school teachers’ qualities that either hinder or foster positive relationships and development.

Viewpoint: Early childhood caries: a New Zealand perspective

Dental caries, primarily a preventable disease, remains the most common chronic disease of childhood and one of the most common reasons for hospital admissions for children in New Zealand. The most vulnerable children are shouldering the burden of the disease, with Maori and Pacific children having greater experience and severity of dental caries. Early childhood caries has deleterious effects on a child’s oral and general health and significant numbers of preschool-aged children experience pain and infection. Early identification by primary health care providers of children at high risk of developing early childhood caries can ensure these children are referred to the appropriate oral health services to receive appropriate and timely management. KEYWORDS: Dental care for children; dental caries; New Zealand; preschool child

Prevalence and risk factors for tobacco smoking among pre-adolescent Pacific children in New Zealand

Pacific New Zealanders have a high prevalence of smoking, with many first smoking in their pre-adolescent years. To identify risk factors for tobacco smoking among Pacific pre-adolescent intermediate school children. A cross-sectional survey of 2208 Pacific students aged between 10 and 13 years from four South Auckland intermediate schools who were asked about their smoking behaviour between the years 2007 and 2009. The prevalence of Pacific ever-smokers (for 2007) in Year 7 was 15.0% (95% Confidence Interval [CI] 12.0%-18.3%) and Year 8, 23.0% (95% CI 19.5%-26.7%). Multivariate modelling showed the risk factors for ever-smoking were Cook Island ethnic group (OR 1.72; 95% CI 1.26-2.36, ref=Samoan), boys (OR 1.47; 95% CI 1.14-1.89), age (OR 1.65; 95% CI 1.36-2.00), exposure to smoking in a car within the previous seven days (OR 2.24; 95% CI 1.67-3.01), anyone smoking at home within the previous seven days (OR 1.52; 95% CI 1.12-2.04) and receiving more than $NZ20 per week as pocket money/allowance (OR=1.91, 95% CI 1.23-2.96). Parents control and therefore can modify identified risk factors for Pacific children's smoking initiation: exposure to smoking at home or in the car and the amount of weekly pocket money the child receives. Primary health care professionals should advise Pacific parents to make their homes and cars smokefree and to monitor their children's spending. This study also suggests a particular need for specific Cook Island smokefree promotion and cessation resources.

Prevalence of obesity and overweight in 4–5 year old children in New Zealand: Descriptive analysis of body mass index measurements from the national before school check (B4SC) programme

Prevalence of obesity and overweight in 4–5 year old children in New Zealand: Descriptive analysis of body mass index measurements from the national before school check (B4SC) programme

Is Obesity Associated With a Decline in Intelligence Quotient During the First Half of the Life Course?

Cross-sectional studies have found that obesity is associated with low intellectual ability and neuroimaging abnormalities in adolescence and adulthood. Some have interpreted these associations to suggest that obesity causes intellectual decline in the first half of the life course. We analyzed data from a prospective longitudinal study to test whether becoming obese was associated with intellectual decline from childhood to midlife. We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (1972-1973) through their fourth decade of life with a 95% retention rate. Intelligence quotient (IQ) was measured in childhood and adulthood. Anthropometric measurements were taken at birth and at 12 subsequent in-person assessments. As expected, cohort members who became obese had lower adulthood IQ scores. However, obese cohort members exhibited no excess decline in IQ. Instead, these cohort members had lower IQ scores since childhood. This pattern remained consistent when we accounted for children's birth weights and growth during the first years of life, as well as for childhood-onset obesity. Lower IQ scores among children who later developed obesity were present as early as 3 years of age. We observed no evidence that obesity contributed to a decline in IQ, even among obese individuals who displayed evidence of the metabolic syndrome and/or elevated systemic inflammation.

Cross-national Comparison of Prenatal Methamphetamine Exposure on Infant and Early Child Physical Growth: A Natural Experiment

The current study seeks to compare the effects of prenatal methamphetamine exposure (PME) on infant and child physical growth between the USA and New Zealand (NZ). This cross-national comparison provides a unique opportunity to examine the potential impact of services provided to drug using mothers on child health. The longitudinal Infant Development, Environment and Lifestyle study of PME from birth to 36months was conducted in the USA and NZ. The US cohort included 204 children with PME and 212 non-PME matched comparisons (NPME); the NZ cohort included 108 children with PME and 115 NPME matched comparisons. Latent growth curve models were used to examine effects of PME, country of origin, and the country × PME interaction on growth in length/height and weight. In regard to length/height, PME and country of origin were associated with initial length and growth over time. There was also a significant interaction effect, such that children with PME in the USA were shorter at birth than children with PME in NZ after controlling for other prenatal exposures, infant set, socioeconomic status, and maternal height. In regard to weight, there was only an effect of country of origin. Effects of PME on infant and child growth were shown to differ across countries, with exposed children in NZ faring better than exposed children in the USA. Implications for prevention programs and public policy are discussed.

Smoke, smoking and cessation: the views of children with respiratory illness

Objective: To explore the attitudes of Māori (indigenous New Zealanders) and Pacific children with respiratory illness towards smoking, secondhand smoke (SHS) and smoking cessation. Methods: Forty-one Māori and Pacific children (aged 6–11 years) in New Zealand (NZ) were interviewed about their attitudes towards smoking, how SHS affects them and their respiratory disease, ideas they have about how to reduce SHS exposure, their fears and concerns about smoking, and experience asking parents to quit smoking. The interviews were transcribed and deductively analysed. Results: The children said that SHS made them feel “bad,” “angry,” “uncomfortable” and “really sick,” making them want to get away from the smoke. They were aware that smoking “is dangerous” and that “you could die from it.” Many children had fears for smokers around them. The children reported on rules restricting smoking around children: “You’re not allowed smoke in the car where babies are.” A number of children reported that adults complied with those rules, but some reported that people still smoked around them. The children had experienced people around them quitting and had an awareness of how difficult it is to quit smoking. The most common reason perceived for quitting was concern for children. A lot of the children thought they could ask parents to quit and other suggestions included hiding people’s tobacco, and use of smoke-free pamphlets, or signs. Conclusions: Even young children from low socioeconomic minority groups are aware of the dangers of smoking and SHS, and hold negative views about smoking. Health promotion messages for parents could have more weight if they convey the concerns voiced by children.

Characteristics influencing location of death for children with life-limiting illness

ObjectiveTo determine whether demographic and diagnostic characteristics were associated with location of death in a series of children with life-limiting illnesses.DesignA population-level case series was carried out by reviewing mortality...

‘Getting fit basically just means, like, nonfat’: children's lessons in fitness and fatness

Current concerns about a childhood obesity crisis and children's physical activity levels have combined to justify fitness lessons as a physical education practice in New Zealand primary (elementary) schools. Researchers focused on children's understandings of fitness lessons argue that they construct fitness as a quest for an ‘ideal’ (skinny or muscular) body. The conflation of fitness with thinness, however, is complex and problematic. In this paper, we draw from research conducted with a class of primary school children in New Zealand. Drawing on the theoretical tools of Foucault and utilizing a visual methods approach, we examine how children experience school fitness lessons and construct notions of fitness, health and body. The children's responses illustrated that obesity discourses and body pedagogies ‘collided’ in a way that shaped understandings of fitness lessons in ways inextricably connected with the avoidance of being fat. The children assumed that fitness lessons increased fitness and that being fit was demonstrated by a ‘correct’ corporeal appearance. We argue that body pedagogies inside and outside the school gates shape children's ideas about the body in ways which exclude other understandings of bodies, health, and physical activity.

Developing an “ecology of learning” within a school sustainability co-design project with children in New Zealand

This paper analyses the inter-relatedness of layers of involvement, as contributing to learning, within a school sustainability project (the eco-classroom project). This engaged students, staff and community members (including professional practitioners) in an architectural co-design project that resulted, after 4 years, in a built classroom. The paper utilises an “ecology of learning” diagram to indicate layers and show connections, which are evidenced by findings from the project, alongside relevant literature in geographies of architecture and childhood, pedagogies of sustainable learning and children's participatory and co-design examples. In conclusion, the ecology of learning approach is critiqued and encouragement of more sustainability co-design projects with children is recommended. It is proposed this could lead to improved processes for all participants while promoting authentic and relevant sustainability learning.

Parents' perception of teen's influence on family purchase decisions

Purpose – The purpose of this paper is to investigate the cultural assimilation influence on family purchase decision making of Chinese immigrant families in New Zealand, and in Chinese families living in China. Design/methodology/approach – The data were collected from 200 respondents. In total, 100 families have been chosen from each of these countries. The data were collected by the snowball sampling method across 11 different products and four decision-making stages. Findings – The results of this research show that cultural assimilation does have an influence on parental perceptions of teen's influence on family decision making. Chinese immigrants' teenage children in New Zealand were perceived as having more influence within the family than their peers in Chinese families living in China. Research limitations/implications – The research used a sample size of only 100 respondents from each country. Furthermore, it used snowball sampling and mid-income group families only. Practical implications – These findings help marketers to gain a better understanding of the influence of cultural assimilation, and use specific marketing communication and promotion strategies. Originality/value – The paper empirically demonstrates that Chinese parents living in China and Chinese immigrant parents living in New Zealand perceive their children's involvement in family purchase decision differently. Chinese immigrant parents perceive that their children are becoming assimilated with New Zealand culture. This is the first ever study done on Chinese Immigrant families living in New Zealand and Chinese families living in China by collecting and using the cross-culture data from New Zealand and China.

"If you talk, you are just talking. If I talk is that bragging?" Perspectives of Parents with Young Gifted Children in New Zealand.

This phenomenological study (Chellapan, 2012) investigates the perceptions and experiences of four sets of New Zealand parents with children identified as intellectually gifted based upon an IQ tes ...

Barriers to the safe transport of children to hospital

BackgroundTrauma while travelling as a passenger in a motor vehicle is a leading cause of mortality and hospitalisation for children in New Zealand. Serious trauma is often the result of...

Prevalence of genetic renal disease in children

Genetic etiology comprises a significant proportion of renal disease in childhood. Completion of the Human Genome Project and increased genetic testing has assisted with the increased recognition of a genetic basis to many renal disorders. Australia and New Zealand have a relatively stable but diverse population, with eight major pediatric nephrology referral centers, which allow ascertainment of disease frequency. To determine prevalence, pediatric nephrologists at the eight centers in Australia and New Zealand were surveyed on their estimated number of patients with renal disease of genetic etiology over a 10-year period. Disease prevalence was calculated using combined national population data. The overall prevalence of genetic kidney disease in children in Australia and New Zealand is 70.6 children per million age-representative population. Congenital anomalies of the kidney and urinary tract (CAKUT) and steroid-resistant nephrotic syndrome (SRNS) are the most frequent, with a prevalence of 16.3 and 10.7, respectively, per million children. We find a similar prevalence of genetic renal disorders in Australia and New Zealand to those reported in other countries. This is likely to be due to inclusion of children with all forms of renal disease rather than being limited to those with renal impairment.

Measuring disparities in immunisation coverage among children in New Zealand

For the past 20 years, New Zealand has experienced low immunisation coverage levels. Following the introduction of the National Immunisation Register (NIR) in 2005 many practitioners envisaged improved overall immunisation uptake through enhanced surveillance and monitoring capacities. This study aimed to investigate the geographical distribution and variables associated with disparities in immunisation uptake in New Zealand using a large NIR data set of children aged 12 months old in 2007–2009. DHB immunisation uptake was adjusted for individual ethnicity and deprivation status, year of birth and geographic location. Substantial variations in uptake by ethnicity and District Health Board (DHB) level were evident. Māori (NZ indigenous) and ‘Other’ ethnicity remain a substantial risk factor for low immunisation uptake after controlling for socio-economic deprivation. In addition, a general north–south gradient was confirmed across New Zealand. Current immunisation programme strategies for planners and providers in New Zealand need to recognise varying DHB compositions in order to provide efficient service provision and to focus on those groups at higher risk of not being immunised.

Azithromycin for Indigenous children with bronchiectasis: study protocol for a multi-centre randomized controlled trial.

BackgroundThe prevalence of chronic suppurative lung disease (CSLD) and bronchiectasis unrelated to cystic fibrosis (CF) among Indigenous children in Australia, New Zealand and Alaska is very high. Antibiotics are a major component of treatment and are used both on a short or long-term basis. One aim of long-term or maintenance antibiotics is to reduce the frequency of acute pulmonary exacerbations and symptoms. However, there are few studies investigating the efficacy of long-term antibiotic use for CSLD and non-CF bronchiectasis among children. This study tests the hypothesis that azithromycin administered once a week as maintenance antibiotic treatment will reduce the rate of pulmonary exacerbations in Indigenous children with bronchiectasis.Methods/designWe are conducting a multicentre, randomised, double-blind, placebo controlled clinical trial in Australia and New Zealand. Inclusion criteria are: Aboriginal, Torres Strait Islander, Maori or Pacific Island children aged 1 to 8 years, diagnosed with bronchiectasis (or probable bronchiectasis) with no underlying disease identified (such as CF or primary immunodeficiency), and having had at least one episode of pulmonary exacerbation in the last 12 months. After informed consent, children are randomised to receive either azithromycin (30 mg/kg once a week) or placebo (once a week) for 12–24 months from study entry. Primary outcomes are the rate of pulmonary exacerbations and time to pulmonary exacerbation determined by review of patient medical records. Secondary outcomes include length and severity of pulmonary exacerbation episodes, changes in growth, school loss, respiratory symptoms, forced expiratory volume in 1-second (FEV1; for children ≥6 years), and sputum characteristics. Safety endpoints include serious adverse events. Antibiotic resistance in respiratory bacterial pathogens colonising the nasopharynx is monitored. Data derived from medical records and clinical assessments every 3 to 4 months for up to 24 months from study entry are recorded on standardised forms.DiscussionShould this trial demonstrate that azithromycin is efficacious in reducing the number of pulmonary exacerbations, it will provide a much-needed rationale for the use of long-term antibiotics in the medical management of bronchiectasis in Indigenous children.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12610000383066

Mandatory fortification of bread with iodised salt modestly improves iodine status in schoolchildren

Iodine deficiency has re-emerged in many parts of the world including the UK, Australia and New Zealand (NZ). In 2009, the NZ government introduced the mandatory fortification of bread with iodised salt as a strategy to improve iodine intakes. The aim of the present study was to assess the impact of fortification on the iodine status of NZ schoolchildren. A school-based cluster survey was used to randomly select schools from two NZ cities. Children aged 8-10 years were administered a general questionnaire, and asked to provide a casual urine and finger-prick blood sample. The median urinary iodine concentration (UIC) of the children (n 147) was 113 μg/l, which falls between 100 and 199 μg/l indicating adequate iodine status; 12 % of children had a UIC < 50 μg/l and 39 % had a UIC < 100 μg/l. The median serum thyroxine concentration was 115 nmol/l. The median serum thyroglobulin (Tg) concentration was 10.8 μg/l and falls in the 10.0-19.9 μg/l range indicative of mild iodine deficiency, suggesting that these children still had enlarged thyroid glands. When compared with the median UIC of 68 μg/l reported in the 2002 NZ Children's Nutrition Survey, the UIC of children in the present study had increased, which is probably caused by the addition of iodised salt to bread. However, the elevated concentration of Tg in these children suggests that the increase in UIC is not sufficient to ensure that thyroid volume has normalised. The fortification of other staple foods, in addition to bread, should be considered to ensure good iodine status in NZ children.

Review of preschool vision screening referrals in South Auckland, New Zealand

Background: Limited data are available on the causes of visual impairment in preschool children in New Zealand. We aimed to review demographic and visual parameters in children referred to the Ophthalmology Department, Manukau Super Clinic from vision screening programs in South Auckland.Methods: Retrospective medical record review of 131 children, aged three to five years, referred from community‐based vision screening programs to the Ophthalmology Department for further assessment. Medical records were reviewed to determine: the reason for referral; findings from ophthalmic assessments; treatment received; and visual acuity at the final visit. The main outcome measures were the cause of visual impairment in children referred from preschool vision screening and the visual acuity at the final follow‐up visit.Results: Thirty‐eight (29.0 per cent) children were discharged after their initial assessment as false positive referrals. Almost half (45.5 per cent) of the children were prescribed glasses for the correction of refractive error, amblyopia or strabismus. Twenty‐nine (22.1 per cent) children were diagnosed with amblyopia with an average follow‐up period of 17.5 ± 2.7-months. In general, compliance with therapy for amblyopia was poor with 48.3 per cent non‐compliant with their prescribed treatment regimen. Despite this, visual outcomes were good with an average final visual acuity in the amblyopic eye of 0.294 ± 0.231-logMAR (Snellen 6/12).Conclusions: The ‘positive predictive value’ for the Counties‐Manukau preschool vision screening program was 47.4 per cent, suggesting that the visual acuity measurements alone produce a significant number of false positive results. In children diagnosed with amblyopia, early detection and intervention showed significant improvement in vision in the amblyopic eye, with many children also showing improved binocular function.