Vaccinations need to reach 90% of First Nations adults and teens to protect vulnerable communities

Paul Komesaroff, Monash University; Donna Ah Chee, Indigenous Knowledge; Ian Kerridge, University of Sydney, and John Boffa, Curtin UniversityWhile some Australians are awaiting the nation reopening after lockdowns with hope and optimism, others are approaching it with dread. This is because a blanket lifting of restrictions when the vaccination rate reaches 70% will have devastating effects on Indigenous and other vulnerable populations.

At present, vaccination rates in Indigenous populations are very low. Meanwhile international data show the risk of serious illness and death among First Nations populations from COVID and other diseases is up to four times that of the wider population.

Once restrictions are lifted everyone unvaccinated will be exposed to the virus. The outcomes for Indigenous people may therefore resemble the early effects of British colonialism, when a high proportion of the population died from introduced infections.

Aboriginal and Torres Strait Islander adults and teenagers need vaccination rates of 90-95% among First Nations people to protect their communities.

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Additional health challenges

As with many other medical conditions, the effects of COVID-19 are worse among people with lower socioeconomic status and especially among Aboriginal and Torres Strait Islander people.

There are multiple reasons for this, including the greater likelihood of underlying conditions and reduced access to appropriate health care.

We saw a similar situation in 2009, when H1N1 influenza rates among Aboriginal and Torres Strait Islander people were more than five times those of other Australians.

Overseas, COVID-19 has been associated with striking racial disparities, with death rates for African Americans more than triple the rates for Caucasians, and more than 4% for Navajo people (compared to 1.6% for the whole population).

Outcomes for other First Nations groups in the United States and elsewhere are similar.

What’s the current vaccination plan?

On September 9, the New South Wales government announced its intention to lift lockdowns and other public health measures when the state reaches a vaccination target of 70% of the adult population. This equates to a little over 50% of the state’s population.

NSW will reach the 70% target in less than a month in NSW and the nation will reach the target by October 30.

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If such a policy were implemented it would have disastrous consequences for Aboriginal and Torres Strait Islander and other vulnerable populations.

Vaccination rates in Aboriginal and Torres Strait Islander communities are lagging badly behind the remainder of the Australian population. In many places in NSW, Western Australia, Queensland and the Northern Territory fewer than 20% are fully vaccinated.

What should happen instead?

Aboriginal organisations have called on state and federal governments to delay any substantial easing of restrictions until vaccination rates among Aboriginal and Torres Strait Islander populations aged 12 years and older reach 90-95%.

The organisations calling for such a target include the National Aboriginal Community Controlled Health Organisation, the Aboriginal Medical Services of the Northern Territory and the Central Australian Aboriginal Congress.

A 90-95% vaccination rate gives about the same level of population coverage for all ages as the 80% target for the entire population. That’s because Aboriginal and Torres Strait Islander communities are younger than the wider population.

Vaccinating 90-95% of the Aboriginal and Torres Strait Islander population will better protect children and other unvaccinated people in First Nations communities from infection.

This will require an immediate, well-resourced and determined effort to lift vaccination rates.

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How can this be achieved?

Many Aboriginal community controlled health services are already running urgent vaccination campaigns with existing resources, but more needs to be done.

The Australian government’s announcement this week of A$7.7 million to fast-track vaccinations in 30 priority areas across the country is an important first step.

But the program needs to be expanded to all areas with significant Aboriginal and Torres Strait Islander populations.

Australia’s First Nations vaccination program needs to:

1. guarantee a sufficient and reliable source of vaccines to Aboriginal and Torres Strait Islander communities
2. ensure health services have the capacity and the workforce to carry out intensive outreach vaccination programs. This includes culturally knowledgeable Aboriginal and Torres Strait Islander workers able to engage with communities, and clinicians
3. address vaccine hesitancy. This should start with the recognition there are many reasons for reluctance to be vaccinated.

What are the reasons for vaccine hesitancy?

For some, there is a historical and understandable distrust of the health system.

Others have been confused or made fearful by misinformation spread on social media or through fringe religious groups.

Many others are not fundamentally opposed to vaccination but are adopting a “wait and see” approach.

To overcome this hesitancy we need urgent government support for financial incentives, in the form of food vouchers or other benefits. This has been done for vulnerable groups in other countries.

Non-financial incentives requiring full vaccination for travel, entering pubs, clubs, restaurants, sporting venues and so on need to be flagged now with a commencement date in the near future.

Effective health education in Aboriginal languages developed by local Aboriginal community controlled health services need to be in the media daily.

Don’t leave vulnerable groups behind

All this is achievable but it requires the combined efforts of government working in partnership with Aboriginal community controlled health services.

Until the 90-95% target is met, rigorous restrictions should remain in place. This is consistent with modelling from the Burnet and Doherty institutes, which inform the NSW and national policies about reopening.

As the Burnet Institute told the authors of this article, Australia:

should not move to Phase B and C until vaccination coverage in each jurisdiction’s Aboriginal and Torres Strait Islander communities is as high as, or even higher than, the general community.

Similar considerations undoubtedly apply to some other vulnerable groups in the population.

Australia remains burdened by the legacy of centuries of harm and damage to its First Nations people. We are facing the possibility of a renewed assault on Aboriginal and Torres Strait Islander health.

The difference today is the outcomes are foreseeable and we know what needs to be done to avert them.

Paul Komesaroff, Professor of Medicine, Monash University; Donna Ah Chee, Central Australian Aboriginal Congress, Indigenous Knowledge; Ian Kerridge, Professor of Bioethics & Medicine, Sydney Health Ethics, Haematologist/BMT Physician, Royal North Shore Hospital and Director, Praxis Australia, University of Sydney, and John Boffa, Adjunct Associate Professor, Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

High priority: why we must vaccinate children aged 12 and over now

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Emma McBryde, James Cook UniversityPeople aged 16 and above will soon be able to get a COVID vaccine in Australia, but this begs the question: what about children in younger age groups?

Currently, only 12-15 year olds with underlying medical conditions, Aboriginal and Torres Strait Islander children, and those living in remote communities are eligible.

Modelling by the Doherty Institute has suggested vaccinating 12-15 year olds would not make a material difference to the COVID epidemic.

However, as a researcher with expertise on modelling infectious diseases, it’s my view children aged 12 and over must be vaccinated with high priority.

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Children and transmission

A key concept you might have heard about is the reproduction number — the number of new cases per infectious case. For the Delta strain, this number could be as high as nine. In other words, if there were no lockdowns or other controls in place, each Delta infection could theoretically lead to as many as nine new infections.

The “effective reproduction number” is how many new cases you get per infectious case after public health measures such as lockdowns have been applied.

The Doherty modelling used a baseline effective reproduction number of 3.6 but acknowledges the effective reproduction number will be different from state to state. It can also change over time.

The effective reproduction numbers in NSW and Victoria are currently under two — but this figure could rise when lockdowns lift.

Modelling by colleagues and I shows that once the value of the effective reproduction number creeps up above four, all else being equal, children including those younger than 16 start to feature highly in transmission.

In other words, we need to vaccinate children aged 12 and above now, in preparation for a scenario when the effective reproduction number is much higher than it has been under lockdowns.

A reality check

In a scenario where children aged 12 and above are returning to school and moving around the community unvaccinated, could masks and social distancing be enough?

Well, perhaps in an ideal world. But many simply assume children will be able to socially distance and wear masks just like adults do. Parents may wish to reflect on that.

We also need to compare old assumptions about COVID and children with what we are now seeing in reality.

The original strain of COVID-19 appeared to spare children; they were less likely than older people to be infected in the first place. The Delta strain seems to have changed all that.

According to NSW Health’s factsheet on coronavirus disease in NSW, only one person under 20 has died due to COVID. However, people in this age group are showing up significantly in overall case numbers.

Since NSW began its current lockdown, about one third of new COVID cases in NSW (around 3,000) have been in under 20 year olds.

According to NSW Health, only one person under 20 has died due to COVID but people in this age group are showing up significantly in overall case numbers.
NSW Health

Victoria’s chief health officer has also noted childcare centres and schools feature heavily among the hotspots in that state.

If Delta does end up infecting children more than the original strain did, children may become the super-spreaders of the Delta variant — just as they are key transmitters of influenza, pertussis, measles, chicken pox and just about every respiratory virus.

Now, some expert groups — including modellers — are starting to call for younger children to be vaccinated with high priority.

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Which vaccine? While Pfizer is scarce, we should direct it to younger people

While Pfizer is scarce, we should be providing Pfizer to the younger population (who are more likely to transmit COVID-19), while giving AstraZeneca to older people.

While both vaccines are over 90% effective at reducing death and severe outcomes from COVID (including Delta), Pfizer is better than AstraZeneca at reducing transmission of the virus.

In Australia, children 12-17 are approved to receive Pfizer but not AstraZeneca.

What are the consequences of not vaccinating younger children?

The risks of not vaccinating children in the 12+ age group include:

• more children becoming sick with COVID
• denying children potential freedoms that may come with vaccination, such as returning to school, travel or avoiding strict lockdowns
• not vaccinating children means living with the knowledge we haven’t done everything possible to ensure they don’t transmit COVID to more vulnerable people.

It’s unlikely Australia will achieve herd immunity to COVID this year.

But even without herd immunity, every little bit helps — and the growing number of cases in younger children suggests we need to vaccinate this group sooner, rather than later.

Emma McBryde, Professor of Infectious Disease and Epidemiology, James Cook University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Teens should have a say in whether they get a COVID vaccine

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Melissa Kang, University of Sydney; Cristyn Davies, University of Sydney, and Rachel Skinner, University of SydneyThe Delta variant has taken hold in NSW and Victoria, which are both in lockdown, and now in South Australia too, which will enter a lockdown tonight.

The World Health Organization has predicted Delta will become the dominant variant globally.

A concerning feature of Delta is the number of children and adolescents becoming infected. Earlier in the pandemic, Australians were able to feel reassured that transmission in schools was negligible. But Delta is already proving different, with some evidence of transmission among school children, teachers and their households emerging in Australia.

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Those who’ve been vaccinated against COVID-19 have been less likely to be infected with the Delta strain. If infected, they’re less likely to require hospitalisation.

There’s now a sense of urgency surrounding Australia’s COVID vaccine rollout, which ranks last among OECD countries.

Some experts are calling for vaccination of children and adolescents to be a high priority as well.

Australia’s drug regulator, the Therapeutic Goods Administration (TGA), may soon approve the Pfizer and Moderna COVID vaccines for adolescents aged 12-15.

If the vaccines are approved for this age group, how might we undertake mass vaccination of adolescents in Australia? And who will be involved in decisions about consent?

How can we vaccinate teens?

Adolescent vaccinations have been effectively delivered in Australian states and territories for many decades, via immunisation programs at schools.

The National Immunisation Program is funded by the federal government, which means vaccines listed in the schedule are provided for free.

Vaccines are given in high schools by nurse immunisers. If a dose is missed at school, adolescents are eligible to “catch-up” via their GP (meaning the vaccine is still free).

The current schedule for adolescents includes vaccines against HPV (human papillomavirus), the “dTpa” (diphtheria, tetanus, pertussis) booster and meningococcal ACWY disease.

It makes good sense to include COVID vaccines as part of the tried and trusted school-based immunisation program.

Who gives consent?

Because these immunisations are given through schools, adolescent vaccination in Australia is a partnership between health and education departments.

Written parental or guardian consent is required prior to the administration of vaccines.

This differs to what’s done through health settings, such as general practice, where adolescent “competency to consent” is an important consideration.

“Competency to consent” refers to the capacity of someone under 18 to consent to or refuse medical treatment. It signifies the minor has reached sufficient intelligence and understanding to fully understand the proposed treatment. The seriousness of the treatment is taken into consideration and capacity is assessed by individual health professionals. If deemed competent, then there’s no legal requirement for parental or guardian consent. Although, parental consent in addition to adolescent consent is encouraged as best practice.

Currently, adolescents need written parental or guardian consent to get vaccinated through high school immunisation programs.
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2 approaches to adolescent COVID vaccination

First, we must improve adolescents’ understanding of vaccination to support their involvement in decision-making. In our own research about HPV vaccination, we found information designed specifically for adolescents is important. Adolescents otherwise have limited understanding of the vaccines they receive, or the diseases they prevent.

Even if consent from a parent or guardian is required as it is in the school-based program, promoting vaccine literacy among adolescents is appropriate and ethical. Understanding the purpose and process of vaccination increases vaccine confidence and reduces fear and anxiety.

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Second, we need to acknowledge adolescents’ legal right to consent where they are competent to do so. This is pertinent where parental consent isn’t obtained, often due to a simple failure to return a consent form in time.

Where this happens, a GP can obtain informed consent in the usual way for medical treatment.

However, the requirement to access a GP practice presents other barriers for mature minors (those under 18 years who are competent to consent), which may impede vaccine uptake.

The national imperative is to achieve as high coverage of COVID vaccination as possible across the population. To achieve this and reduce the impact of the pandemic on young people’s health, we must work with young people.

What do young people think?

The National Health and Medical Research Council (NHMRC) has established a network of researchers who champion adolescent health, called the Wellbeing Health & Youth Centre.

This network has created the WH&Y Commission, which includes the voices of young people. Its goal is to ensure adolescent health research and policymaking are guided by young people themselves.

We asked three young WH&Y Commissioners what they thought about the issue of COVID vaccines and adolescents.

Here’s what they had to say

Young people should be given unbiased, accurate information about the benefits and risks associated with COVID vaccines.

Young people understand that because it’s a new vaccine, there will inevitably be scepticism. They’re aware family members may be hesitant or hold opposing views, which could deny young people their right to be fully informed. They want transparent instruction and information to be a huge priority for governments.

Young people deemed competent should be afforded their legal right to consent to a COVID vaccine. This would acknowledge the autonomy of, and trust placed in, young people to make their own medical decisions. There should be appropriate structures in place to protect young people’s privacy in their decision-making process. This is important to avoid stigmatisation based on their choice.

Australian Common Law reflects the understanding that over the second decade of life, young people gain autonomy over their lives and are capable of making decisions about their own health care. For the majority, this will involve conversations with, and support from, parents and guardians.

From early adolescence, scientific information about COVID vaccine benefits and risks should be provided in a way young people understand.

Ideally, adolescents should also be granted the legal and ethical right to make their own decisions, as would ordinarily happen for medical interventions of low risk. — WH&Y Commissioners Anhaar Kareem, Jenon Castro and Aish Naidu.

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This article was co-authored with WH&Y Commissioners Anhaar Kareem, Jenon Castro and Aish Naidu.

Melissa Kang, Clinical Associate Professor, University of Sydney; Cristyn Davies, Research Fellow in Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, and Rachel Skinner, Professor in Paediatrics, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Best evidence suggests antidepressants aren’t very effective in kids and teens. What can be done instead?

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Sarah Hetrick, University of Auckland; Joanne McKenzie, Monash University; Nick Meader, University of York, and Sally Merry, University of AucklandEven before COVID-19 lockdowns, school closures and strict social distancing, depression was on the rise in children and teenagers around the globe.

By the age of 19, around 25% of adolescents are estimated to have experienced a depressive episode. By the age of 30, this figure grows to 53%.

A number of studies point to an increasing use of antidepressants in young people.

So, what do we now know about how well antidepressants work in children and young people?

Our new Cochrane review, published today, found that on average, antidepressants led to only small improvements in depression symptoms compared with placebo in children and adolescents (ranging in age from six to 18 years old).

Antidepressants shouldn’t be the first port of call

Our findings highlight antidepressants are no panacea for depression in young people. The small improvements might be so small as to not be very noticeable to the individual person. What’s more, we can’t say to any one young person whether antidepressants will definitely improve their symptoms.

But it’s critical to note there are multiple and complex pathways that lead to the distress and demoralisation that are key in depression.

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Different people’s responses to antidepressants are therefore quite specific, and young people may experience anything from marked improvement to deterioration.

Another important finding is that antidepressants are associated with an increased risk of suicidal thinking and self-harm.

These are not necessarily new findings, but they represent the best evidence we have so far. They remain a key consideration for GPs and other health professionals who are considering medications for children and young people.

Our new Cochrane review found, on average, antidepressants lead to only small improvements in depression symptoms compared with placebo in kids and teens.
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What is new is our findings on how different antidepressants compare with each other. Many current guidelines recommend fluoxetine as the only first-line medication that should be tried. This is commonly sold under the brand name Prozac.

Fluoxetine is what’s called a “selective serotonin reuptake inhibitor” (SSRI). Serotonin is a neurotransmitter in the brain linked to positive emotions. After it’s used by nerve cells, serotonin is reabsorbed, which is known as “reuptake”. These types of antidepressants work by blocking the reuptake of serotonin, therefore increasing its availability to pass messages between nerve cells.

Our review shows three other antidepressants, including sertraline, escitalopram, and duloxetine, had similar effects to fluoxetine. Though, there’s the caveat that all of these led to only small reductions in depression on average.

However, this finding may extend treatment options for young people with depression. For example, one of these antidepressants may suit one person better than another in terms of side-effects experienced, and the time it takes to work or to wash out of the system.

What other options are there?

Against a backdrop of a global pandemic, there’s a risk we may start to consider depression as the “norm”, passing it over as a given or as insignificant.

But as those with depression, and their parents, families and friends know, depression is anything but. It impacts every facet of life and is often accompanied by a fear it may never improve.

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Depression varies substantially between people with multiple factors at play, so it’s important a range of support and treatments are available for people.

Antidepressants have been, and will remain, only one of many options for young people with depression. Guidelines continue to highlight that antidepressants should not be the first port of call.

When used, they should be used in combination with evidence-based talking therapy, the most common being cognitive behavioural therapy (CBT), and there must be a commitment to ensure close monitoring of their impact.

Antidepressants should only be considered alongside talk therapy, as well as increased exercise, adequate sleep and good nutrition.
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There’s a range of ways in which young people can and need to be supported. There’s good evidence for regular physical activity, good nutrition, and adequate sleep. Support from family, schools and the broader community is also important.

A decision to use antidepressants should be on the basis of shared decision-making. This refers to conversations where the risks and benefits of all treatment options are described to the young person, and their family, who are then meaningfully involved in making the decision.

If the decision is made to use an antidepressant, it’s critical to ensure health professionals conduct regular (weekly at first) checks on depression symptoms and adverse effects. This is particularly important in terms of monitoring the emergence of suicidal thinking and self-harm.

Treatment with an antidepressant should be in the context of talking therapy, and a holistic approach to well-being.

Ensuring access to support and treatment and conveying a sense of hope is crucial.

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If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Sarah Hetrick, Associate Professor of Youth Mental Health, University of Auckland; Joanne McKenzie, Associate Professor, Biostatistics Unit, School of Public Health and Preventive Medicine, Monash University; Nick Meader, Research Fellow, Centre for Reviews and Dissemination, University of York, and Sally Merry, Professor and Cure Kids Duke Family Chair in Child and Adolescent Mental Health, University of Auckland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why children and teens with symptoms should get a COVID-19 test, even if you think it’s ‘just a cough’

Christopher Blyth, University of Western Australia

A Victorian teenager holidaying on the NSW South Coast has been diagnosed with COVID-19, NSW chief health officer Kerry Chant said on Wednesday.

The revelation follows reports senior students at Al-Taqwa College in Melbourne are now considered the main source of Victoria’s second-biggest COVID-19 cluster.

These cases serve as a reminder that although children and teens are considered less likely than adults to catch and spread COVID-19, everyone with symptoms should get a test — including children and teens.

Children, teens and COVID-19 risk: what we know so far

In my field, paediatric infectious disease, new research is emerging all the time about how SARS-CoV-2 (the virus that causes COVID-19) affects children and teens. In short, the evidence so far says:

• children and teens can contract and spread the disease — but compared to adults, several studies suggest that they are less likely to.

• children and teens are much less likely to get severely unwell, be hospitalised or die compared to adults and older people.

• tragically, children and babies overseas have died of COVID-19, but compared with adults, this is much less common. Thankfully, it has not yet occurred in Australia.

The current thinking is that for most of Australia, the benefit of keeping schools open outweighs the risk. (In metropolitan Melbourne and Mitchell Shire, however, school holidays have been extended for all students except for those in year 11 and 12 or specialist schools.)

In Australia, the youngest COVID-19 death has been a person in their 40s. Less than 7% of all cases in Australia have so far have been recorded in children and teenagers. This proportion may rise, depending on the demographics in areas where community transmission is occurring.

What about older teens?

The risk of becoming unwell with COVID-19 increases with age. We know older teens are very different to young teens, both in growth and development but also in their activities – many of these activities put older teens at greater risk.

As Victoria’s Chief Health Officer Brett Sutton has said

They are older kids, they tend to have more transmission that is akin to adults if they’re not doing the physical distancing appropriately.

And if teens do develop COVID-19, the disease can move incredibly quickly from person to person and may soon reach populations with much greater risk, such as older people.

That’s why the very best strategy we have is to get tested.

Most children or teens with COVID-19, and indeed most people, will experience a mild illness that improves by itself. However, a small proportion of the community will become severely unwell. I’d be encouraging parents to remember that having a test is not just about the child; it’s about the community, children, parents and grandparents.

Most children or teens, and indeed most people, who get COVID-19 will experience a mild illness that improves by itself.
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Younger kids and the constant runny nose or cough

As we head into winter time, we’re starting see more children and adults with common cough and cold viruses. For many parents of younger children, runny noses and coughs are a constant part of life during this time.

To these parents I would say: if it is a new cough, a new fever or sore throat, consider getting the child tested. This is particularly important for those living in places where community transmission is occurring, such as Victoria.

Some children, particularly through winter, will have an ongoing sniffle or cough and one infection will roll into the next. In this situation, the thing to watch for is a worsening of a fever or cough. If this happens, do not hesitate to get tested.

The Conversation, CC BY-ND

Testing is a key strategy

To sum it up, testing is one of the key strategies to contain the spread of COVID-19 in Australia. One needs only look to Victoria to see what can happen when flare-ups occur. Although some of the public health interventions may appear draconian, we have to make sure people who are infectious are separated from those who are susceptible.

If your child is showing symptoms, you might be tempted to think “it’s just a cough” — and most of the time it will be just a cough. It’s not that we think every child with a cough has got coronavirus, but early detection — along with other measures such as physical distancing, staying home if unwell and hand hygiene — is absolutely crucial in our response.

Christopher Blyth, Paediatrician, Infectious Diseases Physician and Clinical Microbiologist, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

140th out of 146: Australian teens do close to the least physical activity in the world

Teenagers across the world are failing to meet physical activity targets – but Australian teens are doing worse than most.
From shutterstock.com

Brendon Hyndman, Charles Sturt University

In a study published in The Lancet today, we find out how 1.6 million adolescent school students from across 146 countries are faring in terms of the World Health Organisation’s (WHO) physical activity recommendations.

The answer: pretty dismally. And Australia is among the worst, ranked 140 out of the 146 countries studied.

The WHO guidelines for this age group recommend a minimum of one hour of moderate to vigorous physical activity each day. That’s a jogging-like intensity that gets you sweating and puffing.

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How much physical activity should teenagers do, and how can they get enough?

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This benchmark has been set based on what we know about the benefits of regular movement for good physical health (fitness, strong muscles and bones) and preventing disease (such as type 2 diabetes, cancer, and heart disease). Not getting enough physical activity is one of the leading causes of death worldwide.

So if young Australians are losing out on these benefits, it’s concerning. While it’s a huge problem to tackle, we can take important steps at school and at home.

The study

The researchers analysed data from students aged 11 to 17 provided in surveys. Although movement devices (such as accelerometers and pedometers) are generally the most accurate way to measure physical activity, surveys can reach large populations and provide valuable insights on a national and even global scale.

The study provided figures for two time points – 2001 and 2016. In 2016, an average of just one in five adolescents across the 146 countries met the recommended physical activity levels. More boys meet these guidelines than girls.

Australia came in seventh from the bottom when it came to the proportion of adolescents not getting enough physical activity. This placed Australia ahead of only Cambodia, Philippines, South Korea, Sudan, Timor-Leste and Zambia.

Kids’ physical activity levels tend to decline when they move from primary school to high school.
From shutterstock.com

These findings align with recent national report cards that graded Australian adolescents’ physical activity as a lowly “D-”.

The researchers predicted just over one in ten Australian adolescents were meeting global physical activity recommendations in 2001 (87% were not) and in 2016 (89% were not). So if anything, things are getting worse.

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Read more:
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Why is this age group doing so poorly?

Research continues to show a child’s physical activity participation has often peaked in primary school, before they transition into secondary school.

In high school, there tend to be less areas conducive to outdoor physical activities, like playgrounds. High school students are often exposed to more spaces for sitting and socialising, and research shows they can start to develop negative attitudes towards physical education.

Sedentary behaviour also increases during secondary schooling, with a higher proportion of students using electronic devices for longer than the recommended two hours per day for recreation and entertainment.

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By secondary school, teenagers have had seven years of primary schooling to develop fundamental movement skills, so will require more advanced movement opportunities to test themselves. This can be difficult if schools don’t prioritise facilities to encourage physical activity.

The blocks of recess time for physical activity can be less in secondary school, with guidance for 30 minute periods, compared with an hour for primary. This can vary according to the priorities of each school, particularly when recess time is competing with lessons, time to eat, and other activities.

Health and physical education requires improved status, resources and time allocation across the board.

How can we improve things?

The WHO is aiming to increase the number of young people meeting physical activity guidelines by 15% in 2030. So we need to consider how we can make some positive changes.

A new national physical literacy framework and campaign is a good start.

According to Sport Australia, physical literacy is about more than playing sport – it’s about holistic development.

Here are some other things we should be focusing on:

1. we need to place more value on recess periods by ensuring there is at least one hour of mandatory recess time scheduled each day for teenagers to be as active as possible. We also need to prioritise quality and accessible facilities for students to test themselves physically (for example, climbing and fitness facilities)

2. families should dedicate one hour after school each day to turning off electronic devices with the goal of moving more

3. school teachers should work to identify teenagers’ physical activity interests, levels and needs as they enter secondary school, looking to provide more physical challenges. If facilities are not available, they should plan for and include relevant excursions

4. schools should encourage more opportunities for safe active transport (travelling to and from school by walking or cycling), organised sport and recreation, student-centred PE classes (promoting choice for more enjoyable activities), and activity opportunities before and after school

5. during unavoidable and prolonged periods of using digital devices (like during classroom lessons), teachers should provide short bursts of movement tasks for even one minute, such as moving to music

6. school staff and training teachers should receive professional development for learning about, accommodating and encouraging physical activities within the context of secondary schools (especially beyond scheduled classes)

7. schools should be engaged with stakeholders such as families and community leaders in a collective effort to improve and model the value of physical activity opportunities in secondary schools.

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Read more:
Adapting to secondary school: why the physical environment is important too

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Leaders from across sectors need to prioritise the development of physical activity strategies and resources for secondary schools. This is not a new concept, but the findings of this research make it impossible to ignore. Trialled programs or policies that encourage physical activity in secondary schools should now be brought in on a larger scale.

Brendon Hyndman, Senior Lecturer in Personal Development, Health & Physical Education / Course Director of Postgraduate Studies in Education, Charles Sturt University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is social media damaging to children and teens? We asked five experts

They need to have it to fit in, but social media is probably doing teens more harm than good.
from http://www.shutterstock.com

Alexandra Hansen, The Conversation

If you have kids, chances are you’ve worried about their presence on social media.

Who are they talking to? What are they posting? Are they being bullied? Do they spend too much time on it? Do they realise their friends’ lives aren’t as good as they look on Instagram?

We asked five experts if social media is damaging to children and teens.

Four out of five experts said yes

The four experts who ultimately found social media is damaging said so for its negative effects on mental health, disturbances to sleep, cyberbullying, comparing themselves with others, privacy concerns, and body image.

However, they also conceded it can have positive effects in connecting young people with others, and living without it might even be more ostracising.

The dissident voice said it’s not social media itself that’s damaging, but how it’s used.

Here are their detailed responses:

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If you have a “yes or no” health question you’d like posed to Five Experts, email your suggestion to: alexandra.hansen@theconversation.edu.au

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Karyn Healy is a researcher affiliated with the Parenting and Family Support Centre at The University of Queensland and a psychologist working with schools and families to address bullying. Karyn is co-author of a family intervention for children bullied at school. Karyn is a member of the Queensland Anti-Cyberbullying Committee, but not a spokesperson for this committee; this article presents only her own professional views.

Alexandra Hansen, Chief of Staff, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why this generation of teens is more likely to care about gun violence

Jean Twenge, San Diego State University

When 17 people were killed at Marjory Stoneman Douglas High School in Parkland, Florida, it was just the latest in a tragic list of mass shootings, many of them at schools.

Then something different happened: Teens began to speak out. The Stoneman Douglas students held a press conference appealing for gun control. Teens in Washington, D.C., organized a protest in front of the White House, with 17 lying on the ground to symbolize the lives lost. More protests organized by teens are planned for the coming months.

Teens weren’t marching in the streets calling for gun control after the Columbine High School massacre in 1999. So why are today’s teens and young adults – whom I’ve dubbed “iGen” in my recent book on this generation – speaking out and taking action?

With mass shootings piling up one after another, this is a unique historical moment. But research shows that iGen is also a unique generation – one that may be especially sensitive to gun violence.

Keep me safe

People usually don’t think of teenagers as risk-averse. But for iGen, it’s been a central tenant of their upbringing and outlook.

During their childhoods, they experienced the rise of the helicopter parent, anti-bullying campaigns and, in some cases, being forced to ride in car seats until age 12.

Their behavior has followed suit. For my book, I conducted analyses of large, multi-decade surveys. I found that today’s teens are less likely to get into physical fights and less likely to get into car accidents than teens just 10 years ago. They’re less likely to say they like doing dangerous things and aren’t as interested in taking risks. Meanwhile, since 2000, rates of teen binge drinking have fallen by half.

With the culture so focused on keeping children safe, many teens seem incredulous that extreme forms of violence against kids can still happen – and yet so many adults are unwilling to address the issue.

“We call on our national and state legislatures to finally act responsibly and reduce the number of these tragic incidents,” said Eleanor Nuechterlein and Whitney Bowen, the teen organizers of the D.C. lie-in. “It’s essential that we all feel safe in our classrooms.”

Treated with kid gloves

In a recent analysis of survey data from 8 million teens since the 1970s, I also found that today’s teens tend to delay a number of “adult” milestones. They’re less likely than their predecessors to have a driver’s license, go out without their parents, date, have sex, and drink alcohol by age 18.

This could mean that, compared to previous generations, they’re more likely to think of themselves as children well into their teen years.

As 17-year-old Stoneman Douglas High School student David Hogg put it, “We’re children. You guys are the adults. You need to take some action.”

Furthermore, as this generation has matured, they’ve witnessed stricter age regulations for young people on everything from buying cigarettes (with the age minimum raised to 21 in several states) to driving (with graduated driving laws).

Politicians and parents have been eager to regulate what young people can and can’t do. And that’s one reason some of the survivors find it difficult to understand why gun purchases aren’t as regulated.

“If people can’t purchase marijuana or alcohol at the age of 18, why should they be given access to guns?” asked Stoneman Douglas High School junior Lyliah Skinner.

She has a point: The shooter, Nikolas Cruz, is 19. Under Florida’s laws, he could legally possess a firearm at age 18. But – because he’s under 21 – he couldn’t buy alcohol.

Libertarianism – with limits

At the same time, iGen teens – like their millennial predecessors – are highly individualistic. They believe the rights of the individual should trump traditional social rules. For example, I found that they’re more supportive of same-sex marriage and legalized marijuana than previous generations were at the same age.

Their political beliefs tend to lean toward libertarianism, a philosophy that favors individual rights over government regulations, including gun regulation. Sure enough, support for protecting gun rights increased among millennials and iGen between 2007 and 2016.

But even a libertarian ideologue would never argue that individual freedom extends to killing others. So perhaps today’s teens are realizing that one person’s loosely regulated gun rights can lead to another person’s death – or the death of 17 of their teachers and classmates.

The teens’ demands could be seen as walking this line: They’re not asking for wholesale prohibitions on all guns. Instead, they’re hoping for reforms supported by most Americans such as restricting the sale of assault weapons and more stringent background checks.

In the wake of the Stoneman Douglas High School shooting, the teens’ approach to activism – peaceful protest, a focus on safety and calls for incremental gun regulation – are fitting for this generation.

Perhaps iGen will lead the way to change.

Jean Twenge, Professor of Psychology, San Diego State University

This article was originally published on The Conversation. Read the original article.

Two Christians Slain in Attack Outside Church in Pakistan

Muslim youths kill two, wound two others after dispute over teasing of Christian women.

KARACHI, Pakistan, March 22 (CDN) — Two Christians were gunned down and two others are in a serious condition with bullet wounds after Muslim youths attacked them outside a church building in Hyderabad last night, witnesses said.

Residents of Hurr Camp, a colony of working-class Christians in Hyderabad in Sindh Province, were reportedly celebrating the 30th anniversary of their Salvation Army church when a group of Muslim youths gathered outside the building and started playing music loudly on their cell phones. They also started teasing Christian women as they arrived for the celebration, according to reports.

Christians Younis Masih, 47, Siddique Masih, 45, Jameel Masih, 22, and a 20-year-old identified as Waseem came out of the church building to stop the Muslim youths from teasing the Christian women, telling them to respect the sanctity of the church. A verbal clash ensued, after which the Muslim youths left, only to return with handguns.

Witnesses told Compass by phone that the Muslim youths opened fire on the Christians, killing Younis Masih and Jameel Masih instantly, and seriously injuring Siddique Masih and Waseem. The injured men have been transferred to a hospital in Karachi, the provincial capital of Sindh.

Younis Masih is survived by his wife and four children, while Jameel Masih was married only a month ago, and his sudden death has put his family into a state of shock.

“My son had gone to the church to attend the anniversary celebrations from our family…a few hours later we were told about his death,” a wailing Surraya Bibi told Compass by telephone from Hyderabad. “I got him married only a month ago. The cold-blooded murderers have destroyed my family, but our most immediate concern is Jameel’s wife, who has gone completely silent since the news was broken to her.”

She said the local police’s indifference towards the brutal incident had exacerbated the Christians’ sorrow.

“The police were acting as if it was not a big deal,” she said. “They did not register a case until late at night, when all of us blocked the main Hyderabad Expressway along with the two dead bodies for some hours.”

Jameel Masih’s paternal uncle, Anwar Masih, told Compass that police were biased against the Christians, as “none of the accused has been arrested so far, and they are roaming the area without any fear.”

He said police had taken into custody some teenagers who had no involvement in the killings.

“This has been done just to show their senior officials that they are not sitting idle,” he said.

Anwar Masih said the families had little hope for justice, because “if we have to dishonor the dead bodies by placing them on the roads to get a case registered, what should we hope for when the investigations begin?”

He said that during their protest, some leaders of the Muttahida Qaumi Movement, a regional political party known for its secular but often violent ideology, arrived and suggested the Christians retaliate against the Muslims.

“We told them that as Christians we are not going to take the law into our hands,” Anwar Masih said.

He said that Jameel Masih’s father, Sardar Masih, and the other Christians would visit the Baldia Colony police station Wednesday morning (March 23) to see whether there has been any progress in the investigation.

“Please pray for us,” he said.

Compass made efforts to contact Hyderabad District Police Officer Munir Ahmed Sheikh to ask about progress in the case and whether any of the named suspects have been arrested by police, but the calls were unanswered.

The killing of the two Christians comes a week after another Christian, sentenced to life imprisonment on false blasphemy charges, died in Karachi Central Prison. The family of Qamar David claims he was murdered on March 15, while conflicting reports from the jail suggest that he died of heart failure.

If David died from torture, yesterday’s killings bring the number of Christians murdered in March alone to four, the most prominent among them being Federal Minister for Minority Affairs Shahbaz Bhatti, who was assassinated in Islamabad on March 2 for opposing the country’s controversial blasphemy laws.

Report from Compass Direct News
http://www.compassdirect.org

Alleged Bomber of Christian Boy in Israel to Stand Trial

Hearing could determine whether Jack Teitel is transferred from mental hospital.

ISTANBUL, September 3 (CDN) — An Israeli man accused of planting a homemade bomb that almost killed the son of a Messianic Jewish pastor in Ariel, Israel has been declared competent to stand trial.

Jack Teitel, 37, who in November was indicted on two charges of pre-meditated murder, three charges of attempted murder and numerous weapons charges, is expected to enter a plea on Sunday (Sept. 5).

David and Leah Ortiz, parents of the teenage victim, said that the 10 months since the indictment have been difficult but their stance toward Teitel remains the same; they have forgiven him for the attack but want him to face justice before a judge and seek salvation from God.

If nothing else, they said, they want him incarcerated to keep other Messianic Jews from being attacked either by Teitel or those following his lead.

“He’s dangerous,” Leah Ortiz said. “He’s an extremely dangerous person. He’s totally unrepentant.”

Sunday’s plea will open the way for a trial expected to start within weeks and last for more than six months. Officials at a hearing possibly the same day as the scheduled plea will decide whether Teitel will be moved from the mental hospital where he has been held for most of his detainment.

It is possible Teitel will enter no plea on Sunday. He has publically stated that he doesn’t “recognize the jurisdiction” of Jerusalem District Court.

 

Bombing

On March 20, 2008, Ami Ortiz, then 15, opened a gift basket that someone had left anonymously at his family’s home in Ariel. The basket disappeared in a massive explosion that destroyed much of the Ortiz home and shattered Ami’s body.

When he arrived at the hospital, Ami was clinging to life. He was bleeding profusely, had burns covering much of his body and was full of needles, screws and glass fragments the bomb-maker had built into the device.

The doctors had little hope for him and listed his condition as “anush,” meaning his soul was about to leave his body.

After countless hours of surgery and even more spent in prayer, Ami went from “near dead,” to burned and blind and eventually to playing basketball on a national youth team. Both his parents said his recovery was nothing short of a miracle from God.

 

‘Most Radical Evangelist’

When Teitel was arrested in October 2009, police found him hanging up posters celebrating the shooting of two teenagers at a gay and lesbian community center in Tel Aviv.

Teitel’s background is still somewhat of a mystery. An emigrant from the United States, he became an Israeli citizen in 2000, got married not long afterwards and is the father of four children. Usually portrayed in Israeli media as part ultra-orthodox ideologue and part fringe survivalist, it is clear that Teitel was motivated by a fascination with end-times prophecy and an extremely violent interpretation of Judaism and Jewish nationalism.

He is a self-described follower of such anti-missionary groups as Yad L’Achim. According to authorities, Teitel sought to kill those he deemed enemies of traditional Judaism: Palestinians, homosexuals, liberal Jewish intellectuals and, in the Ortiz case, Messianic Jews.

David Ortiz is well known in Israel, both for his activities in the Jewish community and for his efforts to expose Palestinians to the gospel.

“He said the reason why he wanted to kill me was that I was the most radical in evangelism, so I had to be first,” said Ortiz, who has seen transcripts of Teitel’s confessions.

Along with the Ortiz case, police said Teitel is responsible for the June 1997 shooting death of Samir Bablisi, a Palestinian taxi driver who was found in his cab with a single bullet wound to his head. Two months later, police said, Teitel allegedly shot Isa Jabarin, a Palestinian shepherd who was giving him driving directions to Jerusalem.

Police also said that Teitel attempted to burn down a monastery and unsuccessfully planted several bombs. He also is accused of the September 2008 bombing of Zeev Sternhell of Hebrew University in Jerusalem. The bombing left the emeritus history professor slightly wounded.

During one court hearing, Teitel flashed a victory sign and reportedly said, “It was a pleasure and honor to serve my God. God is proud of what I have done. I have no regrets.”

 

Long Road to Trial

David Ortiz said that as bad as the bombing itself was, waiting for the trial has been yet another ordeal.

As officials investigated the bombing, police harassed Messianic Jewish friends of theirs, saying, “If you are Jewish, why did you become a Christian?” Ortiz said.

The Ortiz family had to sue police and pay 5,000 shekels (US$1,320) to obtain a copy of a security camera video belonging to the family that police had seized as evidence. The video shows Teitel laying the basket at the Ortiz home.

“We had to hire a lawyer because we understood clearly that our rights as victims had to be protected,” said David Ortiz.

Particularly galling to the pastor has been the hands-off response of government officials to the attack.

“We are the only family in Israel that has been a victim of an attack that hasn’t been visited by a government official,” he said, adding that officials have made no public condemnation of the attack. “If the leaders do not condemn an act, it emboldens others who want to do the same thing.”

According to the International Religious Freedom Report 2009 issued by the U.S. Department of State, there are 10,000 Messianic Jews in Israel. The report documents several cases of violence against Messianic Jews, including cases where baptismal services have been disrupted, Messianic Jews have been beaten and Christian literature has been torched.

 

God Shows Up

Leah Ortiz said that what Teitel intended for evil, God meant for good in order to reach people.

“The Lord has taken the worst tragedy that could possibly happen and has used it for the greatest good that He possibly could,” she said.

The incident, and how the Ortiz family has dealt with it, has become a lightning rod of sorts in Israel, forcing people to think more seriously about the claims of the Messianic Jews.

In a place filled with the type of hatred that causes people to strap bombs to their bodies to kill others, the attack has given people a reason to think and, for some, to choose forgiveness and peace.

Ortiz said he has gotten calls from Palestinians who had said if he could forgive a man who bombed his child, then they can forgive what has happened to them. Orthodox Jews have called him and asked forgiveness for their hatred toward Messianic Jews. Muslims have called Ortiz offering blood for transfusions for Ami.

Ortiz said he was devastated after the attack, but that he has been blessed to see God working “supernaturally” through the incident. Ami is an example of God’s grace and healing power, Ortiz said, explaining, “Ami has been a wonder within my own eyes. How could anyone who went through so much be so peaceful?”

Ami’s high school friends, most of them not Messianic Jews, have sought him out and asked him about the ordeal.  Ortiz said he thinks God will use him in a big way.

His wife explained, “I have that sense this is about something bigger. This is something bigger than what has happened to us and to our family.”

Report from Compass Direct News