Creating a student-led health magazine with an urban,multicultural, resource-restricted elementary school: Approach,process and impact

BACKGROUND:Health magazines effectively deliver health information. No data regarding student-led magazines to promote health exist.OBJECTIVE:To evaluate whether children’s health knowledge, interests and lifestyle choices improve following distribution of a student-led health magazine.METHODS:Elementary students worked with teachers and paediatric residents to publish a health magazine. A healthy lifestyle challenge page promoted reduction in soda pop consumption. Pre- and poststudent questionnaires explored knowledge, interests and behaviours related to health.RESULTS:Sex and grade distributions were similar in pre- and post-questionnaires. Ninety-seven percent of children reported the magazine helped them learn about health. Pre- and postknowledge scores did not differ (P=0.36). Following distribution, the percentage of students who reported drinking no soda increased from 43% to 67% (P=0.004), and those who reported drinking <2 glasses of soda per day increased from 66% to 85% (P=0.01).CONCLUSIONS:A student-led health magazine was effective in motivating short-term student-reported behavioural change.     

Reproductive health awareness of school-going,unmarried, rural adolescents

Objective: In 1996, India included Adolescent Health in Reproductive and Child Heatlh Programme. This Task-Force Study was planned to test the awareness level of adolescents regarding various reproductive health issues and to identify lacunae in knowledge, particularly in legal minimum age of marriage, number of children, male preference, contraceptive practices, about STIs JAIDS etc.Methods: It was a multicentre study, done in rural co-educationJhigher secondary schools of 22 districts located in 14 states through Human Reproductive Research Centre (HRRC’s) of the Indian Council of Medical Research (ICMR). A sample of 8453 school going adolescents (aged 10–19 years) was surveyed by means of open ended, self-administered questionnaires maintaining confidentiality.Results : Mean age of adolescents was 14.3 ± 3/4 years. Awareness of legal minimum age of marriage was present in more than half of adolescents. Attitude towards marriacje beyond 21 years in boys and 18 years in girls was favorable. Mean number of children desired was 2.2 ± 1.4. However, number of children desired by boys (2.2±1.6) Was significantly more (p<0.000) than those desired by girls (2.0±1.1). More boys (23.7%) than girls (9.4%) wanted three or more children with male preference. Only 19.8% of adolescents were aware of at least one method of contraception. Only two-fifth (39.5%) were aware of AIDS Elnd less than one-fifth (18%) were aware of STDs and most of them thought it is same as AIDS. Awareness of at least one method of immunization was present in three-fifth (60.1%) of students. It was least for DPT (13.5%) and most (55%) were aware of polio only. Awareness of all Reproductive Health matters was more in boys than girls and more in late teens (15–19) than earlier teens (10–14).Conclusion: The study showed tremendous lacunae in awareness of all Reproductive Health (RH) matters. There is a need for evolving information, education, and communication strategies to focus on raising awareness on RH and gender related issues. A sociocultural research is needed to find the right kind of sexual health services for young girls and boys.     

Health outcomes among Swedish children: the role of social capital in the family, school and neighbourhood

Aim: The aim of the study was to explore the extent to which Swedish children’s perceptions of social capital in the family, school and neighbourhood predicted health complaints and well‐being. Methods: The study used data from the Swedish Health Behaviour in School‐aged Children survey. The sample consisted of 3926 children aged 11–15 years. Correlations and hierarchical multiple linear regression were performed. Results: Higher degrees of family, school and neighbourhood social capital corresponded to lower levels of health complaints and higher levels of well‐being. Social capital in these three spheres had a cumulative effect on children’s health and well‐being. Conclusions: Social capital in the family, school and neighbourhood matters for children’s health and well‐being and the contributions from each context seem to be additive. Besides the family context, investments for improving child health should primarily be in the school, focusing on social relations and on creating safe and cohesive school environments. Neighbourhood social capital is also of importance and so must be taken into consideration when planning child health promotion interventions.     

Pediatric medical home: foundations, challenges, and future directions

The medical home concept has been in existence since the late 1960s and has recently been significantly broadened to encompass comprehensive primary care for all patient populations throughout the lifespan. This article provides (1) a review of the foundations and evolution of the medical home concept; (2) an analysis of patient/family, provider, and systemic challenges to developing an effective pediatric medical home particularly in relation to children's mental health needs; and (3) a discussion of future directions for its further adoption and successful implementation.     

Three-year prevalence and incidence of diabetes among American Indian youth in Montana and Wyoming, 1999 to 2001

OBJECTIVES: To estimate the prevalence and incidence of type 2 diabetes among American Indian youth. STUDY DESIGN: Medical records were reviewed annually for all patients with diabetes who were <20 years of age at 6 Indian Health Service facilities in Montana and Wyoming. All cases < or =5 years of age or weight per age < or =10th percentile at diagnosis or with islet cell antibodies were considered as probable type 1. Among the remaining cases, probable type 2 diabetes was defined when a child had one or more of the following characteristics: weight per age > or =95th percentile or acanthosis nigricans at diagnosis, elevated C-peptide or insulin, family history of type 2 diabetes; treatment with oral agents with or without insulin or no hypoglycemic therapy after 1 year of follow-up. RESULTS: From 1999 to 2001, 53% of prevalent cases and 70% of incident cases were categorized as probable type 2 diabetes. The average annual prevalence of probable type 1 and type 2 diabetes was 0.7 and 1.3 per 1000. The average annual incidence rates for probable type 1, and type 2 diabetes were 5.8, 23.3 per 100,000. CONCLUSIONS: The incidence of probable type 2 diabetes was approximately 4 times higher than type 1 diabetes among American Indian youth in Montana and Wyoming     

Quality of evidence for the present Swedish child health surveillance programme

The present Swedish health surveillance programme includes 15 examinations by a nurse, 5 examinations by a physician, 7 assessments of development, 2 assessments of hearing and 1 assessment of visual acuity. The WHO criteria for evaluation of screening programmes can be applied to the Swedish health surveillance programme. These criteria state that the health problem must be important, that there should be an early phase during which the condition is only detectable by medical professionals and that treatment at an early phase should favourably affect the prognosis. The quality of evidence for fulfilment of these criteria has been graded I-III. Grade II-2 refers to evidence obtained from well-designed cohort or case-control analytical studies. The following disorders might be affected by health surveillance at child health centres: amblyopia, ADHD/DAMP, failure to thrive, cerebral palsy, congenital heart failure, congenital luxation of hip, hearing impairment (severe or moderate), mental retardation, retentio testis and hydrocephalus. None of these conditions fulfils the WHO criteria with quality of evidence grade II-2 or better.
Thus, the evidence for the present Swedish health surveillance programme is problematic.     

The National Spina Bifida Program transition initiative: the people, the plan, and the process

This article outlines and summarizes the rationale and the working process that was undertaken by the National Spina Bifida Program to address the issues of transitioning throughout the life course for persons growing up with spina bifida. Their challenges include achieving independent living, vocational independence, community mobility, and participation in social activities, and health management. The creation, the underlying concepts, and the dissemination of the Life Course Model are described.     

Health-related quality of life in children diagnosed with asthma, diabetes, juvenile chronic arthritis or short stature

Aim: 1) To assess the reliability and validity of the Swedish version of the Child Health Questionnaire (CHQ), 2) to determine the correlation between children's and parents' responses to the CHQ, and 3) to describe and compare responses to the CHQ of four diagnostic groups. Methods: A total of 199 Swedish children aged 9-16 with diagnoses of asthma (n=53), diabetes (n=48), short stature (n=51) and juvenile chronic arthritis (JCA, n=47) and their parents answered the CHQ and relevant validation instruments at a clinic check-up. Coefficient alphas were determined for all dimensions of the instrument, and all but four had acceptable to very good reliability (0.75-0.94). Results: Concerning construct validity, the CHQ correlated significantly with appropriate dimensions of the validation instruments. In general, there were significant correlations between the children's and parents' responses. Comparisons between the diagnostic groups showed several significant differences. The short stature group had the highest quality of life and the JCA group the lowest. There were no sex differences, but children who had not reached puberty scored better on the dimensions of mental health and self-esteem.

Conclusion: The Swedish version of the CHQ is a reliable and valid instrument. Furthermore, it is recommended to ask children themselves about their health-related quality of life.     

Health care seeking behavior of adolescents: Comparative study of two service delivery models

Objectives. To assess the perceived health problems and help seeking behaviour and utilization pattern of adolescent health clinics   Methods. A pre-tested, semi-structured questionnaire was administered to 360 school going adolescents who were selected by stratified random sampling from two sectors of Chandigarh where services were being provided by a school-based and dispensary-based adolescent health clinic   Result. Majority (81%) of the adolescents reported having some health problem during last three months prior to the survey; predominant (60%) problems were psychological and behavioural in nature. To resolve these problems boys consulted mainly friends/peers (48%) while girls consulted their mothers (63%). Compared to the dispensary-based adolescent health clinic, utilisation was significantly higher in a school-based clinic where proportion of psychological or behavioural problems reported was also significantly higher (p<0.01)   Conclusion. Adolescents have greater counselling needs for psychosocial problems than for medical problems. Schoolbased adolescent health clinic was utilized more often than the dispensary-based clinic particularly for psychosocial problems       

1985至2013年北京市学龄儿童健康水平变化趋势

目的 描述性分析1985至2013年北京市7~18岁学龄儿童的生长发育水平、健康状况和肥胖患病率的变化趋势,并分析肥胖相关慢性病的罹患现状。方法 利用1985、1991、1995、2000、2005和2010年6次全国学生体质调研资料中北京数据,以及首都儿科研究所流行病学研究室2004、2007、2010、2013年完成的北京小、中学生4次抽样调查数据,分析北京市学龄儿童生长发育水平的变化趋势;并以同期北京市GDP数据,分析社会经济水平变化与学龄儿童体格发育及健康状况的关联性。结果 1985至2010年,北京市人均GDP持续增长,学龄儿童的身高、胸围呈持续稳定增长趋势;以12岁男生增长速度最快,城市和农村身高(cm)分别由150.2、144.7增长至159.6、156.1,年平均增速分别为0.24%和0.30%;胸围（cm）分别由69.6、69.0增长至81.1、78.1,年平均增速分别为0.62%和0.49%。而1985至2005年城市学龄儿童一直处于上升趋势的体重和BMI水平在2005至2010年部分年龄组出现下降拐点,但此期间农村学龄儿童的体重和BMI依然呈上升趋势;以12岁男生为例,城市和农村BMI (kg·m-2)分别由19.6、18.1增长至21.6、20.6,年平均增长速度分别为1.62%和2.23%。相比2005年前,50 m跑用时有所缩短;城市男女生肺活量增加,肺活量指数上升;农村男女生肺活量及肺活量指数依然呈下降趋势。结论 北京市城市学龄儿童的体质状况开始有所改善,农村学龄儿童的体质状况依然呈下降趋势。肥胖及相关慢性病患病率持续增高,防控形势依然严峻。