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This document explores the significance of culture and identity in promoting positive health outcomes and wellbeing for Australian children and adolescents, with a particular focus on Indigenous peoples and marginalized groups. It emphasizes the importance of policies that respect and support cultural practices and identities. The document also highlights the lack of national indicators for measuring cultural wellbeing and suggests including measures such as cultural pride, language proficiency, experiences of racism, and the impact of cultural wellbeing on health outcomes. It further discusses the concepts of resilience, social determinants of health, and cultural determinants of health and wellbeing, emphasizing the role of cultural practices and connections in building resilience and improving outcomes in various aspects of life. The document stresses the need for a collaborative, inter-sectoral approach to address the complex drivers of wellbeing and ill health, and recognizes the potential benefits of Indigenous perspectives and practices for mainstream systems and social determinants. It also emphasizes the principles of self-determination, freedom from discrimination and assimilation, and collective rights, and suggests the need for alternative measures of wellbeing that capture people's feelings about their lives and cultural identity. The document was funded by the Victorian Health Promotion Foundation (VicHealth). [Extracted from the article]

The article discusses the threats to the health and well-being of children and young people in Australia due to climate change, ecological degradation, migrating populations, conflict, inequalities, and predatory commercial practices. It highlights Australia's poor performance in climate and sustainability issues, ranking low in carbon emissions and electronic waste production. The article also addresses the impact of unhealthy living conditions on children's mental and physical well-being and emphasizes the need for sustainable environments for children. It suggests viewing government policies through a child's lens and holding politicians accountable for improving children's future. [Extracted from the article]

Fetal head circumference (HC) growth was examined prospectively in children with autism spectrum disorder (ASD). ASD participants (N = 14) were each matched with four control participants (N = 56) on a range of parameters known to influence fetal growth. HC was measured using ultrasonography at approximately 18 weeks gestation and again at birth using a paper tape-measure. Overall body size was indexed by fetal femur-length and birth length. There was no between-groups difference in head circumference at either time-point. While a small number of children with ASD had disproportionately large head circumference relative to body size at both time-points, the between-groups difference did not reach statistical significance in this small sample. These preliminary findings suggest that further investigation of fetal growth in ASD is warranted. (Contains 3 tables and 2 figures.)

Background: Methodological challenges such as confounding have made the study of the early determinants of mental health morbidity problematic. This study aims to address these challenges in investigating antenatal, perinatal and postnatal risk factors for the development of mental health problems in pre-school children in a cohort of Western Australian children. Methods: The Raine Study is a prospective cohort study of 2,868 live born children involving 2,979 pregnant women recruited at 18 weeks gestation. Children were followed up at age two and five years. The Child Behaviour Checklist (CBCL) was used to measure child mental health with clinical cut-points, including internalising (withdrawn/depressed) and externalising (aggressive/destructive) behaviours (n = 1707). Results: Multinomial logistic regression analysis showed that the significant risk factors for behaviour problems at age two were the maternal experience of multiple stress events in pregnancy (OR = 1.20, 95% CI = 1.06, 1.37), smoking during pregnancy (OR = 1.30, 95% CI = 1.06, 1.59) and maternal ethnicity (OR = 3.34, 95% CI = 1.61, 6.96). At age five the experience of multiple stress events (OR = 1.17, 95% CI = 1.08, 1.27), cigarette smoking (OR = 1.19, 95% CI = 1.03, 1.37), male gender (OR = 1.43, 95% CI = 1.02, 2.00), breastfeeding for a shorter time (OR = 0.97, 95% CI = 0.94, 0.99) and multiple baby blues symptoms (OR = 1.08, 95% CI = 1.02, 1.14) were significant predictors of mental health problems. Conclusions: Early childhood mental health is significantly affected by prenatal events in addition to the child's later environment. Interventions targeting adverse prenatal, perinatal and postnatal influences can be expected to improve mental health outcomes for children in the early years.

Objective: To examine infant feeding associations with parent-reported infections and hospitalisations in Western Australian Aboriginal infants and children. Method: Families in Western Australia with children under 18 years of Aboriginal or Torres Strait Islander descent were included. A stratified multi-stage sample using an area-based sampling frame was compiled. Survey weights produced unbiased estimates for the population of families with Aboriginal children. Data were collected on demographic variables, maternal and infant characteristics and parent-reported recurring chest, ear and gastrointestinal infections. The data were linked to the Hospital Morbidity System to identify hospitalisations for infections for the same children. Results: Twenty-seven per cent of Aboriginal children were breastfed for less than three months. Parent-reported recurring chest, ear and gastrointestinal infections were reported in 47% of the 0-3 age group. Hospitalisations due to upper respiratory and gastrointestinal infections were most common in the older children, but wheezing lower respiratory infections were most common in younger children. Breastfeeding for less than three months and birth weight less than 2,500 g were risk factors for parent-reported chest infections and hospitalisations for upper and wheezing lower respiratory infections (p Conclusion: Rates of parent-reported chest infections and hospitalisations due to these infections continue to be high in Aboriginal infants and children. Because breastfeeding for less than three months and low birth weight are risk factors for these infections, interventions to reduce the prevalence of low birth weight and to increase breastfeeding rates should be primary health goals in Aboriginal communities for the benefits of Aboriginal infants and children. Keywords: Infection, Australian Aborigines, infants, children, breastfeeding, hospitalisation.

Objectives: We conducted a case-control study to investigate the effectiveness of efforts to increase folate intake in Western Australia (WA) for the prevention of neural tube defects (NTD). Methods: Case (36) and control (578) mothers completed questionnaires, from which their intake of folate from supplements and food (including fortified foods) was estimated. Results: Almost one-third of women took folic acid supplements periconceptionally. Supplement use was associated with a non-significant 4% reduction in risk. For women not taking supplements, dietary sources of folate were protective, and most women obtained at least some folate from fortified food. Conclusions: For the two-thirds of WA women not taking supplements, fortified food is an important source of folate for the prevention of NTD. Implications: Greater promotion of foods currently allowed to be fortified with folate, or mandatory fortification, is needed to maximise prevention of NTD in Australia.

Objectives. We investigated the relationship between breastfeeding, asthma and atopy, and child body mass index (BMI). Methods. From a prospective birth cohort (n=2860) in Perth, Western Australia, 2195 children were followed up to age 6 years. Asthma was defined as doctor-diagnosed asthma and wheeze in the last year, and atopy was determined by skin prick test of 1596 children. Breastfeeding, BMI, asthma, and atopy were regressed allowing for confounders and the propensity score for overweight. Results. Using fractional polynomials, we found no association between breastfeeding and overweight. Less exclusive breastfeeding was associated with increased asthma and atopy, and BMI increased with asthma. Conclusions. Less exclusive breastfeeding leads to increases in child asthma and atopy and a higher BMI is a risk factor for asthma.

Objective. The aim of this study was to ascertain the early developmental status of children who have a history of newborn encephalopathy. Methods. A longitudinal follow-up was conducted of a population-based, case-control study of children born in Western Australia between June 1993 and December 1996. The study included 276 term children ([greater than or equal to] 37 weeks' gestation) with moderate or severe newborn encephalopathy and 564 unmatched term control subjects. The Griffiths Mental Development Scales was used to ascertain developmental status and a General Quotient (GQ) score. Outcome measures were the Griffiths developmental subscales, GQ, diagnosis of cerebral palsy, and mortality. Results. Thirty-four patients and 1 control subject died before reaching assessment. Between June 1994 and December 1999, 195 (81%) eligible patients and 445 (79%) eligible control subjects were assessed. Statistically significant differences were found between patients and control subjects for GQ and all developmental subscales. Overall, 39% of patients had a poor outcome as defined by death, cerebral palsy, or a significant degree of developmental delay, compared with 2.7% of control subjects. Furthermore, 62% of those with severe encephalopathy had a poor outcome compared with 25% of those with moderate encephalopathy. Patients with a history of seizures were 3 times more likely to develop cerebral palsy than patients without. Overall, 28 (10.1%) of patients have cerebral palsy. Conclusions. These data provide important prognostic information regarding survival and serious disability and indicate that newborn encephalopathy places children at significant risk of developmental delay by their second year. These findings also suggest that comprehensive clinical and educational assessments are required to enable appropriate educational provisions as these infants approach school entry. Pediatrics 2002;109:26-33; Griffiths Mental Development Scales, newborn encephalopathy, developmental delay, cerebral palsy. ABBREVIATIONS. GQ, Griffiths General Quotient; SD, standard deviation., Few long-term studies of the outcomes after newborn encephalopathy have been conducted. Of those conducted, the majority were not population-based, most concentrated on encephalopathy associated with "birth asphyxia," and others [...]