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This narrative review aims to identify key concepts associated with school refusal, including various risk factors, and to discuss current practical assessment and treatment methods available or under trial. For this study, we searched MEDLINE and Scopus databases for articles containing keywords like "school refusal" and associated keywords such as "childhood," "adolescence," "risk factors," "interventions," and "assessment." Thirty-eight original articles in English containing these keywords, published in the last 10 years on the above platforms, were included. We excluded studies focusing on school refusal solely in a subset of the population, such as autistic children or immigrant children. This review found that in India, school refusal is often ignored, especially in lower socioeconomic families, due to non-affordability and poor access to appropriate resources, and is sometimes also equated with truancy and bad behavior. Various risk factors at the parental and school level promote this behavior, and therefore, appropriate interventions at these levels are necessary. As per current evidence, psychoeducation and multidisciplinary treatments are the most effective in managing such children. Early detection of such cases and coordinated efforts by all stakeholders are crucial for effective intervention. [ABSTRACT FROM AUTHOR]

Background: Various studies revealed that adolescent girls have limited knowledge pertaining to sexual and reproductive health (SRH). The current study assessed the effectiveness of SRH education among adolescent girls in urban areas of Odisha, India. Methods: The study design was a cluster randomized trial, where the clusters composed of eight Odia (regional language) medium government girls' high schools in Bhubaneswar, the capital city of the state of Odisha, India. For the selection of study participants, adolescent girls who were studying in the ninth and tenth standards were recruited from each school. Eight schools were randomized through restrictive randomization at a 1:1 ratio, with four schools each in the intervention and control arm. Baseline and end-line assessments were done using a pre-tested, semi-structured questionnaire. Following baseline assessment, an intervention was given with the help of handbooks developed by the study authors to the schools in the intervention arm. Outcomes included change in knowledge, attitude and practices pertaining to SRH. Results: In our study at baseline, there were a total of 790 students, where 469 (59.4%) students were in the intervention arm, and 321 (40.6%) students were in the control arm. At baseline, only 282 (60.1%) in the intervention arm and 171 (53.3%) in the control arm were aware that physical bodily changes due to puberty were normal. After the intervention, there was a statistically significant increase in knowledge in intervention group 367 (94.8%) (p-value < 0.001). Most students used sanitary pads as absorbent, 97.2% in the intervention group and 98.4% in the control group. However, after the intervention, the use of other absorbents reduced to zero in the intervention group with a statistically significant difference (p < 0.05). The number of students having awareness on different methods of contraception increased from 51 (10.9%) to 337 (87.1%) in the intervention arm (p < 0.001), and of those having awareness on STIs/RTIs increased from 177 (38.2%) to 371 (96.1%) in the intervention group (p < 0.001). Conclusion: From our study, there is a significant proportional change in knowledge, attitude, and practices pertaining to SRH. Our study recommends policymakers and program managers for the implementation of comprehensive SRH in the regular school curriculum. Trial registration CTRI/2021/01/030490, registered on January 15, 2021. Prospectively registered at https://ctri.nic.in/Clinicaltrials/login.php Plain language summary: Adolescent girls lack adequate knowledge pertaining to sexual and reproductive health, for which they face various issues such as teenage pregnancy, unsafe abortions and sexually transmitted infections. Hence the authors conducted this study to assess the effectiveness of school-based sexual and reproductive health education among adolescent girls in Odisha state of India in terms of improving knowledge, attitude and practices pertaining to reproductive health. A total of eight vernacular (Odia language) medium schools were selected for the conduct of the study, and the schools were randomly assigned where four schools received SRH education, and the other four received no intervention. A baseline assessment pertaining to SRH was done among adolescent girls studying in ninth and tenth classes of all eight schools, and then education was given to the four schools in the intervention arm. Students were educated on topics such as puberty, menstrual health, pregnancy, contraception and STIs/RTIs with the help of handbooks prepared by the authors. After 3 months of providing education, an endline assessment was done for the adolescent girls in all eight schools. There was an increase in knowledge, attitude and practices pertaining to SRH among the students who received education when compared to those who didn't. Hence our study recommends policymakers and program managers include SRH education in the regular school curriculum. [ABSTRACT FROM AUTHOR]

Introduction: During the initial phase of COVID-19 pandemic crisis, the schools and educational institutions were closed countrywide. Hence, more than 90% of students admitted to educational institutions worldwide are affected as 188 countries have implemented COVID restrictions. Hence, this study focuses on the health status of adolescent students during the shutdown of educational institutions during the COVID-19 pandemic. Aim and Objective: This study assesses mental health, dental health, eye health, physical activity, immunization, and nutrition in adolescents during the COVID-19 pandemic among adolescent boys and girls. Materials and Methods: The current cross-sectional study was done among school-going adolescent children. One hundred and eighty students from different syllabus systems and urban and rural parts of north Kerala participated. The data collected were entered into an excel sheet and analyzed using the SPSS software. Results: 59.4% of students have gained weight due to sedentary behaviour. Students spend more time in front (95%) of a digital screen, leading to computer vision syndrome. Loss of social interactions adversely affected students' mental health by 37.8%. Thirty percentage of physically active students were involved in indoor physical activities such as Zumba and aerobics. In addition, 77% of students have not taken their routine immunization. Conclusion: The newer learning methods have impacted the students' knowledge. There is no uniformity in the form of teaching. Multiple factors have played a role in improving the lockdown situation, including the families, schools, local authorities, government, digital media, and newspapers. [ABSTRACT FROM AUTHOR]

Background In India, adolescents constitute 21.4% that is one-fifth of the total population and world adolescents' (10-19 years) population is more than 1.2 billion. The trend of consumption of fast food increases worldwide, and in India, fast food production and consumption is very high. The popularity of these food is because of easy preparation and more convenient to finish the meal in less time. Great taste, attractive packaging, and advertisement play a very important role in promotion of such food adolescents. Adolescents also develop the various problems related to health because of less nutritious diet, such as Chinese food, junk food, and beverages. Methodology The present study was a cross-sectional study and conducted for a duration of three months from January 2017 to March 2017. A total of 437 adolescents enrolled with their consent from five randomly selected schools of a city in Madhya Pradesh, India. All adolescents who were present in school on the day of visit and willing to participate were included in the study. Result In our study, a total of 437 students were registered, out of which 97.02% were boys. About 41.82% were of early adolescence and the rest of them were of late-adolescence group. Majority of the adolescents consumed regular meals such as chapati (84%), rice (79%), and dal (74%), they consumed relatively less, green leafy vegetables (60%) than the other vegetables (67%). Most of the participants consumed milk most of the days in a week, but more than 20% students consumed fried food/pizza/burger/fast food more frequently (more than 4 days a week) in a week, and only very few students were not consuming these foods or consuming less frequently. Conclusion Most of the adolescents consume regular meals, but adolescents consumed irregular or skipping of meal and breakfast is still high. And more than 50% adolescents consumed chocolate/pastries/sweet/cake/cookies/bread/toast/cookies/biscuits/cold drinks/soft drinks/potato chips/namkeens/deep-fried snacks/pizza/burger/Frankie, or any other fast food (including Chinese food), these foods are highly energy dense and have less nutritious value. [ABSTRACT FROM AUTHOR]

Background: Anxiety is one of the most common mental disorders among school-going children and adolescents worldwide. Multiple factors like internalization of the symptoms, lack of proper objective assessment, societal stigmatization, and influence of parental pressure may alter the prevalence and incidence. Aim: The current study is done to identify the prevalence of anxiety disorders in school children and their associated risk factors. Method: A total of 550 students (266 boys and 284 girls), studying in grades 8 to 12 in urban and rural schools chosen by stratified random sampling, were subjected to a questionnaire survey by the team of trained investigators using "Screen for Child Anxiety and Emotion-related Disorder (SCARED)--child Version.". Results: Total prevalence of anxiety assessed using the SCARED scale was 51%. The prevalence of subtypes of anxiety disorders was also identified viz, generalized anxiety disorder--16%, panic disorder--23%, school phobia--17%, separation anxiety--31%, and social phobia--13%. All the disorders showed higher incidence in girls (P < .01). Discussion: The anxiety disorders were associated significantly with students from rural schools, those studying in the Tamil medium, those staying in hostels, students who had mothers who were employed, and living in extended family environments. Students who walked to school and who had neither of their parents as caregivers were more likely to have panic disorder, school phobia, social phobia, and separation anxiety disorder. Conclusion: This study documented a higher prevalence of anxiety disorders and subtypes and highlighted the factors associated with anxiety disorders in school students of the adolescent age group. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders are significant public health problem among adolescents and young adults. Aim & Objective: We did this study to observe knowledge, attitude, and practice of substance use among school and college going adolescents and young adults. Material & Methods: A cross-sectional study was conducted at 10 schools and colleges from Aligarh. A total of 1431 students were approached with study tools comprising of pre-structured proforma on knowledge, attitude, and practice. Results: We observed that most of the students (89%) had some knowledge about substance use. The risk-taking attitude was common even against drugs like cocaine and charas (30.6% and 29.1% respectively). A high prevalence of ever user and current user was observed (33.3% and 12.9% respectively). The mean age of starting the drug in students and their friends was 15.5 ±2.7 and 16.2 ±2.8 years respectively. Among the ever users, tobacco smoking (56.6) and alcohol (47.6%) were most common. Stress (57.9%) was most common reason to use drugs. Males and college students (40.6% and 41.2% respectively) were using it more. Conclusion: This study found half-baked knowledge, propensity towards a risk-taking attitude, and a substantial prevalence of substance use practices. Proper action and further researches are required to explore variables associated for reducing the prevalence. [ABSTRACT FROM AUTHOR]

Context: Tobacco use is the forerunner among the most serious public health issues threatening the world. Problem is compounded by the fact that most of tobacco users indulge in tobacco from adolescence. More than one-fourth of young men in India consume tobacco. The National Health Policy 2017 aims to reduce the prevalence of tobacco usage by 15% by 2020. To achieve this goal, the youth must be targeted to abstain from tobacco. Aim: To study the correlates of the knowledge and consumption of tobacco in adolescent males. Settings and Design: This was a cross-sectional study in a school in an urban slum in Western Maharashtra. Methodology: The study was conducted in a school in an urban slum on 394 adolescent males using pretested self-administered questionnaire. All the participants gave assent. Ethical permission from the institutional ethics committee was taken. Statistical Analysis Used: Percentages and Pearson's Chi-square test were done using SPSS 20. Results: The proportion of adolescents having knowledge about hazards of tobacco was 65.2%, while the prevalence of tobacco use was 24.4%. Tobacco usage was found to be significantly associated with the usage in family; paradoxically, the adolescents who witness tobacco use at home were more likely to have knowledge about hazards of tobacco. Knowledge about harms of tobacco use was found to be significantly associated with educational status of mother. Conclusion: Important correlates of knowledge about hazards of tobacco usage were the type of family, maternal education, as well as usage of tobacco in family. [ABSTRACT FROM AUTHOR]

Introduction and Context: Sexual health in schools is neglected in most developing countries, [1] however, it is emerging as a major need of the hour. This article captures the author’s experience as a family physician in a boarding school setting in India highlighting the need and possible solutions pertaining to sexual health in the school community. Setting: An international boarding school in India with approximately 600 students, 500 teachers, and administrators who lived on the school campus and 500 support staff who lived off‑campus. Materials and Methods: Three events prodded the author to explore perceptions and needs pertaining to sexual health in the school community. Being a difficult area of inquiry, this was done as informal qualitative research by dialoguing with six groups of people in the school community: School counselors, parents, student supervisors such as teachers, advisors and dorm parents, school administrators, support staff, and the students and the responses were collated. Observations: A mere 17.9% of grade 5 to 12 students, of age‑groups 10 to 19 never had a conversation with their parents about sexuality. Students were largely ignorant or misinformed on most sexuality‑related issues but engaged well when offered anonymity or safe space. Though all stakeholders in the school agreed that students needed an age‑appropriate, gender and culture‑sensitive, scientific and comprehensive sex education, parental responses were mixed. Conclusion: The author’s journey as a family physician in a school setting has prompted exploration of a wholistic model for the provision of comprehensive sexual health in schools and the emerging role of a family physician in schools. [ABSTRACT FROM AUTHOR]

Background: The school health program is a flagship program of Government of India with a focus on improving the physical and mental health of school children, but there is no specific strategy to screen for mental health disorders under the school health program. Also, the estimation of the prevalence of common mental disorders (CMDs) such as anxiety, depression, and psychosocial distress among school children is lacking. Methods: The author conducted a cross‑sectional study among 742 adolescent schoolgirls from one government, one government‑aided, and one private school in an urban area in Gujarat. We used the pre‑validated instrument, general health questionnaire‑12 (GHQ‑12) to screen for CMDs. We estimated adjusted odds of association between screening positive for CMDs and various determinants. Results: 48.78% adolescent girls screened positive for CMDs which is alarming. Among sociodemographic characteristics, the type of school (adjusted odds of private is 1.8 and government 1.6), mother’s higher education (3.0), father’s less education (3.1), and working mother (1.5) had shown significant association with positive cases of the girls. Among psychosocial factors, abnormal sleep patterns (1.9) and disturbance in studies (2.3) have been found statistically significant for the presence of mental health problems among adolescent girls as per the GHQ score. Conclusion: CMDs such as anxiety, depression, and psychosocial distress were indeed very common among adolescent school‑going girls in an urban area of Gujarat, India. There is an urgent need to focus attention on the mental health of adolescent girls. [ABSTRACT FROM AUTHOR]

Interventions early in life are the need of the hour when it comes to controlling the rising incidence of communicable and non-communicable diseases (NCDs) globally. WHO has issued guidelines towards health promotional initiatives at schools as a part of Global School Health Initiative, and the Government of India has directed many policies and programs to integrate health deep within the school activities. School Health Promotion is an international need with programmes implementing across continents due to numerous documented benefits, to not just the individuals but to the community and country as a whole. Simple teachings like hand hygiene have shown to reduce the incidence diarrhea by more than 50% amongst children (a major cause of mortality in India), thus raising an urgent need of developing a model for health promotion at schools that is replicable, sustainable, and can be modified to the local needs as well. Though the existent programmes have a few documented challenges, a multisectorial involvement of government agencies, educational boards, and health sector along with the school is the way forward to address those challenges and covert the theory of health promoting schools (HPS) into a well-established fact. It presents a scope for the various established and newly emerging Schools of Public Health in the country to come forward and collaborate with these multiple sectors. These collaborations can be the only way to ensure sustainability and incorporation of health promotion into the core academic structure of schools in a diverse and highly populous country like India. [ABSTRACT FROM AUTHOR]

Globally, the consumer food environment is often shaped by market interests rather than emphasizing nutritional quantity and quality. In low- income countries like India, such unhealthy food products are becoming increasingly available, accessible, and affordable to the common people, especially the school going children, which is a major concern to us. Despite huge amount of evidence, public health institutions are not addressing this pressing issue adequately. It could be due to the contradictory nature of the policies. Now it will be interesting to observe the implementation of "Eat Right" campaign, new FSSAI guidelines and good food tax policy, which should take care of India's' overall growth in terms of health and economy, both. [ABSTRACT FROM AUTHOR]

Introduction: With growing trends in tobacco consumption, it has been observed that the age of initiation is gradually decreasing. To combat the deep-rooted problem of the Society, we need to target the adolescents at the time of their first consumption of tobacco forms. Hence, this study was conducted to assess the pattern of smokeless tobacco use among school going adolescents in senior secondary schools with the assessment of the sociodemographic factors responsible for initiation of smokeless tobacco use by adolescents., Methods: A cross-sectional survey of total sample of 714 students across 9-11 standards in 3 schools of Delhi was done using a self-administered questionnaire after obtaining approval from Institutional Ethics Committee and School Health Scheme, Delhi., Result: Consumption of tobacco was found to be 27.9% at a frequency of 6-9 days in a period of one month and a majority of 31 (39.2%) students initiated the use in the age group of 10-11 years. Among the different SLT products, pan masala combined with zarda with 56 (70.8%) users, was found to be the most commonly consumed SLT product. Grocery shops were preferred POS among the students as (67%) of students obtained the SLT product from this POS. 56 (70.8%) of the students wanted to quit the habit of SLT use whereas 49 (62%) students tried to quit the habit and 43 (54.4%) students sought help in order to quit the habit., Discussion: Such alarming results in terms of low age of initiation in Delhi is an emerging health problem. Adequate cessation programmes and schemes must be developed and strict implementation of laws and policies to achieve a tobacco free youth is the need of hour.

Background: Adolescent tobacco use in India has increased substantially within the past few decades. Schools can serve as an important avenue for prevention education, but little is known about the current practices of Indian schools in relation to tobacco use prevention education. Methods: To assess the extent and influence tobacco use prevention education in Indian schools, we analyzed the Global Youth Tobacco Survey data for India, which was a population-based study of a national random sample of 10 112 students from 180 private and public schools. Variables such as student demographic profile, tobacco use behavior, perceptions about tobacco use, and exposure to school-based tobacco use prevention education were considered for analyses. Results: Prevalence of any form of tobacco use (14%) and current smoking (8%) was found to differ by gender. A quarter of the students believed that boys who smoke are more attractive or have more friends compared to non-smokers, and almost half of the students reported that smoking and health were never discussed as a part of a lesson in school. The association between school-based prevention education and tobacco use behavior was assessed (after adjustment for age, gender, and parental smoking). Students who were educated in school about tobacco use and its effects were significantly more likely to have negative attitude toward tobacco use and less likely to report use of tobacco. Conclusion: School-based tobacco use prevention education has beneficial influence on adolescents in India. Given the early age of initiation of tobacco use, school curricula in India should emphasize on tobacco use prevention education. [ABSTRACT FROM AUTHOR]

Purpose: To study the prevalence and determinants of compliance with spectacle wear among school-age children in South India who were given spectacles free of charge under a school vision screening program., Methods: A cross-sectional, descriptive study was performed. The participants were recruited from the school from Tirunelveli and Tuticorin districts of Tamil Nadu, where a school vision screening camp was conducted between January 2012 and October 2012. The school screening was performed under., “lavelle Pediatric Eye Care Project”: . Of the 129,720 children examined of 249 schools, 4253 of children had refractive error and 3333 were prescribed and dispensed spectacles. A total of 683 children were interviewed, who were not wearing glasses on follow-up., Results: About 20% of the participants (683/3333) were not wearing their spectacles at examination. The most common reasons given for non-wear were lost (44.9%) or broken (35.3%) spectacles. There was no gender preference on compliance to spectacles., Conclusion: Compliance with spectacle wear is less even when spectacles are provided free of cost, particularly in children among the age group of 5-15 years. Because factors such as type of school, area (urban or rural), parent's income, occupation, and their education were not significantly affecting the compliance of spectacle wear, proper encouragement and counseling of the parents and the child become extremely important., Competing Interests: None

Design: Non-randomised non-blinded school-based intervention study.Setting: Two schools in the cities of Pune and Nasik, India.Participants: The intervention group comprised children attending a Pune school from 7-10 years until 12-15 years of age. Two control groups comprised children of the same age attending a similar school in Nasik, and children in the Pune intervention school but aged 12-15 years at the start of the study.Intervention: A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extracurricular and intracurricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a 'scoring' subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families.Main Outcome Measures: Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing).Results: After 5 years the intervention children were fitter than controls in running, long jump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004).Conclusions: It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These changes resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity. [ABSTRACT FROM AUTHOR]

Background: Identifying the commonly prevailing health and nutritional disorders in school going children is essential to initiate appropriate public health measures. Materials and Methods: A cross-sectional prospective study was designed to conduct a detail physical health assessment of children studying in class 1-8 (age- 5-13 years) of 31 schools of Ahmedabad city, India between December 2011 and February 2012. Under the school health program of state government, medical history, height, weight and general physical examination findings, including dental and ophthalmic examination were recorded by qualified medical practitioners. Children with abnormal results were further investigated and treated by the subject experts. Result: Total 28,256 children were screened (boys-15,087 and girls-13,169). Mean weight and height of the children were 27.04 kg and 128.81 cm, respectively. Analysis of nutritional status of the cohort population as compared to body mass index standards revealed that 8319 (29.44%) children were underweight while only 221 (0.78%) children were either overweight or obese. The subgroup analysis of basic nutrition indices in children revealed prevalence of significant malnutrition (based on Indian Council of Medical Research standards) in children below 10 years of age. Commonly prevailing health disorders included worm infestation (42%), upper respiratory tract infection (36.39%), anemia (30.99%) dental caries (25.19%) and refractory errors (10.2%). Conclusions: Malnutrition and related health disorders are commonly prevailing childhood diseases in the urban community and can effectively be addressed by appropriate public health program. [ABSTRACT FROM AUTHOR]

Menstrual education is a vital aspect of adolescent health education. Culture, awareness, and socioeconomic status often exert profound influence on menstrual practices. However, health education programs for young women in developing countries do not often address menstrual hygiene, practices, and disorders. Developing culturally sensitive menstrual health education and hygiene programs for adolescent females has been recommended by professional health organizations like the World Health Organization and UNICEF. These programs cannot be developed without understanding existing myths and perceptions about menstruation in adolescent females of developing countries. Thus, the purpose of this qualitative study from India was to document existing misconceptions regarding menstruation and perceptions about menarche and various menstrual restrictions that have been understudied. Out of the 612 students invited to participate by asking questions, 381 girls participated by asking specific questions about menstruation (response rate = 62%). The respondents consisted of 84 girls from sixth grade, 117 from seventh grade, and 180 from eighth grade. The questions asked were arranged into the following subthemes: anatomy and physiology, menstrual symptoms, menstrual myths and taboos, health and beauty, menstrual abnormalities, seeking medical advice and home remedies; sanitary pads usage and disposal; diet and lifestyle; and sex education. Results of our study indicate that students had substantial doubts about menstruation and were influenced by societal myths and taboos in relation to menstrual practices. Parents, adolescent care providers, and policy makers in developing countries should advocate for comprehensive sexuality education and resources (e.g., low-cost sanitary pads and school facilities) to promote menstrual health and hygiene promotion. [ABSTRACT FROM PUBLISHER]

Background: Adolescents comprise nearly one-fifth of the total population of India. Undiagnosed adolescent depression can have potentially long term serious consequences along with increased risk of suicide. Objectives: To find out the prevalence of depression among school going adolescents and the socio environmental risk factors associated with it. Materials and Methods: A cross sectional study was carried out among 1632 school going adolescents (13-19yrs) in the rural and urban areas of district Ambala. Two pretested questionnaires were used. Depression subscale of Symptom Check List 80 (SCL 80) was used for ascertaining the prevalence of depression and a self-report questionnaire to assess effect of socio-environmental factors. Results: 29.9% adolescents had evidence of depression having cut off score > 13 in depression subscale of SCL 80. Most of the students in depression syndrome group were found to be suffering from mild category 22.9% followed by moderate category 7%. Depression was found to be associated with increasing age, low socio economic status and urban students. Conclusion: Regular screening of adolescents for depression and strengthening of school health services could provide the impetus for detection, prevention & management of adolescent depression. [ABSTRACT FROM AUTHOR]

Early adolescence is the period of the emergence of most mental disorders contributing significantly to the mental health burden globally, including India. The major challenges in India are early identification of mental health problems, treatment gap, lack of professionals, and interventions that address the same. Our review aimed to assess the effectiveness of mental health interventions among adolescents in India. We systematically searched PubMed, PsycINFO, and Cochrane databases and used cross-referencing to review the interventions published from 2010 to 2020. Eleven interventions were included in this review; nine were school-based, one community, and one digital. Most of the school-based programs used a life skills curriculum. Additionally, coping skills and resilience curricula showed improvement in depressive symptoms, cognitive abilities, academic stress, problem-solving, and overall mental well-being. The multi-component whole-school intervention was quite promising and helped in improving the overall school climate and various other mental health outcomes. Hence, school-based programs should be implemented as an entry point for screening mental health problems. However, there is a need for a more comprehensive mental health program in the country for adolescents. Additionally, there is a need to address the gap by conducting more interventions for early and out-of-school adolescents. [ABSTRACT FROM AUTHOR]

Background: Knowledge about epilepsy and its management is not satisfactory among school students in developing countries. The present study was planned to ascertain the knowledge, attitude and practices (KAP) of students regarding first-aid management of epilepsy seizures in school setting. Materials and Methods: A total of 177 students of government schools of Chandigarh, a city of northern India, were taken. They were administered with a pre-tested semi-structured questionnaire (for knowledge and attitude assessment) and an observational checklist after role play (for practice assessment) on first-aid management of epilepsy. A scoring system was devised to quantify the knowledge and practices of students. Results: Seventy?one percent of them had either heard or read about epilepsy. Half of the students believed epilepsy as a hindrance to education. Ayurvedic treatment was preferred by more than half of the students; however, many believed that visit to religious places and exorcism as ways to cure epilepsy. Nearly 74% of students would call a doctor as first-aid measure for seizure in a person with epilepsy. Conclusion: We concluded that the knowledge about various aspects of epilepsy was average among school students in Chandigarh. However, there was no significant difference in knowledge, attitude and practice between students who lived in urban, urban slum and rural areas. It is recommended that first-aid management of seizures in epilepsy should be a part of school curriculum. [ABSTRACT FROM AUTHOR]

Background: Uncorrected refractive error is an avoidable cause of visual impairment. Aim: To compare the magnitude and determinants of uncorrected refractive error, such as age, sex, family history of refractive error and use of spectacles among school children 6-15 years old in urban and rural Maharashtra, India. Study Design: This was a review of school-based vision screening conducted in 2004-2005. Materials and Methods: Optometrists assessed visual acuity, amblyopia and strabismus in rural children. Teachers assessed visual acuity and then optometrists confirmed their findings in urban schools. Ophthalmologists screened for ocular pathology. Data of uncorrected refractive error, amblyopia, strabismus and blinding eye diseases was analyzed to compare the prevalence and risk factors among children of rural and urban areas. Results: We examined 5,021 children of 8 urban clusters and 7,401 children of 28 rural clusters. The cluster-weighted prevalence of uncorrected refractive error in urban and rural children was 5.46% (95% CI, 5.44-5.48) and 2.63% (95% CI, 2.62-2.64), respectively. The prevalence of myopia, hypermetropia and astigmatism in urban children was 3.16%, 1.06% and 0.16%, respectively. In rural children, the prevalence of myopia, hypermetropia and astigmatism was 1.45%, 0.39% and 0.21%, respectively. The prevalence of amblyopia was 0.8% in urban and 0.2% in rural children. Thirteen to 15 years old children attending urban schools were most likely to have uncorrected myopia. Conclusion: The prevalence of uncorrected refractive error, especially myopia, was higher in urban children. Causes of higher prevalence and barriers to refractive error correction services should be identified and addressed. Eye screening of school children is recommended. However, the approach used may be different for urban and rural school children. [ABSTRACT FROM AUTHOR]

Childhood blindness and visual impairment are as important and perhaps more devastating and disabling than adult onset blindness, because of the long span of life still remaining to be lived. Refractive errors and more particularly myopia, place a substantial burden on the individual and society. School-age children constitute a particularly vulnerable group where uncorrected refractive errors may have a dramatic impact on learning capability and educational potential. This article provides an overview of school eye screening from the perspective of National Program for Control of Blindness (NPCB), Government of India; and challenges, future directions and thrust area envisaged under the program for amelioration of childhood blindness. [ABSTRACT FROM AUTHOR]

Purpose: The study was planned to evaluate the effectiveness of three modes of school dental health education (SDHE) on the oral health-related knowledge, attitude and practice (KAP) behaviour of school children., Methods: An interventional study was carried out among 8-9 year old school children from January 2016 to January 2018. Three hundred and sixty children from three schools in Tiruchengode, Tamil Nadu, India participated in this study. Each school was randomly allotted with a mode (drama, modified snake and ladder game, flashcard) of SDHE, which was delivered for 20 min, every 6 months for 2 years. A validated questionnaire with 18 questions was used to record oral health-related KAP behaviour at baseline and after 2 years., Results: At the end of 2 years, there was an increase in the percentage of correct response for all the nine knowledge questions, in all the three modes. The mean difference in the cumulative knowledge score between baseline and 2 years was 1.39 ± 2.05 for drama mode, 1.8 ± 1.51 for game mode and 1.7 ± 1.5 for flashcard mode of SDHE. There was a significant difference in three knowledge questions and one attitude practice behaviour question between the three groups at the end of 2 years., Conclusions: All the three modes were effective in improving the oral health-related KAP behaviour of school children. Game mode made a better impact on the knowledge scores of these children, and it was observed to be more child-friendly and entertaining.

Background: Adolescence is a period of transition where independence in thinking and behavior is established and food choices that are made are followed for several years, and this can influence their health in adulthood. Hence, understanding the eating habits are necessary to plan effective nutritional interventions in adolescents., Objectives: The main objective of the study is to find out the extent of malnutrition among rural adolescents as well as evaluate their eating habits against recommended dietary food groups and to compare eating habits across gender and age groups., Methods: A cross-sectional study was done among 1425 adolescents from 13 rural schools from 2014 to 2015, and the variables considered in this study were age, sex, body mass index (BMI), and the eating habits of the adolescents., Results: Undernutrition was seen among 23% and overweight/obesity among 8% of adolescents. The habit of taking milk and milk products, fruits, and green leafy vegetables were very poor among the adolescents. Significant association was found between eating habits and BMI. Furthermore, late adolescents had better eating habits, and significant gender difference was seen in certain eating habits., Conclusions: The study shows that it is possible to understand the gaps in eating habits of adolescents, and this can be used to plan tailor-made nutritional interventions to adolescent groups as their eating habits are different and have long-term nutritional and health implications., Competing Interests: None

Objective: Penetration of mobile technology is rapidly rising. Excessive use leads to Technology addiction, which often start early in adolescence. The purpose of the present study was to assess Technology addiction and its correlates among school students in rural India., Methods: This cross sectional study was conducted among 885 school students in north India. Four schools were selected and participants aged 13-18 years, were enrolled randomly. A self-designed 45 item questionnaire was used to evaluate dependence syndrome (intense desire, impaired control, tolerance, withdrawal, persistence despite harm, neglect of alternate pleasure) as used for substance dependence in ICD-10. Screening for depression and anxiety was done by using patient health questionnaire (PHQ-9) and generalized anxiety disorder scale (GAD-7) respectively. Descriptive and logistic regression analyses were done., Results: The mean age of the study participants was 15.1 years. Among the participants, 30.3% (95% Confidence Interval = 27.2%-33.3%) met the dependence criteria. One-third (33%) of the students stated that their grades had gone down due to gadget use. Technology addiction was more among male students (odds ratio = 2.82, 95% CI = 1.43, 5.59), those having a personal mobile phone (2.98, (1.52-5.83), use smart phone (2.77, 1.46-5.26), use one additional gadget (2.12, 1.14-3.94) and those who were depressed (3.64, 2.04-6.49)., Conclusion: Increased mobile phone access in rural India is leading to technology addiction among school students. Certain demographic and gadget specific factors predict addiction. The technology addiction possibly contributes to poor academic performance and depression. This warrants studies on a larger scale, with interventions for judicious use of gadgets., (Copyright © 2019. Published by Elsevier B.V.)

Purpose: School teachers can play a key role in the first-aid management of school children experiencing a seizure. The teachers have a pivotal role in disseminating knowledge to the children of diseases experienced by them and developing positive attitudes among the children regarding the diseases. The present study investigated the knowledge and practices used by teachers to manage epileptic seizures. The study also tested an epilepsy intervention educational package to see whether it improved the knowledge and practices of the teachers regarding epilepsy., Methods: A total of 85 teachers in schools from Chandigarh, a city of northern India, participated in the study. At the start of the study the teachers completed a pre-tested, semi-structured questionnaire on the first-aid management of epileptic seizures. They were then presented with an intervention package that included audio-visual material on basic aspects of epilepsy. The teachers were then retested after the intervention (one immediately and another after three months from the intervention). A scoring system was devised to quantify the knowledge, attitude and skills of teachers., Results: More than 90% of the teachers had previously either heard or read about epilepsy. Nearly half of the teachers said that books and magazines were the most common source of their information, followed by the internet. A comparison of the knowledge, attitudes and skills about the first-aid management of epilepsy based on the before and after questionnaire scores showed significant improvements in the various domains (p<0.05)., Conclusion: The epilepsy intervention educational package provided a positive, short term, impact on the knowledge and skills of teachers about epilepsy. There is a need for regular workshops to improve and reinforce the knowledge and skills of the teachers about health problems like epilepsy., (Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Childhood obesity has recently been reported as a growing problem in low- and middle-income countries. One potential prevention strategy is to apply effective obesity prevention approaches from the United States and/or other Western countries into programs that can be implemented in developing countries such as India. The purpose of this study was to explore Indian students' perceptions of social-contextual factors related to obesity and whether they perceived a role for school-based obesity prevention. This study was conducted as a first step in a model to translate interventions from one culture to another. A total of 183 fourth- and fifth-grade students of middle socioeconomic status participated in focus group discussions. Analyses were guided by the essential principles of qualitative research and informed by social cognitive and social ecological theories. Results yielded five relevant themes: (a) student health behavior knowledge, (b) parental influence on health behavior, (c) school influence on health behavior, (d) media influence on health behavior, and (e) contexts for health promotion intervention. We found that students had moderate knowledge related to health behaviors (i.e., food intake and physical activity); that parents, schools, and the media are all important contributors to healthy and unhealthy behavior; and that schools can play an important role in the prevention of obesity. Results suggest that Indian middle socioeconomic status students are already moderately aware of the health benefits to nutritious food intake and physical activity, but parents, schools, and the media can influence unhealthy behaviors.

Background: Despite the available epidemiological evidence on the prevalence of mental health problems in childhood and adolescence, there is limited knowledge on whether there are differences in the level of need and service utilisation by young ethnic minority groups., Methods: Adolescents of 13-15 years from nine schools in two English cities in which children of Indian ethnicity were over-represented (n=2900), completed rating scales on different types of mental health problems, contacts with services and informal supports., Results: Indian adolescents scored significantly lower on general mental health and depression symptoms. They were also less likely than White adolescents to self-report having mental health problems, even for a similar level of need. Among those with mental health scores within the clinical range, Indian adolescents were less likely to have visited specialist services. Instead, they were more likely to first approach family members, teachers or general practitioners., Conclusions: Rather than a blanket approach being applied to policy and service planning to meet the needs of diverse communities of young people, more specific evidence needs to be gained about patterns of referrals of minority groups and their strategy of accessing supportive adults.