Search

For some children and young people (CYP) with long-term physical health conditions (LTPHCs) attending school can be difficult. There is a lack of evidence documenting their school attendance experiences, how schools manage absence for these children, and subsequent effects. This study utilised an existing dataset from eighty-nine 11-18-year-olds in mainstream secondary schools in the United Kingdom across 11 LTPHCs that provided first-hand accounts about the children's experiences of school. Data pre-coded "attendance" were subject to thematic analysis to explore issues emerging. Findings showed attendance patterns varied, with some CYP missing little and others significant amounts of education. Children with LTPHCs wanted to attend school and did their best to navigate education alongside health. School systems for attendance were inconsistent and adversarial. Remedial and supportive action emerged as lacking, and children felt it was their personal responsibility to make up for lost time and missed work when absent. Decisions on whether they attended school, coupled with practices promoting high attendance had detrimental consequences for CYP with LTPHCs educationally, emotionally and socially. Overall, children with LTPHCs felt punished, stigmatised, unfairly treated, unequal and excluded. Results have implications for education, health, and policy practitioners to better plan and target attention so that the LTPHC cohort are treated sensitively and equitably and afforded their entitlement to education when they cannot go to school for health reasons often outside of their control.

Students with Long-Term Conditions (LTCs) experience prolonged absences that can impact their school connectedness and belonging. Inclusive education policies in New Zealand advocate for equitable learning opportunities for students with disabilities. Students with LTCs are included under this purview, but responses to their unique learning and connectedness needs are not well articulated. Literature suggests the potential of technology to enable virtual connections to keep these students' continued presence and engagement in class (i.e., sustainable connections). Studies internationally and in New Zealand, argue that virtual connections with schools can enhance educational opportunities and a sense of belonging for students with LTCs. However, limited research is available on developing and nurturing such ongoing connections with schools. This article reports on a qualitative study investigating New Zealand stakeholder perspectives on the facilitators of virtual connection with schools for students with LTCs. Findings from a thematic analysis of 18 individual interviews with stakeholders highlighted six facilitators for virtually connecting these students with schools, indicating the need for a flexible approach tailored to students' needs, strong support systems and purposeful, safe and inclusive connection opportunities. The stakeholders indicated these facilitators as essential for the virtual school connections to be sustainable and enhance students with LTCs' presence, belonging and social connection in schools.

Background: Disparities in school attendance exist for children with medical complexity (CMC) due to COVID-19. Longitudinal changes in family-reported school safety perceptions and predictors of full-time, in-person school attendance are unknown. Methods: This was a prospective, longitudinal cohort study with 3 survey waves (June 2021-June 2022) among English- and Spanish-speaking families of CMC aged 5 to 17 years and pre-pandemic school attendance. Changes in Health Belief Model perceptions and full-time in-person school attendance were estimated using multivariate generalized linear modeling with repeated measures. Results: Among 1601 respondents (52.9% of 3073 invited), 86.8% participated in all 3 surveys. School safety perceptions improved with time; however, perceived susceptibility to COVID-19 increased. Full-time in-person school attendance rose from 48.4% to 90.0% from wave 1 to 3 (p < 0.0001), and was associated with motivation, benefits, and cues. For example, families with low compared to high motivation for in-person attendance had 76% versus 98% predicted probability for child's school attendance, respectively at wave 3 (p < 0.0001). Implications for School Health Policy, Practice, and Equity: Probability of full-time in-person school attendance was associated with several health belief model perceptions. School health policy and programs may benefit from promoting family motivation, benefits, and cues during future respiratory illness epidemics including COVID-19. Conclusions: In-person school attendance improved for CMC over time. Opportunities exist to continue optimizing in-person attendance and family-perceived safety for CMC at school.

Autistic adults experience stark health disparities and difficulties accessing health care. Their realities of managing complex health conditions are unknown. Our research explored the experience of Autistic adults self-managing diabetes. Interviews with Autistic adults with diabetes and their support people were thematically analysed to identify three key themes. The Autistic experience influenced diabetes self-management, including autism-unique challenges and strengths. Participants prioritised avoiding Autistic burnout over diabetes self-management; mitigating the psychosocial pressures of neurotypical systems took precedence. Health professionals often separated autism and diabetes subsequently overlooking key factors impacting diabetes self-management. To better meet the needs of Autistic adults, diabetes care and health management more broadly should be considered within the context of autism, including supports for self-management during Autistic burnout.

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT-FPOCC) models can assist assessment of low-risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best-practice care, consideration of other low-risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT-FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT-FPOCC procedures, with ENT triaging referrals, then SLT completing pre- and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post-service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty-three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre-/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT-FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre- and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services.

Background: Little is known about how health issues identified at the annual health check (AHC) are followed up and addressed, how participants self-manage their health in between AHCs, and what support they receive. This research aimed to explore this. Methods: People with intellectual disabilities (n = 12), and/or their supporters residing in Wales, were interviewed following their AHC and again at 6 and 11 months. A recurrent cross-sectional thematic analysis was undertaken. Results: Five main themes emerged from interview one: going for a health check, issues identified, and actions taken, supporting the self-management of health, the personal context, and addressing health inequities. Four main themes emerged from follow-up interviews: follow-up, supporting the self-management of health, the need for reasonably adjusted health services, and going for another health check. Conclusion: A broader system of support around the AHC is required if people are to achieve or maintain the best possible health.

COVID-19 spread across the nation with Black Americans experiencing twice of the prevalence of deaths than White Americans. Black American college students are facing a unique set of biopsychosocial costs including less retention and poorer mental health. Therefore, the purpose of this study was to examine how Historically Black College or University (HBCU) students contextualize COVID-19. Interviews were conducted with 19 participants and lasted 40-60 minutes. They discussed topics including: their COVID-19 knowledge, precautionary measures, and barriers and promoters of school success were covered. Data were coded through semi-open coding and discussed among the research team. Responses were summarized by eight themes: emotional responses, colorblind rhetoric, lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health. These findings may be used to develop interventions that moderate the impact of COVID-19 and future pandemics on mental health.

The COVID-19 pandemic has created significant challenges for Early Childhood Education and Care (ECEC) services and families, impacting family access to services and their communication and engagement with educators. This study aimed to examine parents' perspectives of family engagement with ECEC services during the pandemic. Primary caregivers in Victoria at the time of recruitment (September-November 2020) were invited to participate. Of the 66 participants who completed an online survey, 25 also took part in semi-structured video call or phone interviews; qualitative findings from these interviews are reported in this paper. Four key themes were conceptualised using a reflexive thematic approach: (1) disruptions to ECEC access and attendance impacting on family routines and relationships, and child development; (2) barriers to family engagement; (3) ECEC educators' support of families and children during the pandemic; and (4) increased parental appreciation of the ECEC profession. Findings revealed that disruptions to ECEC access and routines during the pandemic adversely impacted family engagement, and child learning and social-emotional wellbeing for some families. These were aggravated by other stressors, including increased parental responsibilities in the home, financial and health concerns, and changed work conditions. Findings also demonstrated successful methods used by educators to maintain communication and connections with families. Importantly, parents expressed increasing appreciation of the profession and an increased awareness of the value of family involvement in children's learning. Learnings regarding strategies for effective and alternative ways of engaging families are discussed.

This is the first study to investigate instrumental activities of daily living in older autistic adults. We conducted interviews with fifteen adults (mean age = 60.1, SD = 7.4, range = 50-73) from Australia with no intellectual disability. Analysis included both deductive and inductive steps, to categorise responses using the Occupational Performance Model Australia and identify themes across participants' experiences. Strengths and challenges were unique to the individual, as were the methods they had developed to manage tasks. Challenges occurred mostly at the interaction between aspects of the environment (sensory, cognitive, social and cultural) and personal factors such as health conditions and sensory sensitivities. Enhanced person-environment fit is needed, as is a shift in wider sociocultural attitudes to enable comfort and autonomy in later life.

The City of Kitchener is the largest city in Waterloo Region in the province of Ontario, the third fasting growing region in Canada, yet it has only one air quality monitoring station. Our research group launched a pilot project in September 2020 to install a network of AQMesh multisensor mini air quality monitoring stations (pods) near elementary schools in Kitchener. Here, we describe an outreach and educational project (The Clean Air Outreach Project), which we launched in May 2021 for elementary-school-aged students attending schools near the pods. The primary goal of this project was spreading awareness about air quality and its connection to health impacts, principles of chemical reactions in the atmosphere, and climate change. The project continued until December 2021. Virtual presentations were delivered by a team of undergraduate university students to a total of 350 students in grades 5-8. Student knowledge was assessed using poll questions and Kahoot games. Follow-up interviews were conducted with the teachers, who reflected on the impact and educational elements of our presentations. The outcomes of this outreach project and teachers' feedback revealed that such initiatives can spark interest in scientific knowledge in general and engagement in environmental issues at the school and community levels.

Background: Black men and women have the highest rates of obesity in the United States. Behavioral weight loss programs incorporating intimate partners may be effective in combating obesity among this population. Yet, current participation in these programs is low. Identifying motivations and triggers to weight loss may provide insight in designing programs to increase participation. Aim: To determine triggers and motivations for weight loss among Black men and women in committed relationships to inform development of weight loss interventions. Method: Twenty semi-structured interviews, based on an integrated theoretical framework of interdependence and communal coping and the social cognitive theory, were conducted among Black heterosexual couples where one or both individuals intentionally lost [greater than or equal to]5% of their body weight in the last 6 months in a metropolitan region in a southern state. Interviews were transcribed and coded. Themes were identified following multi-rater coding and direct and conventional content analysis. Recommendations were developed from emergent themes. Results: Among individuals with recent weight loss, personal relevancy and awareness (health awareness and self-awareness) were identified as personal triggers for weight loss initiation. Health concerns and appearance were general motivations among the total sample. Conclusion: Emphasizing the impact of weight on daily functioning and quality of life, and increasing awareness of personal weight status and health consequences, may increase weight loss initiation and participation in weight loss programs among Black men and women in committed relationships. Findings also highlight strategies to improve recruitment and retention and guide intervention development and implementation for this population.

Background: As the life expectancy of people with intellectual disability increases, they may now outlive their parents or their parents' ability to continue to care. Siblings of adults with intellectual disability often succeed their parents as primary carers. Little is known about the health and well-being of this important cohort of carers who will be both caring for and ageing alongside their brother or sister with intellectual disability. The Carer's Study within The Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) provides a unique insight into the health and well-being of family carers of older adults with intellectual disability including sibling carers in Ireland. This article reports on the findings from waves 1, 2, 3 and 4 of the IDS-TILDA Carer's Study. Methods: The IDS-TILDA Carer's Study surveys family carers of older people (aged 40 years and older) with intellectual disability on a 3-yearly cycle. The family carers complete a self-administered, mixed-methods questionnaire. The qualitative data are analysed thematically, and a descriptive analysis of the quantitative data is conducted using SPSS. Findings: In each wave, sibling carers comprised a significant proportion of the Carer's Study participants: W1 58%; W2: 61.4%; W3: 76.7%; and W4: 45.8%. The siblings were predominantly female, not in paid employment and were caring without the support of a spouse or partner. Across the four waves, siblings reported good general health. However, a high prevalence of particular conditions including back pain, aching joints and stress was also reported, and in each wave, siblings reported feeling completely overwhelmed by their care responsibilities. Although sibling carers reported that they have considered the future, only a minority have progressed to action in this regard. Conclusions: There is evidence of the strong relational and emotional commitment by the siblings to their brother or sister with intellectual disability. However, through the four waves of data, there was also evidence of physical, mental and financial toll. An urgent need exists to identify and engage with siblings to protect their well-being as they provide care for an increasingly ageing sibling.

Gradients across socioeconomic status occur for many children's health and improvement in high-income countries. The objective is to explore infant growth and child development in four developed countries around the socioeconomic landscape. In this paper, Structural Equation Modeling (SEM) enhances the socioeconomic status gradients for the child's developmental health. The proposed model develops the socioeconomic status is related to a huge list of health issues, including low birth weight, cardiovascular diseases, hypertension, arthritis, diabetes, and cancer, regardless of whether it is determined by income, education, or profession. This is a global phenomenon, seen in countries with low, medium, and high incomes. The size of disparities found in scores and percentiles across neighborhoods is comparable to the results of more developed growth forecasters such as sex. These results have significant consequences for the nature of tailored, efficient, and timely programs to support early childhood success.

Individual with intellectual disabilities can have special health care concerns and will often need support in managing their health care needs. These health care needs can include diabetes, obesity management or fitness. Activity trackers have become widely available as a tool for managing health needs by monitoring number of steps, activities, and consumption. Individuals with ID can become independent users of activity trackers using self-management skills such as visual checklists and task analysis. This article provides a model for setting up and using activity trackers with self-management for individuals with ID.

I have often felt ashamed of the disabled aspect of my masculine identity. Reflexive, autoethnographical practices help me to ask why? These practices facilitate a reorientation of my frames of reference, from shame to acceptance, by examining attitudes which coalesce around what has been described as the dilemma of disabled masculinity. This dilemma arises as disability is associated with helplessness whereas masculinity is associated with power and autonomy. Power and strength are particularly salient as my own condition is one of weakness, a neuro-muscular disorder. Living outside societal constructions of masculinity can impact identity formation, employment prospects, and educational attainment. I describe the uncommon interplay between my health condition and working as a Further Education teacher to outline an accord between the precarity of this role and a disabled, masculine intersectionality. Accordingly, I assert that my disabled male identity is vital, vibrant, and valuable.

The purpose of this study is to investigate outdoor play experiences of preschool children in Turkey and to compare the experiences of these children with previous generation. The sample of the study consists of 398 parents with children aged 3-6 years old attending to a pre-school education institution in the province of Adana, a city located in the south of Turkey. The questionnaire of "the parents and children's outdoor play experiences", which was based on the study of Clements (2004) was adapted by the researchers and was used as the data collection tool. While the quantitative data were analysed through frequency and percentage, the qualitative data were analysed by means of content analysis. Results revealed that today's children got involved in outdoor play activities significantly less than their parents did. Health conditions, safety concern, lack of environmental opportunities and use of technological device (computer, television, tablet pc etc.) were reported as the main reasons of the findings in the present study by parents. The results show similarity with the related literature.

Adults with autism and co-occurring intellectual disability engage in low levels of physical activity and are at increased risk of developing secondary health conditions attributed to physical inactivity compared to adults in the general population. Few studies have examined the use of objective measures to characterize physical activity levels for adults with autism and intellectual disability. The current study aimed to examine the relationship between physical activity, using an activity tracker, and quality of life in adults with autism and intellectual disability. In the current study, 38 adults with autism and intellectual disability, ages 18-55, wore a Fitbit Flex 2® activity tracker for 1 week, and completed the Quality of Life Questionnaire. The relationship between average daily step count quality of life was examined. Most adults in the sample were overweight and taking fewer daily steps than recommended guidelines. Increased average daily step count was significantly associated with quality of life.

Objective: This study aimed to assess the quality and readability of web-based information on familial hypercholesterolaemia. Design, setting and methods: Internet searches using the terms 'familial hypercholesterolemia', 'hypercholesterolemia', 'inherited high cholesterol', 'hereditary high cholesterol' and 'inherited high LDL' were conducted with the Google, Yahoo! and Bing search engines using default settings during August 2021. The first 50 web links that appeared using each search engine were evaluated using the Flesch Reading Ease Score (FRES) and DISCERN instrument for readability and the quality of the website. The LIDA tool was used to assess reliability and usability. Results: In all, 750 websites were accessed and 38 websites were included in the analysis. The majority of the websites (29, 76.3%) were owned by non-governmental institutions. Twelve (30.8%) websites were certified by the Health On the Net Foundation (HON) code of conduct. Only 17 websites (44.7%) had a stated author. Twenty-nine (76.3%) websites had a stated date of publication. Only 16 (42.1%) provided references for the statements made. Infographics were used in 17 (44.7%) websites. The median FRES was 47.15 (range: 22.3-91.8), which is equivalent to college-level readability. The median LIDA usability and reliability score was 38.00 (range: 25-46) and 15.00 (range: 7-24), respectively. The median DISCERN score was 45.00 (range: 17-76). The DISCERN score was significantly associated with the FRES (0.047) and whether the website was governmental or not (0.028). Conclusion: According to this study, the readability, reliability, usability and quality of the majority of websites were inadequate. Due to the rapid growth in the use of the Internet, steps need to be taken to standardise and regulate patient education websites for this and perhaps other health conditions.

The increasing prevalence of chronic health conditions (CHCs) in school-aged children highlights the need to better understand school health services' role regarding CHCs. Using U.S. nationally representative district-level data from the 2016 School Health Policies and Practices Study, we examined whether having policies on school nurses' employment was associated with having policies on CHCs and whether having such policies varied by geographic location. Compared to districts without such employment policies, districts with such policies (52.3%) were significantly more likely to have CHC management policies. For each CHC policy examined, more than 20% of school districts did not have the CHC policy, with Northeast districts having the greatest proportion of such policies and West districts having the least. Thus, many students' CHC needs may not be met at school. It is important for school nurses to play a key role in advocating for the development of school-based policies on CHCs.

Productivity demand of Brazilian Postgraduate Programs has increased as a result of global scientific and technological competitiveness, leading to stresses among researchers and students. Thus, this work was aimed at evaluating the quality of life of students of one Postgraduate Program in Agronomy through the WHOQOL-bref. Of the 36 students evaluated, there was a predominance of single women, childless, with a median age of 27 years, in a Master Degree, without paid work or scholarship. The sample studied presented values below the median of the Brazilian population, when corrected for gender and age, for the psychological, social relations and environment domains. Students with partner had lower values for physical and psychological domains and students with paid work showed a lower value for physical domain. The work phase affected the quality of life. The values for the environment domain increased when the student was writing the project, studying subjects and seeking theoretical framework and decreased when the student was analysing the data. As the University is the dominant environment for the students when in post graduation, the activities that are associated with academic infrastructure as library and laboratories, and with human resources as teachers and colleagues are realized with successful in relation to those that depend of the students themselves as the data analysis. These results alert us for the need for therapeutic interventions aimed at improving the health conditions of postgraduate students.

Racial bias in research impacts a study's relevancy, validity and reliability, though presently this aspect is not addressed in critical appraisal tools, and consequently appraisers may not take racial bias into account when assessing a paper's quality. Drawing on critical race theory (CRT) tenets that racism is ubiquitous and race a social construct, this paper discusses concerns regarding racism in research which have been broadly divided into two categories for critical appraisers to consider: the underrepresentation of minoritised ethnic groups in health studies, especially where minoritised populations see higher rates of disease occurrence and; the utilisation of racial/ethnicity data to interpret disparities in outcomes, including speculation of biological race, the misinterpretation of genetic ancestry as race, and the lack of investigation into social determinants of health, including systemic, institutional and interpersonal forms of racism. The injustices exposed in this paper impact the health of minoritised ethnic groups and are therefore a Black Lives Matter issue. They risk resurrecting dangerous theories regarding biological inferiority among minoritised ethnic populations, as well as hindering study findings. The application of CRT frameworks in health science research quality appraisal is discussed in relation to the above themes--using largely UK-based contexts with supporting examples from the US--followed by recommendations for critically appraising for antiracism. Further information to support critically appraising for antiracism can be found via https://www.criticallyappraisingantiracism.org/.

The pandemics and epidemics experienced in Turkey after the second quarter of the twentieth century had a profound impact on society and education. The "General Hygiene Law", which came into force in 1930 in an attempt to fight against increasing epidemic diseases, was a service provided by the state to improve health conditions in the country and to combat all diseases that threatened the health of the nation. Flu (influenza) epidemics that occur almost every winter in Turkey were experienced particularly severely in the years 1932, 1949 and 1957 and dominated the whole agenda of the country. Another disease that was as severe as flu and that was experienced every year as an epidemic was tuberculosis, and it wrought havoc in the lives of people in many cities, towns and villages across the country. During the periods of these epidemics, education was interrupted from time to time and, schools were suspended. In this study, changes in education, restrictions, obstacles, measures taken and methods developed against epidemic diseases in Turkey are discussed. The data of the study were obtained from primary sources, such as documents from the State Archives, newspapers and magazines published in that period, laws and regulations, books and articles written in the period, and brochures and textbooks published.

Background: People with developmental disabilities experience worse health than typically developing peers. This health differential is often described in terms of health disparities, which refers to differences caused or exacerbated by social or access issues. Objective: the goal of this study was to compare the weight status and health conditions of adults with Down syndrome to comparison groups of adults with developmental disabilities and adults with no disability. Methods: Information about health risks and health conditions was collected for 291 adults with Down syndrome living in Ohio through an online survey. We compared this data on adults with Down syndrome to state-level data from adults without disabilities (2012 BRFSS) and Ohio data on a random sample of adults with developmental disabilities other than Down syndrome (2012-2013 National Core Indicators). Results: Adults with Down syndrome were 3 times more likely to be overweight or obese than adults without disabilities. Surprisingly, despite having a body mass index in the overweight or obese range, 70% of adults with Down syndrome reported having eating habits that were good to excellent and less than 6% of the Down syndrome sample reported having co-occurring diabetes or hypertension. Discussion: Despite high rates of overweight and obesity, few adults with Down syndrome reported having the chronic health conditions associated with excess weight. Further research is needed to understand the health risks of overweight in adults with Down syndrome and the availability of health promotion programs for this population.

Inpatient hospitalizations for ambulatory care sensitive conditions (ACSC) among beneficiaries with and without intellectual and developmental disabilities (IDD) were examined using Medicaid and commercial claims from 2010-2014 in New Hampshire. IDD was defined with "International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM)" codes using algorithms from the Centers for Medicare and Medicaid Services, and inpatient encounters were identified using the Healthcare Effectiveness Data and Information Set. In adjusted analyses, beneficiaries with IDD had more hospitalizations for ACSC than those without IDD in both insurance groups. Differences in patterns of ACSC prevalence, comorbidities, and hospital admissions between the commercially and Medicaid-insured groups show the value of using all-payer claims data, when possible, to understand health needs and health care utilization of insurance beneficiaries with IDD.

The Islamic Republic of Iran is obliged to respect the right to education under international human rights law and has made legal commitments to conform to the 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR) and the 1989 Convention on the Rights of the Child (CRC). Drawing on the framework developed by former Special Rapporteur of the UN High Commission for Human Rights on Education, Katarina Tomaševski, that education must be available, accessible, acceptable and adaptable, this article discusses Iran's response to its obligation to make education available and accessible. It illustrates how the state is falling short in its duty to make education available and accessible to all children under its jurisdiction, reinforcing the gender inequities experienced by girls and practising religious discrimination in educational access.

Background: Given the disparity of research regarding Historically Black College and University (HBCU) students' health and chronic disease risk, investigation of exercise readiness and life stress is warranted. Purpose: This study investigated exercise readiness and life stress among undergraduate students at an HBCU. Method: The quantitative cross-sectional study utilized a Stages of Change framework. A survey determined exercise readiness and life stress scores among HBCU undergraduates (n = 304). Results: Most respondents (57%) were exercising regularly and classified in the Action and Maintenance stages. Approximately 44% reported normal Body Mass Index (BMI), and nearly 50% were overweight or obese. Life stress scores ranged from 1 to 31 (M = 14.23, SD = 6.05). Scores were highest in the Precontemplation stage (M = 15.64, SD = 4.31) and lowest in the Contemplation stage (M = 12.54, SD = 5.64). Median life stress scores were not statistically different between exercise readiness groups X[superscript 2] (4) = 55.61, p = 0.193. Discussion: Freshmen, especially females, should be encouraged to continue exercising to maintain a healthy BMI and reduce chronic disease risk. Translation for Health Education Practice: HBCU exercise interventions call for a socio-ecological approach based on current readiness stage distribution.

Purpose: The literature has acknowledged that good health is a crucial component of well-being. This study explores the country-specific understanding of slum dwellers' occupational activities and their environmental behavior. Design/methodology/approach: Using the environmentally responsible behavior model, the study utilized exploratory qualitative approach to purposely sample 35 respondents, who responded to health-related behaviors through in-depth interviews. Findings: Findings show that respondents are engaged in diverse socio-economic occupational activities such as selling of cooked and uncooked food in polythene bags, selling of sachet water and burning the waste generated from these activities in the slum environment. In addition, the study found specific occupational activities of masons, carpenters, tilers, salon beauticians, scrap dealers and unhygienic waste disposal in the slums. Finally, this study uncovered divided opinions in terms of respondents' environmental responsibility and awareness of environmental ramifications. Therefore, issues such as health hazards, unhealthy environment and soil deterioration are common at the slum dwellings. Research limitations/implications: The study findings and the conclusion drawn cannot be generalized to represent the entire population of slum dwellers in Ghana due to the qualitative methodology employed. Practical implications: This study revealed a country-specific understanding of the environmentally responsible behavior of slum dwellers based on their occupational activities, which can inform health policies. Originality/value: The outcome of this study advanced contextual culturally specific understanding, concerning health-related behavior of slum dwellers, which is important to policymakers and practitioners in contexts.

Rousseau is among the most influential and important public moralists of the eighteenth century. His popular treatise on education, Emile, argues that parents should ideally rear their own children. It is small wonder, therefore, that his decision to place his own children in a foundling hospital has exposed Rousseau to the charge of hypocrisy and seriously damaged his credibility as a moralist and educational theorist. This article argues that this view is unfair. Only when his behaviour as a parent is put in the context of his theory of public education in its entirety, including works other than "Emile," can a fair judgement be made about his treatment of his own children. Above all, it will be shown that Rousseau's denial that he was a hypocrite is substantially correct and vitally important to the credibility of the new moral sensibility that was central to his theory of education.

Good health is positively related to children's educational outcomes, but relationships may not be causal. Demonstrating a causal influence would strongly support childhood and adolescent health as important for education policy. We applied genetic causal inference methods to assess the causal relationship of common health conditions at age 10 (primary/elementary school) and 13 (mid-secondary/mid-high school) with educational attainment at 16 and school absence at 14-16. Participants were 6113 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Exposures were symptoms of attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression, asthma, migraines and BMI. Genetic liability for these conditions and BMI was indexed by polygenic scores. In non-genetic, multivariate-adjusted models, all health conditions except asthma and migraines were associated with poorer attainment and greater school absence. School absence substantially mediated effects of BMI (39.9% for BMI at 13) and migraines (72.0% at 10), on attainment with more modest mediation for emotional and neurodevelopmental conditions. In genetic models, a unit increase in standardized BMI at 10 predicted a 0.19 S.D. decrease (95% CI: 0.11, 0.28) in attainment at 16, equivalent to around a 1/3 grade lower in all subjects, and 8.7% more school absence (95% CI:1.8%,16.1%). Associations were similar at 13. Genetic liability for ADHD predicted lower attainment but not more absence. Triangulation across multiple approaches supports a causal, negative influence on educational outcomes of BMI and ADHD, but not of ASD, depression, asthma or migraine. Higher BMI in childhood and adolescence may causally impair educational outcomes.

The number of students with chronic and complex health conditions significantly affects a teacher's ability to teach and meet the needs of the whole child--especially combined with the impact of societal issues such as poverty, violence, and the growing population of families who speak a language other than English at home. Education in America is free, but healthcare is not. This fact presents a unique divide among schools and even within classrooms, where some students have parents who have good healthcare coverage and seek medical attention regularly, while others come from families who are limited to emergency room visits for chronic illnesses or only see a healthcare professional in life-threatening situations. School nurses can help bridge this divide. Often, they are the only healthcare professional that students see regularly. So when a class includes Paul (who has missed multiple days of school, seems distracted when he does attend, and often has a deep, penetrating cough), Keisha (who stays in her seat during class but always seems drowsy), Aidan (whose disruptive behavior makes instruction difficult), and Anni (who is struggling to learn English), the school nurse should be one of the first resources their teacher turns to. Unfortunately, not every school has a nurse. Only about 50 percent of schools have a full-time registered nurse for at least 30 hours per week, and 18 percent do not have a nurse at all. American children have chronic health conditions (such as asthma, diabetes, severe food allergies, and seizure disorders), which school nurses are trained to help manage. With so many students in need of medical care in school--whether that care is related to a chronic illness or an emergency situation--and so few nurses in schools to help them, policymakers, educators, and the general public must understand all that school nurses do so they can advocate for having one in every public school.

The purpose of the article is to present and analyze the results of experimental work to verify the efficiency of the developed and approved program aimed at the formation of social competence in adolescents with physical problems. The leading method in the study of this problem is a consequent version of the pedagogical experiment. The results of this experimental work approved the consistency of the proposed program "I'm in the world of people" to improve the overall indicator level of social competence in adolescents with physical illness and its components, such as cognitive, value-meaningful, activity-based and communicative. The developed program includes content, a variety of forms and methods of pedagogical interaction with teenage pupils with physical problems. The paper identified the differences in systemically important components of social competence of adolescents with poor health at the ascertaining and control stages of the experiment, determined specific nature of socialization and social networking features of the sample participants. The program developed for the formation of social competence in adolescents can be used in the practice of special institutions for children with physical illnesses, as well as recommended for the comprehensive school, contributing to the expansion of the arsenal of tools used for the formation of social competence in adolescents.

In Russia the system of spreading health-culture among the young generation, the students, has not been formed yet, which makes the paper topical and up-to-date. The young generation is characterized by a low level of education and professional training efficiency in healthy life-style and health culture. It has caused depreciation of the concepts "health" and "healthy life-style," they have been excluded from the value system of the young. Deplorable health condition of contemporary students was the reason that made the state authorities shift the national policy priorities and improve and upgrade valeological knowledge. Thus the paper aims at showing the ways of spreading health culture by means of a special academic course. The key research methods are the following: health monitoring of the future Bachelors of Education, analyzing normative documents, getting together and generalizing the facts, making a pedagogical experiment, and forming the informational field for the theoretical grounds of health-culture. The paper presents the results of physical health monitoring of students who are future teachers, it reveals the ways of forming health-culture by means of an academic course. The necessity of improving valeological knowledge of the students and providing the bases for protecting and improving health of the future Bachelors of Education is explained. The research material has a practical value for the headmasters, teachers, and students of higher educational establishments, as well as for the scientists whose research sphere deals with students' health condition and the ways of its protecting and improving.

Incarcerated people are at disproportionately high risk of contracting COVID-19. Prisons are epicenters for COVID-19 transmission, including to the community. High rates of preexisting health conditions, limited access to quality health care, and inability to social distance make it impossible to reduce the impact of COVID-19 in prisons. Due to a history of compounded social determinants, incarcerated populations are disproportionately composed of people of color and people with stigmatized behavioral health disorders. Rapid decarceration is needed to promote health equity. Historical mass decarceration events demonstrate feasibility to rapidly release large groups of people while maintaining public safety. Iran and Ireland have released substantial portions of their prison populations by transitioning people to home confinement. In the United States and Uganda, some jurisdictions have reduced new incarcerations through policies that decrease arrests. These policies must be globally expanded to contain the epidemic, and its potential health consequences, while addressing health equity.

Purpose: This study aimed to explore the health literacy profile of individuals attending a metropolitan community rehabilitation center in Victoria, Australia. Methods: 295 consecutive attendees of a community rehabilitation program between January and August 2015 were invited to complete the Health Literacy Questionnaire (HLQ), a 44-item questionnaire comprising nine independent scales of health literacy, and provide demographic data. Exclusion criteria were having severe dementia and inability to communicate to complete the HLQ. Participants and nonparticipants were compared using descriptive analysis. Means cores were calculated for each of the nine health literacy scales. Linear regression was used to establish associations between demographic variables and HLQ scale scores. Results: 149 individuals participated in the study (response rate 50.5%). Several demographic characteristics were associated with lower scores in one or more health literacy scales. Largest differences were observed for participants who spoke a language other than English at home. Conclusions: This study describes the health literacy profile of individuals attending a community rehabilitation program. These data can facilitate generation of ideas and opportunities to address the needs of this population.

This study explored Ghanaian primary school teachers' values and challenges of integrating cultural games in teaching mathematics. Using an In-depth conversational interview, ten (10) certificated teachers' voices on the values and challenges of integrating games were examined. Thematic data analysis was applied to the qualitative data from the interviews. Results indicated that although cultural games count as instructional tools in four knowledge domains, actualizing their value in the classroom appears problematic for lack of game-based pedagogical know-how. The study recommended looking into the classroom for a complete understanding of the values and challenges of integrating games in teaching and learning mathematics.

In theory, improving low-income families' housing and neighborhoods could also improve their children's health, through any number of mechanisms. For example, less exposure to environmental toxins could prevent diseases such as asthma; a safer, less violent neighborhood could improve health by reducing the chances of injury and death, and by easing the burden of stress; and a more walkable neighborhood with better playgrounds could encourage children to exercise, making them less likely to become obese. Yet although neighborhood improvement policies generally achieve their immediate goals- investments in playgrounds create playgrounds, for example-Ingrid Gould Ellen and Sherry Glied find that many of these policies don't show a strong effect on poor children's health. One problem is that neighborhood improvements may price low-income families out of the very neighborhoods that have been improved, as new amenities draw more affluent families, causing rents and home prices to rise. Policy makers, say Ellen and Glied, should carefully consider how neighborhood improvements may affect affordability, a calculus that is likely to favor policies with clear and substantial benefits for low-income children, such as those that reduce neighborhood violence. Housing subsidies can help families either cope with rising costs or move to more affluent neighborhoods. Unfortunately, demonstration programs that help families move to better neighborhoods have had only limited effects on children's health, possibly because such transitions can be stressful. And because subsidies go to relatively few low-income families, the presence of subsidies may itself drive up housing costs, placing an extra burden on the majority of families that don't receive them. Ellen and Glied suggest that policy makers consider whether granting smaller subsidies to more families would be a more effective way to use these funds.

There are many reports that identify the communication of persons with deafblindness. These reports are descriptive in nature, highlighting comprehension, gesture development, communication actions (that is, forms) and purposes (that is, functions), and the collection of verbal skills. This report extends the literature with an in-depth descriptive analysis of sign language, spoken words (that is, speech), communication repair strategies, and Communication Matrix levels. As already noted, sign language and speech are typically included in other research reports, but few consider Communication Matrix levels or repair skills despite the importance and relevance of both. Results of the study reported here imply that parents and educators might expect a wide range of skills as children who are deafblind develop speech and sign language abilities, specifically, and communication skills more generally. It is difficult to know why particular children develop more skills than others. To address this gap, future research needs to consider which intrinsic and environmental influence the acquisition of communication skills so that parents and professionals (that is, special education teachers, developmental pediatricians, educational psychologists, or speech-language pathologists) can consider evidence-based prognostic elements during educational assessment activities.

Health and nutrition are the fundamental elements which impact on the schooling process of children irrespective of their level of education. These are non-negligible aspects that affect the performance of school going children. Recent developments in the effort to enhance the education for all initiative have been emphasizing on improved health and the nutrition status of pupils in order to better school performance. Given that human environment influences the health of individuals and communities in terms of their performance, discussions on nutrition and health are worthy of provoking debates involving several aspects of the political, social, economic and cultural developments of societies because the progress of a community depends on the health of its members. This is because health conditions of individuals affect their performance and output which have long run implications on the well being of the community as a whole. Societies that guarantee good health and nutrition for their citizens can boast of higher output including high performance in school. It is in this perspective that we carried out a study on school health, nutrition and school performance in rural Cameroon. Cameroon is divided into ten administrative regions with two of them speaking the English language while the rest speak French. Our study was carried in four of these ten regions. The choice of these localities was done from the assumption school distribution in the country is according to the different agro ecological zones which are: the Sudano-Sahelian region -- (Adamawa, North and far north); equatorial forest region (Centre, South and East); the Savanna region (West and Northwest regions) and the coastal region (Littoral and Southwest). The different sites were selected from the four zones as follows: the Far North, the South, the Southwest and Northwest regions. In each of these localities, 180 teachers were interviewed in 30 schools from each while for each of the schools, 210 pupils in the final classes were interviewed. The category of schools which were considered from the rural areas were: lay private, mission schools and state owned schools. Two types of research tools were administered to the study population as follows: questionnaires for both teachers and parents while interviews through interview guides were administered to pupils of the senior primary classes (five and six). Data was obtained equally from parents and other key informants from government ministries and none governmental organisations through focus group discussion guides. We also carried out some observations in the different schools which enable us to see the different health and nutrition facilities available in these schools. Therefore, the data collection for this study was both quantitative and qualitative by the use of the aforementioned tools.

Parents' health and children's health are closely intertwined--healthier parents have healthier children, and vice versa. Genetics accounts for some of this relationship, but much of it can be traced to environment and behavior, and the environmental and behavioral risk factors for poor health disproportionately affect families living in poverty. Unhealthy children are likely to become unhealthy adults, and poor health drags down both their educational attainment and their income. Because of the close connection between parents' and children's health, write Sherry Glied and Don Oellerich, we have every reason to believe that programs to improve parents' health will improve their children's health as well. Yet few programs aim to work this way, except for a narrow category of programs that target pregnant women, newborns, and very young children. Glied and Oellerich assess these programs, discuss why there are so few of them, and suggest ways to expand them. Their chief conclusion is that structural barriers in the U.S. healthcare system stand in the way of such programs. Some of these barriers have to do with health insurance, access to care, and benefits, but the biggest one is the fact that physicians typically specialize in treating either children or adults, rather than families as a whole. The Affordable Care Act has begun to break down some of these barriers, the authors write, but much remains to be done.

Objectives: To understand the views of qualified medical practitioners regarding "reasonable adjustments" and the quality of the care and treatment provided to adults with intellectual disabilities when admitted to acute hospitals as inpatients. Methods: Semi-structured interviews took place with 14 medical practitioners, seven from each of two acute hospitals, with a thematic analysis of the resulting data. Results: All 14 medical practitioners reported problems in the diagnosis and treatment of patients with intellectual disabilities. Most participants attributed these difficulties to communication problems and/or behaviours that, in the context of a hospital ward, were non-conforming. However, a minority reported that, because they were likely to have multiple comorbid health conditions, patients with intellectual disabilities were more complex. In addition, half of all these respondents reported making little use of "reasonable adjustments" introduced to improve the quality of the care received by this group of patients. Conclusions: Medical practitioners should make better use of the "reasonable adjustments" introduced in the UK to address inequities in care and treatment received by patients with intellectual disabilities. However, training should also focus on the biomedical complexities often presented by these men and women.

People with intellectual and developmental disabilities (IDD) are frequent users of health services. We examined how their service utilization of emergency department (ED), inpatient hospitalization, and primary care physicians changed as they transitioned from fee-for-service to Medicaid managed care (MMC). Our results showed that MMC reduced the utilization of all of these services. A substantial decrease in ED visits was associated with the reduction in visits due to mental/behavioral health conditions and conditions that could be nonemergent and manageable with the community-based health services. These findings suggest that health service utilization of people with IDD is related not only to their health needs, but also to the delivery model that provides their health services.