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Objective 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. Design and setting Prospective community study, in Melbourne, Victoria. Participants and method 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). Results 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). Conclusions 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. [ABSTRACT FROM AUTHOR]

Context: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.Objective:To (1) quantify physical and psychosocial morbidities experienced by 2-18-year-olds according to BMI status and (2) explore morbidity patterns by age.Design, setting and participants: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.Main measures: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.Analyses:The variation in comorbidities across BMI categories within and between age bands was examined using linear and logistic regression models.Results: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.Conclusions: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. [ABSTRACT FROM AUTHOR]

Background 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. Methods 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. Results 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. Conclusions 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. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine relationships between body mass index (BMI) status and indicators of health and morbidity in a nationally-representative population sample of preschool children. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. [ABSTRACT FROM AUTHOR]

Objective: To determine relationships between body mass index (BMI) status and indicators of health and morbidity in a nationally-representative population sample of preschool children. Methods: 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 socio- demographic factors. Results: 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% Cl 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

ObjectiveThough 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.DesignProspective community study.SettingMelbourne, Australia.Subjects317 mother–child dyads.Main exposuresChild and maternal BMI (kg m−2) at 4.0 and 6.5 years; maternal concern about child overweight at 4.0 years.Outcome measuresPaired 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.ResultsFor 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.ConclusionsDespite 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.International Journal of Obesity (2008) 32, 1001–1007; doi:10.1038/ijo.2008.12; published online 26 February 2008 [ABSTRACT FROM AUTHOR]

Objective:(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.Design:Cross-sectional population survey.Setting:Wave 1 (2004) of the Longitudinal Study of Australian Children.Participants:Nationally representative sample 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)).Main outcome measures:Prevalence of overweight and obesity (International Obesity TaskForce definitions) and waist circumference (cm).Analysis: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.Results: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.Conclusions: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.International Journal of Obesity (2007) 31, 1044–1051; doi:10.1038/sj.ijo.0803503; published online 5 December 2006 [ABSTRACT FROM AUTHOR]

Objectives:To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting.Design:Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey.Setting:Twenty nine general practices, Melbourne, Australia.Participants:(1) BMI survey: 2112 children visiting their general practitioner (GP) April–December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0) children aged 5 years 0 months–9 years 11 months (82 intervention, 81 control).Intervention:Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials.Main outcome measures: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.Results:Attrition was 10%. The adjusted mean difference (intervention–control) in BMI was −0.2 kg/m2 (95% CI: −0.6 to 0.1; P=0.25) at 9 months and −0.0 kg/m2 (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.Conclusions:This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized 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.International Journal of Obesity (2007) 31, 630–636. doi:10.1038/sj.ijo.0803509; published online 12 December 2006 [ABSTRACT FROM AUTHOR]

A short model of asymmetric force free magnet with single beam aperture was tested at Fermilab together with the excitation test of VLHC transmission line magnet. The design concept of asymmetric force free superconducting magnet was verified by the test. The testing reached up to 104 kA current and no indication of force imbalance was observed. Since the model magnet length was only 10 cm, A 0.75 m model was constructed and tested at KEK with low current to ensure the validity of the design. The cool down and the excitation at KEK were also successful finding very small thermal contraction of the conductor and reasonable field homogeneity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Better language outcomes are reported for preschool children with hearing impairment (HI) diagnosed very early, irrespective of severity. However, population studies of older children are required to substantiate longer term benefits of early detection. AIMS: To study impact of age of diagnosis and severity of HI in a population cohort of 7-8 year old children. METHODS: Eighty eight 7-8 year old children born in Victoria, who were (a) fitted with hearing aids for congenital HI by 4.5 years and (b) did not have intellectual or major physical disability were studied. Main outcome measures were Clinical Evaluation of Language Fundamentals (CELF) and Peabody Picture Vocabulary Test (PPVT). Predictors were pure tone average (0.5, 1, 2 kHz) in better ear at diagnosis and age at diagnosis. Marginal (adjusted) means were estimated with general linear models. RESULTS: Response rate was 67% (n = 89; 53 boys). Mean age at diagnosis was 21.6 months (SD 14.4); 21% had mild, 34% moderate, 21% severe, and 24% profound HI; mean non-verbal IQ was 104.6 (SD 16.7). Mean total CELF score was 76.7 (SD 21.4) and mean PPVT score 78.1 (SD 18.1). Age of diagnosis, adjusted for severity and IQ, did not contribute to language scores. In contrast, adjusted mean CELF and PPVT language scores fell sequentially with increasing severity of HI. CONCLUSIONS: More severe HI, but not later diagnosis, was strongly related to poorer language outcomes at 7-8 years. Further systematic study is needed to understand why children with hearing impairment have good or poor outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To clarify relationships between body mass index (BMI) and self-esteem in young children at a population level. To assess whether low self-esteem precedes or follows development of overweight/obesity in children. DESIGN: Prospective cohort study in elementary schools throughout Victoria, Australia. Child BMI and self-esteem were measured in 1997 and 2000. SUBJECTS: Random sample of 1157 children who were in the first 4 y of elementary school (aged 5–10 y) at baseline. MEASURES: BMI was calculated from measured height and weight, then transformed to z-scores. Children were classified as nonoverweight, overweight or obese based on international cut-points. Low child self-esteem was defined as a score below the 15th percentile on the self-esteem subscale of the parent-reported Child Health Questionnaire. RESULTS: Overweight/obese children had lower median self-esteem scores than nonoverweight children at both timepoints, especially at follow-up. After accounting for baseline self-esteem, higher baseline BMI z-score predicted poorer self-esteem at follow-up (P= 0.008). After accounting for baseline BMI z-score, poorer baseline self-esteem did not predict higher BMI z-score at follow-up. While nonoverweight children with low baseline self-esteem were more likely to develop overweight/obesity (OR = 2.1, 95% CI = 1.2, 3.6), this accounted for only a small proportion of the incidence of overweight. CONCLUSIONS: Our data show an increasingly strong association between lower self-esteem and higher body mass across the elementary school years. Overweight/obesity precedes low self-esteem in many children, suggesting a causal relationship. This indicates that prevention and management strategies for childhood overweight/obesity need to begin early to minimise the impact on self-esteem. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and incidence of overweight and obesity, the frequency of overweight resolution and the influence of parental adiposity during middle childhood.Design: 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.Setting: Primary schools in Victoria, Australia.Subjects: In total, 1438 children aged 5-10 years at baseline.Results: 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 beta=0.03, 95% confidence interval 0.01-0.05). The influence of parental adiposity largely disappeared when children's baseline BMI was adjusted for.Conclusions: 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. [ABSTRACT FROM AUTHOR]

Objective: 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.Methods: 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.Results: 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.Conclusions: 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. [ABSTRACT FROM AUTHOR]

Two three-dimensional models of the fourth and fifth vertebrae were developed to clarify the mechanical causes of low back pain. The lumbar structures produced allowed the simulation, by the performance of finite element analysis, of different situations not normally achievable by experimentation. The simulations yielded data on the stress distribution inside the vertebrae and the amount of deformation that takes place.Models of the vertebrae were reconstructed by transferring data points to the software package I-DEAS Master Series™. The results show large stress concentrations were found in the superior and inferior facet region and on the central surfaces of the vertebral body. Higher stress concentrations were also found in the cortical shell of the vertebrae. Whilst it was observed that the cancellous core was absorbing some of the compressive loading. The study indicated that the vertebrae act similar to man-made sandwich materials, where the outer hard cortical bone has the ability to resist indentation and abrasion, while the cancellous core is tough and has the ability to absorb energy. With mechanical loading playing a central role in many low back disorders, even when there is no history of trauma, and when degeneration is evident. This present study provides a strong rationale for use of this modelling method as a research tool to assist the clinician in many ways: by indicating how to avoid overloading spinal structures, by assisting diagnosis and the development of surgical techniques. [Copyright &y& Elsevier]

Abstract Objective: To compare the effect of a behavioural sleep intervention with written information about normal sleep on infant sleep problems and maternal depression. Design: Randomised controlled trial. Setting: Well child clinics, Melbourne, Australia Participants: 156 mothers of infants aged 6-12 months with severe sleep problems according to the parents. Main outcome measures: Maternal report of infant sleep problem; scores on Edinburgh postnatal depression scale at two and four months. Intervention: Discussion on behavioural infant sleep intervention (controlled crying) delivered over three consultations. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Examines the parent-reported health status of overweight and obese primary school children in Victoria. Body mass index category of the children; Characteristics of the children; Proportion of parents reporting concern about child's weight. [ABSTRACT FROM AUTHOR]

SUMMARY Aims To study parent and adolescent-reported physical, psychosocial and family wellbeing in children aged 5–18 years with diabetes. Methods Subjects: 5–18-year-olds attending a diabetes clinic at a tertiary children's hospital. Measures: (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. Results Reports were obtained from 128 parents and 71 adolescents (90 and 92% response). The CHQ demonstrated good psychometric properties in this sample of children with diabetes. Parents reported children with diabetes to have generally poorer health than children in the normative sample, 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 sample. Conclusions Parents report children aged 5–18 years with diabetes to have poorer health than children in the normative sample 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. [ABSTRACT FROM AUTHOR]

BACKGROUND: 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. OBJECTIVE: To seek anthropometric evidence of a recent secular increase in BMI in primary school children in Victoria, Australia. DESIGN: Data from two cross-sectional population-based surveys of primary school children (the Victorian subsample of the 1985 Australian Health and Fitness Survey and the 1997 Health of Young Victorians Study) were compared. Similar stratified random sampling and standardized measurement methods were employed in the two studies. Subjects were all children aged 7-12y 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 12y interval. RESULTS: 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 sample for all but 12y-old girls and for boys aged 7, 8 and 10y (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. CONCLUSIONS: 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... [ABSTRACT FROM AUTHOR]

Objective: 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.Methodology: 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.Results: 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.Conclusion: 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. [ABSTRACT FROM AUTHOR]

Objective: 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.Methods: We surveyed a representative cross-sectional samples 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.Results: 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.Discussion: 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. [ABSTRACT FROM AUTHOR]

Reports that battery energy can be used for superconducting magnet operation if the current of the battery is controllable. Discussion of several current-control methods; Conclusion.

A letter to the editor is presented in response to the article "Systematic review of the literature on characteristics of late-talking toddlers," by C. Desmarais, A. Sylvestre, F. Meyer, I Bairati, and N. Rouleau.

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. [ABSTRACT FROM AUTHOR]

In this issue's report on Australasian longitudinal birth cohort studies since 1970, Nicholson and Rempel paint an interesting yet chequered picture of outstanding research contributions interspersed with mediocre publication records. As Australia gears up for its largest and most complex study of Australian children ever, these reflections are timely. The Australian Federal Government recently committed 20.2 million dollars to the Longitudinal Study of Australian Children; commencing March 2004, a nationally representative sample of 10000 children (5000 infants and 5000 4-year-olds) will be followed at least biannually over 8 years.

Editorial. Comments on the results of a study on childhood oral communication difficulties. Determination of parent-reported prevalence of childhood communication difficulties; Flaws in the current state of measurement of childhood speech or language difficulties; Overview on speech development in children.

An abstract of the article "How Confident Are General Paediatricians at Assessing and Managing Obesity in Childhood?," by M. Wake and colleagues is presented.

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 sample 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. [ABSTRACT FROM AUTHOR]

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 sample 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. [ABSTRACT FROM AUTHOR]

Focuses on the parental beliefs on infant teething. Conduction of survey to English-speaking parents with seven to nine month old infants; Majority of parental beliefs; Management of parents over teething symptoms.

Examines several views from medical practitioners from Victoria on the teething symptoms in babies. Provision of survey questionnaires to five groups of practitioners; Response rate for the five groups; Identification of the most common teething symptoms.

Examines the measurement of the physical and psychosocial wellbeing of children with learning difficulties in Melbourne, Victoria. Effect of learning difficulties on the children; Use of the Child Health Questionnaire; Benefits of the instrument used.

Examines the health concerns of adolescents determined by health service use in Victoria. Way to help address the health concerns of adolescents; Abundance of individual concerns in females; Prevalence of the feeling of depression.

Silicon carbide (SiC) is one of the most promising materials for next-generation power electronic devices, owing to its superior physical properties. Among existing SiC power devices, the SiC junction field-effect transistor (JFET) (SiC-JFET) has excellent performance. A high-power discrete package of a SiC-JFET was developed with the aim of being applied to the High Energy Accelerator Research Organization (KEK) digital accelerator. The device was assembled on a 58 mm × 36 mm copper base plate and with a height of 7 mm. The size of the die was 4.16 mm × 4.16 mm. The device was tested using a pulse discharge circuit and successfully operated at 1 MHz, 1 kV, and 27 A. The power dissipation and the thermal resistance were estimated at 235 W and 0.56 K/W. [ABSTRACT FROM PUBLISHER]

Abstract: Aim: To examine the feasibility and determine the maximum tolerated dose of outpatient carboplatin given with synchronous hypofractionated accelerated radiotherapy for squamous cell carcinoma of the head and neck (SCCHN). Materials and methods: Patients with stages II–IV SCCHN and unresected primary tumour were treated with synchronous carboplatin given in an outpatient setting on day 1 and day 21 in cohorts of three to six patients with incremental area under curve (AUC) factors commencing at 3.5. Grade 3 mucositis persisting for 4 weeks in two patients in a cohort was considered dose limiting. Results: A total of 19 patients were enrolled and assessable for toxicity. All 19 patients completed 55Gy of radiotherapy and were assessable for response. Grade 3 mucositis lasting 4 weeks or more was seen in three patients, two of them received AUC 5 carboplatin. A complete response was seen in 16 patients, with a further patient having a partial response, giving a response rate of 89%. With a median follow-up of 24 months (range 11–30 months), 13 patients were alive with no evidence of recurrent disease. Local recurrence had occurred in four patients with distant spread in three patients. Conclusion: Carboplatin with concurrent hypofractionated accelerated radiotherapy is feasible for patients with advanced SCCHN and good performance status. The recommended phase II dose of carboplatin given in week 1 and week 4 with 55Gy in 20 fractions is AUC 4.5. [Copyright &y& Elsevier]

Objective: To trial the Parents' Evaluation of Developmental Status (PEDS) as an instrument for reporting developmental concerns for Australian preschool children.Method: 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.Results: 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 sample. 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.Conclusions: 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. [ABSTRACT FROM AUTHOR]

Aims: To assess short and longer term parent reported impacts of false positive referrals in the Victorian Infant Hearing Screening Program (VIHSP). Methods: 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. Results: Final sample: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]