Background Despite advancements in the use of body mass index (BMI) to categorize obesity severity in pediatrics, its utility in guiding individual clinical decision making remains limited. The Edmonton Obesity Staging System for Pediatrics (EOSS‐P) provides a way to categorize the medical and functional impacts of obesity according to the severity of impairment. The aim of this study was to describe the severity of obesity among a sample of multicultural Australian children using both BMI and EOSS‐P tools. Methods This cross‐sectional study included children aged 2–17 years receiving obesity treatment through the Growing Health Kids (GHK) multi‐disciplinary weight management service in Australia between January to December 2021. BMI severity was determined using the 95th percentile for BMI on age and gender standardized Centre for Disease Control and Prevention (CDC) growth charts. The EOSS‐P staging system was applied across the four health domains (metabolic, mechanical, mental health and social milieu) using clinical information. Results Complete data was obtained for 338 children (age 10.0 ± 3.66 years), of whom 69.5% were affected by severe obesity. An EOSS‐P stage 3 (most severe) was assigned to 49.7% of children, the remaining 48.5% were assigned stage 2 and 1.5% were assigned stage 1 (least severe). BMI predicted health risk as defined by EOSS‐P overall score. BMI class did not predict poor mental health. Conclusion Used in combination, BMI and EOSS‐P provide improved risk stratification of pediatric obesity. This additional tool can help focus resources and develop comprehensive multidisciplinary treatment plans.
There are very few longitudinal studies examining family functioning in early childhood. This was a prospective cohort study to identify maternal sociodemographic factors associated with family functioning over the first 5 years postpartum, using data from the Healthy Beginnings Trial. Family functioning was measured using the General Functioning Subscale of the McMaster Family Assessment Device. A total of 667 first-time mothers participated, of which 369 remained at 5 years. Family functioning did not change significantly over the 5 years. Mothers being Australian born, being employed, and having a partner were predictors for healthy family functioning. Targeting support for immigrants, low-income and single-mother families may therefore improve family functioning.
BackgroundSouth Western Sydney (SWS) region, in the state of New South Wales (NSW) in Australia is a culturally and linguistically diverse area of marked social disadvantage. Using the best available data sources, we aimed to explore the prevalence of children with developmental disability and their access to disability and special education support services, to identify equity gaps. MethodsData on the potential number of children in SWS with neurodisability was identified from the district wide Child Developmental Assessment Service (CDAS) database of public-funded Community Paediatrics services, the NSW/Australian capital territory (ACT) Cerebral Palsy (CP) register, the State-wide Infant Screening-Hearing (SWISH) Program, the Royal Institute for Deaf and Blind Children and the Department of Education. The proportion of children with access to disability services for children up-to 18 years of age was explored from the datasets of the National Disability Insurance Scheme (NDIS). Relative risks were calculated to compare any differences in proportion of supports in SWS compared to NSW. ResultsIn 2018, 503 children (median age 4.3 years) were assessed by CDAS; 65% had autism spectrum disorder (ASD) either alone or in association with global developmental delays and 24% had global developmental delay. The prevalence of CP in SWS was 1.86/1000; with a higher proportion of severe functional and intellectual impairment in SWS compared to the state. The prevalence of sensori-neural hearing loss in SWS was 2.2/1000, and more children in SWS had severe visual impairment compared to the state (P=0.003). Students in support classes with special needs were overrepresented in SWS compared to the state (P<0.0001). There were slightly more children with intellectual disability in SWS supported by the NDIS, but proportions for other conditions were comparable to NSW. Conclusions While available data sources are incomplete, we identified greater proportions of children with neurodisability, experiencing more functional impairment in SWS, compared to NSW; with ASD being the most common neurodisability presenting to developmental clinics. We also identified potential equity gaps in disability service provision. A state-wide child disability register would aid planning and research, with concerted advocacy needed to improve equity in disability support provision in this region.
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