The relationship between food habits and physical activity and the IQ of primary school children

BACKGROUND

Children's intelligence quotient (IQ) is influenced by various environmental and genetic variables. The current study aimed to determine how children's dietary choices and physical activity levels correlated with their IQ.

METHODS

A total of 190 students (111 girls and 79 boys) between the ages of 8 and 10 were chosen randomly for this cross-sectional research. For all children, questionnaires were utilized to gather information on their anthropometry, socio-economic position, food habits, and 24-h memory. Children's physical activity questionnaire (CPAQ) was also used to gauge their level of physical activity. Raven's color progressive intelligence test was also used to gauge children's IQ. All the questions may be filled out online with the assistance of parents. SPSS software was used to gather and evaluate the generated data.

RESULTS

Of 190 respondents, 79 (41.6%) are males, and 111 (58.4%) are girls. The results of the study showed that, a positive correlation between children's IQ and physical activity (P = 0.017, r = 0.17), if this relationship was not seen by gender. In addition, a positive correlation was observed between the IQ and food habits scores in all children (P = 0.001, r = 0.24), as well as by gender, that is, male (P = 0.04, r = 0.23) and female (P = 0.006, r = 0.26), which indicates that children with better food habits were associated with higher IQ.

CONCLUSION

It was shown that elementary school children's IQ, food habits, and degree of physical activity are all positively correlated.

Misreporting of height and weight by primary school children in Japan: a cross-sectional study on individual and environmental determinants

BACKGROUND

Appropriate body constitution during childhood is important for future health. However, it has been suggested that thinness is increasing among adolescent girls and boys in Japan. Since misreporting of height/weight may be a possible reflection of the child's ideal body image, we investigated the magnitude and direction of height/weight misreporting and its determinants among Japanese young adolescents.

METHODS

A total of 1019 children in public primary schools were included in the analysis. Both measured and self-reported values of height/weight were obtained. Misreporting of height/weight was calculated by subtracting the measured value from the self-reported value. The association between misreporting and several variables such as the BMI z-score of individuals and body constitution of surrounding children was explored by multivariate linear mixed models.

RESULTS

As BMI z-score increased, 'overreporting' of height by boys and 'underreporting' of height by girls became larger (p = 0.06 in boys, p = 0.02 in girls). Both boys and girls with a larger body size tended to underreport their weight (p < 0.01 in boys, p < 0.01 in girls). Boys who belonged to a school with a larger average BMI z-score were more likely to overreport their weight. This tendency was not observed for girls.

CONCLUSIONS

Self-reported height/weight was generally accurate in Japanese primary school children. However, even primary school children misreported their height/weight intentionally like adults, possibly due to social pressure to lose weight or that not to stand out. Thus, health education about appropriate body constitution should be provided from the beginning of adolescence, particularly for girls.

Asymptomatic nasopharyngeal bacterial carriage, multi-drug resistance pattern and associated factors among primary school children at Debre Berhan town, North Shewa, Ethiopia

BACKGROUND

Nasopharyngeal carriage of bacteria is the main source for transmission of pathogens across individuals and horizontal spread of organisms in the community. It is an important risk factor for the acquisition of community-acquired respiratory tract infection. It is the major public health problem among children. The asymptomatic carriage of nasopharyngeal bacteria is different globally, particularly in Africa, carriage is higher in children and decreases with increasing age, 63.2% in children less than 5 years, 42.6% in children 5-15 years, and 28.0% in adults older than 15 years.

OBJECTIVE

The aims of this study was to determine asymptomatic nasopharyngeal bacterial carriage, multi-drug resistance pattern and associated factors among primary school children at Debre Berhan town, North Shewa, Ethiopia.

METHODS

Institutional based cross-sectional study was conducted at Debre Berhan town primary schools from February 1 to April 30, 2021. Primarily, the schools were stratified into two strata, public and private primary schools. From a total of sixteen government and fourteen private primary schools, five government and five private schools were selected by using a simple random sampling technique. Socio-demographic variables and potential risk factors were assessed using a structured questionnaire. A total of 384 nasopharyngeal swab samples were collected using sterile swabs aseptically; and inoculated on Blood agar, Chocolate agar, MacConkey agar, and Mannitol salt agar. The colony was characterized to isolate bacteria, and bacterial identification was performed by Gram reaction, hemolysis patterns, colonial characteristics and pigmentation, catalase test, coagulase test, mannitol fermentation test, oxidase test, fermentation of carbohydrates, H₂S production, motility, formation of indole, triple sugar iron agar (TSI), citrate utilization, lysine decarboxylase or methyl red vogues proskur utilization, urea hydrolysis and satellitism tests. Antimicrobial sensitivity tests were performed by using modified Kirby-Bauer disk diffusion method. Data were entered into statistical package Epi data 4.0.0.6 and transferred to and analyzed using SPSS software version-23. P value of < 0.05 with Odds ratio (OR) and 95% confidence interval (CIs) was considered as statistically significant.

RESULTS

The overall prevalence of nasopharyngeal carriage of bacterial isolate was 35.7% (95% CI 30.7-40.7%). The predominant isolates were Staphylococcus aureus 54.5% followed by coagulase-negative Staphylococcus 35.8%, and Streptococcus pyogens 4.5%. Most bacterial isolates were susceptible to chloramphenicol, ciprofloxacin, gentamycin, nitrofurantoin, azithromycin, ciprofloxacin; and the overall multidrug resistance pattern of isolated bacteria was 62.03% out of 137 bacterial isolates. Numbers of rooms ≤ 2 per house [AOR = 5.88, 95%CI 1.26-27.57], having history of hospitalization [AOR = 4.08, 95%CI 1.45-11.53], passive smoking [AOR = 4.87, 95%CI 1.49-15.97], family size of > 5 members [AOR = 2.17, 95%CI 1.24-3.81], and number of students in the classroom [AOR = 2.35,95%CI 1.37-4.02] were statistically significant associated risk factors for nasopharyngeal bacteria carriage.

CONCLUSION

Asymptomatic nasopharyngeal bacteria carriage in children is alarming for community-acquired infection. The overall multidrug resistance was very high. The risk of the carriage was increased with having a history of passive smoking, being in large family size and number of students per class. Longitudinal follow-up studies would be helpful for better understanding the infection risk in bacterial pathogen carriers.

Application of the integrated behavioral model to identify the predictors of toothbrushing practices among primary school children at Bahir Dar city, Ethiopia

Knowing the level of behavioral intention and tooth-brushing practices is crucial for the implementation of the intervention. However, such studies are too limited in Ethiopia. The current study employed a health behavior model to identify predictors that can serve to support primary school children's attitudes, intentions, knowledge, environmental constraints, and practices of tooth brushing. Thus, this study aimed to assess tooth brushing practices and their predictors among primary school children in Bahir Dar city, Ethiopia. An Institutional based cross-sectional study was conducted among primary school children in Bahir Dar city. A multi-stage sampling technique was used to select 610 participants. Data were collected using pre-tested interviewer-administered questionnaires. Questionnaires adapted from items' previous literature were used for integrated behavioral model constructs incorporated with elicitation study results. Data were entered into Epi data and then analyzed by Stata. Descriptive statistics were done. Confirmatory factor analysis was performed to check the convergent validity of the measurement. The Internal reliability of the items was also checked using composite reliability. Multivariable logistic regression was used to predict the role of independent variables in toothbrushing practices. Moreover, path analysis was performed to check the causal effect of integrated behavioral model constructs on toothbrushing practices. The goodness of fit of the final model was checked using the Hosmer and Lemeshow test of best fit with a large p value = 0.97 and Area under receiver operating characteristics curve = 0.98. The overall prevalence of the current practice of toothbrushing among the respondents was 45.4%. The prevalence of brushing frequency was 243 (89.01%), 27 (9.89%), and 3 (1.09%) brushed once a day, twice a day, and more than twice a day respectively. Female child's [AOR 3.23, 95% CI 1.48-7.02], mothers' education [AOR 4.6; 95% CI 1.22-17.44], past experience of toothbrushing [AOR 0.042; CI 0.018-0.101], knowledge about tooth brushing practices [AOR 1.3; 95% CI 1.09-1.60], behavioral intention [AOR 2.01; 95% CI 1.74-2.32], experiential attitude [AOR 1.09; 95% CI 1.01-1.17],instrumental attitude [AOR 1.02; 95% CI 1.01-1.03], and descriptive norm [AOR 1.07; 95% CI 1.01-1.14] were predictors of toothbrushing practices. The findings indicate that the practice of toothbrushing practices among primary school students was low. Sex, mother's education, knowledge, intention, experience, experiential attitude, instrumental attitude, and descriptive norm, have significant effects on toothbrushing practices; indicating that the integrated behavioral model showed adequate utility in predicting toothbrushing practices in the study area. School-based toothbrushing practices change interventions such as communication strategy.

Prevalence of developmental dyslexia in primary school children: a protocol for systematic review and meta-analysis

BACKGROUND

Developmental dyslexia (DD) is a specific impairment during the acquisition of reading skills and may have a lifelong negative impact on individuals. Reliable estimates of the prevalence of DD serve as the basis for evidence-based health resource allocation and policy making. However, the prevalence of DD in primary school children varies largely across studies. Moreover, it is unclear whether there are differences in prevalence in different genders and writing systems. Hence, the present study aims to conduct a systematic review and meta-analysis to assess the global prevalence of DD and to explore related factors.

METHODS

We will undertake a comprehensive literature search in 14 databases, including EMBASE, PubMed, Web of Science, China National Knowledge Infrastructure and Cochrane, from their inception to June 2021. Cross-sectional and longitudinal studies that describe the prevalence of DD will be eligible. The quality of the included observational studies will be assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. The risk of bias will be determined by sensitivity analysis to identify publication bias.

RESULTS

One meta-analysis will be conducted to estimate the prevalence of DD in primary school children. Heterogeneity will be assessed in terms of the properties of subjects (e.g., gender, grade and writing system) and method of diagnosis in the included primary studies. Subgroup analyses will also be performed for population and secondary outcomes.

CONCLUSION

The results will synthesize the prevalence of DD and provide information for policy-makers and public health specialists.

Biomonitoring of BTEX in primary school children exposed to hookah smoke

Hookah smoking is one of the major indoor sources of benzene, toluene, ethylbenzene, and xylenes (BTEX). This study aimed to investigate the potential exposure to BTEX among primary school children, particularly those exposed to hookah smoke. This cross-sectional study was conducted in Khesht, one of the southwestern cities in Iran, in mid-June 2020. Totally, 50 primary school children exposed to hookah smoke were chosen as the case group and 50 primary school children were selected as the control group. Urinary un-metabolized BTEX was measured by a headspace gas chromatography mass spectrometry (GC-MS). Additionally, a detailed questionnaire was used to gather data and information from the students' parents. The mean levels of urinary benzene, toluene, ethylbenzene, m,p-xylene, and o-xylene were 1.44, 5.87, 2.49, 6.93, and 7.17 μg/L, respectively in the exposed children. Urinary BTEX was 3.93-folds higher in the case group than in the controls (p<0.05). Household cleaning products, the floor on which the house was located, children's sleeping place, and playing outdoors were found to be important factors in predicting urinary BTEX levels. Overall, it was found necessary to avoid indoor smoking to prevent the emission of BTEX compounds via exhaled mainstream smoke and to protect vulnerable non-smokers, especially children, from exposure to second-hand and third-hand smoke.

Parent-focused online intervention to promote parents' physical literacy and support children's physical activity: results from a quasi-experimental trial

Background

The development of physical literacy (PL) early in life may influence children's subsequent physical activity (PA) participation and consequent health benefits across the life course. Interventions designed for parents are lacking, but such efforts can potentially enhance the PL of parents and their children’s PA participation. Additionally, there is insufficient evidence to support the feasibility of delivering a PL intervention using an online format. Therefore, the purpose of this study was to examine the feasibility and effectiveness of a parent-focused, theory-driven, online-delivered intervention designed to improve the parents’ PL and children’s PA behaviors.

Methods

A non-randomized trial was conducted to evaluate the effects of the program. 224 Hong Kong families (primary school-aged children and their parents) registered to the program were considered the experimental group and were exposed to an online intervention over three months. Another 220 families in Hong Kong were considered the comparison group and did not receive any intervention. Outcome measures included PA behaviors (daily steps and moderate-to-vigorous PA), parent–child co-activity behaviors, family PA routines, and parent perceived PL. Linear mixed models were used to analyze the differences in terms of changes in measured outcomes between groups over time.

Results

No significant group-by-time effects were found for children’s or parents’ PA behaviors. In terms of the family Co-PA routines, a small positive effect size in favor of the experimental group was found (p = .44, d = 0.2). Group-by-time effects favorable to the experimental group was detected for parent–child co-activity (p < .001, d = 0.7) and parental PL (p < .001, d = 0.9) at post-intervention. The results demonstrated that the intervention was acceptable and that there was potential for scale up.

Conclusions

Findings indicated that the intervention was effective in increasing parent–child co-activity and parent perceived PL. During the pandemic, online intervention delivery was found to be feasible. Using this mode of delivery, the intervention has the potential to reach a wide population in the local context.

Trial registration

The study was prospectively registered at the Chinese Clinical Trial Registry, Registration number: ChiCTR2100041903, Registered 09 January 2021.

EXPRESS: Orthographic Facilitation of Oral Vocabulary Acquisition in Primary School Children

Children's oral vocabulary acquisition is an important aspect of language development that plays a crucial role in reading and literacy development and subsequent academic success. Therefore, it is important to identify and implement evidence-based effective strategies of vocabulary instruction for primary school children. Orthographic facilitation refers to the benefit afforded to word learning by incidentally presenting spellings when new words are introduced (Ricketts et al., 2009). The current study aimed to replicate the orthographic facilitation effect in primary school (grades 1 to 6) children and further assess whether children in different grades benefitted differently from the presence of orthography during spoken word learning. To do this, ninety-one children from grades 1 to 6 were taught novel picture-word pairs with or without spellings. Word learning was assessed during and after training using behavioural and eye tracking data from picture-naming and picture-word-matching (PWM) tasks. Irrespective of grade, all children experienced a significant orthographic facilitation effect during training. The post-training results were more task dependent with all grades showing a significant orthographic facilitation effect on the picture-naming task, and only grades 1-4 showing a facilitation effect on the PWM task. The theoretical and practical implications of these findings are discussed.

The influence of peripheral emotions on inhibitory control among children

In this study, we investigated the cognitive-emotional interplay by measuring the effects of executive competition (Pessoa, 2013), i.e., how inhibitory control is influenced when emotional information is encountered. Sixty-three children (8 to 9 years of age) participated in an inhibition task (central task) accompanied by happy, sad, or neutral emoticons (displayed in the periphery). Typical interference effects were found in the main task for speed and accuracy, but in general, these effects were not additionally modulated by the peripheral emoticons indicating that processing of the main task exhausted the limited capacity such that interference from the task-irrelevant, peripheral information did not show (Pessoa, 2013). Further analyses revealed that the magnitude of interference effects depended on the order of congruency conditions: when incongruent conditions preceded congruent ones, there was greater interference. This effect was smaller in sad conditions, and particularly so at the beginning of the experiment. These findings suggest that the bottom-up perception of task-irrelevant emotional information influenced the top-down process of inhibitory control among children in the sad condition when processing demands were particularly high. We discuss if the salience and valence of the emotional stimuli as well as task demands are the decisive characteristics that modulate the strength of this relation.

The feasibility of using life skills training in primary schools to improve mental health and academic performance: a pilot study in Kenya

BACKGROUND

There is no Kenyan evidence on the relationship between mental illness and academic performance. We aimed to determine the effect of life skills training on mental health and academic performance.

METHODS

We administered to 1848 primary school children a researcher designed socio-demographic questionnaire, and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) to their parents, followed by eight sessions of life skills training. We extracted data from the individual records of each child on overall performance pre and post training separated by one year. We conducted descriptive statistics, paired sample t-tests, multivariate linear regression analysis and linear mixed model analysis to assess changing patterns of academic performance and any predictive characteristics.

RESULTS

There was significant (p < 0.05) improvement in overall academic performance (aggregate marks and all individual subjects) for both lower primary and upper primary classes after the life-skills training intervention. For lower classes (2-4 grades) increase in academic performance was significantly associated with fathers and mothers education levels, region and class. For upper classes, (5-7 grades) increase in academic performance was associated with region, class and age.

CONCLUSIONS

Life skills training is recommended as it could improve academic performance, but predicted by socio-demographic factors.

Prevalence of lactose intolerance and malabsorption among children of two ethnic groups from the urban areas of Malaysia and its relation to calcium intake and bone health status

Lactase insufficiency could develop into lactose intolerance (LI) and disrupt the intake of calcium, which is a core nutrient for bone development in children. However, data regarding the prevalence of LI and bone health status (BHS) among Malaysian children are scarcely reported.

PURPOSE

This study aimed to determine the prevalence of LI and lactose malabsorption (LM) in Malay and Chinese children and examine its relationship with calcium intake (CI) and BHS.

METHODS

A total of 400 children participated in this study. The prevalence of lactose tolerance (LT) was assessed using hydrogen breath test, LT test, and visual analogue scales. Assessment of CI was performed using a 24-h dietary recall interview (24-h DR) and food frequency questionnaire (FFQ). Calcaneal broadband ultrasound attenuation (BUA) was measured using a quantitative ultrasonometer.

RESULTS

The prevalence of LI among Chinese children (37%) was significantly higher (p = 0.002) than among Malay children (22.5%). However, 61.5% of Malay and 54.5% of Chinese children were found to have LM. CI of the children fulfilled 30.5% and 33.9% of the Malaysian recommended CI (1300 mg/day) for 24-h DR and FFQ, respectively. The BUA score of Malay children was significantly higher (p < 0.001) than that of Chinese children. However, LT and CI were not correlated with BHS (p > 0.05, respectively).

CONCLUSIONS

LI was diagnosed among Malay and Chinese children. However, the higher prevalence of LM is rather worrying as it could develop to LI. The prevalence possibly has been worsened by insufficient CI. Thus, effective approaches to increase CI are highly needed as bone development occurs rapidly at this age and is important for the attainment of the optimum peak bone mass during late adolescence.

Relationship between maternal employment status and children's food intake in Japan

Background

Although long maternal working hours are reported to have a negative effect on children’s dietary habits, few studies have investigated this issue in Japan. Healthy dietary habits in childhood are important because they may reduce the risk of future disease. Here, we examined the relationship between maternal employment status and children’s dietary intake in 1693 pairs of Japanese primary school 5th and 6th graders and their mothers.

Methods

The survey was conducted using two questionnaires, a brief-type self-administered diet history questionnaire and a lifestyle questionnaire. The analysis also considered mothers’ and children’s nutrition knowledge, attitudes toward diet, and some aspects of family environment.

Results

Longer maternal working hours were associated with children’s higher intake of white rice (g/1000kcal) (β 11.4, 95%CI [1.0, 21.9]; working ≥8h vs. not working), lower intake of confectioneries (g/1000kcal) (β −4.0 [−7.6, −0.4]), and higher body mass index (BMI) (kg/m²) (β 0.62 [0.2, 1.0]). Although maternal employment status was not significantly associated with lower intake of healthy food (e.g., vegetables) or higher intake of unhealthy food (e.g., sweetened beverages) in the children, in contrast with previous studies, it may have affected children’s energy intake through their higher intake of white rice. Further, children’s nutrition knowledge and attitudes toward diet, mothers’ food intake, and some family environment factors were significantly associated with intakes of vegetables and sweetened beverages in the children.

Conclusions

Longer maternal working hours were significantly associated with higher intake of white rice and lower intake of confectioneries, as well as higher BMI among children. Even when a mother works, however, it may be possible to improve her child’s dietary intake by other means such as nutrition education for children or enhancement of food environment.

Oral Language and Story Retelling During Preschool and Primary School Years: Developmental Patterns and Interrelationships

Oral language and narrative skills constitute very critical factors for children's academic performance and social competence. The aim of the present study was to investigate the developmental patterns of story retelling, as well as the relationship between oral language and story retelling in preschool and primary school children. Two hundred and thirty-seven Greek-speaking children (4-5, 5-6 and 6-7 years old) participated in the study. Vocabulary knowledge, phonological awareness, morphological awareness skills and pragmatics were examined through a standardized psychometric test. Story retelling was measured by inviting the children to listen to a story and then retell it. Children's narratives were evaluated according to microstructure (use of conjunctions and lexical cohesion) and macrostructure (story grammar and temporal sequencing) criteria. The results showed that children performed better as they got older across all the oral language and story retelling tasks. Structural equation modeling revealed that vocabulary skills stand out as a stable predictor across all the three age groups. A new finding was also demonstrated, highlighting that morphological awareness, phonological awareness skills and pragmatics work together with vocabulary skills in diverse patterns at different points of a child's development, in order to support his/her ability to retell a story.

The cognitive profiles for different samples of mathematical learning difficulties and their similarity to typical development: Evidence from a longitudinal study

Several cognitive deficits have been suggested to induce mathematical learning difficulties (MLD), but it is unclear whether the cognitive profile for all children with MLD is the same and to what extent it differs from typically developing (TD) children. This study investigated whether such a profile could be distinguished when cognitive skills and math performance are compared between TD children and children with MLD. This was accomplished by employing two-way repeated-measures analyses of covariance in 276 10-year-old participants (60 with MLD) from fourth and fifth grades. In addition, we investigated whether more restrictive selection criteria for MLD result in different mathematical and cognitive profiles by means of independent-samples t tests. Results revealed that cognitive mechanisms for math development are mostly similar for children with MLD and TD children and that variability in sample selection criteria did not produce different mathematical or cognitive profiles. To conclude, the cognitive mechanisms for math development are broadly similar for children with MLD and their TD counterparts even when different MLD samples were selected. This strengthens our idea that MLD can be defined as the worst performance on a continuous scale rather than as a discrete disorder.

Health questionnaire on back care knowledge and spine disease prevention for 6-10 years old children: development and psychometric evaluation

Background

Back school programs, that improve back care and spine disease prevention knowledge are recommended at the age of 4-14 years. There is Health Questionnaire on Back Care Knowledge in the literature for children aged 14-17 years. At other ages, there is no questionnaire examining this knowledge. We aimed to develop a Health Questionnaire on Back Care and Spine Disease Prevention Knowledge for 6-10 years old children and validate its psychometric properties (internal consistency, test-retest reliability, agreement, convergent validity, discriminant validity) in 6-10 years old children, who attended back school program or not.

Methods

463 children took part in the research (6-10 years old). The development was performed according to the Delphi method. The final version contained 7 questions. 463 participants completed the questionnaire twice with an interval of 7 days to evaluate test-retest reliability. The internal consistency was tested by Cronbach’s alpha value, test–retest reliability was calculated by Intraclass Correlation Coefficients (ICC), Standard Error of Measurement (SEM) and 95% of Minimal Detectable Change (MDC95) and Bland–Altman plots. Convergent validity was tested against the age variable and discriminant validity was tested by Kruskal-Wallis tests among the different subgroups.

Results

Cronbach’s alpha of the total score was (α=0.797), showed a strong internal consistency with minimal SEM (0.606) and MDC95 (1.680). The test-retest result for the total score was strong (0.989), for the questions showed moderate to strong results (0.742-0.975), the limits of agreement of the Bland-Altman plot showed a narrow error of measurement range (-3.49-1.29), and the value of mean differences was −1.10 (SD ± 1.22). The convergent validity showed a weak, but significant relationship between total score and age (R=0.171; p < 0.001). The discriminant validity showed significantly different mean scores in non-back school and back school groups.

Conclusion

For the examination of back care and spine disease prevention knowledge of 6-10 years old children, the questionnaire proved to be a valid and reliable tool. The knowledge requested in the questionnaire covers the knowledge material of the theoretical part of the back school for children aged 4-10 years.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04667-x.

Development of a stand-alone index for the assessment of diet quality in elementary school-aged children

OBJECTIVE

To develop and evaluate a stand-alone Elementary School-aged Children's Index of Diet Quality (ES-CIDQ).

DESIGN

In this cross-sectional study, children filled in a food frequency questionnaire (FFQ) with twenty-nine multiple-item questions on the consumption of foods, portion sizes and eating frequency and a 5-d food diary. Nutrient intakes were calculated with nutrient analysis software. FFQ questions best reflecting a health-promoting diet with reference to dietary recommendations were identified by correlations, logistic regression modelling and receiver-operating characteristics curve analysis.

SETTING

Southwest and Eastern Finland.

PARTICIPANTS

Healthy elementary school-aged volunteers [n 266, mean (sd) age 9·7 (1·7) years] were recruited between March 2017 and February 2018.

RESULTS

A set of questions was identified from the FFQ that best depicted the children's diet quality as defined in the dietary recommendations. These fifteen questions were scored and formulated into a stand-alone index as a continuous index score (range 0-16·5 points) and a two-category score: good and poor diet quality. The cut-off score of six points for a good diet quality had a sensitivity of 0·60 and a specificity of 0·78. Children with a good diet quality (49·8 % of the children) had higher intakes of protein, dietary fibre, and several vitamins and minerals, and lower intakes of sucrose, total fat, SFA and cholesterol compared to children with a poor diet quality.

CONCLUSIONS

The developed short stand-alone index depicted diet quality as defined in the dietary recommendations. Thus, ES-CIDQ may be used for assessing diet quality in Finnish elementary school-aged children in school health care and nutrition research.

Exposome changes in primary school children following the wide population non-pharmacological interventions implemented due to COVID-19 in Cyprus: A national survey

BACKGROUND

Non-pharmacological interventions (NPI), including lockdowns, have been used to address the COVID-19 pandemic. We describe changes in the environment and lifestyle of school children in Cyprus before the lockdown and during school re-opening, and assess compliance to NPI, using the exposome concept.

METHODS

During June 2020, parents completed an online questionnaire about their children's lifestyle/behaviours for two periods; school re-opening (May 21-June 26) following the population-wide lockdown, and the school period before lockdown (before March).

FINDINGS

Responses were received for 1509 children from over 180 primary schools. More than 72% of children complied with most NPI measures; however, only 48% decreased the number of vulnerable contacts at home. Sugary food consumption was higher in the post-lockdown period with 37% and 26% of the children eating sugary items daily and 4-6 times/week, compared to 33% and 19%, respectively, for the pre-lockdown period (p<0.001). Children's physical activity decreased compared to pre-lockdown (p<0.001), while screen time increased in the post-lockdown period, with 25% of children spending 4-7 hours/day in front of screens vs. 10% in the pre-lockdown period (p<0.001). About half of the children washed their hands with soap 4-7 times/day post-lockdown vs. 30% in the pre-lockdown period (p<0.001).

INTERPRETATION

This national survey showed a high degree of compliance to NPI measures among school children. Furthermore, the exposome profile of children may be affected in the months following NPI measures due to alterations in diet, physical activity, sedentary behaviour, and hand hygiene habits.

FUNDING

Partial funding by the EXPOSOGAS project, H2020 Research and Innovation Programme (grant #810995).

Mathematical achievement: the role of spatial and motor skills in 6-8 year-old children

Several studies have tried to establish the factors that underlie mathematical ability across development. Among them, spatial and motor abilities might play a relevant role, but no studies jointly contemplate both types of abilities to account for mathematical performance. The present study was designed to observe the roles of spatial and motor skills in mathematical performance. A total of 305 children aged between 6 and 8 years took part in this study. A generalized linear regression model with mathematical performance as a dependent variable was performed. Results revealed that Block design (as a visuospatial reasoning measure) accounted for mathematical performance, especially among 6- and 7-year-olds but not in 8-year-olds. After controlling for the effect of the block design, mental rotation and manual dexterity predicted mathematical performance. These findings highlight the role of underlying cognitive (spatial) and motor abilities in supporting mathematical achievement in primary school children.

Relation of attention deficit hyperactivity disorder (ADHD) to basic number skills and arithmetic fact retrieval in children

Although research has provided evidence for a clear association of core executive function (CEF) to math performance, fewer studies have been carried out on arithmetic fact retrieval in relation to the symptoms of attention deficit hyperactivity disorder (ADHD). The present study assessed mathematical achievement on a basic number skill test and on an arithmetic fact retrieval task. Besides math achievement, self-ratings of ADHD symptoms (attention deficits, hyperactivity, impulsivity), core executive functions (inhibition, cognitive flexibility, working memory capacity, global index) and state anxiety in 646 fourth and fifth grade students (48.1 % girls) were measured. CEF was evaluated by means of a tablet-based test. Regression analysis showed different predictors for both math abilities. While all CEF measures, inattention and impulsivity self-ratings predicted basic number skills, only inhibition, WMC and inattention self-rating were predictors of arithmetic fact retrieval. On the basis of a cluster analysis of ADHD self-ratings and CEF performance, three different groups were identified: 1: low ADHD, average CEF; 2: high ADHD, low CEF; 3: moderate ADHD, high CEF. Cluster 2 showed scores below the mean in both math scores, whereas cluster 3 exhibited performances above the mean in both math scores. No math differences were found between cluster 1 and 3. The data yield evidence that the association between CEF and math achievement depends on the specific math skill and test type. The results underline the importance of differentiating between CEF components and specific math abilities. Implications for future research on the associations between mathematics, ADHD and CEF are discussed.

Psychometric evaluation of the child oral impacts on daily performances (C-OIDP) for use in Turkish primary school children: a cross sectional validation study

BACKGROUND

As patient-reported outcome, the Child Oral Impacts on Daily Performances (C-OIDP) has been commonly used for assessing children's oral health needs in order to facilitate oral health service planning. It was translated and cross-culturally adapted into Turkish in 2008. Since then, there is no study to assess its psychometric properties in Turkish child population. This cross-sectional study aimed to investigate the psychometric properties and factor structure of the Turkish version of the C-OIDP for use in Turkish primary school children.

METHODS

The Turkish translated version was tested on a convenience sample of primary school children aged 11 to 12 years attending two public schools in Istanbul. Data were collected by clinical examinations, face-to-face interviews and self-completed questionnaires. The internal consistency, test-retest reliability, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), criterion related validity (concurrent and discriminant) were evaluated.

RESULTS

A total of 208 children were subjected to the tested the C-OIDP. Overall, 93.7% of them reported at least one oral impact in the last 3 months. The most frequently affected performances were "eating" (72.1%) and "cleaning mouth", while the performance with the lowest impact was "studying" (13%). The internal consistency and reproducibility of the C-OIDP were acceptable, with a Cronbach's alpha of 0.73 and an intra-class correlation coefficient of 0.83. The EFA yielded a two-factor model termed "functional limitation" and "psychosocial limitation". CFA identified the two- factor model which fit the data better than the previously proposed three-factor model, namely physical, psychological and social health. Having malocclusion, the presence of gum disease, reported history of oral problems in the mouth, dissatisfaction with oral health, bad self-rated oral health and having a problem-oriented pattern of dental attendance were found to be the most important factors related to worse oral health- related quality of life, supporting its criterion-related validity.

CONCLUSION

This study provided preliminary evidence the psychometric properties of the C-OIDP index among Turkish school children aged 11-12 years. It may be applied to evaluate the oral health impact on quality of life in this population.

Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component

BACKGROUND

Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies.

METHODS

Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019.

RESULTS

From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups.

CONCLUSIONS

Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.

Toxocara infection: seroprevalence and associated risk factors among primary school children in central China

Toxocariasis is a zoonotic disease that poses a threat to public health worldwide. In the present study, we investigated the seroprevalence of Toxocara infection among primary school children in Henan province, central China, which was previously unknown. Sera from 2451 primary school children were collected from September 2015 to October 2018, and evaluated for anti-Toxocara antibodies by enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence of Toxocara infection was 5.14% (126/2451). The main risk factors related to Toxocara infection identified in this study were the age of children, residence area of children, contact with cats or dogs, and exposure to soil. Hand washing before eating was considered to be a protective factor. These findings demonstrate that Toxocara infection is relatively common among primary school children in Henan province.

Seroprevalence and risk factors of Toxoplasma gondii infection in primary school children in Henan province, central China

Toxoplasma gondii is an obligate intracellular protozoan parasite with global distribution. However, data on T. gondii infection among children in primary school in Henan province, central China were lacking. In this study, 2451 serum samples of primary school children in this province were collected from September 2015 to October 2018 and evaluated for T. gondii antibodies using an enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence was 9.51% (233/2451), of which 7.59% (186/2451) showed IgG positivity, 0.73% (18/2451) IgM and 1.18% (29/2451) both. The main risk factors related to T. gondii infections were the age of children, residence area, contact with cats, and exposure to soil. Moreover, hand washing before eating was considered a protective factor. Seroprevalence of T. gondii infection among the study population was common, emphasizing the need to prevent and control this infection. This is the first report of T. gondii seroprevalence in primary school children in Henan province, central China.

Associations between perceived and actual physical literacy level in Chinese primary school children

Background

The concept of physical literacy (PL) is gaining popularity within public health and physical education circles. However, little is known about the relationship between perceived and actual PL levels among school-aged children. The aim of this study is to explore the associations between perceived and actual levels of PL of primary school students in China.

Methods

A total of 327 children (153 boys and 174 girls) with a mean (SD) age of 10.0 (±1.0) years were included for analysis. PL perceptions were measured using the Perceived Physical Literacy Instrument. Children’s actual level of PL was objectively assessed by the Chinese version of the Canadian Assessment of Physical Literacy, 2nd edition, which consists of four domains: Daily Behavior, Physical Competence, Motivation and Confidence, and Knowledge and Understanding. Pearson’s correlation coefficients were calculated to examine the relationship between students’ perceived and actual PL levels, whereas Multivariate Analysis of Variance (MANOVA) was calculated to investigate the gender, relative age differences, and interaction effect (2 × 4) on perceived and actual PL levels respectively.

Results

Significant correlations were observed between the perceptions and actual PL scores in both boys (r = .46, p < .01) and girls (r = .41, p < .01). Low to moderate significances were shown between each domain of perceived PL and actual PL (from .16 to .49). Further MANOVA results revealed that there were significant gender differences in the Daily Behavior domain of actual PL (F (1, 319) = 30.15, p < .001, Wilks’ Λ = 540.88, η²_partial = .09). Overall, boys had both higher actual PL scores (58.9) and PL perceptions (37.3) than girls. Neither relative age effect nor interaction effect (2 × 4) was observed for the current participants in all the variables.

Conclusions

This study is the first to examine the associations between the perceived and actual levels of PL in Chinese children. Additional studies should explore the importance of children’s perceptions of PL when assessing the actual level of PL in physical education and health settings. Girls should be more encouraged by PE teachers to participate actively in physical activities in the school environment.

Common Elements of Practice, Process and Implementation in Out-of-School-Time Academic Interventions for At-risk Children: a Systematic Review

Academic achievement is a strong preventive factor against marginalization. Children at risk of academic failure and drop out can benefit from out-of-school-time academic (OSTA) interventions. Wide-scaled implementation and sustainment of effective interventions remain a struggle across education, welfare, and health. The need for approaches to increase implementability, effectiveness, and efficiency of interventions is pressing. Advancements in the field of education and mental health suggest identifying and studying discrete elements that are common across interventions for the purpose of hypothesis generation, intervention optimization, design improvement, and implementation. This review identified OSTA interventions for primary school children at risk of academic failure. Common elements methodology was used to code practice elements (n = 62), process elements (n = 49), and implementation elements (n = 36) in 30 effective and six ineffective OSTA interventions in matrices. Based on frequency counts, common practice, process, and implementation elements across the interventions were identified, and given frequency count values (FV) reflecting how often elements were included in effective studies as opposed to in ineffective studies. The five common practice elements with the highest FVs were homework support, training in positive parental school involvement, positive reinforcement, structured tutoring, and psychoeducation. The most common process element was regular support to intervention receiver, and the most common implementation element was quality monitoring. Common combinations of elements were also identified and given FVs. Results from this review can inform efforts to design or optimize OSTA interventions, and inform education, implementation, and practice to improve academic achievement for children at risk.

Animation as Supplementary Learning Material About Carcinogenic Liver Fluke in Classes for Primary Schoolchildren

Carcinogenic liver fluke is still an issue of great concern in some countries of Southeast Asia, particularly in Thailand, Cambodia, the Lao People's Democratic Republic, and Vietnam. The infection, caused by Opisthorchis viverrini, is associated to cholangiocarcinoma and is endemic among human populations for whom raw fish is frequently consumed. Prevention and health education are required. Therefore, this study aimed to evaluate the effectiveness of educational intervention to improve knowledge among primary schoolchildren based on animation-assisted education. In this study, 80 participants (40 participants in the experimental group and 40 participants in the comparison group) were selected in 2018. The effectiveness of an interactive animation program in improving the knowledge of students studying liver fluke was determined based on scores on tests given before and immediately after completion of a 4.29-min animated program on the liver fluke life cycle, risk factors, disease, diagnosis, treatment, prevention, and control. Data were analyzed using SPSS-22 via paired t tests and independent samples t tests at a significance level of 0.05. A marked and significant improvement was observed in the immediate posttest compared with the pretest scores. More importantly, the students who had used the animated program achieved a significantly higher score on the final test than the comparison group. The results offered in the first report show that the use of the animated program facilitated education about liver fluke. It is strongly believed that animations are good supplementary learning materials for students, particularly for learning about serious concepts.

Effects of different types of classroom physical activity breaks on children's on-task behaviour, academic achievement and cognition

AIM

This study examined the effects of different types of classroom physical activity breaks on children's on-task behaviour, academic achievement and cognition.

METHODS

Participants were 87 Australian primary school students (mean age 9.11 ± 0.62 years), recruited from one school. Three classes were randomly assigned either to activity breaks only (n = 29), activity breaks and mathematics combined (n = 29), or control conditions involving only mathematical content (n = 29). Students were engaged in five minutes of classroom physical activity breaks, three times per week, for four weeks (divided into two minutes at the beginning of the usual mathematics curriculum lesson and three minutes in the middle of the lesson). Assessments were conducted at baseline and post-test.

RESULTS

Significant group-by-time effects were found for on-task behaviour (active engagement: activity breaks and mathematics combined versus control, p ≤ 0.001; activity breaks versus control, p ≤ 0.001; activity breaks and mathematics combined versus activity breaks, p = 0.037; passive engagement: activity breaks and mathematics combined versus control, p ≤ 0.001) and mathematics scores (activity breaks versus control, p = 0.045).

CONCLUSION

Physical activity breaks with and without integrated mathematics content were effective in improving children's on-task behaviour and learning scores.

Advanced theory of mind uniquely contributes to children's multiple-text comprehension

This study examined the contribution of advanced theory of mind (AToM), operationalized as second- or higher-order recursive mentalistic reasoning, to multiple-text comprehension in fourth and fifth graders (N = 184). The role of AToM was analyzed by taking into account children's individual characteristics (i.e., age, gender, prior topic knowledge, word reading fluency, vocabulary knowledge, and single-text comprehension) and task features (i.e., contrast between positions on the topic of two sets of texts). Mixed models analysis revealed that AToM uniquely contributed to comprehension of multiple texts over and above the individual and task variables. In addition, the contribution of AToM to the comprehension of multiple texts did not significantly differ for the two tasks despite differences in contrast between positions on the topic. Results indicate that children's ability to consider different perspectives and mental states is a relevant unique predictor of multiple-text comprehension.

Factors associated with tungiasis among primary school children: a cross-sectional study in a rural district in Rwanda

BACKGROUND

Tungiasis is a relatively frequent ectoparasitosis in low-income settings, yet its morbidity and social impact are still not well understood due to the scarcity of information. In Rwanda, data on the magnitude and conditions leading to the tungiasis is rare. This study sought to determine the prevalence and factors associated with tungiasis among primary school children in Rwandan setting.

METHOD

A descriptive cross-sectional study utilising systematic random sampling method was adopted to select 384 children from three primary schools. From July to October 2018, data were collected on socio-demographic characteristics of children, parents, and households. Logistic regression was applied to analyse socio-demographic factors associated with tungiasis with a level of significance set at P-value< 0.05.

RESULTS

Prevalence of tungiasis among three primary schools was 23%. Factors associated with tungiasis included walking barefoot (AOR: 78.41; 95% CI: 17.91-343.10), irregular wearing of shoes (AOR: 24.73; 95% CI: 6.27-97.41), having dirty feet (AOR: 12.69; 95% CI: 4.93-32.64), wearing dirty clothes (AOR: 12.69; 95% CI: 4.18-38.50), and living in a house with earthen plastered floor (AOR: 28.79; 95% CI: 7.11-116.57). Children infected with tungiasis attended class less frequently (AOR: 19.16, 95%CI: 7.20-50.97) and scored lower (AOR: 110.85, 95%CI: 43.08-285.20) than those non-infected. The low school attendance and poor performance could be partly explained by difficulty of walking, lack of concentration during school activities, and isolation or discrimination from classmates.

CONCLUSION

Tungiasis was a public health challenge among school going children in a rural Rwandan setting. This study revealed that children affected with tungiasis had poor hygiene, inadequate housing environments and consequently poor school attendance and performance. Improving socio-economic conditions of households with special emphasis on hygiene of family members and housing conditions, would contribute to preventing tungiasis.

A comparison of the effects of the colour and size of coloured overlays on young children's reading

This study compared the effects of the colour and size of overlays on reading time, reading errors and on the clarity of text with young primary school children. The sample comprised a non-clinical, typical, sample from an East London primary school. One hundred and six children aged between four and seven years were asked to read 11 short passages of text (60 words) either with full page overlays or smaller reading rulers (53 in each group). This sample included younger children than has often been tested before. The 11 short passages allowed an assessment of baseline reading performance (no reading aid) and performance while reading with each of a set of ten coloured reading aids. Two different, yet beneficial, colours were determined: the most effective and the clearest/most comfortable. Both of these measures are not usually recorded. All but four children had reduced reading times with one of the reading aids and all but one reported their aid improved the perceived visual clarity of the text: the size of the reading aid did not affect reading time or visual clarity significantly. The numbers of skipped words and errors/mis-read words also decreased when reading with the most effective and most comfortable reading aid. Near visual acuity was assessed with and without each child's most effective coloured aid. The most effective aid improved acuity in over a third of the children. Acuity has not been assessed in previous studies. As reported previously, different colours helped different children. In conclusion, coloured reading overlays reduced reading times on the reading test employed here and the size of the reading aid was not crucial to facilitate performance. The largest reductions occurred for the youngest readers, suggesting these aids may be particularly effective for early readers.

Prevalence of goiter and its associated factors among primary school children in Chole District, Arsi Zone, Ethiopia: a cross- sectional study

Background

Goiter remains one of the major public health problems particularly among young children in economically disadvantaged countries like Ethiopia. The aim of the study was to assess the prevalence of goiter and its associated factors among children aged 6-12 years in Chole district, Arsi Zone, Eastern Ethiopia.

Methods

A school based cross-sectional study was conducted in February, 2017 among 422 primary school children in Chole district, eastern Ethiopia. The schools and study subjects were randomly selected. A structured, pretested and interviewer- administered questionnaire was used to collect the required data. It was conducted after getting due consents from the school administration and assent from caregiver/parent. Spot testing kits were used to estimate the level of iodine in salts. Descriptive statistics, cross-tabulations for chi-square test, and bivariate and multivariate logistic regression models were used to show the magnitude of goiter and its associated factors. Odds ratios with 95% confidence intervals were computed to determine the presence and strengths of associations.

Results

From the 422 study participants, 407 (96.4%) completed the questionnaire. Of these 205(50.3%) were female. The mean age of participant school children was 9.87(SD ± 1.6) years. The prevalence of goiter among study subjects was 36.6% (95% CI, 31.6-40.8%). History of goiter in the family (AOR = 6.80; 95% CI: 3.34-13.84), cabbage consumption (AOR = 2.52; 95% CI: 1.38-4.60) and living with family in a single room (AOR = 2.30; 95% CI: 1.13-4.67) were positively associated with the development of goiter among primary school children in Chole district, eastern Ethiopia. But consuming milk (AOR =0.37; 95% CI: 0.23-0.59) was found to be negatively associated or protective against the development of goiter among the study subjects.

Conclusions

Iodine deficiency was found to be significant public health problem in the study area. Consuming milk was found to be protective, whereas consuming goitrogenic foods like cabbage were found to be the risk factors for the development of goiter among school -aged children. Thus, ensuring the consumption of iodized salt and promoting iodine rich food items among the community in Chole district and other similar settings in Ethiopia are strongly recommended.

Prevalence and factors associated with warts in primary school children in Tema District, Sohag Governorate, Egypt

BACKGROUND

Warts are one of the most common, persistent, and frustrating cutaneous problems encountered in dermatology clinical practice especially in younger generations.

OBJECTIVE

To determine the prevalence of warts in primary school children in Tema District, Sohag, Egypt, and to determine possible factors associated with transmission.

PARTICIPANTS AND METHODS

A school-based cross-sectional (prevalence) study was carried out during the academic year 2015-2016 in six primary schools in Tema District, Sohag Governorate, Egypt. A total of 1045 students were examined. Data was collected using a self-administered semi-structured questionnaire which was taken home by the student to be completed by his/her caregiver.

RESULTS

Among 1045 examined school students, 108 students were diagnosed as having warts with a prevalence rate of 10.3%. Common wart was the most common type among students (49.0%) followed by plantar and plane warts (24.1%, each) while genital wart was the least one (2.8%). There was no significant sex or age difference. The prevalence of warts was significantly higher among students from public schools, rural areas, and big families; students with lower paternal education level; and students who were sharing shoes, walking barefoot, having contact with house pets, or exposed to water channels.

CONCLUSION

Warts, especially the common variant, are highly prevalent in primary school children. The significant factors associated with the development of warts in these children were big family size and sharing shoes. Other significant associated factors included living in rural areas, attending public schools, illiterate parents, fathers with manual work, and swimming in water canals.

Nutrient patterns and their relation to anemia and iron status in 5- to 12-y-old children in South Africa

OBJECTIVE

The aim of this study was to assess nutrient patterns and their relation to anemia and iron status of school children using pooled data from three study populations in South Africa.

METHODS

Data from 5- to 12-y-old children (N = 578) from three independent studies conducted in two provinces in South Africa were pooled. Data used in the analysis were dietary intake, hemoglobin, and plasma ferritin concentrations. Nutrient patterns were determined using factor analysis. Logistic regression analysis was performed to determine relationships of nutrient patterns with anemia and iron deficiency.

RESULTS

In the pooled group, 13.8% of the children were anemic and 27.7% were iron deficient (ID). More than half of children did not meet the Estimated Average Requirement for various nutrients, including vitamins A, C, B₁₂, folate, and zinc, although only 17.7% of children had an iron intake below the requirements. Median intakes for vitamins A and C were lower for anemic than non-anemic children (P = 0.03 and 0.02, respectively) and for ID versus non-ID children (P = 0.03 and 0.046, respectively). Four nutrient patterns were identified: plant protein, carbohydrate, iron, and B vitamins; animal protein and saturated fat; vitamins A and B₁₂; and calcium and fiber. The vitamin A and B₁₂ nutrient pattern was associated with lower odds of being anemic (odds ratio, 0.63; 95% confidence interval, 0.49-0.91; P = 0.035).

CONCLUSION

The present results highlighted the potential role of the combination of dietary vitamin A and B₁₂ in the etiology of nutritional anemia in school-age children in South Africa. Nutrient pattern analysis may improve the understanding of the synergistic role of nutrients related to anemia and may assist in planning intervention strategies.

Molecular characterization and antifungal susceptibility profile of dermatophytes isolated from scalp dermatophyte carriage in primary school children in Arak city, Center of Iran

OBJECTIVE

Asymptomatic carriage is a condition of positive dermatophyte scalp culture without signs and symptoms of tinea capitis. Carriers are the source of dermatophytes that are able to transfer fungal agents to other people. The aim of this study was evaluating asymptomatic dermatophyte scalp carriage among students of primary schools in Arak city.

MATERIALS AND METHODS

Sampling by a sterilized hairbrush from scalp was performed among 3174 students. Hairbrush was inoculated onto Mycosel agar plates. Dermatophyte isolates were identified by PCR-RFLP using MvaI enzyme. In vitro antifungal susceptibility test was done according to the Clinical and Laboratory Standards Institute (CLSI) M38-A2 protocol. The antifungal drugs used included griseofulvin (GRZ), terbinafine (TER), itraconazole (ITC) and fluconazole (FLU).

RESULTS

A total of 3174 schoolchildren were screened, 15 cases (0.48%) had a positive culture for dermatophytes. Asymptomatic carriers including 11 (73.3%) boys and 4 (26.7%) girls and their age range were between 7-12 years. Trichophyton tonsurans (80%), T. interdigitale (13.3%) and T. rubrum (6.7%) were the most common isolated dermatophyte. Based on the obtained antifungal susceptibility results, terbinafine had the lowest and fluconazole had the highest MIC values for all of the tested dermatophyte isolates.

CONCLUSION

In the study, T. tonsurans was the most common species isolated from asymptomatic carriers and of the four antifungals tested, terbinafine had the most active antifungal in vitro against all isolates. Identifying and treating scalp dermatophyte carriers can prevent the spread of tinea capitis in the community.

Knowledge translation in child welfare-improving educational outcomes for children at risk: study protocol for a hybrid randomized controlled pragmatic trial

BACKGROUND

In Norway, a disproportionately high number of children receiving Child Welfare Services (CWS) struggle academically and drop out of school. Academic attainment is one of the strongest protective factors against societal marginalization. The present study is part of a knowledge translation project in collaboration with local CWS with the aim to develop, implement, and evaluate Enhanced Academic Support (EAS) for primary school children in CWS.

METHODS/DESIGN

The study is a mixed-methods hybrid type 2 randomized, controlled pragmatic trial. The participants are approximately 120 children whose families receive support measures from three child welfare agencies in and around Oslo, Norway, and practitioners from these agencies. Families are randomly assigned to either the EAS condition or "business as usual" support. Primary outcomes are math and reading skills, parental involvement in school, and intervention fidelity. Questionnaires and academic tests are administered at baseline, post-intervention (after 6 months), and at follow-up (after 12 months). Implementation drivers are assessed before and after the trial period, and intervention fidelity is monitored during the trial through checklists and structured telephone interviews. Semi-structured interviews and focus groups are conducted after the trial.

DISCUSSION

This hybrid study has two implications. (1) The effects of providing EAS to children in child welfare will be investigated. The study also explores how each core component of the intervention and the use of specific adaptations, implementation drivers, and other important child-level covariates moderate the overall effects. The results can provide valuable knowledge about how to deliver precise and effective academic support to increase academic skills and prevent dropout. In turn, this can promote academic completion and well-being, outcomes that are beneficial for both children and society at large. (2) The study also evaluates the feasibility of applying an Integrated Knowledge Translation model designed to develop, implement, and evaluate research-supported practice in health, care, and welfare services in less time than is usually the case. If deemed successful, this model will provide an efficient collaborative approach to translate the best available evidence into effective evidence-based practice, applicable in effectiveness research and quality improvement efforts.

TRIAL REGISTRATION

ISRCTN, ISRCTN38968073 . Registered on 18 September 2017. https://doi.org/10.1186/ISRCTN38968073 .

Family-based intervention using face-to-face sessions and social media to improve Malay primary school children's adiposity: a randomized controlled field trial of the Malaysian REDUCE programme

BACKGROUND

Social media may be an effective medium by which parents could be trained to promote healthy eating behaviour and physical activity for their children. This trial evaluates the effectiveness of a family-based intervention using social media in combination with face-to-face sessions - the REDUCE (REorganise Diet, Unnecessary sCreen time and Exercise) programme - on adiposity of Malay children.

METHODS

Five primary schools in an urban area in Selangor, Malaysia participated in this two-arm randomized controlled field trial. Participants were parents (n = 134) and their primary school-going children 8-11 years of age who were either overweight or obese. These parent-child dyads were randomly allocated to intervention and wait-list control groups and were blinded to group assignment. The intervention was a four-week training programme using two face-to-face sessions and two Facebook sessions followed by weekly booster sessions over a three-month period using WhatsApp. The primary outcome was body mass index (BMI) z-score. Height, body weight, waist circumference and percentage of body fat were measured by blinded assessors. Data were collected at baseline (T1), immediately post-training (T2) and at three- (T3) and six-month post training (T4) and were analysed using generalized linear mixed modelling adjusted for covariates to estimate the intervention effects. Subgroup analysis was conducted for overweight and obese children.

RESULTS

Ninety-one percent of parents completed the study, 64 in intervention group and 58 in wait-list group. At the sixth month post-training, BMI z-scores were significantly reduced in the intervention group compared to the wait-list group, for the all children (overweight and obese children) and within the obese subgroup ((F(6, 517) = 2.817, p = 0.010) and (F(6, 297) = 6.072, p < 0.001) respectively. For waist circumference percentile and body fat percentage, the intervention group experienced a significant reduction compared to the wait-list group, within the obese subgroup ((F(6, 297) = 3.998, p = 0.001) and within the overweight subgroup (F(6, 201) = 2.526, p = 0.022).

CONCLUSIONS

The four-month REDUCE intervention programme was effective in reducing childhood adiposity. Further research using this approach needs to be conducted including cost-effectiveness studies before implementing it in a child obesity prevention programme.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12617000844347 (7 June 2017 retrospectively registered). National Medical Research Register, Ministry of Health Malaysia: NMRR-14-685-21,874 (July 2014).

Prevalence of Ear Infections in First Year Children of Primary Schools in A Western Ugandan Community

Ear infections in the United Kingdom were reported at a prevalence of 90% in children aged 0-6 years peaking at six years, the commonest age for Ugandan children to start primary school. This study was done to determine prevalence of ear infections in primary one children in Mbarara district, identify commonest ear infections, the causative pathogens isolated and their antibiograms and comparing the prevalence of ear infection in urban and rural schools. A cross sectional study was carried out among three urban day schools and three rural day schools randomly chosen in Mbarara district. History was taken using a data collection form and examinations were done using an otoscope. All pus swabs from infected ears were inoculated on Blood agar, Chocolate agar, MacConkey Agar plates before smears for Gram staining were made. Identification of the pathogen was through biochemical tests and API system. Sensitivity tests to antibiotics were set on Mueller Hinton Agar using the disc diffusion technique of Kirby-Bauer. Otoscopy was done on 600 children, 8.0 %( 48) showed signs of ear infections. The commonest ear infection was otitis externa. Staphylococcus aureus species showed the highest prevalence with 75% (6). Staphylococcus aureus species showed 100% sensitivity to gentamicin, 80% sensitivity to ciproflaxin. Serratia marcencens also showed 100% sensitivity to ciproflaxin, The prevalence of ear infection was 8.0% among children in primary one in Mbarara district in a cross sectional study.

Long-term effect of intensive prevention on dental health of primary school children by socioeconomic status

OBJECTIVES

Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders.

MATERIALS AND METHODS

The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed.

RESULTS

A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school.

CONCLUSIONS

Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution.

CLINICAL RELEVANCE

Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children.

Two-dimensional digital photography for child body posture evaluation: standardized technique, reliable parameters and normative data for age 7-10 years

BACKGROUND

Digital photogrammetry provides measurements of body angles or distances which allow for quantitative posture assessment with or without the use of external markers. It is becoming an increasingly popular tool for the assessment of the musculoskeletal system. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique.

MATERIAL AND METHODS

The purpose of the study was twofold. The first one comprised 91 children (44 girls and 47 boys) aged 7-10 (8.2 ± 1.0), i.e., students of primary school, and its aim was to develop the photographic method, choose the quantitative parameters, and determine the intraobserver reliability (repeatability) along with the interobserver reliability (reproducibility) measurements in sagittal plane using digital photography, as well as to compare the Rippstein plurimeter and digital photography measurements. The second one involved 7782 children (3804 girls, 3978 boys) aged 7-10 (8.4 ± 0.5), who underwent digital photography postural screening. The methods consisted in measuring and calculating selected parameters, establishing the normal ranges of photographic parameters, presenting percentile charts, as well as noticing common pitfalls and possible sources of errors in digital photography.

RESULTS

A standardized procedure for the photographic evaluation of child body posture was presented. The photographic measurements revealed very good intra- and inter-rater reliability regarding the five sagittal parameters and good reliability performed against Rippstein plurimeter measurements. The parameters displayed insignificant variability over time. Normative data were calculated based on photographic assessment, while the percentile charts were provided to serve as reference values. The technical errors observed during photogrammetry are carefully discussed in this article.

CONCLUSIONS

Technical developments are allowed for the regular use of digital photogrammetry in body posture assessment. Specific child positioning (described above) enables us to avoid incidentally modified posture. Image registration is simple, quick, harmless, and cost-effective. The semi-automatic image analysis, together with the normal values and percentile charts, makes the technique reliable in terms of child's posture documentation and corrective therapy effects' monitoring.

Evidence for the need for vision screening of school children in Turkey

BACKGROUND

In many countries, access to general health and eye care is related to an individual's socioeconomic status (SES). We aimed to examine the prevalence of oculo-visual disorders in children in Istanbul Turkey, drawn from schools at SES extremes but geographically nearby.

METHODS

Three school-based vision screenings (presenting distance visual acuity, cover test, eye assessment history, colour vision, gross stereopsis and non-cycloplegic autorefraction) were conducted on 81% of a potential 1014 primary-school children aged 4-10 years from two private (high SES) schools and a nearby government (low SES) school in central Istanbul. Prevalence of refractive errors and school-based differences were analysed using parametric statistics (ANOVA). The remaining oculo-visual aspects were compared using non-parametric tests.

RESULTS

Of the 823 children with mean age 6.7 ± 2.2 years, approximately 10% were referred for a full eye examination (8.2% and 16.3% of private/government schools respectively). Vision had not been previously examined in nearly 22% of private school children and 65% of government school children. Of all children, 94.5% were able to accurately identify the 6/9.5 [LogMAR 0.2] line of letters/shapes with each eye and 86.6% the 6/6 line [LogMAR 0], while 7.9% presented wearing spectacles, 3.8% had impaired colour vision, 1.5% had grossly impaired stereo-vision, 1.5% exhibited strabismus, 1.8% were suspected to have amblyopia and 0.5% had reduced acuity of likely organic origin. Of the 804 without strabismus, amblyopia or organic conditions, 6.0% were myopic ≤ - 0.50DS, 0.6% hyperopic ≥ + 2.00DS, 7.7% astigmatic ≥1.00 DC and 6.2% anisometropic ≥1.00DS.

CONCLUSIONS

The results highlight the need for general vision screenings for all children prior to school entry given the varied and different pattern of visual problems associated with lifestyle differences in two populations raised in the same urban locale but drawn from different socioeconomic backgrounds.

Effect of age at cochlear implantation and at exposure to Cued Speech on literacy skills in deaf children

The aim of this study was to investigate how age at cochlear implantation (CI) and age at exposure to Cued Speech (CS, Manual system that resolves the ambiguity inherent lipreading) could impact literacy skills in deaf children. Ninety deaf children fitted with CI (early vs late) and exposed to CS (early vs late) from primary schools (from Grade 2 to Grade 5) took part in this study. Five literacy skills were assessed: phonological skills through phoneme deletion, reading (decoding and sentence comprehension), word spelling and vocabulary. The results showed that both age at CI and age at first exposure to CS had some influence on literacy skills but there was no interaction between these factors. This implies that the positive effects of age at CI, especially on all literacy skills in the younger children, were not strengthened by age at exposure to CS.

Prevalence of attention-deficit/hyperactivity and other disruptive behaviour disorder symptoms among primary school-age children in Kayseri, Turkey

Objectives This study aimed to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD), and their influencing factors on primary school-age children. Methods This cross-sectional study was conducted among 2045 students, 7-15 years old, who were randomly selected from seven schools in Kayseri, Turkey, in 2012. Participants were stratified by socioeconomic status. Data were collected using the Turgay DSM-IV-Based Child and Adolescent Behavioural Disorders Screening and Rating Scale (T-DSM-IV-S). For statistical analyses, the t-test and analysis of variance were used. Results Rates of disruptive behaviour disorders (DBDs) among children were as follows: ADHD, 6.2%; CD, 14.4%; and ODD, 6.7%. The prevalence of ADHD was higher in boys and children whose mothers were homemakers and from poorly-educated and low-income families, compared with their peers. CD was more prevalent among boys and children 13-15 years old, whose parents had low income levels and were separated. ODD was higher in boys and children whose mothers were homemakers. Conclusions Our findings suggest that the overall prevalence of DBDs in our study area is 27.4%, which is similar to the pooled worldwide prevalence. Adverse family factors are closely associated with the prevalence of DBDs.

Use of mobile and cordless phones and change in cognitive function: a prospective cohort analysis of Australian primary school children

BACKGROUND

Some previous studies have suggested an association between children's use of mobile phones (MPs)/cordless phones (CPs) and development of cognitive function. We evaluated possible longitudinal associations between the use of MPs and CPs in a cohort of primary school children and effects on their cognitive function.

METHODS

Data on children's socio-demographics, use of MPs and CPs, and cognitive function were collected at baseline (2010-2012) and follow-up (2012-2013). Cognitive outcomes were evaluated with the CogHealth™ test battery and Stroop Color-Word test. The change in the number of MP/CP voice calls weekly from baseline to follow-up was dichotomized: "an increase in calls" or a "decrease/no change in calls". Multiple linear regression analyses, adjusting for confounders and clustering by school, were performed to evaluate the associations between the change in cognitive outcomes and change in MP and CP exposures.

RESULTS

Of 412 children, a larger proportion of them used a CP (76% at baseline and follow-up), compared to a MP (31% at baseline and 43% at follow-up). Of 26 comparisons of changes in cognitive outcomes, four demonstrated significant associations. The increase in MP usage was associated with larger reduction in response time for response inhibition, smaller reduction in the number of total errors for spatial problem solving and larger increase in response time for a Stroop interference task. Except for the smaller reduction in detection task accuracy, the increase in CP usage had no effect on the changes in cognitive outcomes.

CONCLUSION

Our study shows that a larger proportion of children used CPs compared to MPs. We found limited evidence that change in the use of MPs or CPs in primary school children was associated with change in cognitive function.

Malnutrition and poor oral health status are major risks among primary school children at Lasbela, Balochistan, Pakistan

BACKGROUND

This survey was focusing on health and oral hygiene status of primary school children at Lasbela district considering the comparatively less developed and socio demographically deprived part of the Country.

METHODS

A cross sectional survey was conducted to determine the health status of primary school children in seven tehseels of district Lasbela, Balochistan after applying proportionate sampling technique from March 2015 to July 2015. Field teams visited assigned schools to screen children and collect health related data on predesigned and pre coded proforma.

RESULTS

Out of 200 schools, 196 schools found opened, while 2% of schools (04) remained closed. A total of 6363 students were clinically screened. About 45% of the school children had normal body mass index (BMI) and rest were falling in different categories of malnutrition. More than 19% had ear, nose and throat (ENT) problems and around 19% presented with clinical anemia. Less than 50% of children had scar of BCG vaccination and 4% informed about use of gutka/supari chewing (smokeless tobacco use).

CONCLUSION

In conclusion, we estimated high prevalence of malnutrition, poor oral health including smokeless tobacco use, and low BCG coverage among primary school children at Lasbela. Current scenario suggests immediate and contextually focused interventions to confine existing public health risks and avoid future burden of disease.

Factors associated with anemia among Sri Lankan primary school children in rural North Central Province

Background

Despite interventions, childhood anemia is still a major public health problem in low and middle income countries. Purpose of the present study is to determine factors associated with anemia among rural primary school children in Sri Lanka, a country undergoing rapid socioeconomic changes.

Methods

Multi stage cluster sampling was used to select 100 rural schools in NCP and a maximum of 50 children aged 60–131 months were enrolled from each school. Self-administered questionnaires were sent to parents. Anthropometric measurements and blood samples were obtained by trained investigators. Blood reports were analyzed in a commercial laboratory with external quality control measures.

Results

Total of 4412 children were included in the analysis. A Multiple regression was performed for hemoglobin. Only 4.2% of the change in hemoglobin could be explained by the model. District (p > 0.001), age (p > 0.001), timing of warm treatment(p = 0.026) and BMI for age (p = 0.002) uniquely contributed 1.12%, 1.19%, 0.13% and 0.26% to change in hemoglobin level respectively whereas, sex, monthly family income and frequency of meat and green leaf consumption didn’t contribute significantly.

Peripheral blood film analyses were available for 146 anemic children. Blood film was reported as normal in 19.9% while evidence of iron deficiency (18.5%), early iron deficiency (32.5%) and thalassemia trait with iron deficiency (29.5%) were reported in the rest.

Serum ferritin level was available for 417 children with hemoglobin less than 12 g/dl. Mean ferritin level was 63.7 microgram/l. Only 0.5% had depleted iron stores. A multiple regression was performed for serum ferritin and R² was 0.123 (p < 0.001). Area under the curve for serum ferritin and anemia was 0.436.

Conclusion

Anemia among rural primary school children in NCP cannot be well explained by routinely assessed socioeconomic characteristics which mainly provide clues to access for food. Commonly used anemia related investigations have low validity in detecting and explaining anemia in this population. Since behavioral factors have been shown to affect nutrition of younger children in Sri Lanka, studying weather behaviors are related to anemia in primary school children is important. Possible etiologies including but not limited to nutritional deficiencies need to be studied further.

Nutritional status among primary school children in rural Sri Lanka; a public health challenge for a country with high child health standards

Background

Nutritional status of pre adolescent children is not widely studied in Sri Lanka. The purpose of this study was to determine the nutritional status among pre-adolescent school children in a rural province of Sri Lanka.

Methods

A school based cross sectional study was carried out in North Central Province in 100 rural schools, selected using multi stage cluster sampling with probability proportionate to size. Children in grade one to five were enrolled with a maximum cluster size of fifty. Anthropometric measurements were done by trained data collectors and venesection was done at site by trained nurses. WHO AnthoPlus was used to calculate the BMI, height for age and weight for age Z scores. Survey design adjusted prevalence estimates with linearized standard errors were generated using svy function of STATA. Mean haemoglobin concentration (Hb) was calculated using methaeamoglobin method. Screening for iron deficiency and thalassemia trait was done using peripheral blood films.

Results

Height and weight measurements were done for 4469 of children and the Hb data was available for 4398 children. Based on the survey design adjusted estimates, prevalence of severe thinness, thinness, overweight and obesity in this population was 8.60% (SE 0.94), 2.91%(SE 0.74), 2.95%(0.26) and 2.43%(SE 0.92) respectively. Similarly, survey design adjusted prevalence of underweight and stunting were, 25.93% (95% CI 24.07–27.89%) and 43.92%(95% CI 40.55–47.56%). Adjusted mean estimates for hemoglobin was 12.20 (95% CI 12.16–12.24) g/dL. Prevalence of anemia was 17.3% (n = 749). Prevalence of mild and moderate anemia was 9.4 and 7.6% respectively.

Conclusion

This study confirms that malnutrition is still a major problem in North Central Province, Sri Lanka.

Academic Achievement and Psychosocial Profile of Egyptian Primary School Children in South Sinai

BACKGROUND

Population of South Sinai has suffered from negligence for many years. Solving educational problems of this population is the main concern nowadays.

AIM

To assess academic achievement in primary school children in South Sinai in relation to intelligence and psychosocial profile.

SUBJECTS AND METHODS

A descriptive cross-sectional survey was conducted on 407 Bedouin and urban students randomly selected from twelve public primary schools in six cities in South Sinai. Intelligence was assessed using Goodenough-Harris test. The midyear Arabic language and Arithmetic scores were used to assess academic achievement. The teachers completed a Pediatric-Symptom Checklist for evaluation of children behaviour.

RESULTS

A statistically significant difference in academic achievement (P < 0.001), total psychosocial scores, (P < 0.05), and externalization (P < 0.05) was found between urban and Bedouin students with significant gender differences (P < 0.05). Highly significant positive correlations were observed between IQ percentile and mid-year Arabic language scores and Arithmetic scores (P < 0.001), and significant negative correlations with the total score of PSCL and its subscale scores (externalising, inattention, and internalising behaviour) (P < 0.001) among the students.

CONCLUSION

Comorbid academic and psychosocial dysfunction in primary school children were observed in South Sinai. A national strategy to minimise the educational gap between Bedouin and urban areas should be implemented.

Prevalence of intestinal parasitic infection among primary school children in southern Iran

A cross-sectional study was carried out to determine the prevalence of intestinal parasites in primary school children in Bandar Abbas, southern Iran during January to March 2016. Single stool samples were collected from 1465 participants by clean stool cup. The questionnaire was prepared on the basis of demographic characteristics. The diagnosis was made on the basis of the direct wet mount, formalin-ether concentration, and Ziehl-Neelsen and trichrome stained slides. Out of the 1465 school children examined, six species of intestinal parasites were identified with an overall prevalence of 95 positive students (6.5%). Prevalence of protozoan infections (6.2%) was significantly higher than helminth infections (0.3%). The most common protozoan species were Giardia lamblia (n = 42, 2.9%) and Blastocystis hominis (n = 31, 2.1%). Only two cases of Hymenolepis nana and two cases of Enterobius vermicularis were detected. The prevalence of parasitic infections was higher in boys (n = 52, 7%) than girls (n = 41, 5.7%), but the difference was not significant. The parasitic infections were higher among the children whose parent's education was less than high school diploma (p = 0.000), and there was also a significant association between the parents' jobs and the intensity of parasitic infection. The prevalence of intestinal parasites, compared to the previous studies in this area, was significantly lower; that is mainly due to an increase in the quality of life and parents' education as well as the accessibility to health services. The most prevalent intestinal parasite was G. lamblia; therefore, it is recommended that more emphasis is applied to controlling and preventing this parasitic infection by washing hands, particularly before each meal course.

Effect of supervised brushing with fluoride gel during primary school, taking into account the group prevention schedule in kindergarten

OBJECTIVES

In one region of Germany, a group of children took part in regular fluoride gel applications during primary school following intensified prevention in kindergarten. This observational study aimed to ascertain whether the dental health of primary school children can be improved by introducing a group prevention program based on applications of fluoride gel.

MATERIALS AND METHODS

The subjects were distributed among six groups with varying preventive measures in kindergarten and at school. The basis for determining caries experience and calculating the caries increment consisted of dental findings gathered in the second and fourth grade.

RESULTS

While second graders without professionally supported daily toothbrushing in kindergarten exhibited an average d_3-6mft of 2.17, in those who had enjoyed intensive dental prevention, the corresponding value was 19% lower (d_3-6mft = 1.74). The caries increment was significantly lower mainly among children who had received the maximum of group prevention (intensive prevention in kindergarten and gel program at school).

CONCLUSIONS

The results show that intensified preventive programs in kindergartens and schools, based mainly on supervised toothbrushing, have a positive effect on the dental health of primary school children.

CLINICAL RELEVANCE

Such programs are efficient in reducing caries experience especially in socially deprived areas.

Physical activity of German children during different segments of the school day

AIM

This study objectively investigated the amount and intensity of German primary school children's physical activity (PA) during different segments of the school day and explored the contribution of physical education (PE) and break times to daily moderate to vigorous PA (MVPA).

SUBJECT AND METHODS

PA of 294 children (7.1 ± 0.7 years, 48 % male) was objectively measured for 6 days using Actiheart®. Based on children's timetables, break times and PE periods were determined and PA was calculated individually and subsequently classified in light (1.5-3 MET), moderate (3-6 MET) and vigorous (>6 MET) intensities. Weight status was determined during a school visit.

RESULTS

Children spent 133 ± 61 min in MVPA; on weekdays, this amount increased significantly (141 ± 66 min, p ≤ 0.01). 45.9 % of children reached physical activity guidelines of 60 min of MVPA daily, with boys achieving this goal significantly more often than girls (65.6 vs. 28.7 %, respectively; p ≤ 0.01). PE lessons and break times accounted for 15 ± 13 min (12.7 %) and 7 ± 6 min (5.8 %) of daily MVPA, respectively. On days with PE, children spent 144 ± 68 min in MVPA, whereas on days without PE, this time decreased significantly to 122 ± 63 min (p ≤ 0.01).

CONCLUSION

The findings suggest that segments such as PE lessons and morning breaks are important sources for MVPA for boys and girls. This should therefore be considered for policies, timetables and curriculums in order to offer sufficient opportunities for children to be physically active during the school day.