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INTRODUCTION There is a wide variation in the knowledge related to oral radiology. This study aims to assess the prior knowledge of radiology among freshman dental students prior to beginning any formal dental school instruction. MATERIALS AND METHODS 139 newly matriculated freshman dental students were asked to complete a seven-question radiology take home survey regarding their prior knowledge. The questionnaire was built within their course site and was presented prior to beginning the radiology lectures. RESULTS The responses were varied for all seven questions based on previous experiences and existing knowledge. Significant variation was noted in responses to Q4, Q6, and Q7 as opposed to Qs 1-3 and 5. Many students believed that the acquisition of radiographs should be selective. The acquisition of radiographs in pregnant women yielded comments in line with the belief that dose and frequency of radiation exposure would impact the health of the pregnant woman and developing fetus. Additionally, many students agreed with the statement regarding orthodontists over-radiating children as reported in the New York Times. Perceptions based on social media and news outlets needs to be addressed and changed in a dental school setting based on evidence. CONCLUSION Dental school instruction must use the cues from surveys similar to that used in this research and structure their instruction to increase the critical teaching of radiology. The eventual goal of such an instruction would be to have a scientifically accurate information and remove the perceptions that the students came with when they began their dental education.

Introduction In the coronavirus disease 2019 era, debate around the risk of contagion in school is intense in Italy. The Department of Welfare and Health of Florence promoted a screening campaign with rapid antigen tests for all students and school personnel. The aim of this study was to assess the circulation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the school setting by means of mass screening in every primary and middle school in Florence. Methods All students and school personnel at primary and middle schools in Florence were asked to take part. The campaign started on 16 November 2020 and was completed on 12 February 2021. If a subject had a positive result on rapid antigen testing, a molecular test was performed to confirm the result. Results In total, 18,414 subjects were tested: 15,233 students (82.7%) and 3181 school personnel (17.3%). The rapid antigen test gave a positive result in 27 cases (0.15%). Of these, only 14 tests were confirmed to be positive on molecular testing. These results show a very low number of cases of SARS-CoV-2 among the study subjects (0.08%). Conclusions These results show that the spread of SARS-CoV-2 in the school setting was low in Florence during the screening period.

Background In 2014, the Danish Government introduced a wide-ranging school reform that applied to all public schools in Denmark. A distinctive feature of the reform was that it became mandatory to implement an average of 45 min of daily physical activity within the curriculum. Using the RE-AIM framework as an evaluation tool, the objective of the current study was to evaluate the reach, effectiveness, adoption, implementation, and maintenance of mandatory physical activity within the curriculum at ten Danish schools. Methods A complementary mixed-methods approach using accelerometers, questionnaires, and semi-structured interviews was conducted. A total of 10 schools were invited to participate, including 846 students, 76 teachers, and 10 school managers on various levels. Students were invited to wear an accelerometer for seven consecutive days. Teachers were invited to participate in a questionnaire, and school managers were encouraged to take part in a semi-structured interview. Results Results showed that, on average, 45.2% of the students were active at least 45 min daily within the curriculum. Teacher and school management interest in physical activity, competencies development, and shared decision-making were identified as central factors for adoption of the requirement. Scheduling physical activity within scheduels and collaborations with external parties were found to influence implementation. Finally, internal coordination, motivated school staff, and school management priority were identified as central factors for maintenance. Conclusions This study provides an evaluation on a nationwide physical activity requirement in Danish public schools. When introducing a wide-ranging nation-wide requirement on physical activity within the curriculum, school managers need to prioritize and support the implementation process. Teachers need to be involved in the decision processes in order to ensure motivation and local ownership. The study also highlights the benefits of an internal coordinator as well as development of a shared strategy among schools, municipalities, and other stakeholders in order to succeed with the implementation.

OBJECTIVES This cluster-randomized controlled community trial aimed to assess the efficacy and costs of fluoride varnish (FV) application for caries prevention in a high-risk population in South Africa. METHODS 513 children aged 4-8 years from two schools in a township in South Africa were randomly allocated by class to the FV or Control (CO) groups. In addition to supervised toothbrushing with fluoridated toothpaste in both groups, FV was applied in 3-month intervals by trained local non-professional assistants. Intraoral examinations were conducted at baseline, 12, 21 and 24 months. Primary outcome was the increment of teeth with cavitated lesions (i.e. newly developed or progressed, formerly non-cavitated lesions), requiring restoration or extraction over the study period. Additionally, treatment and re-treatment costs were analyzed. RESULTS 513 children (d1-4 mft 5.9 ± 4.3 (mean ± SD)) were randomly allocated to FV (n = 287) or CO (n = 226). 10.2% FV and CO teeth received or required a restoration; 3.9% FV and 4.1% CO teeth were extracted, without significant differences between groups. While FV generated high initial costs, follow-up costs were comparable in both groups, resulting in FV being significantly more expensive than CO (1667 ± 1055 ZAR vs. 950 ± 943 ZAR, p

Do-it-yourself (DIY) artificial pancreas systems (APSs) are gaining popularity among children with type 1 diabetes. Little is known about how school systems provide care for children who use DIY APSs, and available guidance for schools is limited. This study explored school staff perspectives on DIY APSs through a national survey of school nurses about their current practices, beliefs, and attitudes toward DIY APSs. Although one-quarter (23%) of school nurses reported experience with DIY APSs in school, nearly half (46%) had no prior knowledge of this new technology. The majority (82%) reported that children should be allowed to use DIY APSs in school, although there was less consensus about school nurse responsibilities with these devices. Qualitative responses added context regarding potential barriers, including the need for more informed guidelines and training and fears of liability. Future development of school guidelines for DIY APSs is necessary and should incorporate stakeholder perspectives.

BACKGROUND: Spinal pain is one of the leading causes of morbidity globally. There is an increase in the number of children and adolescents who experience spinal pain and the lifetime prevalence of adolescent spinal pain varies between countries. In Africa, one in two adolescents experiences spinal pain and the prevalence is increasing. OBJECTIVE: This study reports on the knowledge and perspectives of school-attending children, adolescents, teachers, and parents/guardians regarding spinal health. METHODS: We conducted a descriptive qualitative case study with an interpretative and phenomenological approach. Data coding, management and analysis was done using ATLAS.ti computer software. RESULTS: Ninety-three participants (66 women and 27 men) were enrolled in the study. The barriers associated with students’ spinal health were multifactorial, including low levels of physical activity, dangerous gameplay, sports risks, poor ergonomics, school bags, insufficient knowledge, and pregnancy risks. Participants proposed strategies to improve spinal health including the provision of students’ lockers, advice on appropriate school bag types, embedding spinal education in the curriculum, general advocacy for spinal health, and integration of technology in teaching and learning. CONCLUSION: There is a need for further engagement on school-based spinal health promotion programs that consider local socio-economic, educational, and cultural factors.

Objectives The aim of this study was to identify perceptions of safety and effectiveness of a provincial type 1 diabetes school care plan, and to best inform future improvements in school care to accommodate the shifting needs of families, best clinical practices and new medical technologies. Methods A cross-sectional satisfaction and feedback questionnaire to inform quality improvement was offered to both families of children with type 1 diabetes who receive care at school through a Delegated Diabetes Care Plan and to their program coordinators during the 2017‒2018 school year. Results The response rate was 29.8% (160 of 537) for families and 68.2% (45 of 66) for coordinators. The majority of parents and coordinators reported that the care plan is meeting both safety and diabetes management needs. On a 7-point Likert scale, the safety score, expressed as mean (standard deviation), was 6.0 (1.2) by families and 5.7 (1.3) by coordinators, with higher scores reflecting greater satisfaction. Diabetes management was rated 5.6 (1.2) out of 7 by families, and 5.4 (0.8) out of 7 by coordinators. Families and coordinators expressed the need for individualization of care, and suggested modifications to how information is presented. There was near-unanimous support for future integration of continuous glucose-monitoring devices into the school setting. Conclusions British Columbia’s provision of diabetes care in the school setting is overall perceived to be safe and is generally well received by families and coordinators. In this study, we provide valuable information to improve the care of children with type 1 diabetes in schools, including support for further individualization of care and future integration of diabetes technology into the school setting.

Typically students in their final year of school report high levels of anxiety, depression and stress. This study evaluated Study without Stress, a group cognitive behavioural program to reduce student stress. Fifty-six final year students (77% female) from four Australian secondary schools were randomly allocated to Study without Stress delivered by school staff, or to an 8-week usual care condition. Changes in self-reported stress, anxiety, depression, self-efficacy, and teacher reported emotional problems were assessed pre to post-treatment using intent-to-treat analyses. Maintenance of changes were examined 3-months later. Compared to usual care, Study without Stress led to significant reductions in self-reported stress and distress, and increases in self-efficacy that were maintained over time, with no significant changes in anxiety, depression or teacher reported emotional problems. Study without Stress is beneficial for reducing academic stress and improving self-efficacy in final year students when delivered in a school setting.

Food allergy is a growing health and safety concern that affects up to 8% of school-age children. Because children spend a significant part of their day in school, and the overall number of school-age children with food allergy has been increasing, management of food allergies relies on the collaboration of allergists, families, and schools to treat and prevent acute allergic reactions. For schools, this involves policies centered on food allergen avoidance, preparedness with epinephrine autoinjectors, adequate school personnel training, and accommodations for an equal opportunity learning environment. Partnerships with allergists, primary care providers, students, families, school nurses, and school staff are vital for creating individualized and effective care plans that will allow all children, including those with food allergies, a safe and nurturing learning environment.

To date, little research has systematically considered the ways in which schools can better address the needs of immigrant-origin youth (IOY). Further, considering the increased negative attitudes toward and policies targeting IOY and families within the U.S., there is a need to go beyond targeting just IOY at risk for mental health concerns and promote a culture of inclusion throughout the school. The goal of this paper is to address ways in which schools can best attend to the mental health needs of IOY by systematically integrating prevention and intervention efforts across three tiers of support within the school setting. Specifically, we propose a three-tiered model of school based mental health services for IOY. Based on a thorough review of current literature, we propose universal, selective, and targeted programming to support the MH needs of IOY and families. We discuss implications for implementation as well as future directions for research.

Mental health is a major component of overall health and is considered a contributor to the significant levels of disability in Saudi Arabia. Levels of mental health knowledge and awareness, particularly in the school setting, require investigation. The purpose of this study was therefore to explore the levels of mental health knowledge among secondary school female teachers, their readiness to support the mental health needs of their students, and the perceived barriers to supporting mental health. A cross-sectional study was conducted in 35 female secondary public schools in Riyadh between July and September 2019. A modified Knowledge, Barriers and Perceived Readiness Survey was distributed to female secondary school teachers. The primary outcomes were levels of knowledge, perceived barriers, and perceived readiness. Among the 431 participants who completed the survey, 84% were teachers of direct involvement with the students. Overall, participants showed poor knowledge, perceived their barriers as higher, and demonstrated poor readiness, as indicated by the percentage who scored below a 75th percentile cut-off point (74%, 64%, and 69%, respectively). The southern region of the city had lower levels of readiness (OR 3.34; 95% CI 1.547–7.447) compared to the eastern area of Riyadh. Our findings demonstrate that female secondary public school teachers and staff in Riyadh have low levels of mental health knowledge and readiness and perceive barriers with regard to mental health support and services. Focused awareness programs and campaigns, particularly in the eastern part of the city, may therefore be beneficial. Further implications are discussed.

Purpose The purpose of this study was to explore the extent to which child- and therapy-level factors contribute to gains in speech sound production accuracy for children with speech sound disorders in receipt of school-based services. Method Data were obtained from 126 kindergarten and first- and second-grade children currently in receipt of speech therapy services in their public school setting. Pretest and posttest measures of spontaneous speech production and language ability were collected at the beginning and end of one academic year. Using a spontaneous speech sample, percentage of consonants correct (PCC) was calculated for each child; a gain score was computed by subtracting the pretest PCC score from the posttest PCC score. The children's speech-language pathologist completed weekly therapy logs during business-as-usual therapy, indicating the frequency, duration, and group composition of services throughout the school year. Results Results supported that gain in PCC from pretest to posttest was predicted by several child- and therapy-level variables. Children's initial speech sound severity was negatively related to gains in PCC. Our results also supported that the total number of therapy sessions received in a year was positively predictive of PCC gain. Interestingly, the number of individual therapy sessions was negatively associated with PCC gain. Conclusion Several malleable therapy factors contribute to gains in speech sound accuracy for children with speech sound disorders. Speech-language pathologists should consider how these factors may be manipulated to best tailor treatment to the individual needs of the children on their caseloads.

The participant was a boy diagnosed with autism spectrum disorder (ASD) who displayed severe food selectivity, which raised concerns about imbalanced nutrient consumption. The intervention used combined stimulus fading with simultaneous stimulus presentation without escape extinction (EE) and was implemented by teachers in a school setting. In intervention I, which used only stimulus fade-in of non-preferred foods, favorable results were not obtained. In intervention II, simultaneous stimulus presentation of a preferred food combined with stimulus fade-in of non-preferred foods, Silva’s consumption was stabilized at 100% consumption of three non-preferred foods. When intervention II was terminated, the child’s mother requested the inclusion of two additional non-preferred foods, so the intervention was extended based on a fading protocol planned with and to be used by the mother. The effects of the intervention were maintained at the 3-month post-intervention follow-up. The child’s parents and teachers showed high acceptance of this intervention. The current study offers further evidence that combining antecedent-based interventions without EE has the potential to yield favorable results with some children.

This article serves as a Position Statement of the Pediatric Pharmacy Association (PPA), which supports safe and effective medication use in schools. PPA recommends that schools develop comprehensive medication use policies to support safe and appropriate administration of both chronic and emergency medication in schools. These policies must address issues specific to pediatric patients, including off-label and over-the-counter medication use, various pediatric dosage forms, as well as appropriate medication storage, administration, and disposal practices. PPA also advocates for continued staff development and education regarding laws, regulations, and policies surrounding medication use in school to ensure safe and effective care of children and adolescents in the school setting.

There is a lack of training for parents, school staff, and residential staff aimed at helping persons with intellectual disabilities acquire menstrual self-care skills. This may be due in part to the sensitive nature of this topic, the aversion to performing menstrual care for individuals with a disability, and the lack of empirically supported training protocols. This chapter critically reviews behavior analytic research on menstrual care that has been published in peer reviewed journals. This is followed by a case illustration using behavior analytic methods to teach menstrual self-care skills for a student with autism spectrum disorder in a public school setting. Evaluated using a multiple baseline across behaviors design, it was shown that the student increased her independent performance of selected menstrual self-case skills.

AIM Whilst prevalence of paediatric feeding disorders is high amongst children in specialist schools, there is little guidance for professionals supporting families with a child feeding orally with established risk of aspiration. We sought perceptions of the complex feeding decision-making process amongst health professionals supporting families in the specialist school setting in New Zealand. METHODS An observational, cross-sectional, national online survey of speech-language therapists was followed by in-depth interviews with seven health professionals associated with one specialist school. RESULTS Survey responses from 32 speech-language therapists showed inconsistency in assessment processes and how family, children and school staff are involved in feeding decisions, with 71% reporting a doctor had been involved. Respondents were not confident in their ability to predict aspiration risk, with 41% reporting that they could often determine risk, 41% sometimes and 16% never. Sixty-three percent of respondents indicated that level of risk was written in a report for a child and 50% reported that every child at high risk had a management plan. Speech-language therapists valued professional supervision, but it was not always available. Health professionals were broadly positive about the collaborative nature of decision-making in most but not all situations. They described communication, access/institutional and emotional barriers to timely, shared decision-making. CONCLUSION These findings demonstrate variability in how families are supported to make complex feeding decisions. Health professionals identified a need for clearer processes and strengthened communication between family, school and health professionals. Trusting relationships are critical if all families are to be well-supported.

Purpose This study aimed to investigate the prevalence of online and homeschool attendance in transgender and gender-diverse (TGD) youth. Methods Caregivers of 12- to 17-year-olds participated in a phone survey about school attendance. Subjects included TGD youth receiving care in a gender health clinic and youth receiving care in a pediatric endocrinology/diabetes (PED) clinic. Results Parents of 83 TGD and 83 PED youth participated in the study. Current/past enrollment in a nontraditional school setting was higher among TGD than PED youth (37.3% vs. 19.3%; p = .01). In addition, 14.5% of TGD and 7.2% of PED youth had transferred between traditional school settings (public, private, and charter) for psychosocial reasons. Conclusions Approximately half of the TGD youth had either attended a nontraditional school setting or changed schools for psychosocial reasons, compared with approximately one fourth of PED youth (51.8% vs. 26.5%, p = .001). This suggests that traditional school environments present significant psychological difficulties for TGD adolescents.

Aim Regular physical activity and low levels of sedentary time have positive health effects on youth, and data are needed to base public health recommendations on. Here, findings of device-based physical activity and sedentary time in sixth graders are presented. Data below are presented as mean (SD). Subject and methods Three hundred and eight sixth-grade girls [11.6 (0.6) years] from the CReActivity study in Germany wore accelerometers (ActiGraph GT3X) for 7 consecutive days. Moderate to vigorous physical activity (MVPA), light physical activity (LPA), and sedentary time (ST) was obtained during school days with a focus on recess times. Results Girls spent 79.9 (23.2) minutes in MVPA and 9.4 (1.2) hours in ST during schooldays, of which 20.5 (8.2) minutes and 3.8 (0.4) hours respectively were accumulated during school hours. On average, students had 35.4 (4.5) minutes break, of which 6.3 (3.2) minutes (17.8%) were spent in MVPA activity and 16.5 (6.2) minutes (46.6%) in ST. Conclusion School setting is an important factor for physical activity and sedentary time. Therefore policy, curriculums, and school environment should promote physical activity und reduce sedentary time during school hours.

Introduction: In Hungary vaccination against Hepatitis B is mandatory in 7th grade (age 12-13) and is given by the school doctor. In this pilot study, following the best practices for patient-centered communication, a program was organized when the school doctor met the classes prior to immunization for an interactive conversation. The aim of the program was to minimize the possible fears of the students about vaccination, to seek their assent to immunization, to get the adolescents involved in disease prevention, and to expand the protective effect of immunization by means of health education. Indirect aims were to facilitate responsible health behaviour and to improve vaccine adherence in the future. In association with the immunization against Hepatitis B, the program was focused on protecting the liver and health gen-erally. With the active participation of the students and a natural flow of questions several issues of health protection were reached. Method: To evaluate the success of the program described in the article, a question-naire was used. Results: Participation on the evaluation 8, 20 and 32 months after the program was 85%, 65% and 30% respectively, showing that it has reached the attention of the adolescents. On the question how the program influenced their attitude towards immunization, 63% of the answers indicated positive effect, 33% negated any change in attitude and 4 % had remaining questions or was still stressed about the immunization. Conclusion: At the mandatory vaccination of 7th graders against hepatitis B by the school doctor, the school setting provides efficient circumstances for interactive communication; vaccination against hepatitis B provides a unique starting point for health education. The pilot study has demonstrated that the program was able to raise the adolescents’ interest in topics of health protection with a lasting memory and that it could facilitate their assent to immunization. However, it has also proved that adolescents can be often stressed - and do have questions - about immunization and emphasises the need for programs to alleviate their stress and to answer their ques-tions. It might be an important factor to prevent vaccine hesitancy and improve vac-cine adherence in the future. Bevezetes: Magyarorszagon a Hepatitis B elleni vedőoltast iskolai kotelező kampanyoltas kereteben 7. osztalyos tanuloknak (12-13 eves kor) adjak az iskolaorvosok. Ebben a probakutatasban a paciens-kozpontu kommunikacio legjobb gyakorlatat kovetve olyan programot szerveztunk, melyen az iskolaorvos az oltas előtt egy interaktiv beszelgetesre talalkozott az osztallyal. A program celjai voltak, hogy minimalizalja a tanulok lehetseges felelmet az oltassal kapcsolatban, hogy megnyerje az ő tudatos bele-egyezesuket az oltashoz, hogy bevonja a fiatalokat a betegsegmegelőzesbe, es hogy kiterjessze az immunizacio vedő hatasat az egeszsegneveles modszere altal. Indirekt celok voltak, hogy elősegitse a felelős egeszseg-magatartast es javitsa a jovőbeni oltas-elfogadast. A Hepatitis B oltashoz kotődően a program fokusza a maj es altalaban az egeszseg vedelme volt. A diakok aktiv reszvetelevel es a kerdesek osszefuggő lancolataval a program az egeszsegvedelem szamos teruletet erintette. Modszer: A cikkben leirt program eredmenyessegenek vizsgalatara kerdőives felmerest hasznaltam. Eredmenyek: A kerdőives felmeresben valo reszvetel 8, 20 es 32 honappal a program utan 85%, 65% illetve 30% volt, ami azt mutatja, hogy sikerult felkelteni a diakok figyelmet. Arra a kerdesre, hogy hogyan befolyasolta a program az oltashoz valo hozzaallasukat, a valaszok 63%-ban pozitiv hatast mutattak, 33% tagadta, hogy valtozott volna a hozzaallasa, 4%-nak tovabbi kerdesei maradtak, vagy igy is stressznek eltek meg az oltast. Kovetkeztetesek: A 7. osztalyosok Hepatitis B elleni kampanyoltasa soran az iskola hatekony kornyezetet teremt az iskolaorvossal valo interaktiv kommunikaciora; a Hepatitis B elleni vedőoltas egyedulallo kiindulopontot nyujt az egeszsegneveleshez. A probakutatas bebizonyitotta, hogy a program felkeltette a diakok erdeklődeset az egeszsegmegőrzes temajaval kapcsolatban maradando emleket hagyva, es elősegitette a vedőoltashoz valo tudatos beleegyezesuket. Azt is igazolta azonban, hogy a serdulők sokszor stresszkent elik meg a vedőoltast es kerdeseik vannak ezzel kapcsolatban. Nyomatekositja tovabba olyan programok szuksegesseget, amelyek ezt a stresszt csokkentik, es a felmerulő kerdeseket megvalaszoljak. Utobbi fontos tenyező lehet a jovőbeni oltasellenesseg megelőzeseben es az oltasi hajlandosag javitasaban.

There are a significant number of students on maintenance medications for chronic diseases or with diagnoses that may result in medical emergencies requiring administration of medications in school. With passing of legislation in all 50 states allowing self-administration of emergency medications for allergic reactions and asthma, the landscape of medication use in schools is changing. These changes have raised questions about the need for legislation or policy development relating to self-carrying and self-administration of medications for other disease states, undesignated stock of emergency medications, and administration of medications by non-medical personnel. Medication administration in the school setting has become a complex issue, and this review will discuss current legislation related to medication use in schools and provide best practices for administering medications to children and adolescents while at school.

Background:High-quality data in Electronic Dental Records (EDR) is essential for dental schools to provide high-quality patient care, improve dental students’ professionalism, and support a platform for research. Therefore, ensuring data quality in EDRs is extremely important.Objective:To perform a quality appraisal of EDRs by evaluating their accuracy and completeness.Methods:This was a Cross-sectional Observational Study conducted over four consecutive years in a dental school setting. Manual chart reviews were performed on an annual basis. EDR data were audited for accuracy and completeness. Accuracy was evaluated by comparing the entered data with an external source, where possible. An EDR data field was considered complete if it was not missing.Results:A total of 1,720 de-identified chart reviews were studied. The accuracy of the data to identify the patient was 93%. The completeness of the essential components of EDRs was 48-94%. Completeness was highest for documenting the patient’s chief complaint (94%) and the lowest for recall plan (48%). Completeness of data documenting social and behavioral determinants of health in EDRs was 36-77%, with the highest proportion of completeness in this domain being for oral hygiene habits, smoking habits, and social history.Conclusion:The quality appraisal of EDRs varied according to the data field. Understanding patterns of accuracy and completeness in EDRs will guide training and quality enforcement activities.

A significant body of critical scholarship exists problematizing the dominant behavioural-individualist approaches to public health policy and intervention, and practice theories have been noted for their potential in providing an alternative. Children’s physical activity in primary school settings continues to be a major area of attention in public health, yet no critical examination of a practice theory approach exists in this context. This paper addresses this gap by applying the prevalent three-elements model of practices to the case of children’s school-based physical activity. Drawing on focus group, interview and observation data from pupils, staff and parents at one primary school setting in England, our analysis highlights; first, how the configurations of (a) physical resources (e.g. playground space and equipment), (b) practical know-how (e.g. a skilled understanding of performing the activity), and (c) the socio-cultural significance of practices (e.g. the values and meanings of the activity) impact how, and whether children’s physical activity happens, and is sustained or interrupted; and second, by showing how physically active practices are contingent on being simultaneously in harmony or conflict with other routinized practices of the school day. We conclude that the three-elements model offers a helpful framework for understanding school physical activity which de-centres the individual, but that there are challenges in using this analysis to support primary schools as they attempt to enable physically active practices more effectively. Further research is required to develop and evaluate a practice theory approach to promoting children’s physical activity.

Beverley Bostock-Cox explains what school nurses can do to ensure the safety of pupils with asthma

The Developmental, Individual Differences, Relationship-Based (DIR) model, also known as DIR®/Floortime™, is a comprehensive approach for individuals with developmental disabilities and other disor...

Atopic dermatitis, a form of eczema, has a physical, psychological, and social impact on students at school. The purpose of this article is to provide current information surrounding the symptoms and treatment of this disorder. School nurses can be a partner in atopic dermatitis care and improve health outcomes for these students.

International audience; Aim : General practitioners (GPs) are ideally placed to identify suicidality in adolescents. However, adolescents are often reluctant to confide in their GPs about these problems, and GPs are not comfortable when questioning them about suicide. We previously proposed the BITS test, a set of four opening and four additional questions, to alert doctors about possible suicidality in an adolescent. We validated its use in the identification of suicidality (“frequent suicidal ideation or suicide attempts at one time or another)” in 15‐year‐old adolescents in a school setting. The objective of the present study was to assess the detection utility of this method in 13‐to‐18‐year‐olds in primary care.Methods : We carried out a screening utility study in general practices in 17 French‐speaking sites in four countries and three continents. Each GP was instructed to use the bullying, insomnia, tobacco, stress (BITS) test with five to ten 13‐to‐18‐year‐old adolescents, consulting consecutively, for any reason. They subsequently asked them questions about their suicidality.Results : One hundred and two GPs tested a total of 693 adolescents; 13.0% of the adolescents (girls 15.4%, boys 9.9%) reported suicidality (1.6% known, 11.4% previously unknown). A score of at least 3 on the BITS scale was associated with suicidality (sensitivity: 65.9, specificity: 82.5%).Conclusions : The BITS test is a pragmatic instrument, alerting the GP to an adolescent's previously unknown suicidability, whatever the reason for consultation.

OBJECTIVES In January 2014 implementation of the Medicaid expansion of the Affordable Care Act (EACA) in Oregon increased the number of children and adults qualifying for the Oregon Health Plan (OHP). Simultaneously, dental care benefits for adult Medicaid members were restored in Oregon after a period of noncoverage. This study evaluated the impact of these changes on the receipt of endodontic services in the Graduate Endodontic Clinic (GEC) at Oregon Health & Science University. METHODS A retrospective electronic health records (EHRs) database review was conducted from July 2010 through June 2017, a seven-year period covering 3.5 years before (pre-EACA) and 3.5 years after (post-EACA) implementation of EACA. The number of completed anterior, premolar and molar non-surgical root canal therapies (NS-RCT) was retrieved from de-identified EHRs by targeting dental codes. Pre- and post-EACA frequencies were compared and analyzed by patient age [

Objectives The aim of the study was to investigate the effect of silver diamine fluoride (SDF) therapy on the oral health-related quality of life (OHRQoL) of preschool children and their families in a school-based setting. Methods A prospective study was conducted in six kindergartens in Hong Kong. Parents of the children were invited to complete an oral health questionnaire and to have their child undergo a dental examination. The decayed, missing and filled teeth (dmft) index was adopted for recording oral health status. The Chinese Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to evaluate the OHRQoL of the children and their families. Children with untreated caries were treated with SDF. The Wilcoxon Signed Ranks Test was used to determine the changes in C-ECOHIS scores before and after SDF treatment for six months. Results At baseline, 117 preschool children aged 4–5 years received SDF treatment for caries arrest. Their mean(SD) dmft score at baseline was 4.9(3.8). After six months, 113(96.6%) returned a completed questionnaire. Their mean(SD) C-ECOHIS scores at baseline and follow-up were 7.4(6.6) and 7.8(6.4), respectively. The overall differences between pre- and post-treatment scores were not significant (p = 0.301). Concerning parent section, a negative impact was found (p = 0.014), whereas no significant impact was found in the child section (p = 0.831). Conclusion Based on the 6-month results, the SDF treatment conducted in a school setting did not affect the overall OHRQoL of preschool children and families. Clinical significance These results can provide important information to dental professionals regarding the use of SDF for caries control.

To assess variability in caries management decision-making by faculty and dental students. Understanding sources of variability during training can aid in implementing evidence-based clinical decision-making in caries management.A voluntary, anonymous survey including clinical scenarios was distributed online to dental students in their first (D1) and third-year (D3) of training, and to faculty in the Department of Cariology, Restorative Sciences and Endodontics.The response rate was 100% (108/108) for D1 students, 56% (73/130) for D3 students, and 39% (34/88; 12 full-time and 22 part-time) for faculty. D1 students, who were completing a cariology course, were in general more conservative in restorative thresholds for less severe caries lesions than D3 students and sometimes clinical faculty (e.g., for lesions at the DEJ, a significantly [p 0.05] higher percentage of D3 students would restore these [53%] compared to D1 students and faculty [19% and 18%, respectively; p 0.05]). For all groups, the threshold for doing restorative intervention was shifted toward less severe caries lesions as the caries risk increased (e.g., very few respondents would restore an occlusal lesion confined to enamel, with significantly [p 0.05] less percentage of D1 students [lower risk scenario-LR = 4%; higher risk scenario-HR = 22%] compared to D3 students and faculty [LR = 15% and 18%; HR = 66% and 62%, respectively; p 0.05]). Class lectures/preclinical instructors were the most important factor influencing decision-making for D1 students, versus clinical experiences/instructors for D3 students.Although the majority of respondents used best-evidence deciding caries management, there was variability in how to manage less severe lesions, with caries risk influencing clinical thresholds, and clinical experiences influencing students' decision-making over time.

Objectives Workplace non-sharps injuries are a common occurrence in a dental school setting. In dentistry, the importance of preventing non-sharps injuries is often overlooked due to emphasis on sharps-related injuries. The aim of this research was to analyse the incidences of non-sharps injuries over an 11-year period in a dental school to identify trends and the possible causative factors for these injuries. Methods Injury reports lodged with the University of Queensland Workplace Health and Safety databases between 2009 and 2019 were categorised and analysed. Results Of 1156 incidents reported, 35.7% (n = 413) were non-sharps injuries, and the most common type of non-sharps injury was general incidents (48.4%, n = 200). The most common body site for injury was the hands (19.4%, n = 80), and the most common location where an injury occurred was in clinical patient care (53.8%, n = 222). The personnel type most at risk of a non-sharps injury fluctuated between students and staff throughout the study period. Conclusions All personnel, including students and staff, are at similar risk of experiencing a non-sharps injury within a dental school setting. The equipment and facilities of a dental clinic as well as the level of adherence to safe working procedures are contributing factors. Continuous quality improvement is essential for minimising these injuries.

BACKGROUND Menstrual hygiene management is an important public health issue for adolescents. The objective of this study was to explore teacher perceptions and experiences addressing adolescent menstruation experiences at school and examine their perception of the impact of menstruation on student learning. METHODS Teachers in a Midwest school district participated in an online survey about their perceptions of adolescent school-based menstruation experiences, including: experience and comfort-level with providing menstruation assistance, presence of menstrual products in classroom/office for students, perceptions about adolescent school-based menstruation experiences, and perceptions on the impact of menstruation on student learning. RESULTS Two hundred and nine teachers participated in this study. Teachers perceived students' school-based menstruation experiences to be mostly negative, stressful, embarrassing, and focused on concealment. Teachers described school-based menstruation events as a distraction to learning and responded by offering emotional support and menstrual products, typically purchased by teachers. CONCLUSION Teachers' negative perception of about menstruation and distractions in the classroom are amplified by social norms associated with overall menstruation-related stigma. Findings emphasize the importance of educating teachers on how to more positively address student menstruation experiences to foster a more supportive environment conducive to learning for these students.

To date, little research has longitudinally examined young children’s physical activity (PA) during school hours, nor questioned children’s perceptions of their own PA behaviours. This study investigated 20 children’s actual physical activity levels (APA) and their perceived physical activity levels (PPA) (10 infants, mean age 6.6 years, 10 juniors, mean age 9.5 years). APA was evaluated using accelerometers across 36 whole school days (371 min per day), 18 days included Physical Education (PE) lessons and 18 did not. A repeated-measures three-factor ANOVA analysed: type of day, age phase, parts of the day and sex. PPA was collected by an interactive handset and an adapted version of the PA Questionnaire for Children (PAQ-C). Participants undertook 10 more minutes of moderate to vigorous PA (MVPA) on PE days (53 ± 19 min) compared to non-PE days (43 ± 15 min) (F = 92.32, p &lt, 0.05) and only junior boys reached daily MVPA recommendations (60 ± 13 min) on PE days. Juniors over-estimated, and infants under-estimated, their APA levels. Educators need more support to teach and embed different PA intensities into the school day to enable children to better understand the health benefits associated with varying the intensity of their PA during school hours.

Purpose This study examined intervention intensity and service delivery with school-age children with mild or mild–moderate speech sound disorders. The commonly used business-as-usual (BAU) service delivery model and a shorter, more frequent, individual model (experimental [EXP]) were compared. Method A between-subjects group design was selected. In BAU, 11 children received group sessions, 2 times per week, 30 min per session for 6 weeks. In EXP, 11 children received individual session, 3 times per week, 5 min per session for 6 weeks. Group differences on measures of dose (i.e., therapeutic input and production trials) and cumulative treatment intensity were examined. The extent to which children, across both conditions, demonstrated gains in speech sound accuracy and the extent to which gains differed between BAU and EXP were examined. Results There was a significant group difference on dose. Children in BAU received more therapeutic input and production trials than children in EXP. Cumulative treatment intensity was not statistically different between groups when dose was calculated as therapeutic input or production trials. Results from both conditions indicated statistically significant differences on measures of speech sound accuracy with large effect sizes. No group differences on gains were noted. Conclusions Dose calculated as therapeutic input and production trials plays an important role in understanding the impact of cumulative intervention intensity. Children with mild or mild–moderate speech sound disorders may benefit more from a shorter, frequent, individual service delivery model than a BAU model.

Registered professional and advanced practice nurses in the school setting, as a specialized practice entity, are leaders in implementation of evidence-based practice, skilled coordinators of care, advocates for students, and experts in designing systems assisting individuals and communities to reach full potential. Child trafficking (CT) is an emerging public health threat impacting safety and well-being of students present in the school setting. This literature review identified four themes in five studies: (1) training impacts nurses’ knowledge, awareness, and attitudes; (2) school nursing is underrepresented in training, education, prevention, response, and research; (3) lack of collaboration exists between school staff and school nurses; and (4) formal education and length of experience impact levels of interventions school nurses are able to provide. School nurses are opportunely situated to intervene as advocates for vulnerable children to develop a coordinated, effective response to CT risk factors, mitigating risk and fostering resiliency with systems-based change.

Over the past 2 decades, eosinophilic esophagitis (EoE) has become increasingly recognized as a common cause of gastrointestinal morbidity in children. A mainstay of treatment is food avoidance, which must be implemented in both the home and school settings for school-aged children. The aim of this study is to assess school nurses’ familiarity with EoE with regard to food avoidance and treatment in the school setting. We conducted a 19-question online survey of 60 school nurses (elementary through high school) recruited from Dauphin, Lebanon, and Lancaster Counties in Pennsylvania. Results indicated that 62% of respondents were familiar with EoE. However, only 22% felt comfortable distinguishing between symptoms of EoE and food-dependent anaphylaxis. Almost all respondents (97%) were interested in learning more about EoE. We report significantly increased familiarity with food-dependent anaphylaxis in comparison with EoE among school nurses. There is an interest and need for increasing education on EoE.

School-based interventions have reported effectiveness on back health; however, there are no specific guidelines for teaching body mechanics and posture in primary and secondary schools. To identify, describe, and analyze the educative features of randomized controlled trials (RCTs) on back health developed to date in the school setting, a systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. RCTs exclusively focused on educational setting electronic databases included PubMed, EMBASE, PEDro, Web of Science, SPORTDiscus, ERIC, and MEDLINE on the Ovid platform. Databases were searched for potentially eligible studies from the earliest date up to 18th March 2020. A total of 584 records were obtained from the database searches. A total of six articles that applied inclusion criteria were assessed for eligibility. All of these studies found improvements in postural habits and the level of knowledge with regard to back health, as well as a reduction in the prevalence of back pain. None of the studies used the student-centered method, and three studies used evaluation instruments with a pilot validation. Research on RCT interventions concerning back health in the school setting is scarce. None of the interventions applied a constructivist or student-centered method. The use of validated and standardized assessment instruments is required.

Background Sweden is home to a large and growing population of refugee youths who may be at risk of mental health problems such as post-traumatic stress disorder (PTSD). Thus, there is a need for interventions that address mental health problems in these populations. Schools have been identified as an ideal setting for delivering such interventions as they offer a non-stigmatizing space and are often central to young refugees’ social networks. The RefugeesWellSchool trial in Sweden will investigate an intervention comprising two programmes: Teaching Recovery Techniques (TRT) and In-service Teacher Training (INSETT), delivered in a school setting, among refugee youth. TRT is a group-based programme for children and adolescents, informed by Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). INSETT is a multi-module course for teachers providing information on trauma and the refugee experience to build teachers’ cultural competence and capacity for supporting refugee youths in schools. Methods This trial employs a cluster randomized-control design with two arms: (1) the intervention arm in which the TRT and INSETT programmes are offered (n = 350), (2) the wait-list control arm (n = 350) in which services are provided as usual until the TRT and INSETT programmes are offered approximately six months later. Data will be collected prior to the intervention, immediately following the intervention, and at three months post-intervention. Outcomes for the trial arms will be compared using linear mixed models or ANCOVA repeated measures as well as the Reliable Change Index (RCI). Discussion This study will provide knowledge about the effectiveness of an intervention comprising two programmes: a group-based programme for youth reporting symptoms of PTSD and a training course for teachers, in order to build their competence and ability to support refugee youths in schools. Trial registration ISRCTN, ISRCTN48178969, Retrospectively registered 20/12/2019.

Traditionally postural control was considered an automatic task, currently it is considered a process that involve higher control levels. The aims of study were to investigate the effects of cognitive and motor secondary tasks on postural control in healthy students and reveal which of two tasks have a greater impact on simple task. We enrolled eleven healthy children, who were asked to perform the following task: standing with open eyes and performing the same task while performing a cognitive (an n-back subtraction) or motor (finger tapping) dual task (DT). Our results demonstrated that both DT affects the postural control. Specifically, we find higher Centre of Pressure (COP) sway area during cognitive DT as compared to both single task and motor DT. Furthermore, results showed higher COP oscillation velocity in anteroposterior direction during cognitive DT then motor DT. Moreover, this parameter was significantly different in single task compared to motor DT. However, the secondary cognitive task showed a greater impact on postural control then motor secondary task on postural control. Our findings may be applied in school setting to elaborate motor programs useful to improve the postural stability and the ability to perform two tasks simultaneously.

BackgroundRapid antigen tests for SARS-CoV-2 became available recently, offering an opportunity to vastly increase testing capacities. Antigen tests offer lower sensitivity than the gold standard, RT-PCR, but rapid sample-to-answer time. High-frequency testing with an antigen test may offset the lower sensitivity, and testing can be done with at-home collection of samples, offering potential benefit in screening efforts. In this study, we set out to evaluate the practical application of self-performed high-frequency antigen test in a school setting.MethodA total of 711 teachers from 86 schools were enrolled in a seven-week study. After instruction, participants tested themselves every 48 hours at home with a rapid antigen test for SARS-CoV-2 (target: nucleocapsid protein) in a self-collected anterior nasal swab. Positive results in the antigen test were confirmed via RT-PCR from the same sample that had been determined to be positive by the study participant. A questionnaire was given to all participants to evaluate whether the test failed to detect infection.Findings10 836 tests from 602 teachers were recorded and analyzed. A total of five confirmed cases of viral shedding of SARS-CoV-2 was detected by use of the antigen test. One study participant with a SARS-CoV-2 infection was presymptomatic and four were mildly symptomatic at the time of the antigen test. Sixteen false positive antigen tests (0.15% of all tests) were reported, predominantly when the local incidence in the general population was low. In four cases, the study participant reported that a PCR had detected a SARS-CoV-2 infection, but the antigen test was negative, indicating a false negative result.InterpretationHigh-frequency, self-performed rapid antigen tests can detect individuals with a SARS-CoV-2 infection, and therefore potentially reduce transmissions. Testing may be most beneficial when applied during high local incidence of SARS-CoV-2 infections and when mild or atypical symptoms are present. To avoid a high rate of false positive results, a test with optimized specificity should be used.FundingThe study was commissioned and funded by the Hessian Ministry of Education and the Hessian Ministry of Integration and Social Affairs.

Objectives: to evaluate the impact of a health program performed in a school setting on the blood pressure levels of schoolchildren in the public school system in Vitória/ES-Brazil. Methods: a randomized community trial was performed with 237 schoolchildren (6 to 12 years) from two public schools, randomly defined as the intervention and control school. Participants of the intervention group attended 11 education sessions over 4 months (July to October 2014). To test for differences between groups, the chi-square (categorical variables), and the paired t test or Wilcoxon (continuous variables) was used. The rate of variation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) throughout the follow-up, according to allocation group, was evaluated using linear generalized models for time-repeated measures. Results: there was a reduction in the means of SBP (0.5 mmHg) and DBP (0.6 mmHg) in the intervention group and an increase in the control group, with a significant difference in the BP variation between groups over the follow-up period (p

BackgroundHuman rhinovirus (HRV) is the most common cause of the common cold but may also lead to more severe respiratory illness in vulnerable populations. The epidemiology and genetic diversity of HRV within a school setting have not been described.ObjectiveTo characterise HRV molecular epidemiology among children attending primary school in a rural location of Kenya.MethodsBetween May 2017 to April 2018, over three school terms, we collected 1859 nasopharyngeal swabs (NPS) from pupils and teachers with symptoms of acute respiratory infection in a public primary school in Kilifi County, coastal Kenya. The samples were tested for HRV using real-time RT-PCR. HRV positive samples were sequenced in the VP4/VP2 coding region for species and genotype classification.ResultsA total of 307 NPS (16.4%) from 164 individuals were HRV positive, and 253 (82.4%) were successfully sequenced. The proportion of HRV in the lower primary classes was higher (19.8%) than upper primary classes (12.2%), p-value ConclusionHRV was frequently detected among school-going children with mild ARI symptoms, and particularly in the younger age groups (Summary pointsWe describe the molecular epidemiology of human rhinovirus (HRV) within a school setting over one-year in rural coastal Kenya. A high diversity of HRV infections was observed across all classes with evidence of introduction and transmission of 47 different genotypes.

Objective: to evaluate the sensitivity and specificity of three hearing screening protocols: audiometry, tympanometry, and transient evoked otoacoustic emissions (TEOAE). Methods: a cross-sectional study comprising 70 schoolchildren aged 6-14 years old (9.9 ± 2). All participants underwent a complete audiological evaluation and screening procedures. Procedures were compared regarding sensitivity, specificity, and positive and negative predictive values. Results: sensitivity and specificity were, respectively, 64.71% and 66.04% for audiometry, 64.71% and 73.58% for tympanometry, and 66.67% and 78.85% for TEOAE. The positive and negative predictive values were 37.93% and 14.63% for audiometry, 44% and 13.33% for tympanometry, and 52.17% and 12.77% for TEOAE. Conclusions: in the school setting, TEOAE stands out from the two other screening protocols, in all measures regarding sensitivity, accuracy, and predictive values.

PurposeThe study aimed to compare auditory processing and cognitive test scores measured in a clinical setting with that measured in a school setting using a repeated-measures design. This was done on typically developing children and children with auditory processing disorder (APD).MethodThirty-two children (16 typically developing and 16 with APD), aged 7 years, were evaluated using three diagnostic auditory processing tests and a cognitive test. The tests included the Speech Perception in Noise Test in Kannada, the Gap Detection Threshold Test, the Dichotic Consonant–Vowel Test, and the Auditory Memory and Sequencing Test in Kannada. All the children were evaluated in an audiological diagnostic setting, as well as in their school.ResultsNo significant difference in scores was obtained in the two settings for all the four tests that were administered. This was seen in the typically developing children and the children with APD. Additionally, the pass/fail decision for each test did not alter in the two settings. Moderate to almost perfect agreement was seen between the tests carried out in the two settings in both groups, on a Kappa test of agreement. In both settings, the children with APD performed significantly poorer than the typically developing children on the four diagnostic tests.ConclusionsThe findings of the study indicate that the diagnostic auditory processing tests and the cognitive test can be carried out in school settings as effectively as tests carried out in an audiological diagnostic clinical setting. This will enable carrying out diagnostic tests on children in schools soon after they are referred on screening auditory processing tools, administered in the educational setting. This will prevent missing diagnosis of children who fail to report to a diagnostic audiological center for detailed auditory processing evaluation.

SummaryBackgroundData on SARS-CoV-2 transmission from a pediatric index patient to others at the school setting are limited. Epidemiologic data on pediatric COVID-19 cases after school opening is warranted.MethodsWe analyzed data of the pediatric patients with COVID-19 collected from the press release of the Korea Centers for Disease Control and Prevention. Information on the school opening delay and re-opening policies were achieved from the press release from Korean Ministry of Education.FindingsThe school openings were delayed three times in March 2020. Online classes started from April 9, and off-line classes started from May 20 to June 8 at four steps in different grades of students. There was no sudden increase in pediatric cases after the school opening, and the proportion of pediatric cases remained around 7.0% to 7.1%. As of July 11, 45 children from 40 schools and kindergartens were diagnosed with COVID-19 after off-line classes started. More than 11,000 students and staff were tested; only one additional student was found to be infected in the same classroom. Among those 45, 32 (71.1%) patients had available information for the source of infection. Twenty-five (25/45, 55.6%) were infected by the family members. The proportions of pediatric patients without information on infection sources were higher in older age group (middle and high school students) than in younger age group (kindergarten and elementary school students) (47.6%vs12.5%,p=0.010). In the younger age group, 79.1% of children were infected by family members, while only 28.6% of adolescents in the older age group were infected by family members (pInterpretationKorea had a successful transition from school closure to re-opening with online and off-line classes. Although partial, off-line school opening did not cause significant school-related outbreak among pediatric population although young children and adolescents may have different epidemiologic features.FundingNone.

Con el propósito de abordar las diversas problemáticas que afectan a la postura de los escolares, desde la materia de Educación Física se han implementado numerosas intervenciones de carácter preventivo con niños y adolescentes. Los programas desarrollados no presentan siempre las mismas valoraciones o contenidos tratados. El objetivo del presente estudio fue analizar las características de los programas de ejercicio físico para el cuidado de la espalda aplicados en la etapa escolar. El periodo de búsqueda estuvo comprendido desde el 1980 hasta 2016. Se analizaron tanto los contenidos teórico-prácticos tratados en el programa para el cuidado de la espalda como las pruebas de evaluación de los mismos en un total de 34 intervenciones en el ámbito escolar. Los resultados mostraron que el tipo de valoración más utilizada en los estudios analizados ha sido la medición a través de prueba de conocimientos (62%); resaltar que solo dos de las investigaciones (6%) valoraron el conocimiento sobre fuerza y flexibilidad para la mejora de la postura. La mayoría de las pruebas de conocimientos se centran en la higiene postural y ergonomía en las tareas de la vida diaria (95%). Los contenidos que predominaron en las intervenciones fueron higiene postural y ergonomía en las tareas cotidianas con un 82% de prevalencia, seguido de intervenciones con ejercicio físico con un 35% del total de las intervenciones. La higiene postural es el contenido más frecuente y más ampliamente evaluado, mientras que la fuerza y flexibilidad han sido incluidos escasamente en los programas del cuidado de la espalda analizados en el ámbito escolar.

School-based body mass index (BMI) screening is required in 50% of states with parent notification letters distributed among 11 of those states. Additional research is needed to effectively communicate screening results to parents. We conducted a pilot investigation of parent acceptability of an electronic, interactive BMI parental notification letter (e-BMI) along with the feasibility of implementing an e-BMI letter in the school setting. In addition, we assessed parental attitudes and practices regarding their child’s weight-related behaviors. Electronic letter distribution and parent receipt were consistent with traditional paper letter mailings; however, we did not observe any significant behavioral impacts with either letter format. Parents reported interest in wellness programming offered by the school, a potential opportunity for schools to engage families in healthful practices. Additional research is needed to understand the impact of e-BMI letters and accompanying web-based resources specifically for parents of students with overweight or obesity.

Food allergy is increasing in prevalence, and management focuses on strict avoidance of known allergens and appropriately treating reactions. Any reaction has the potential to result in anaphylaxis, which can be fatal. Children spend a significant amount of time in the childcare or school setting, and interactions between families, school personnel, and clinicians are important to ensure the health and safety of children with allergies and asthma. This review examines current food allergy guidelines and legislation, an assessment of allergen-free schools, the importance of written anaphylaxis action plans, training and education of school personnel, emerging treatment options, and the social implications of having food allergies. As the clinical use and research into food allergen immunotherapy continues to expand, an additional level of education and management is required of school personnel and caregivers. Food allergy has both medical and social implications, which are magnified in the school setting.

Substance use and its associated effects have contributed significantly to the increase of public health problems in Indonesia including among adolescents. Therefore, an effective substance use prevention program should be developed and implemented. This study aimed to identify teachers’ perceptions about the implementation of substance use prevention programs for school-age children in the Aceh Province in particular, and Indonesia in general. This qualitative study involved teachers and principals from four junior high schools randomly selected from a municipal district in the western part of Indonesia. Data were collected through in-depth interviews and analysed manually using content analysis techniques. Findings of this study suggest that all the interviewed teachers and school principals agreed to the importance of school-based substance use prevention programs for school-age children. An effective and appropriate program should be carried out continuously, use interactive methods, involve teachers and related experts, be implemented integrative and conducted during school time. The involvement of religious teaching and religious experts were considered vital for program effectiveness. Lack of time and low parent participation were considered as the main potential barriers for the program implementation. The implementation of school-based substance use prevention programs in schools would be accepted, feasible, and considered effective by school teachers in Aceh, Indonesia. The findings can be used as a basis for further research on substance use prevention programs for adolescents in school setting.