School Health System Research Articles

Improving Access to Safe Water in Rural Schools of Kenya: Qualitative Multisectoral Insights.

Comprehensive strategies in water, sanitation, and appropriate hygiene behaviors can improve school enrolment and improve gender parity disparities. Lack of safe drinking water negatively impacts the social capital of people, especially school-going children in rural areas. In this study, we systematically evaluated and documented evidence on the barriers and facilitators in the access and adoption of safe water practices in rural schools in Laikipia County, Kenya. An ethnographic formative, collaborative implementation research design was used in an iterative and participatory process to evaluate community, socio-economic, and health system-related factors affecting water, hygiene, and sanitation strategies. Qualitative data was collected using key informant interviews (n=5) and focus groups (n=3) from various multisectoral participants. Directed content analysis was used to develop codes, categories, and themes from textual data. Data was organized according to the Promoting Action on Research Implementation in Health Services framework. The findings were classified and described under three key elements: context, evidence, and facilitation. Contextual elements showed an association of diarrhea outbreaks with unsafe hygiene practices compounded by water scarcity. The evidence elements were indicative of the applicability of water backpacks in strengthening handwashing, storage, and transport of water. Facilitation elements indicated evidence of gaps in synergy between the school health and public health systems, necessitating multisectoral collaboration and social capital capacity building. The national and county governments play an imperative role in ensuring access and continuous supply of safe drinking water in schools. This is fundamental in efforts towards reducing social inequalities of health among school-going children and building their social capital. Participatory, collaborative, multisectoral interventions and decision-making are crucial, leveraging on creating local ownership, in meeting the water consumption needs of children and communities in water-scarce regions.

School health systems under strain: an example of COVID-19 experiences & burnout among school health staff in Pima County, Arizona

BackgroundSchool health staff lead and provide a variety of care for children in schools. As school districts have navigated the COVID-19 pandemic, school health staff have faced unprecedented challenges in protecting the health of students and school staff. Our objective was to qualitatively characterize these pandemic challenges and experiences of school health staff in Pima County, Arizona to identify gaps in school health staff support for improving future emergency preparedness.MethodsWe conducted two focus group discussions (FGDs) with 48 school health staff in Pima County, Arizona in two school districts using a discussion guide including ten open-ended questions. The FGDs were audio recorded and transcribed verbatim. We used the socioecological model (SEM) to organize the thematic analysis and generate codes and themes; data were analyzed using Atlas.ti software.FindingsThe pandemic has significantly challenged school health staff with new pandemic-related job tasks: managing isolation, vaccination, and developing/implementing new and evolving COVID-19 guidelines. School health staff also reported increased stress related to interactions with parents and school administration as well as frustrations with rapid changes to guidance from the health department and policy makers. A common issue was not having enough staff or resources to complete regular job responsibilities, such as providing care for students with non-COVID-19 related health issues.ConclusionsIncreased workload for school health staff resulted in physical burnout, mental distress, and disruption of core functions with long term implications for children’s health. These focus groups highlight the need for improved emergency preparedness in schools during pandemics or infectious disease outbreaks. These include basic infrastructure changes (e.g., personnel support from health departments for tasks such as contact tracing to enable school nurses to continue core functions), and increased funding to allow for hazard pay and more school health personnel during emergency situations. In addition, basic school health infrastructure is lacking, and we should include a licensed school health nurse in every school.

School Nurses' Experiences and Needs in COVID-19 Pandemic Response: A Qualitative Study.

The coronavirus disease 2019 pandemic drastically shifted the public health burden onto the school health system. We, therefore, explored the school nurses' experiences and needs for confronting the pandemic in school settings across Korea. This qualitative investigation enrolled 30 participants after their written consent. A written interview conducted through email and focus group interviews using an online meeting application verified participants' opinions and experiences. Collected data were subjected to text-mining and content analysis. The school nurse was found to be responsible for many tasks, including education on preventive measures with unclear quarantine guidelines. Content analysis identified three key themes: "aggravated difficulties owing to lack of support resulted in burnout," "reflection on supportive resources; direct provisions were helpful," and "needs and suggestions to safeguard students' health in the event of another pandemic." Recommendations should all be considered to keep schools and students safe from future pandemics.

VISUAL HANDICAP CERTIFICATES: A TOOL TO EVALUATE THE CAUSES FOR PERMANENT VISUAL IMPAIRMENT IN KURNOOL DISTRICT

Aim: To analyze the causes of visual impairment amongst the patients coming for the visual handicap certificate and its application in eye health planning to prevent the blindness. Methods and Materials: A retrospective data analysis of medical records of 1020 people who had applied for the visual handicap certification. Examination was done by the ophthalmologists appointed for the handicap board. BCVA < 20/60 to 20/120 in better eye was included in visual impairment Cat I (40%) and BCVA 20/200 or less is blindness category II to IV (75%to100%). Results: Majority of them belonged to age group of 16 year to 45 years of age, 264 cases got rejected, 530 individuals had mild visual Impairment (< 40%), in 136 individualÂ’s moderate visual impairment (40%) was found in 90 individuals had sever visual impairment to blindness. Overall Optic Atrophy was the most common cause followed by Retinitis Pigmentosa, followed by macular pathology followed by corneal opacity followed by phthisis bulbi followed by amblyopia. Conclusion: Visual handicap registers are useful for the rehabilitation of visually impaired individuals and to assess the pattern or causes of blindness in particular area. The most common etiological factors causing visual impairment in our study are preventable so we propose the empowerment of the school health system and general health delivery system.

Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

BackgroundIt has been more than 20 years since the malaria epidemiologic shift to school-aged children was noted. In the meantime, school-aged children (5–15 years) have become increasingly more vulnerable with asymptomatic malaria prevalence reaching up to 70%, making them reservoirs for subsequent transmission of malaria in the endemic communities. Intermittent Preventive Treatment of malaria in schoolchildren (IPTsc) has proven to be an effective tool to shrink this reservoir. As of 3rd June 2022, the World Health Organization recommends IPTsc in moderate and high endemic areas. Even so, for decision-makers, the adoption of scientific research recommendations has been stifled by real-world implementation challenges. This study presents methodology, challenges faced, and mitigations used in the evaluation of the implementation of IPTsc using dihydroartemisinin-piperaquine (DP) in three councils (Handeni District Council (DC), Handeni Town Council (TC) and Kilindi DC) of Tanga Region, Tanzania so as to understand the operational feasibility and effectiveness of IPTsc on malaria parasitaemia and clinical malaria incidence.MethodsThe study deployed an effectiveness-implementation hybrid design to assess feasibility and effectiveness of IPTsc using DP, the interventional drug, against standard of care (control). Wards in the three study councils were the randomization unit (clusters). Each ward was randomized to implement IPTsc or not (control). In all wards in the IPTsc arm, DP was given to schoolchildren three times a year in four-month intervals. In each council, 24 randomly selected wards (12 per study arm, one school per ward) were chosen as representatives for intervention impact evaluation. Mixed design methods were used to assess the feasibility and acceptability of implementing IPTsc as part of a more comprehensive health package for schoolchildren. The study reimagined an existing school health programme for Neglected Tropical Diseases (NTD) control include IPTsc implementation.ResultsThe study shows IPTsc can feasibly be implemented by integrating it into existing school health and education systems, paving the way for sustainable programme adoption in a cost-effective manner.ConclusionsThrough this article other interested countries may realise a feasible plan for IPTsc implementation. Mitigation to any challenge can be customized based on local circumstances without jeopardising the gains expected from an IPTsc programme.Trial registration clinicaltrials.gov, NCT04245033. Registered 28 January 2020, https://clinicaltrials.gov/ct2/show/NCT04245033

COVID-19 surveillance in the Flemish school system: development of systematic data collection within the public health school system and descriptive analysis of cases reported between October 2020 and June 2021

BackgroundThe age-specific distribution of SARS-CoV-2 cases in schools is not well described. Reported statistics reflect the intensity of community transmission while being shaped by biases from age-dependent testing regimes, as well as effective age-specific interventions. A case surveillance system was introduced within the Flemish school and health-prevention network during the 2020–2021 school year. We present epidemiological data of in-school reported cases in pre-, primary and secondary schools identified by the case surveillance system, in conjunction with test data and community cases from October 2020 to June 2021.MethodsWe describe the development of the surveillance system and provide the number of reported cases and standardized rates per grade over time. We calculated absolute and relative differences in case incidence according to school grade (primary: grades 1–6, and secondary: grades 7–12) using grades 7–8 as a comparator, relating them to non-pharmaceutical infection prevention interventions. Cumulative population incidences (IP) stratified by age, province and socioeconomic status (SES) of the school population are presented with their 95% confidence intervals (CI).ResultsA total of 59,996 COVID-19 cases were reported in the school surveillance system, with the highest population adjusted IP in grade 11–12 of 7.39% (95%CI 7.24–7.53) and ranging from 2.23% to 6.25% from pre-school through grade 10. Age-specific reductions in mask introduction and in-person teaching were temporally associated with decreased case incidence, while lower pupil SES was associated with an increase in cumulative cases (excess 2,739/100,000 pupils compared to highest SES tertile). Community testing volumes varied more for children compared to adults, with overall higher child test-positivity. Holidays influence capturing of cases by the system, however efficiency increased to above 75% after further automation and integration in existing structures.ConclusionWe demonstrate that effective integration of case surveillance within an electronic school health system is feasible, provides valuable data regarding the evolution of an epidemic among schoolchildren, and is an integral component of public health surveillance and pandemic preparedness. The relationship towards community transmission needs careful evaluation because of age-different testing regimens. In the Flemish region, case incidence within schools exhibited an age gradient that was mitigated through grade-specific interventions, though differences by SES remain.

Overnutrition in Indian Children: Challenges and Opportunities.

Global and Indian data indicate that children from all the segments of population face dual nutrition burden and related health consequences. Long-term cohort studies have shown that both the under- and overnutrition are risk factors for overnutrition and non-communicable diseases in adult life. Halting the rise in overnutrition is one of the Sustainable Development Goal (SDG) targets to be achieved by 2030. With the development and inclusion of body mass index (BMI)-for-age in the WHO child growth standards, it has become possible to assess over- and undernutrition in short-statured children. In India, the Annual Health Survey (AHS) (2014) and the District Level Household Survey 4 (DLHS4) (2013) undertook measurement of height/length and weight (AHS 557016 and DLHS4 295663) in the 0–18-year of school-age children from selected households. Prevalence of overnutrition in 0–18-year children was calculated from these two surveys by using the WHO standards for BMI-for-age (BMI-for-age z scores (BAZ) > +2 in 0–5 and BAZ > +1 in 5–18-year children) as well as uniform norms of either > +1 or > +2 BAZ across 0–18-year children. An attempt was made to explore the policy and program implications of using different norms for assessing overnutrition in preschool and school age children in the Indian context. Body mass index-for-age curve for the 0–18-year Indian children was calculated and compared with the WHO BMI-for-age curve. Across 0–18-year children, the mean BMI-for-age of Indian boys and girls was lower than the mean of the WHO standards, but the trajectory followed was similar. Therefore, Indian high-risk under- and overnourished children can be monitored by using the WHO BMI-for-age curve. Irrespective of the cutoff used for BMI-for-age, prevalence of overnutrition was higher in preschool as compared to school-age children. Overnourished school-age children outnumbered preschool children, especially if the WHO cutoffs were used. The school health system may find it difficult to implement programs that aimed at detection and management of large number of overnourished children. If uniform norm of BAZ > +1 was used, prevalence of overnutrition in preschool children was high and almost similar to undernutrition. Currently, nutrition programs for preschool children are focused on undernutrition and they may find it difficult to manage program focused on overnutrition in large number of children. If the uniform norm of BAZ > +2 was used, both the prevalence of overnutrition and number of children requiring intervention were relatively low in all the age groups. The existing preschool and school nutrition programs can take up an integrated program aimed at early detection and effective management of both the under- (BAZ < −2) and overnutrition (BAZ > +2) in 0–18-year children and strive to achieve the SDG targets.

The Role of School Engagement in Increasing Vaccination During Measles Mass Vaccination Campaign in Nigeria, 2018: The Lagos State Experience

Background: Schools based vaccination provide opportunity for the delivery of routine vaccines, using the school as the venue of delivery. During the 2017/2018 measles vaccination campaign, the school system stakeholders were systematically engaged for buy-in to vaccinate 9-59 months old children in Lagos State, Nigeria. This paper is a report of how the Lagos state school authority were engaged for the 2018 measles vaccination campaign. It also highlights the contribution of the engagement in the overall performance of the state looking at the vaccination coverage data and comparing that with the previous campaign. Method: We reported on the role of engaging the school health system in improving coverage using a descriptive mixed-method study design. The stakeholders cutting across the government, education sector, public and private schools were identified and engaged through coordination meetings, dialogues, lobby and sensitization to support vaccination in schools. We summarized the outcome of the engagement activities, analyzed the administrative, post-campaign coverage data and compared it with the 2016 measles supplemental activities coverage. Results: A total of 12,903 schools were used as venues (vaccination posts), while 22 sensitization meetings were held with school associations. About 80% of all eligible children vaccinated in the Local Government Areas (LGAs) during the 2018 Measles Vaccination Campain (MVC), received the vaccine at schools. The lowest proportion of children vaccinated at school was 45.0% in Oshodi LGA. Surulere LGA had the highest proportion of children vaccinated in schools (95.0%). Overall, Lagos state had a weighted average coverage of 93.8% for the post-campaign coverage survey. Conclusion: The implementation of the school engagement process for supplemental immunization activities contributed to achieving high vaccination coverage as most of the children aged 9-59 months were vaccinated in schools.

Academic-Practice Partnership Pivot During COVID-19 Pandemic Surge.

Health care systems continue to experience the sequential aftermath of the COVID-19 pandemic, with major care access, quality, safety, financial sustainability, and workforce considerations. Yet, academic-clinical partnership opportunities exist for transformational change, even when efforts to respond to a pandemic seem insurmountable. A nursing partnership between an academic health center nursing school and university health system provided short- and long-term support for the nursing workforce shortage during a COVID-19 surge. An academic-clinical integration framework guided planning, clinical support activities, outcomes achieved, technology innovations, and shared lessons associated with these efforts. The COVID-19 surge response steps included a call to action, preparation for surge support by the academic and clinical partners, and a team approach for clinical service delivery by faculty, students, and staff. Through the 6-week COVID-19 surge response, more than 10 000 hours of hospital nurse staffing were provided by nursing school faculty and students; over 770 worked shifts that provided approximately 30% of the full surge hospital supplemental staffing and approximately 46 000 vaccine encounters. Well-established academic-clinical nursing partnerships allow for quick pivots in the rapidly changing COVID-19 environment that can enhance nursing clinical proficiency and competency, augment clinically immersive learning, and reinforce analytics to measure health outcomes, lower costs, improve access, quality, safety, and workforce conditions.

Analysis of the equipment of school medical offices in the context of the studied regions in the Republic of Kazakhstan

Background. The European Region's school attendance rate is almost 100%, providing a unique opportunity to reach the entire population of school-age children and adolescents, regardless of their socioeconomic status. By providing equal access to opportunities in health promotion, preventive care, and health surveillance, growth, and development, school health services significantly contribute to social equity by optimizing health care and improving education, improving the academic achievement of all children and teenagers.According to the World Bank, global enrollment rates in primary education are 89%. Educational institutions are a unique platform for implementing long-term and large-scale programs to protect the health of children and adolescents. Thus, the school health system can be an institutional way of covering the health needs of most school-age children and adolescents daily.The aim. The analysis aims to assess the equipment of medical rooms in schools in Kazakhstan to provide the required assistance to students.Methods. We analyzed the medical offices of 10 schools in Astana, Akmola, Kyzylorda, East Kazakhstan, and the Atyrau regions.Results. The share of medical offices that meet the sanitary and epidemiological requirements in the country is 85.5%. In Astana, the share of medical offices that meet the requirements of sanitary and epidemiological standards is 99.1%. The indicators of compliance with the sanitary and epidemiological requirements of medical offices in the East Kazakhstan (84.6%) and Atyrau (80.4%) regions were lower than the republican value (14).Conclusion. The health care system has sanitary and hygienic standards for educational institutions regarding lighting, ventilation, heating, size, and location. These rules are observed throughout most of the country.Key words: Health Services, School, School Health Promotion, School-Based Health Services, School-Based Services, Services, School Health.

Визначення шляхів удосконалення системи медичного забезпечення дітей шкільного віку із використанням swot-аналізу

The search for ways to effectively provide medical care to the child population is an urgent issue of our time. With the participation of experts, a SWOT analysis of the organization of medical support for schoolchildren in modern conditions was carried out. The strengths and weaknesses, opportunities and threats of medical support for schoolchildren are identified, which contributes to the identification of promising directions for improving medical care for children in the conditions of general educational institutions. So, in the absence of an alternative system of medical support for schoolchildren, existing experience of medical personnel and institutions that have the practice of training school health workers, it is advisable to clearly build the vertical of the school health system, consolidate at the legislative level competencies of medical personnel and credentials, an algorithm for improving their skills in health matters and health-saved programs. The nearest threat is the turnover of medical personnel from educational institutions through a decrease in the attractiveness of medical work in schools, which will help to limit the preventive capabilities of the health care system for children in educational institutions. The directions determined by the results of the SWOT analysis will make it possible to make informed management decisions, to coordinate activities in a timely manner and to use the available opportunities most effectively in order to improve the system of medical support for children in the conditions of general secondary education.

Participation of children in school health in Japan.

The importance of promoting child participation in school health has been emphasized internationally. This study examined ways in which Japan's school health system involves children, and factors enabling child participation in this system. It also suggests strategies to promote child participation in school health in developing countries. We conducted a document review to clarify the importance of, and recent trends in, child participation in school health. We summarized the system of child participation in school health in Japan and examined factors enabling child participation. We identified the following four factors that enable child participation in school health in Japan: (i) having an explicit legal basis for participatory activities at the national level; (ii) having clear notification, in relevant administrative documents at the prefectural and municipal levels, of the necessity for children's voluntary participation; (iii) establishing a system for teachers to provide support for participatory activities at the school level, and (iv) having a shared understanding among stakeholders about the pedagogical importance of participatory activities in school health. To promote child participation in school health activities in developing countries, it is necessary to describe clearly the importance, benefits, impacts, and purposes of child participation in relevant legal and administrative documents at relevant administrative levels. Schools should also ensure that stakeholders have a common understanding of the educational benefits of child participation considering the cultural context of each country. It is helpful to conduct appropriate training for teachers to enable them to facilitate child participation.

Schools As a Vital Component of the Child and Adolescent Mental Health System.

This review examines the history and contemporary landscape of school mental health, describing evidence that schools are an essential component of the system of child and adolescent care and providing recommendations to advance this vital care delivery system. This literature review of scientific data and shifts to policy and practice in school mental health documents the evolution of collaboration between the education and mental health systems to support student mental health. This review describes best practices and provides examples for achieving the standards of the comprehensive school mental health systems model in states and local communities. Data demonstrate that multitiered systems of mental health support and services in schools, including mental health promotion, prevention, early intervention, and treatment, improve academic and psychosocial functioning and reduce risk of poor outcomes, including mental illness and school failure. Policy and practice shifts in the field reflect a movement toward integrating mental health systems into the education sector, including preparing the education workforce to promote mental health and to support early identification of and intervention to address mental illness. To create a full continuum of mental health supports for students, states and districts can draw on national best practices and state exemplars as they install multitiered systems of mental health supports in all schools, conduct universal student mental health monitoring, and coordinate school and community mental health systems.

School health services in Egypt: Critical analysis

• School health program (SHP) with health appraisal, preventive & curative services is crucial for children physical & mental health. • School Health insurance provides medical services through its urban clinic, but without coverage of children with health appraisal. • Initiatives for screening students have limitations of: expensive, not sustainable and low coverage rate. • Supporting SHP through primary health care facilities could ensure providing preventive and curative services. Egypt was exposed to political instability and auxiliary changes in the period 2011–2014. Throughout this period different activities were made within concept of knowledge based development. Of these activities was School Health Project (SHP) conducted by Arab Medical Union (AMU)/Egypt Medical Syndicate in-cooperation with Ministry of Education (MOE), Ministry of Health and Population (MOHP), National Research Center (NRC) and Public Health Department, Faculty of Medicine Cairo University in 2012–2013. The project considered focusing on primary schools students (PSSs) especially in governorates that rank as low-grade human development index i.e. Fayoum. The objectives of the project is critical analysis of school health system in Egypt throughout out the period of its affiliation to MOHP up to its link to health insurance system (HIS) in 2003. Qualitative and quantitative research methods were used. In-depth interview with policy makers involved in MOHP, MOE, SHI and disk review and analysis of SHP documents. Through multispecialty medical coveyes quantitative data were recorded by physicians and nurses. From those records representative systematic random sample of 7000 students proportionally distributed in 355 schools in seven Districts in Fayoum Governorate. SHI was less successful in providing preventive services to PSSs. AMU- SHP covered 82% of targeted students with clinical, referral and health education services. Clinical findings showed anemia as major problem (84%) followed by dental problems (33%), hair/scalp problems (9%) and visual errors (6%). Referral to secondary level of care was for 24% of examined children to different medical specialties, and 29% to dental clinics. Current School Health Insurance for School Children revealed shortage in coverage of students with comprehensive clinical services for primary school children who suffer from different morbidities that could influence education promotion. Upgrading school health preventive and curative services is crucial especially in low grade socioeconomic governorates.

COVID-19, Cardiological Issues &amp; Health Education

Polymorbidity is a major concern in medicine and public health, and recent developments have given evidence of alarming interactions between COVID-19 and cardiovascular diseases. For decades cardiology has been promoting preventative measures and highlighted the importance of risk factors, healthy life styles, physical exercise and stress-management. By contrast, COVID-19 measures have been dominated by social isolation, quarantine and intensive care and thus given rise to the question how to strengthen the immune system of the general population. Moreover, pathological sequelae of COVID-19 measures and political conflicts became a heterogeneously discussed topic. In this context, Beijing Normal University (BNU) is about to issue a comprehensive health education programme that includes cardiovascular and immunological perspectives. The programme is based on translational studies replacing ‘bedside’ with ‘school bank’. It involves educational sciences, evidence based medicine, differential and clinical psychology, cultural anthropology and public health. The present article outlines the programme’s framework, which is based on systemic meta-syntheses of preventative medicine and particularly focuses on educational and sustainable transfer that addresses the entire younger generation. Similar to rehabilitation, long-term adherence is a main issue, which involves individual preference of health-promoting measures, and cardiovascular fitness, improvement of the immune system, avoidance of obesity and stress, body awareness and knowledge of one’s own risk profile are cornerstones. Educational and preventive interventions comprise a broad spectrum of models such as dance therapy, creative martial arts or vocal therapies. Implementation within the Chinese school and public health system is targeted.

School Health Needs Assessment in Chanchamayo, Peru: A Health Promoting School Project.

Background: School-based health promotion can be particularly valuable in developing countries. However, there is a lack of information about the health needs of Peruvian school students. The purpose of this study was to conduct a health needs assessment to develop strategies for a school health promotion program in a jungle and indigent region in Chanchamayo, Peru.Methods: This study was conducted using a mixed method approach that included a literature review, national and local statistics, stakeholder interviews, and a survey. Participants of the survey were 210 teachers, 2,504 elementary school students, and 2,834 secondary school students from six ‘schools in two planned project implementation regions. A self-administered questionnaire for students was developed based on WHO's Global School-based Student Health Survey. Collected data were analyzed using descriptive statistics, chi-square tests, and t-tests for the survey data and content analysis for the interviews.Results: Weak school health systems were identified, including school health policies, curriculum, trained health care personnel, and health-related facilities and equipment. Common health problems of students were anemia, nutritional deficiency, infectious diseases, tuberculosis, drug abuse, poor hygiene, and sex-related problems. High absence rates from school due to family problems and high dropout rates due to pregnancy were also critical issues. Teachers identified personal hygiene, nutrition, reproductive health, and sex education as high priorities for school health education, while students identified prevention of infectious diseases, nutrition education, psychological health, and healthy lifestyles as priorities. Identified strategies included: establishment of school health policies, curriculum-based interventions, increasing community participation and raising school health awareness, capacity building for health care promotors, training of trainers, and partnership between schools and communities.Conclusions: Findings from this study will help guide the development and implementation of a school-based health promotion program in Chanchamayo. Multicomponent school-based interventions that consider feasibility and sustainability will be developed and evaluated based on WHO's Health Promoting School concepts.

Visual handicap certificates: A tool to evaluate the causes for permanent visual impairment in Northern Maharashtra

To analyse the causes of visual impairment amongst the patients coming for the visual handicap certificate and its application in eye health planning to prevent the blindness. A retrospective data analysis of medical records of 553 people who had applied for the visual handicap certification. Examination was done by the ophthalmologists appointed for the handicap board. BCVA &amp;#60; 20/60 to 20/120 in better eye was included in visual impairment Cat I(40%)and BCVA20/200 or less is blindness category II to IV(75%to100%). Data was analysed using SSPE software and Chi square test for significance. The prevalence of male patients was significantly higher than that of females (p&amp;#60;0.05), majority of them belonged to age group of 16 year to 45 years of age, 332 (60.03%) individuals had mild visual Impairment(&amp;#60; 40%), in 59(10.66%) individuals moderate visual impairment (40%) was found; in162(29.29%) individuals had sever visual impairment to blindness, over all phthisis (p=0.0001)was the most common cause followed by corneal opacity(p=0.0249)and Amblyopia (p=0.03). Most of the causes are preventable and some of them are emerging as complications of cataract surgery, increased road traffic accidents and occupational hazards. Visual handicap registers are useful for the rehabilitation of visually impaired individuals and to assess the pattern or causes of blindness in particular area. The most common etiological factors causing visual impairment in our study are preventable so we propose the empowerment of the school health system and general health delivery system, early detection of amblyogenic factors and its timely treatment, applying strict safety precautions to factory workers who are prone to ocular injuries and increased safety for road traffic in Northern part of Maharashtra.

School-Based Telemedicine Interventions for Asthma: A Systematic Review.

BackgroundSchool health systems are increasingly investing in telemedicine platforms to address acute and chronic illnesses. Asthma, the most common chronic illness in childhood, is of particular interest given its high burden on school absenteeism.ObjectiveConduct a systematic review evaluating impact of school-based telemedicine programs on improving asthma-related outcomes.Data SourcesPubMed, Cochrane CENTRAL, CINAHL, ERIC, PsycINFO, Embase, and Google Scholar.Study Eligibility CriteriaOriginal research, including quasi-experimental studies, without restriction on the type of telemedicine.ParticipantsSchool-aged pediatric patients with asthma and their families.InterventionsSchool-based telemedicine.Study Appraisal and Synthesis MethodsTwo authors independently screened each abstract, conducted full-text review, assessed study quality, and extracted information. A third author resolved disagreements.ResultsOf 371 articles identified, 7 were included for the review. Outcomes of interest were asthma symptom-free days, asthma symptom frequency, quality of life, health care utilization, school absences, and spirometry. Four of 7 studies reported significant increases in symptom-free days and/or decrease in symptom frequency. Five of 6 reported increases in at least one quality-of-life metric, 2 of 7 reported a decrease in at least 1 health care utilization metric, 1 of 3 showed reductions in school absences, and 1 of 2 reported improvements in spirometry measures.LimitationsVariability in intervention designs and outcome measures make comparisons and quantitative analyses across studies difficult. Only 2 of 7 studies were randomized controlled trials.Conclusions and Implications of Key FindingsHigh-quality evidence supporting the use of school-based telemedicine programs to improve patient outcomes is limited. While available evidence suggests benefit, only 2 comparative trials were identified, and the contribution of telemedicine to these studies’ results is unclear.

Social determinants of health in teenage girls involved with sexual exploitation on downtown streets late at night.

ABSTRACTThe purpose of this study was to chronicle the experiences of teenage girls who stay downtown late at night and are involved in sexual exploitation, and to clarify characteristics of their social circumstances and social determinants of health: socioeconomic status and educational opportunities. Between November 2009 and June 2013, we spoke with 89 adolescents who were loitering late at night in downtown Nagoya, Japan. We focused our research efforts on a case series of 22 girls who were 14–19 years of age and were involved in sexual exploitation. Semi-structured interviews were performed with the use of a questionnaire on the girls’ sexual and mental health, families, school life, living conditions, and future aspirations. Along with the questionnaires, we analyzed case series interviews with a qualitative approach (narratives-under-analysis by in-depth understanding in context). Nine girls worked in the sex industry, while thirteen were independent sex workers. Our observations included child maltreatment, unstable families, distressing school life, insufficient education, and inappropriate relationships with gangs and similar organizations. Moreover, an illegal sex market was linked with these gang associations. Despite their severe living conditions, most of them hoped to have happy families someday. To provide support to this vulnerable population and support their life aspirations, improvement of public health, social welfare, education, and school health systems should be considered carefully.

HYGIENE OF CHILDREN AND ADOLESCENTS IN MODERN SCHOOL MEDICINE

Hygiene of children and adolescents makes a significant contribution in solving the problems of health protection and promotion of the younger generation. However, its achievement is not fully used by such sectors as health, sanitary and epidemiological supervision and education. Objective to justify the place for hygiene of children and adolescents in the school health system. The work is expert-analytical. In accordance with the number of students in the country the number of doctors on hygiene of children and adolescents in the health care organization must exceed 8500 persons. The provision of sanitary and epidemiological welfare of the students as medical activity includes: hygienic control of the educational conditions; hygienic control of educational tools; control over the compliance with the sanitary-hygienic requirements to conditions and management of nutrition in school; control over the compliance with the sanitary-hygienic requirements to the conditions and organization of physical training in the educational organization; preventive measures; hygienic training; the formation of stereotypes of a healthy lifestyle. Technologies of the sanitary-epidemiological well-being of students in educational institutions include: the algorithm of visual and laboratory control over the compliance with sanitary-hygienic requirements to conditions of the organization of education and training in educational institutions; the algorithm for the determination of the level of sanitary and epidemiological welfare of the educational organization, hygienic assessment of the load training activities in students; control over the compliance with the sanitary-hygienic requirements to conditions and organization of lessons with the use of e-learning in educational institutions; algorithm of the interaction between physician on hygiene of children and adolescents in medical organization and Federal Service for the Oversight of Consumer Protection and Welfare and other agencies for the protection of health of minors. The practical activity of the doctor on hygiene of children and adolescents is an important component of the medical support in educational institutions and sanitary-epidemiological well-being of children population in the country. Training students should be carried out with taking into account the specifics of the activity of the doctor on hygiene of children and adolescents in medical institutions for children and modern technologies for their practical activities in educational institutions.