Perceptions of Schoolteachers About Teledentistry Use in Makkah City

OBJECTIVES

Teledentistry is a combination of communication technology and dentistry. Teledentistry is an alternative and useful way to remotely provide advisory, preventive, and emergency services in places with poor access to dental care. Few studies in Saudi have investigated the implementation of teledentistry at schools or assessed the perceptions of school personnel. This research aimed to evaluate teachers' perceptions about the use of teledentistry to examine schoolchildren in Makkah city.

METHODS

 The study was conducted on 20 intermediate schools randomly selected from different regions of Makkah city using a multistage cluster sampling method. Two data collectors visited the schools to administer the study questionnaire, exploring teachers' perceptions of teledentistry. The questionnaire was adapted from a validated survey based on the technology acceptance model (TAM). Descriptive statistics, analysis of variance, Mann-Whitney U test, and the Kruskal-Wallis tests were conducted to compare the mean differences in participants' perceptions of teledentistry based on their demographics.

RESULTS

 A total of 241 teachers completed the survey, 131 of whom were females (54.4%), and the mean age of participants was 42.5±7 years. Over 80% of participants taught ≥16 classes a week, and their experience ranged from less than a year to more than 31 years. Sixty participants (25%) knew teledentistry before watching the study video. The results revealed a significant difference between male and female teachers regarding perceptions of teledentistry. Female participants had higher scores in TAM dimensions than males.

CONCLUSION

 This survey revealed a generally favorable attitude toward teledentistry utilization in schools. Including non-dental employees, such as teachers to provide such a service will assist in alleviating the shortage or unavailability of dentists at schools. This goes in line with the government's plans to promote telehealth as part of the Saudi Vision 2030.

Pain-Related Stigma and Its Associations With Clinical and Experimental Pain Severity in Youth With Chronic Musculoskeletal Pain Conditions

OBJECTIVE

Many children with chronic musculoskeletal pain conditions experience stigma which can have negative downstream consequences. This study compares ratings of clinical pain (current pain intensity and pain interference), experimental pain (temporal summation, cold water tolerance, and cold pain intensity), and pain-related stigma among three groups of youth with rheumatic conditions. The relations among ratings of pain-related stigma and pain variables were explored.

METHODS

Eighty-eight youth aged 8-17 years with a diagnosis of juvenile idiopathic arthritis (JIA = 32), juvenile fibromyalgia (JFM = 31), or non-specific chronic pain (NSCP = 25) completed measures of clinical pain ratings (average 7-day pain intensity, day of assessment pain (DoA), and pain interference), experimental pain (cold pain tolerance, cold pain intensity, and temporal summation of mechanical pain), and pain-related stigma. Data analysis compared pain-related stigma and pain ratings across the three groups and examined the relations among pain-related stigma and pain ratings.

RESULTS

Youth with JFM reported higher ratings of clinical pain and pain-related stigma than their counterparts with NSCP or JIA. However, there were no differences in experimental pain. Pain-related stigma was associated with greater ratings of pain interference, particularly for those with JIA and NSCP. Pain-related stigma was also associated with greater average daily pain intensity but not DoA.

CONCLUSION

Youth with medically unexplained pain report greater stigma and worse pain than their peers; thus, robust assessment of pain in this population is necessary. Future work should longitudinally explore the impact of pain-related stigma on pain outcomes and treatment responses.

Prevalence of anisometropia and influencing factors among school-age children in Nantong, China: a cross-sectional study

Objective

To investigate the prevalence of anisometropia and associated parameters among school-aged children in Nantong, China.

Methods

This school-based, cross-sectional study examined students from primary schools, junior high schools, and senior high schools in an urban area of Nantong, China. Univariate and multivariate logistic regression analyses were used to investigate the specific correlations between anisometropia and related parameters. Non-cycloplegic autorefraction was assessed for each student. Anisometropia was defined as the spherical equivalent refraction (SE) difference ≥ 1.0 D between eyes.

Results

A total of 9,501 participants were validated for analyses, of which 53.2% (n = 5,054) were male, and 46.8% (n = 4,447) were female. The mean of age was 13.32 ± 3.49 years, ranging from 7-19 years. The overall prevalence of anisometropia was 25.6%. Factors such as myopia, scoliosis screening positive, hyperopia, female sex, older age, and higher weight had a significantly higher risk of anisometropia (p < 0.05).

Conclusion

There was a high prevalence of anisometropia in school-age children. Some physical examination parameters are closely related to children's anisometropia, especially myopia and scoliosis. Preventing myopia and controlling its progression may be the most important ways to reduce the prevalence of anisometropia. Correcting scoliosis may be an important factor in controlling the prevalence of anisometropia, and maintaining good reading and writing posture may be helpful in controlling the prevalence of anisometropia.

The prevalence of intestinal parasites, undernutrition and their associated risk factors among school-age children in Sekota Town, Northeast Ethiopia: A community-based cross-sectional study

Background and Aims

In developing countries, intestinal parasitic infections and malnutrition are among the most serious health issues affecting school-aged children. They have synergetic consequences. This study aimed to determine the prevalence of intestinal parasites, undernutrition, and their associated risk factors among school-age children.

Methods

A community-based cross-sectional study was conducted from April to June 2021 among school-age children in Sekota Town, Northeast Ethiopia. Households were selected using a systematic random sampling technique. Risk factor variables were collected using pretested questionnaires. Stool samples were collected from study participants and examined using a wet mount, formol-ether concentration, and modified acid-fast techniques. The height and weight of children were also measured using a meter and a standard calibrated balance, respectively. Data were analyzed using SPSS version 26.0 statistical software.

Results

The overall prevalence of intestinal parasites among school-age children was 44.3% (178/402). About seven species of intestinal parasites were identified. The predominant parasite identified was E. histolytica/dispar (11.2%), followed by H. nana (9.2%) and G. lamblia (6.7%). The well as a source of drinking water (adjusted odds ratio [AOR] = 7.93; 95% confidence interval [CI]: 4.38-14.36), habit of open-field defecation (AOR = 7.02; 95% CI: 13.05-12.06), and being undernourished (AOR = 5.67; 95% CI: 2.98-10.79) were independent predictors of intestinal parasitic infections. On the other hand, the overall prevalence of undernutrition was 46.3%. Undernutrition was significantly more likely in children with a dietary diversity score (DDS) of 3 (AOR = 3.73, 95% CI: 2.37-5.88), meal frequency of no more than three times per day (AOR = 2.00, 95% CI: 1.71-2.98), intestinal parasite infection (AOR = 5.25, 95% CI: 3.24-8.52), and no access to school-based feeding (AOR = 3.52, 95% CI: 2.17-7.96).

Conclusion

The prevalence of intestinal parasitic infections and undernutrition was high among school-age children in Sekota Town. The results imply the need for strengthening integrated strategies for the reduction of intestinal parasitic infections and undernutrition.

Effect of outdoor games among school children in Northern Gujarat, India

Outdoor play works as an important tool for the children education. Providing a natural learning environment for children helps them to have an active and fulfilling life. Also, higher levels of attention and well-being are promoted when children play in green outdoor spaces. The importance of play for children's healthy development is grounded in a strong body of research. The study used an experimental research methodology, and data was obtained from 60 school-aged children using a purposive sample strategy and a checklist. The mean, standard deviation, and chi square test were used to analyze the data. After giving act out method, majority (85%) of the school age children had adequate knowledge, 15% of the school children had moderate knowledge regarding outdoor games and its importance. In data analysis the mean of pretest score was 6.43 and mean of post test score was 15.88. The mean difference was 9.45. Post test mean was more than pretest mean, which indicate the effectiveness of actout method on deficiency of outdoor game among school children. The standard deviation of pretest knowledge score was 3.9; the post test knowledge score was 2.47. The computed 't' value was 16.1, the DF was 59, and the P value was 1.67, all of which are significant. Religion, monthly income, and the age of the children all had an impact on the calculated chi square value. According to the findings of this study, the act out method was successful in boosting understanding about the lack of outdoor games among school-aged children.

Door-to-door Screening as a New Model Augmenting School Eye Screening: Reaching Out to School Age Children in the Midst of a Pandemic

PURPOSE

Explore door-to-door eye screening in India as a model to reach school age children in need of eye care, especially during school closures due to the Covid-19 pandemic.

METHODS

Children between 5 and 18 years were screened in an urban-slum of Delhi from September 2020 to March 2021. Screening included capturing ocular complaints, visual acuity and conducting a torchlight examination. Children with any eye-related complaints, gross abnormality or a LogMAR acuity of more than 0.2 in either eye were referred to the nearby vision centre. Data were disaggregated by gender and age group. Reporting after referral and proportion of true positives referrals were used to assess the model.

RESULTS

32,857 children were screened. 55% were boys. Only 917 children (2.8%) had previous eye examinations. 1814 (5.5%) children were referred. Overall compliance rate amongst those referred was 59% (1070 of 1814) and compliance was significantly higher (72%) amongst those referred with poor vision as compared to those with only ocular morbidities (38%). Overall compliance was significantly higher amongst older age group (64% vs 50%) and amongst girls than boys (61% vs 56%). 3.9% children were detected with refractive error (RE) and 2.5% with uncorrected RE which was significantly higher in girls and in older age group. Of 1070 children reporting after referral, 85% had confirmed diagnosis for RE or other ocular pathology.

CONCLUSION

Door-to-door screening had good referral compliance and positive predictive value. We recommend this model as a supplement to school screening especially in regions with low enrolment and high absenteeism in schools.

Multimodal Assessment of Medication Adherence Among Youth With Migraine: An Ancillary Study of the CHAMP Trial

OBJECTIVE

Examine preventive medication adherence among youth with migraine.

METHODS

Adherence (self-report, pill count, and blood serum drug levels) was assessed as an ancillary study that utilized data from 328 CHAMP Study participants (ages 8-17). CHAMP was a multisite trial of preventive medications. Participants completed a prospective headache diary during a six-month active treatment period during which youth took amitriptyline, topiramate, or placebo pill twice daily. Self-reported medication adherence was collected via daily diary. At monthly study visits, pill count measures were captured. At trial month 3 (trial midpoint) and 6 (end of active trial), blood serum drug levels were obtained. Self-report and pill count adherence percentages were calculated for the active trial period, at each monthly study visit, and in the days prior to participants' mid-trial blood draw. Percentages of nonzero drug levels were calculated to assess blood serum drug level data. Adherence measures were compared and assessed in context of several sociodemographic factors. Multiple regression analyses investigated medication adherence as a predictor of headache outcomes.

RESULTS

Self-report and pill count adherence rates were high (over 90%) and sustained over the course of the trial period. Serum drug level adherence rates were somewhat lower and decreased significantly (from 84% to 76%) across the trial period [t (198) = 3.23, p = .001]. Adherence measures did not predict headache days at trial end; trial midpoint serum drug levels predicted headache-related disability.

CONCLUSIONS

Youth with migraine can demonstrate and sustain relatively high levels of medication adherence over the course of a clinical trial.

Nutrient Intake in Children 4-13 Years Old in Ibadan, Nigeria

The paucity of adequate data on dietary and nutrient intakes of school-age children is a barrier to addressing malnutrition and associated risks in Nigeria. This study included 955 children aged 4-13 years from Ibadan, Nigeria, using a stratified random sampling design. Information on family socio-demographic characteristics was reported, and child anthropometrics were measured. Dietary intake data were collected using a multi-pass 24 h dietary recall method; 20% of subjects completed a second 24 h recall to estimate usual nutrient intakes. Means and distributions of usual intakes of energy and nutrients as well as prevalence of inadequacy were estimated. Usual energy intake (kcal/day) was 1345 and 1590 for younger (4-8 years) and older (9-13 years) age groups, respectively. The macronutrient intakes of most children did not conform to Adequate Macronutrient Distribution Ranges (AMDRs), which were characterized by a higher proportion of energy from carbohydrates and lower proportion from total fats. Protein intake was largely within the AMDR. Compared to recommendations, over 60% of 4-8-year-old children had inadequate intakes of calcium, copper, iron, folate, and vitamins A, D, and E. There were more micronutrient inadequacies in the older children. This study identifies nutrition gaps and suggests future research and education to improve child nutrition in Nigeria.

Prevalence and the factors influencing soil-transmitted helminths among school age children (5-14 years age) in a rural area of Coimbatore district

Context

Highest intensity of soil-transmitted helminthiasis (STH) is seen among school age children.

Aims

The aim of this study is to find out the prevalence and factors associated with soil-transmitted helminthic infection among school age children (5-14 years) in a rural area of Coimbatore district.

Settings and Design

The study was conducted in the field practice area of the Rural Health Training Centre (RHTC) Vedapatti, Coimbatore. RHTC caters to a total population of 23,841 distributed in 14 villages. After getting ethical clearance, five of the 14 villages of Vedapatti were selected by the cluster sampling method. Totally, 819 participated in the survey conducted between November 2015 and July 2016 in the field practice area.

Subjects and Methods

Structured questionnaire was used to collect the information. Consent from parents and assent from child were obtained. Totally, 610 gave one adequate stool sample. Early morning samples were collected and transported to the laboratory within four hours. Formal ether concentration method was performed, and examination was done.

Statistical Analysis Used

Data analysis was performed with the SPSS version 19 software. The prevalence is expressed in percentage with 95% confidence interval (CI). Univariate and multivariate analyses were performed. Strength of association was expressed in terms of odds ratio (OR) and adjusted OR with 95% CI. P < 0.05 was considered as statistically significant.

Results

The prevalence of STH was 7.70% (95% CI: 5.58-9.82). Ascaris lumbricoides was highly prevalent 6.9% (4.89%-8.91%) followed by Hook worm 0.7% (0.04%-1.36%), and Trichuris trichura 0.2% (0.15%-0.55%). Mulitivariate logistic regression analysis showed that pucca houses offered protection against STH.

Conclusions

The prevalence of STH in a rural area of Coimbatore is 7.7% (95% CI: 5.58-9.82), and is continuing as a public health problem.

Association Between Obsessive-Compulsive Symptom Dimensions in Mothers and Psychopathology in Their Children

Background: The non-clinical presentation of obsessive-compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children. Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL). Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). "Aggression/violence" was the most frequent symptom dimension (32.2%), followed by the "symmetry/ordering" (16.4%) and the "sexual/religious" dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p < 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p < 0.001), internalizing (p < 0.001), externalizing (p < 0.001), and OCS subscale scores (p < 0.001) on the CBCL. Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.

Prevalence and risk factors of soil-transmitted helminth infections in school age children (6-14 years) - A cross-sectional study in an urban resettlement colony of Delhi

Background

Soil-transmitted helminth (STH) infections have adverse physical and mental effect, especially in preschool (3-6 years) and school-age children (6-14 years). They are associated with socio-behavioral factors of poverty and poor personal and community hygiene.

Objectives

To determine the prevalence, intensity, and the type of helminths infection harbored by the school age children (6-14 years) and to examine the relationship between STH infection and their potential risk factors and associated variables.

Methods

This cross-sectional study was conducted from January to December 2016 among 250 school age children residing in an urban resettlement colony of East Delhi. Data were collected using a semistructured interview schedule. Stool sample was tested using the Kato Katz technique. Data were analyzed in SPSS software version 16, and multivariable regression analysis was done to calculate the odds of various risk factors.

Results

The prevalence of STH was found to be 54.8%, and majority (85.3%) of Ascaris and all Trichuris infections were of light intensity. Multivariable logistic regression analysis confirmed that children having poor handwashing behavior in school, irregular handwashing before eating, having pica, and lack of de-worming had higher odds of having STH infection.

Conclusion

The prevalence of STH in the study area is substantially high, and the findings suggest that besides mass de-worming strategy, behavior change, and improvement in hygiene are required to control STH.

Feasibility Study of a Therapeutic Mobility Summer Camp for Children with Severe Cerebral Palsy: Power Fun

Aim: Powered mobility has positive effects on development of children with limited independent locomotion, but many are deprived of this opportunity due to their limitations. This study aimed to evaluate the feasibility of Power Fun, a therapeutic summer camp, for students with severe cerebral palsy (CP).Methods: Five students with CP, ages 11-15, received personally adapted powered wheelchairs and participated daily in the camp. The camp ran five days a week during three weeks and included two mobility sessions daily. Assessments were conducted three weeks prior to the camp (T1), at baseline (T2), post-intervention (T3) and six weeks follow-up (T4). Measures used were Power Mobility Program (PMP), Assessment of Learning Power mobility use (ALP), Wheelchair Outcome Measure for Young People (WhOM-YP), Goal Attainment Scaling (GAS) and Dimensions of Mastery Questionnaire (DMQ).Results: All participants finished the camp. Outcome measures showed no change between T1-T2 but improved significantly (p<.05) after the intervention (T2-T3), and gains were maintained at T4 (Wilcoxon signed-rank test). Goals improved to slightly above the expected outcome (GAS average 0.11).Conclusions: Power Fun shows good feasibility and significant improvement in mobility skills and goals of children with severe CP. Further studies are warranted.

Improving Food Safety Behavior through Mind Map Methods in School-Age Children

School-age children who do not practice safe food behavior are at risk of experiencing health problems. The aim of the study was to determine the effect of education with mind map methods on safe food behavior in school-age children. The study design was a quasi-experimental with pre- and posttests design, involving 88 school-age children, and each group consisted of 44 respondents who were divided into intervention group and control group. Multistage random sampling was used to determine the research area and school where the research was conducted, while the research subject was selected using simple random sampling. Measuring instruments used questionnaires from previous researchers regarding food safety behavior in school-age children. The results showed that the mind map method significantly affects knowledge (p-value = 0.000), attitude (p-value = 0.000), and skill (p-value = 0.000) for safe food. This study recommends that the mind map method be applied in an effort to improve clean and healthy living behavior in school-age children.

Remarkable Increase in the Prevalence of Overweight and Obesity Among School Age Children in Antalya, Turkey, Between 2003 and 2015

OBJECTIVE

Childhood obesity (OB) is an acknowledged global problem with increasing prevalence reported around the world. We conducted this study with the aim of determining the local trend in OB and overweight (OW) prevalence in the last decade and to observe the alteration of OB and OW prevalence by age group. An additional aim was to construct new age- and gender-specific body mass index (BMI) reference percentile charts for Turkish children living in the city center of Antalya.

METHODS

This cross-sectional study included 1687 school aged children. International Obesity Task Force guidelines were used to determine the OB and OW prevalence. OW was defined as a BMI between 85^th and 95^th percentile, and OB >95^th percentile. The data were compared with a previous study carried out in the same region in 2003. The least mean square method was used to construct the BMI reference percentile charts.

RESULTS

The prevalence rates for OB and OW were 9.8% and 23.2%, respectively, with a combined OW/OB rate of 33%. OB prevalence was higher in boys than girls (p<0.05). The prevalence of combined OW/OB was highest at age 9-10 years. The prevalence of OB has increased 2.9 times during twelve years in this location.

CONCLUSION

Comparing the current findings with rates of OW and OB in the previous decade, childhood OB in Antalya has reached alarming levels. Urgent measures integrated into the national education system should be taken to prevent OB. In addition more surveillance studies should be planned to show the future trend of OB prevalence nationally.

Advancing Child Sexual Abuse Prevention in Schools: An Exploration of the Effectiveness of the Enough! Online Training Program for K-12 Teachers

Child sexual abuse (CSA) in schools and educator misconduct represents a threat to the safety and well-being of our children. The Enough! Preventing Child Sexual Abuse in My School program is a 1-hour online training course developed to address the problem of sexual misconduct and CSA in K-12 education via the use of two avatars/teachers who are navigating CSA and misconduct in their schools. One hundred and thirty-four teachers from three school districts participated in a study to examine the effectiveness of the program in terms of knowledge awareness, including prevalence rates, types of CSA behaviors, impact of CSA on children, signs and symptoms, reporting responsibilities and responses to suspected abuse. Participants were randomly assigned to intervention and control groups: the intervention group (A) received the Enough! training and completed a pre-/posttest and an evaluation of the training (n = 61), Group B (control) completed the posttest only (n = 55), and Group C (control) completed both the pre- and posttests (n = 18). Results indicated that the intervention group's knowledge was significantly higher than that of the control group's at posttest. Group A participants reported a high level of satisfaction in the training, as well as increased knowledge, awareness and willingness to take action in the future. This study points to the need to further test the effectiveness of the Enough! program (and programs like it) on a wider-basis in an effort for educators to be better prepared to protect from the threat of CSA and sexual misconduct.

Nutrient composition and dietary diversity of on-site lunch meals, and anthropometry of beneficiary children in private and public primary schools in Ghana

BACKGROUND

On-site lunch provided through the Ghana School Feeding Programme is expected to be nutritionally adequate thereby contributing to reducing hunger and malnutrition.

AIM

The aim of this study was to assess the dietary diversity and nutrient composition of on-site school lunch and estimate the extent to which it met the Food and Agriculture Organization Reference Nutrient Intakes for children aged 3-12 years.

METHODS

In this cross-sectional food consumption survey, on-site lunch menus were reviewed, dietary diversity assessed and meal preparation/serving observed during a typical school week. Three randomly selected portion sizes were weighed and the average weight (grams) entered into the RIING nutrient software to estimate the nutrient composition. Anthropometry of participants enrolled in seven public (n = 113) and six private (n = 216) primary schools in Hohoe municipality, Ghana was analysed using World Health Organization Anthroplus software.

RESULTS

The menu consisted largely of energy-dense staples, some vegetables and fish. Eggs, dairy and fruits were never served. Meals served in the public and private schools were statistically similar. Fat (23.8 vs. 27.7 g), iron (3.0 vs. 2.8 mg), vitamins A (417.3 vs. 280.8 µg retinol equivalent) and C (25.1 vs. 16.5 mg) requirements were fully met. Energy (420.6 vs. 462.2 kcal), protein (6.8 vs. 6.8 g), thiamin (0.18 vs. 0.17 mg) and zinc (1.3 vs. 1.2 mg) were 50-75% met. Calcium (62.6 vs. 61.4 mg), riboflavin (0.09 vs. 0.07 mg) and niacin (1.6 vs. 1.3 mg) were 26-37% met. Concerning nutritional status, prevalence of stunting (8.9% vs. 7.9%), underweight (3.6% vs. 5.7%), thinness (1.8% vs. 3.7%) and overweight/obesity (3.5% vs. 4.2%) were also statistically similar.

CONCLUSION

Enhancing dietary diversity is crucial to achieving nutrient-dense school meals.

Effect of Salt Reduction on Children's Acceptance of Bread

Salt reduction is becoming a major concern for public authorities, especially in cereal products. As childhood is important for the development of healthy eating habits, this study aimed to formulate salt-reduced breads with satisfying sensory properties for children. Sourdough and an artisanal bread-making process were used to compensate the flavor loss due to salt reduction. French breads (FBs) made with sourdough and artisanal processing were compared with white breads (WBs). Two salt levels were applied (1.2 and 1.8 g /100 g flour). To determine their acceptability and characterization, the four breads were assessed (i) by an adult panel (n = 39) according to cohesiveness, overall odor intensity, overall aroma in the mouth and saltiness intensity and (ii) a panel of children (n = 100, aged 6 to 11 years) according to overall liking and saltiness intensity. Finally, consumption by children (n = 89, aged 6 to 11 years) was measured during school lunch to evaluate the acceptability of salt reduction in a real consumption context. Both formulation and salt level induced physical and sensory changes in breads perceived by adults. They described WB as less dense, cohesive, and aromatic but more odorant than FB. Saltiness differences were perceived by adults but not by children. Children showed a preference for the saltiest breads and the FB but these drivers of preference were not confirmed during consumption measurements. These results shed new light on how natural solutions to enhance the flavor of bread can reduce its salt level while maintaining acceptability.

PRACTICAL APPLICATION

Salt reduction in bread could be compensated by the use of sourdough and an artisanal bread-making process. These methods allow an improvement of the nutritional quality of breads while maintaining their acceptance by young consumers by favoring the development of appealing organoleptic characteristics (aroma, texture). These methods are natural, easy to implement, and could be adapted to other fermented products in order to improve their nutritional quality.

Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review

Background: Some vaccine preventable diseases (VPDs) still remain a public health burden in many African countries. The occurrence of VPDs in all age groups has led to the realization of the need to extend routine immunisation services to school age children, adolescents and adults. Supplemental immunisation activities (SIAs) and school based vaccinations (SBVs) are common strategies used to complement the expanded programme on immunisation (EPI). This review aimed to assess the effectiveness of SIAs compared to SBVs in the administration of vaccines to 5-19 year olds in Africa.

Methods: Systematic review methods were used to address our study aim. Several electronic databases were searched up to March 30, 2017 for primary studies investigating the delivery of vaccines via SIAs or SBVs to 5-19 year olds. This search was complemented by browsing reference lists of potential studies obtained from search outputs. Outcomes considered for inclusion were: vaccination coverage, costs of the strategy or its effect on routine immunisation services.

Results: Out of the 4938 studies identified, 31 studies met the review inclusion criteria. Both SIAs and SBVs showed high vaccination coverage. However, the SIAs reported higher coverage than SBVs: 91% (95% CI: 84%, 98%) versus 75% (95% CI: 67%, 83%). In most settings, SBVs were reported to be more expensive than SIAs. The SIAs were found to negatively affect routine immunisation services.

Conclusions: Both SIAs and SBVs are routinely used to complement the EPI in the delivery of vaccines in Africa. In settings where school enrolment is suboptimal, as is the case in many African countries, our results show SIAs may be more effective in reaching school age children and adolescents than SBVs. Our results re-iterate the importance of evaluating systematic evidence to best inform African authorities on the optimal vaccine delivery strategies targeting school age children and adolescents.

Exploration of the Influence of Factors Identified in the Literature on School-aged Children's Emotional Responses to Asthma

Approximately 6.3 million US children suffer from asthma. The purpose of this study was to explore factors on school-aged children's emotional responses to asthma, N=85, ages 6-12. Correlations included Asthma related child emotional functioning QOL and (a) asthma severity, r=-0.30, p<0.01, (b) child internalizing behaviors, r=-0.26, p<0.05, (c) child externalizing behaviors r=-0.43, p<0.001; Caregiver emotional functioning QOL and (a) asthma severity, r=-0.39, p<0.001, (b) child internalizing behaviors, r=-0.22, p<0.05, (c) child externalizing behaviors, r=-0.25; p<0.05. Multiple regression analysis revealed that asthma severity and child externalizing problems accounted for 26% of the variance in asthma related child emotional functioning QOL, F (4, 79)=7.051, p<0.001 (asthma severity, β=-0.31, p<0.01; child externalizing problem behaviors, β=-0.43, p<0.001). Findings imply that asthma research should consider problem behaviors of school-aged children when addressing asthma related emotional functioning QOL.

EPIDEMIOLOGY OF MUSCULOSKELETAL DISORDERS IN PRIMARY SCHOOL CHILDREN IN BOSNIA AND HERZEGOVINA

Introduction:

Musculoskeletal disorders represent a significant problem of modern society which are more pronounced in young people and school children. Etiology of these disorders is found in inadequate ergonomic conditions, too heavy school bag, school furniture inadequate to age, poor posture, sedentary lifestyle, reduction of physical activity and lack of exercise.

Material and methods:

This cross-sectional study included 1315 pupils aged 8- 12 years. As a method was used “cluster sample” in the selection of subjects. The survey was conducted by questionnaire containing information on the demographic and individual characteristics of participants (age, gender, class), the manner and style of life and the performance of school tasks, followed by standardized Nordic questionnaire. The following parameters were measured: body height and weight for each student, and the weight of full and empty school bag that students that day brought to class.

Results:

The incidence of musculoskeletal pain regardless of localization was 48%. There is a statistically significant correlation between acute pain in the right shoulder and total weight of school bags, duration of caring the bag in school and time of wearing bag from school to home but not with the manner in which school bag was carried. Acute pain in the right shoulder and acute neck pain were significantly associated with the duration of sitting in school or in front of a computer at home. Acute pain in the shoulder negatively correlated with BMI percentile value of the respondents. Acute pain in the neck is also significantly associated with the weight of a full school bags, as well as time spent sitting at home doing homework. Acute back pain is statistically significantly correlated with the weight of school bags and duration of sitting periods in school.

Conclusion:

The prevalence of musculoskeletal pain, particularly chronic pain in school children aged 8-12 years is high. Weight of school bags, manner in which the bag is carried to and from school, duration of carrying bags, time spent sitting in the school and in front of the computer, duration of sitting and posture during homework, body mass index are ergonomic reasons for the development of musculoskeletal pain.

Iodine nutritional status in Uttarakhand State, India

INTRODUCTION

Uttarakhand (UK) state is a known endemic region to iodine deficiency (ID).

OBJECTIVE

To assess the current status of iodine nutrition in a population of UK.

METHODOLOGY

Three districts, namely Udham Singh Nagar (USN), Nainital (N), and Pauri Garhwal (PG) were selected. In each district, 30 clusters were identified by utilizing the population proportional to size cluster sampling methodology. Total of 6143 school age children (SAC) (USN; 1807, N; 2269, PG: 2067), 5430 adolescent girls (AGs) (USN; 1823, N; 1811, PG: 1796), 1727 pregnant mothers (PMs) (USN; 632, N; 614, PG: 481), and 2013 Neonates (USN; 649, N; 670, PG: 694), were included in the study. Clinical examination of thyroid of each child, AG and PM was conducted. Spot urine and salt samples were collected from children, AGs and PMs. Cord blood samples were collected from neonates for estimation of thyroid stimulating hormone (TSH).

RESULTS

In SAC, total goiter rate (TGR) was 13.2% (USN), 15.9% (N), and 16.8% (PG). Median urinary iodine concentration (UIC) level was 150 μg/l (USN), 125 μg/l (N), and 115 μg/l (PG). In AGs, TGR was 6.8% (USN), 8.2% (N) and 5.6% (PG). Median UIC level was 250 μg/l (USN), 200 μg/l (N), and 183 μg/l (PG). In PMs, TGR was 16.1% (USN), 20.2% (N), and 24.9% (PG). Median UIC level was 124 μg/l (USN), 117.5 μg/l (N) and 110 μg/l (PG), respectively. In Neonates, TSH levels of >5 mIU/L were found in 55.3 (USN), 76.4 (N) and 72.8 (PG) percent of neonates.

CONCLUSION

UIC level in PMs and TSH levels among neonates indicate the prevalence of ID in three districts surveyed.

Asthma and overweight/obese: double trouble for urban children

OBJECTIVE

To evaluate the effects of overweight/obese versus normal weight on symptoms, activity limitation and health care utilization among a group of urban children with persistent asthma.

METHODS

Data were obtained from the School Based Asthma Therapy trial. We enrolled 530 children ages 3-10 with persistent asthma from 2006 to 2009 (response rate: 74%). We conducted in-home interviews to assess symptoms and health care utilization. We measured height and weight in school nurse offices to determine BMI percentile, and compared normal weight children to overweight/obese (BMI >85th percentile) children. Bivariate and multivariate analyses were used.

RESULTS

We collected BMI data from 472 children (89%); 49% were overweight/obese. When controlling for child race, child ethnicity, intervention group, caregiver age and screen time, overweight/obese children had more days with asthma symptoms (4.25 versus 3.42/2 weeks, p = 0.035) and more activity limitation (3.43 versus 2.55/2 weeks, p = 0.013) compared to normal weight children. Overweight/obese children were more likely to have had an ED visit or hospitalization for any reason (47% versus 36%, OR 1.5, 95% CI 1.01, 2.19), and there was a trend for overweight/obese children to have more acute asthma visits in the past year (1.68 versus 1.31, p = 0.090). Overweight/obese children were not more likely to be taking a daily preventive inhaled corticosteroid (OR 1.0, 95% CI 0.68, 1.56).

CONCLUSIONS

Overweight/obese children with persistent asthma experience more asthma symptoms, activity limitation and health care utilization compared to normal weight children, with no increased use of inhaled corticosteroids. Further efforts are needed to improve the health of these children.

Sonographic determination of spleen to left kidney ratio among Igbo school age children of south east Nigeria

BACKGROUND

Clinical determination of mild splenomegaly is notoriously inaccurate.

OBJECTIVES

To determine sonographically the spleen to left kidney ratio according to age and somatometric parameters among school age children in a tropical environment.

METHODS

A cross sectional study and convenience sampling were done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6-17 years at the University of Nigeria Medical Centre, Nsukka. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen and left kidney lengths were obtained using appropriate techniques. The weight and height of the subjects were obtained with the participants wearing light weight street clothes without shoes.

RESULTS

Measurement of spleen and left kidney lengths were reliable within and between sonographers. The spleen and left kidney lengths were not statistically different in boys and girls (p > 0.05). The spleen to left kidney ratio according to age and somatometric parameters is constant at about 1.13 with 1.3 as the upper limit of normal in the studied population.

CONCLUSION

Sonography can be used to detect mild splenomegaly if the spleen to left kidney ratio is greater than 1.3 in the absence of renal disease among school age children.

To assess the effects of nutritional intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz

BACKGROUND

The present study was carried out to assess the effects of community nutrition intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz, Iran.

MATERIALS AND METHODS

This case-control nutritional intervention has been done between 2008 and 2009 on 2897 primary and secondary school boys and girls (7-13 years old) based on advocacy approach in Shiraz, Iran. The project provided nutritious snacks in public schools over a 2-year period along with advocacy oriented actions in order to implement and promote nutritional intervention. For evaluation of effectiveness of the intervention growth monitoring indices of pre- and post-intervention were statistically compared.

RESULTS

The frequency of subjects with body mass index lower than 5% decreased significantly after intervention among girls (P = 0.02). However, there were no significant changes among boys or total population. The mean of all anthropometric indices changed significantly after intervention both among girls and boys as well as in total population. The pre- and post-test education assessment in both groups showed that the student's average knowledge score has been significantly increased from 12.5 ± 3.2 to 16.8 ± 4.3 (P < 0.0001).

CONCLUSION

This study demonstrates the potential success and scalability of school feeding programs in Iran. Community nutrition intervention based on the advocacy process model is effective on reducing the prevalence of underweight specifically among female school aged children.

Sonographic biometry of spleen among school age children in Nsukka, Southeast, Nigeria

BACKGROUND

Normative value of spleen size among school age children is important for objective assessment of the spleen.

OBJECTIVES

This study was aimed at determining sonographically the normal limits of the spleen size according to age, sex, and somatometric parameters among school age children.

METHODS

A cross sectional study was done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6 - 17 years. The subjects were recruited from some primary and secondary schools within Nsukka metropolis and also from out patients in the study centre. A pilot study was done to determine the intra- and inter rater reliability of sonographic measurements of the spleen. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen sizes were obtained with the subject in a right lateral decubitus position.

RESULTS

Measurement of spleen length was reliable while measurement of spleen width was less reliable within and between sonographers. Dimensions of the spleen were not statistically different in boys and girls (p > 0.05). Height correlated best with spleen dimensions.

CONCLUSIONS

Normogram of the spleen size with respect to height is important in the determination of some pathology associated with changes in its size.

Concurrent and construct validity of oral language measures with school-age children with specific language impairment

PURPOSE

This study investigated the psychometric properties of 2 oral language measures that are commonly used for diagnostic purposes with school-age children who have language impairments.

METHOD

Two hundred sixteen children with specific language impairment were assessed with the Test of Language Development-Primary, Third Edition (TOLD-P:3; Newcomer & Hammill, 1997) and the Comprehensive Assessment of Spoken Language (CASL; Carrow-Woolfolk, 1999) within a 3-month period. The concurrent and construct validities of these 2 published tests were explored through correlation analysis and principle-component factor analysis.

RESULTS

The TOLD-P:3 Spoken Language Quotient and CASL Core Composite scores were found to have an intertest correlation value of r = .596 within this sample, and a paired samples t test revealed a statistically significant difference between these scores. Principle-component factor analyses revealed a 2-factor structure solution for the TOLD-P:3, whereas data from the CASL supported a single-factor model.

CONCLUSIONS

Analyses of assessment measure performance data from a sample of school-age children with specific language impairment revealed concurrent validity values and construct validity patterns that differed from those found in the norming samples as cited in examiner manuals. Implications for practice patterns and future research are discussed.

Asthma symptoms among adolescents who attend public schools that are located near confined swine feeding operations

OBJECTIVES

Little is known about the health effects of living in close proximity to industrial swine operations. We assessed the relationship between estimated exposure to airborne effluent from confined swine feeding operations and asthma symptoms among adolescents who were aged 12 to 14 years.

METHODS

During the 1999-2000 school year, 58169 adolescents in North Carolina answered questions about their respiratory symptoms, allergies, medications, socioeconomic status, and household environments. To estimate the extent to which these students may have been exposed during the school day to air pollution from confined swine feeding operations, we used publicly available data about schools (n = 265) and swine operations (n = 2343) to generate estimates of exposure for each public school. Prevalence ratios and 95% confidence intervals for wheezing within the past year were estimated using random-intercepts binary regression models, adjusting for potential confounders, including age, race, socioeconomic status, smoking, school exposures, and household exposures.

RESULTS

The prevalence of wheezing during the past year was slightly higher at schools that were estimated to be exposed to airborne effluent from confined swine feeding operations. For students who reported allergies, the prevalence of wheezing within the past year was 5% higher at schools that were located within 3 miles of an operation relative to those beyond 3 miles and 24% higher at schools in which livestock odor was noticeable indoors twice per month or more relative to those with no odor.

CONCLUSIONS

Estimated exposure to airborne pollution from confined swine feeding operations is associated with adolescents' wheezing symptoms.