Improved population coverage of the human papillomavirus vaccine after implementation of a school-based vaccination programme: the Singapore experience

INTRODUCTION@#Cervical cancer has a high disease burden in Singapore, and it is strongly associated with human papillomavirus (HPV) infections. Despite constant efforts to encourage vaccination, local HPV vaccine uptake remains low. Universal mass vaccination is a proven cost-effective method to reduce the cervical cancer disease burden. This paper reviews the newly implemented school-based HPV vaccination programme in Singapore and the factors that led to its success.@*METHODS@#Fully subsidised HPV vaccinations were offered to all Secondary 1 female students on an opt-in basis, starting as a rollout dose in 2019. One-time catchup vaccination was also offered to female students in Secondary 2-5. Eligible recipients were identified using enrolment data provided by Ministry of Education schools. A total of 19,144 students across 139 schools were offered the rollout dose, and 20,854 students across 140 schools were offered the catchup doses.@*RESULTS@#High vaccine uptake rates of 80.6%-87.3% were noted with the introduction of the school-based programme, translating to high vaccine coverage of 90.3%-93.4%. Only a small proportion of students (1.5%-1.9% per cohort) opted out. The rate of reported side effects, which were commonly known effects, was low at one in 1000. Among the students who reported side effects, those who received the second vaccine dose did so uneventfully.@*CONCLUSION@#High HPV vaccine coverage was achieved after implementation of the school-based immunisation programme. Timely assessment of knowledge lapses and targeted intervention, strong partnerships with stakeholders, constant on-site adaptation and positive social influence contributed to its success. This model can be applied to future school health programmes.

An outcomes-based evaluation of the mindfulness for safe schools program

Objectives@#The objective of this evaluation was to assess the effectiveness of Mindfulness for Safe Schools, a mindfulness-based intervention adapted for sexual abuse prevention during peer-to-peer dating among Filipino public school children in Grades 7 and 8. It was hoped that through the intervention, children would be able to regulate their emotions so that they do not react impulsively to emotionally stimulating events, especially during peer dating. The study consists of four levels of evaluation: reaction, learnings, and behaviors of teachers toward the program, as well as effect of the intervention on emotion regulation and peer conformity among students. @*Methods@#This study utilized a mixed methods design using a concurrent embedded method. For teachers, quantitative surveys and focused group discussions were conducted to determine their reactions to the training, their learnings, and behaviors after the program, as well as their observations of students’ responses to the intervention. Focused group discussions were analyzed through thematic analysis. Effect of the program on emotion regulation and peer conformity among students were determined mainly through a pre and post-test survey and analyzed through paired samples t-test. Video content analysis of the classroom delivery was also conducted to determine student engagement during the program. @*Results@#Teachers reacted favorably to the training workshops and were able to use what they learned from the workshops to increase their patience and understanding towards themselves, their job, and their students. Students also reacted favorably to the Mindfulness for Safe Schools modules and were observed to use the skills taught in the modules to regulate their emotions. Emotion regulation improved (t=3.47, significant with p=0.00) and susceptibility to peer pressure decreased (t=8.94, significant with p=0.00) for Grade 8 students (n=950) after the modules were delivered. However, teachers reported implementation issues, such as conflicting requirements of the program with their official workload, which may have affected program effects. @*Conclusion@#Our findings indicate that Mindfulness for Safe Schools was associated with improvements in emotional awareness, management of negative emotions, and showing care and respect for student peers. It also suggests that integrating mindfulness interventions in schools requires close coordination with all stakeholders: teachers, schools, and appropriate government divisions to ensure fidelity and reaching desired effects.

School environment and adherence to school meals among Brazilian public-school adolescents

ABSTRACT Objective: To assess whether the school environment is associated with adherence to school meals among adolescent students in Brazilian public schools. Methods: Data from the 2015 National School Health Survey were analyzed. The provision of school meals was assessed according to student report and adherence through the frequency of weekly consumption, classified as adherence (≥3x/week), unsatisfactory adherence (≤2x/week), and non-adherence (none). The following characteristics of the school environment were considered: availability of a properly functioning kitchen and dining hall, cafeteria, and alternative outlets inside or outside schools, and sale of unhealthy food in the cafeteria and alternative outlets. Prevalence estimates were calculated considering the sample's complex design. Results: 86.5% of public schools offered school meals, to which 31.3% of students adhered, 37.9% had unsatisfactory adherence, and 30.8% did not adhere to school meals. Adherence to school meals was higher among schoolchildren in the Midwest Region, from non-capitals, and rural area, while less adherence was observed among students from schools with a cafeteria, an alternative food outlet, and a cafeteria selling soft drinks. Conclusions: Low adherence to school meals is associated with the school geography and food environment. These results can support the formulation of actions to improve the school environment and help the universality of participation in the School Nutrition and Food Policy.

RESUMEN Objetivo: Evaluar si el ambiente escolar está asociado con la adherencia a las comidas escolares entre los estudiantes adolescentes de las escuelas públicas brasileñas. Métodos: Se analizaron datos de la Encuesta Nacional de Salud Escolar de 2015. La provisión de comidas escolares se evaluó de acuerdo con el informe del estudiante y la adherencia a través de la frecuencia de consumo semanal, clasificada como adherencia (≥3x/semana), adherencia insatisfactoria (≤2x/semana) y no adherencia (ninguna). Las características del entorno escolar consideradas fueron: la disponibilidad de una cocina y comedor, quiosco y punto alternativo de venta de alimentos dentro o en la entrada de la escuela, y la venta de alimentos no saludables en el quiosco y en los locales alternativos. Las estimaciones de la prevalencia se calcularon considerando el complejo diseño de la muestra. Resultados: 86.5% de las escuelas públicas ofrecieron comidas escolares, a las cuales se adhirió 31.3% de los estudiantes, 37.9% tuvo adherencia insatisfactoria y 30.8% no se adhirió a las comidas escolares. La adherencia a las comidas escolares fue mayor entre los escolares de la Región Centro-Oeste, de las no capitales y del área rural, mientras que se observó una menor adherencia entre los estudiantes de las escuelas con cafetería, un punto de venta de comida alternativa y una cantina que vende refrescos. Conclusiones: La baja adherencia a las comidas escolares se asocia con variables geográficas de la escuela, así como con el entorno alimentario escolar. Por tanto, estos resultados pueden apoyar la formulación de acciones que tengan como objetivo mejorar el entorno escolar y ayudar a la universalidad de la asistencia a la Política de Nutrición y Alimentación Escolar.

The acceptability of weekly iron-folic acid supplementation and its influencing factors among adolescent school girls in Yogyakarta city: a mixmethods study

@#Introduction: Indonesia has initiated the weekly iron-folic acid supplementation programme (WIFS) among adolescent school girls since 2016. However, its acceptability needs to be investigated. This study aimed to assess the acceptability of WIFS and its influencing factors. Methods: A mixed-methods study was conducted in six schools in Yogyakarta from January-April 2018. Totally, 211 participants aged 12-18 years were involved in the cross-sectional survey, followed by four focus group discussions (FGDs) and in-depth interviews (IDIs). Body mass index-for-age, haemoglobin, serum ferritin, habitual intake, and acceptability (defined as selfreported iron folic acid tablet consumption) were assessed. Results: This study reported that 22.3% and 12.4% of the participants were categorised as iron deficient and anaemic, respectively. Almost 90% of participants had received the tablet, but only 62.0% of them reported consuming it. Logistic regression test indicated that the participants were more likely to take the tablet if it tasted good [OR (95%CI): 4.66 (1.90-11.43)]. Meanwhile, motivation for tablet consumption declined when respondents perceived the odour of tablet was unpleasant, reported forgetfulness, lacked peer support, and experienced side effects, with OR (95%CI) of 0.23 (0.07- 0.77), 0.35 (0.13-0.95), 0.30 (0.08-0.58), and 0.04 (0.04-0.39), respectively. The results from FGD and IDIs strengthened the findings that the experience of nausea, organoleptic properties of iron-folic acid tablet, forgetfulness, and mother’s support play important roles in students’ acceptability. Conclusion: This study found moderate acceptability towards the WIFS programme. The inhibiting and reinforcing factors of WIFS acceptability in this study could be considered as inputs for programme improvements in the future.

The Characteristic of Obesity Intervention Studies Among School Children in Malaysia: A Scoping Review Ciri-ciri Kajian Intervensi Obesiti Dalam Kalangan Murid Sekolah di Malaysia:Suatu Tinjauan Penskopan / Jurnal Sains Kesihatan Malaysia

@#Obesity among school children has now reached an alarming level in most developing countries, including Malaysia. Thus, numerous strategies to curb the rising of obesity focusing on school children have been taking place. However, this issue management is complex, and a holistic approach is needed to address it comprehensively. This scoping review aimed to identify the characteristics of obesity interventions conducted among school children in Malaysia as a principal recommendation to develop a comprehensive obesity intervention. Arksey and O'Malley’s framework used to guide the scoping review process. Published articles on intervention studies conducted for school children in Malaysia from 2007 to 2020 retrieved based on keyword using the selected electronic and local databases. The NVivo 12 Plus software used to place findings in the systematic framework matric form and evidence tables. The final results reported in descriptive tables. Eighteen studies only reviewed among 3417 extracted articles. Thirteen aspects of the characteristics of the interventions identified. The influence of environmental intervention (family and school communities) on children lifestyle identified as a research gap. Combined environmental interventions and educational guides with technology application recognised as one of the potential components for future obesity intervention design amongst school children.

Bridging the Gap of Feasibility and Practicality in the Malaysian Context: Preliminary Single Cohort School-Based Cognitive Behavioral Therapy (Cbt) Intervention

@#Objective: The onset of symptomatology in depression many a time occurs in adolescence. Although the symptoms of depression frequently appear during adolescence, the delays in detection often happen among young individuals due to the covert and internalizing nature of depression, self-embarrassments, attempts to conceal symptoms, and possibly due to poor insight. Cuijpers et al. (2006) demonstrated that early intervention especially in school will reduce the burden of disease later and yield better prognosis. Therefore, this study is aimed to evaluate the preliminary feasibility and practicality of a validated school-based Cognitive Behavioral Therapy (CBT) intervention program among Malaysian secondary school students who exhibits elevated depressive symptoms. Methods: A locally adapted and contextualized school-based CBT module for use with secondary school students having depressive symptoms was conducted via a single cohort study. The 8-session weekly CBT intervention was conducted among 10 (ten) Malaysian secondary school students (mean age=16) who reported elevated levels of depressive symptoms on a screening survey (N=98) via group approach. Results: The application of the validated school-based CBT module was associated with lower levels of depressive symptoms and negative automatic thoughts among the students who were observed through the repeated measures and this was sustained until 1-month follow up period. Conclusion: This study answered the feasibility and practicality of the execution of a clinically-based therapy as a school-based intervention. Furthermore, this study contributes greatly as a baseline evidence for future research in school-based intervention for Malaysian adolescents.

Belief patterns and drug use in a sample of Brazilian youth: an exploratory latent class analysis

Objective: Adolescent substance abuse is a public health concern worldwide, and its prevention is the subject of numerous programmatic efforts. Yet, little research exists on the structure of drug-related belief patterns in youth and their utility in preventive program planning. The aim of this study is to determine the structure of drug-related beliefs among 12-15-year-old students in Brazil using latent class analysis. Methods: De-identified survey data were obtained from the baseline sample (n=6,176) of a randomized controlled trial on the #Tamojunto drug use prevention program in Brazilian middle schools. Using 11 survey items assessing drug-related beliefs as indicators, four models were run and assessed for goodness-of-fit. For the best fitting model, demographic variables and substance use across latent classes were assessed. Results: Model fit statistics indicated that the best fit was a three-class solution, comprising a large Drug-Averse Beliefs class (80.9%), a smaller Permissive Beliefs class (12.7%), and an Inconsistent Beliefs class (6.4%). Respondents in the Permissive Beliefs and Inconsistent Beliefs classes reported greater past-year drug use, were slightly older and less likely to be female than those in the Drug-Averse Beliefs class. Conclusions: These results indicate that conceptualizing drug beliefs as a categorical latent variable may be useful for informing prevention. Longitudinal studies are needed to establish temporality and assess further applicability of this construct.

School-based nutrition education to improve children and their mothers’ knowledge on food and nutrition in rural areas of the Philippines

@#Introduction: Nutrition education among school children and their mothers is an opportunity to promote lifelong healthy eating behaviours to improve their nutrition and well-being. The present study determined the effectiveness of nutrition education modules in improving children and their mothers’ knowledge on food and nutrition. Likewise, changes in attitude and behaviour among children were also determined. Methods: Five nutrition education modules were developed with key messages on healthy plate, fruits and vegetables, protein sources, nutrientdense sources of energy, and water and healthy beverages. Grades 2 and 3 students received 60 hours of nutrition education with a duration of 25 minutes per session. Students were divided into two groups: (1) nutrition education alone (n=83) and (2) nutrition education with feeding (n=83). Simultaneously, a total of nine onehour nutrition education sessions were conducted among mothers, following the same five modules taught to the students. Mothers were also grouped according to their child’s group. Results: Student participants in both groups exhibited improvements in mean scores on knowledge, attitude, and behaviour (KAB) from baseline to end line. Based on results of mothers’ classes, mean post-test scores of participants were significantly higher than mean pre-test scores in both groups. Group 1 had a higher increase in score from 67.2±32.8 at pre-test to 71.8±33.7 in post-test. Conclusion: The developed nutrition education modules were effective in teaching children proper nutrition. Incorporation of these modules into the K to 12 curriculum will emphasise importance of proper nutrition in early childhood. Moreover, mothers’ classes can be an effective way to bridge the gap between school and community nutrition interventions.

Who are the Brazilian adolescents most actives during commuting to school? a population-based study

Abstract Aims: 1) to identify the prevalence of active commuting to school (ACS) among Brazilian regions; and 2) to determine associated factors related to ACS in this population. Methods: Cross-sectional study comprising 16,493 adolescents (mean age 14.09±2.12 years). The data comes from the National School Health Survey (2015), and the information was collected by a self-reported questionnaire. Logistic regression models were performed to identify correlates of ACS. Results: Adolescents who live in the Southeast are more prone to have ACS compared to those who live in other regions. Do not have motor vehicles been positively associated with ACS [girls: 2.04 (1.72;2.42); boys 1.85(1.63;2.10)]. Those whom self-reported white was less prone to have ACS compared to their peers from other ethnicities. Those enrolled in private schools [girls: 0.43(0.34;0.54); boys (0.45(0.39;0.53)] and schools setting in rural area [girls: 0.38(0.25;0.57); boys: 0.51(0.37;71)] are less prone to show ACS. In addition, adolescents who accumulated less active time during physical education classes [girls: 0.80(0.66;0.97)] and extracurricular shifts [boys: 0.69(0.60;0.80)] were less prone to have an ACS, compared to their most active peers. Lastly, girls who spent ≤ 2 hours presented fewer odds to have an ACS [0.75(0.63;0.90)]. Conclusions: ACS was most prevalent among those who live in the Southeast region and seems to be negativity associated with the socioeconomic level. Moreover, less active adolescents during both school and leisure time may be more prone to have passive travel go/from school.

El programa EQUIPAR para Educadores: sus efectos en el pensamiento y la conducta social / The EQUIP Program for Educators: Its Effects on Cognition and Social Behavior / O programa Equipar para Educadores: seus efeitos no pensamento e a conduta social

Resumen Objetivo. EQUIPAR para Educadores (EpE; DiBiase et al., 2010) es un programa educativo cuyo objetivo es equipar a los jóvenes con habilidades y conocimientos para su vida diaria, a fin de prevenir conductas antisociales. El presente estudio se propone analizar los efectos de la aplicación del programa en las distorsiones cognitivas, el clima de aula y las actuaciones del alumnado en situaciones de acoso escolar. Método. Participaron 123 estudiantes de 3º y 4º de ESO. Se utilizó un diseño cuasi-experimental pretest/postest con un grupo control (128 estudiantes). Resultados. Se observaron cambios positivos en las actuaciones ante el acoso escolar, pero las distorsiones cognitivas y el clima de aula percibido no mostraron cambios después de la aplicación del programa. Conclusión. Una percepción muy positiva del clima de aula y el bajo nivel de distorsiones cognitivas antes de la intervención podrían explicar la falta de efectos, junto a aspectos relacionados con la implantación del programa EpE.

Abstract Objective. EQUIP for Educators (DiBiase et al., 2010) is an educational program, whose purpose is to equip young people with skills and knowledge for their daily life in order to prevent antisocial behavior. The present study aims at analyzing the effects of the program's application on cognitive distortions, class climate and students' behavior in bullying situations. Method. A total of 123 3rd and 4th grade students from secondary education participated. A quasi-experimental pretest/posttest design with a control group (128 students) was used. Results. Positive changes were observed in students' actions in bullying situations, however no changes in cognitive distortions and perceived class climate were found after the program's application. Conclusion. A very positive perception of the class climate and the low level of cognitive distortions before the intervention could explain the lack of effects, together with other aspects related to the implementation of the EQUIP for Educators program.

Resumo Escopo . Equipar para Educadores (EpE; Di Biase et al., 2010) é um programa educativo com o objetivo de equipar aos jovens com habilidades e conhecimentos para sua vida diária, com o fim de prever condutas antissociais. O presente estudo tem como proposto analisar os efeitos da aplicação do programa nas distorções cognitivas, o clima da aula e as atuações do alunado em situações de intimidação escolar. Metodologia . Participaram 123 estudantes de 3º e 4º de ESO. Foi utilizado um desenho quase experimental pretest/postest com um grupo de controle (128 estudantes). Resultados . Foram observadas mudanças positivas nas atuações ante a intimidação escolar, mas as distorções cognitivas e o clima da aula percebidos não mostraram mudanças depois da aplicação do programa. Conclusão . Uma percepção muito positiva do clima da aula e o baixo nível de distorções cognitivas antes da intervenção poderiam explicar a falta de efeitos, junto a aspetos relacionados com a implementação do EpE.

LARS&LISA: a universal school-based cognitive-behavioral program to prevent adolescent depression

Abstract Adolescent depression is a prevailing international mental health concern as up to 27% of adolescents experience either subsyndromal depression or a major depressive episode by the age of 18. Depression in adolescence has been found to negatively impact current and future academic achievement, functioning, mental health, and quality of life. Accordingly, the authors emphasize the importance of proactively preventing depression (and its negative outcomes) instead of waiting and having to "fix" the problems after they have already developed. The current article begins with a discussion of the various types of prevention, including their respective advantages and disadvantages. Further and more importantly, the article's primary focus is to provide a summary of the theoretical basis, development of, empirical support for, and content of a universal school-based cognitive-behavioral program to prevent adolescent depression entitled LARS&LISA (Lust An Realistischer Sicht & Leichtigkeit Im Sozialen Alltag). As the program exists within the overlapping realms of universal prevention, school-based programs, and cognitive-behavioral interventions, the content of this article is relevant to all three areas and offers insight into the development of depression prevention in general. Finally, empirical support for the positive effects of the program is presented and some ideas for further research are discussed.

Five Months Follow-up Study of School-based Crisis Intervention for Korean High School Students Who Experienced a Peer Suicide

BACKGROUND: The purpose of this study was to examine post-traumatic stress, depression, anxiety, and complicated grief in Korean high school students who experienced a peer suicide. METHODS: A total of 956 students were included in the statistical analysis. One week after a peer suicide, a school-based crisis intervention program was conducted. The cohort was followed-up at one week and five months after a peer suicide. The program consists of screening tests, educational sessions, and further interview with psychiatric specialists for the selected group. Screening tests were conducted for all students to measure the Child Report of Post-traumatic Symptoms (CROPS), the post-traumatic stress symptoms (The University of California at Los Angeles post-traumatic stress disorder [PTSD] reaction index; UCLA-PTSD-RI), the anxiety symptoms (The Korean-Beck Anxiety Inventory; K-BAI), the depressive symptoms (The Korean-Beck Depression Inventory-II; K-BDI-II), and the complicated grief reaction (The Inventory of Complicated Grief; ICG). For statistical analysis, the SPSS Statistics 21.0 program was used. RESULTS: At baseline and five months follow-ups, 8.6% and 2.9% of the students showed post-traumatic stress symptoms. At five months follow-up, there was a statistically significant decline in the post-traumatic stress symptoms, anxiety, depression, and complicated grief among the ‘trauma group.’ A higher proportion of the female students showed post-traumatic stress symptoms after the incident of peer suicide than the male students. CONCLUSION: School-based crisis intervention helps improvement of trauma-related symptoms. It might be an effective way to prevent suicide spreading among students by alleviating trauma-related symptoms.

Effect of School-Based Social Skills Training Program on Peer Relationships: Preliminary Study

OBJECTIVES: The aim of this study was to evaluate the effect of a school-based social skills training program on peer relationships in children and adolescents and to assess the plan for effective school-based mental health services. METHODS: The Child and Adolescent Mental Health Promotion Team of Bugok National Hospital conducted 7-sessioned school-based social skills training for elementary and middle school students (n=90). Changes in peer relationships were evaluated before and after application of the program using a name generator question. RESULTS: The social skills training program increased peer relations, indicating significant changes in social network indices. CONCLUSION: The social skills training program positively influenced peer relationships. The school-based social skills training program can be expected to have positive effects on school-based mental health services. Future investigation is needed to validate the long term effects of this program.

Juara Sihat: assessing the sustained impact of a school-based obesity intervention

Introduction: Obesity and physical inactivity among schoolchildren are among the most challenging health problems inMalaysia. The present study aimed to evaluate the sustainedimpact of Juara Sihat programme on physical activity leveland anthropometric status at 18-month post-intervention.Method: Participants of Juara Sihat (n=55) were followed-upat 18 months after completion of the intervention. JuaraSihat intervention was implemented over 12 weeks andfocused on four key components: (i) five one-hour nutritioneducation classes, (ii) four one-hour physical activityeducation sessions, (iii) family involvement, and (iv)empowerment of Parents and Teachers Association.Anthropometric variables (body mass index, body fatpercentage and waist circumference) were measured andphysical activity level was evaluated by using PhysicalActivity Questionnaire for Children (PAQ-C) at baseline (P0),immediately upon completion of intervention (P1), atthree-month post-intervention (P2), and at 18-month postintervention(P3). Analyses of repeated measures analysisof covariance (ANCOVA) with intention-to-treat principlewere applied.Results: Sustained effects were found in BMI-for-age z-scorewhich showed a reduction (P0 2.41±0.84 vs P3 2.27±0.81)and physical activity level which showed positiveimprovements (P0 2.46±0.62 vs P3 2.87±0.76) at 18 monthsafter intervention was completed. Body fat and waistcircumference had increased over the same time period.Conclusion: Overall, this study successfully demonstratedsustained intervention effects of Juara Sihat intervention onBMI-for-age z-score and physical activity, but not on body fatpercentage and waist circumfere

Compliance to the National Immunization Program: A review of Immunization Records of Grade 1 Students in a Public Elementary School in Manila for the academic year 2017-2018

Background@#Vaccination is a cost-effective primary preventive measure against infectious diseases. However, protection for specific diseases may wane over time. The National Immunization Program was launched to improve vaccine coverage but despite this, some countries including the Philippines have erratic vaccine coverage.@*Objective@#To determine the compliance to the National Immunization Program of Grade 1 students in a public elementary school@*Methodology@#The study utilized a descriptive cross-sectional design. Simple random sampling of students enrolled in first grade for A.Y. 2017-2018 was done to determine the study respondents. Primary and secondary data were obtained through a pretested structured questionnaire with interview of the students’ caregiver and verification via the students’ immunization records. Compliance to immunization was correlated with the subjects’ age, birth rank, primary caregiver and socio-demographic profile of the caregiver, place of birth and place of vaccination. Data were analyzed using descriptive statistics and logistic regression was used to assess factors for increased vaccination compliance.@*Results@#Most respondents had their mothers as primary caregivers. Majority were institutional deliveries and immunized at a health center. Mean compliance to vaccination was 69%. Among the factors, only place of birth, specifically, hospital delivery, was associated with increased compliance to vaccination (OR = 0.3312, 90% CI 0.1496 to 0.7333, p value 0.0064). Subjects whose primary caregivers were the mothers and whose parents had higher educational attainment or were both employed were shown to have higher vaccination compliance, although this was not statistically significant. Vaccination coverage was observed to decrease over time as the subjects grew older. Most common reasons cited for missing vaccinations were vaccine unavailability (68%), financial constraints 46%), and lack of information (40%).@*Conclusion@#Compliance to vaccination in this study was 69% and is affected by multiple factors. Policymakers and stakeholders should address these barriers to improve vaccination coverage and overall health status.

Prevalence Rate of Adolescent Idiopathic Scoliosis: Results of School-based Screening in Surabaya, Indonesia

Introduction: Scoliosis is a lateral spinal deformity of 10 degrees or more, resulting in a C-shaped or S-shaped curve of the spine. Information about adolescent idiopathic scoliosis (AIS) prevalence rate is important not only for paediatric health care planning strategy but also for parent's awareness. This study aims to find the suitable inclination cut-off angle and the prevalence rate of AIS in Surabaya, Indonesia. Materials and Methods: This is a descriptive crosssectional study conducted in 2010. We performed stratified random sampling of 784 Elementary and Junior High School students in Surabaya between 9-16 years of age. Scoliosis screening was performed by the Adam's forward bending test (FBT). The students with positive FBT were measured for the inclination angle with scoliometer, and then subjected to radiologic examination. Prevalence rate, gender ratio, and the cut-off point value of inclination angle were determined by a descriptive statistics analysis. Results: Adam's forward bending test was positive in 50 students (6,37%). Among them, 23 students (2,93%) four males and 19 females had Cobb angle of ≥10°. The 5° cutoff point value of inclination angle had a 95.6% sensitivity, an 18.5% specificity, a 50% positive predictive value (PPV), and a 83.33% negative predictive value (NPV); while the 7° cut-off point had a 78.26% sensitivity, a 88.88% specificity, a 85.7% PPV, and a 82.7% NPV. Conclusion: The prevalence rate of AIS in Surabaya is 2.93% and the 7° cut-off point of inclination angle is suitable for school-based screening.

Dificultades de escritura en el contexto escolar chileno: abordaje de terapia ocupacional y la utilizacion de estrategias de integración sensorial / Handwriting difficulties in chilean school context: occupational therapy intervention and sensory integration strategies

La escritura y las dificultades de escritura son un tema importante para los Terapeutas Ocupacionales. La literatura evidencia que las dificultades de escritura constituyen uno de los motivos más frecuentes de derivación a Terapia Ocupacional (Feder et al., 2007) En la investigación participan 25 Terapeutas Ocupacionales chilenos que trabajan en Programas de Inclusión Educativa (PIE) con niños de 6 a 9 años. Los resultados indican que el 80 por ciento de la muestra considera que los problemas de escritura son un motivo frecuente de derivación a Terapia Ocupacional en el contexto escolar. Las estrategias de Integración Sensorial para abordar los problemas de escritura en el contexto escolar son utilizadas en promedio por el 57 por ciento de los participantes, observándose en 3er lugar en la frecuencia general, luego de la utilización de estrategias visomotoras y de estrategias volitivas/motivacionales. Las estrategias de Integración Sensorial son percibidas como las más efectivas para abordar los problemas de escritura en el contexto escolar en niños con Trastornos del Espectro Autista y Síndrome de Déficit Atencional, versus otras estrategias tales como las sensoriomotoras, volicionales / motivacionales, cognitivas o conductuales. Las estrategias de integración sensorial más utilizadas para abordar los problemas de escritura en el contexto escolar, son las “sugerencias a profesores basadas en dicho enfoque”, realizadas por el 87 por ciento de los Terapeutas Ocupacionales participantes en el estudio.

Writing and handwriting difficulties are a major issue for Occupational Therapists. The literature shows that the handwriting difficulties are one of the most common reasons for derivation to Occupational Therapy (Feder et al., 2007) In this research are participating 25 chilean Occupational Therapists whose work in Inclusion Educational Programs ( I E P ) with children 6 to 9 years. Regarding the results; 80 percent believe that writing problems are a common reason derivation to Occupational Therapy in the school context. Sensory integration strategies to address handwriting problems in school context are used on average by 57 percent of participants in the sample observed in 3rd place in the overall frequency after visual motor strategies of and volitional / motivational strategies. Sensory Integration strategies are perceived as the most effective in addressing the problems of writing in the school context in children with Autism Spectrum Disorder and Attention Deficit Disorder, versus other strategies such as sensorimotor, volitional /motivational, cognitive or behavioral. Sensory integration strategies most commonly used to address the problems of writing in the school context, are “suggestions to teachers” based on this approach, carried by 87 percent of occupational therapists in the study.

Effects of School-Based Social Skills Training Program on Alexithymic Tendency: Preliminary Study

OBJECTIVES: The purposes of this study are to evaluate the effect of a school-based social skills training program on the emotional regulation of children and adolescents and to assess the plan for effective school-based mental health services. METHODS: The Child and Adolescent Mental health promotion team of Bugok National Hospital conducted school-based social skills training (N=90, 7 sessions) for elementary and middle school students. Evaluations were conducted before and after the application of the program using a prosocial behavior questionnaire, a cohesiveness questionnaire, the Korean version of the 20-item Toronto Alexithymia Scale, a self-esteem scale, and the Novaco anger scale, in order to identify any changes. RESULTS: The social skills training program increased the prosocial behavior and cohesiveness of the children and adolescents and decreased their alexithymic tendency and degree of anger, but did not significantly change their self-esteem. CONCLUSION: The social skills training program positively influences the emotional and behavioral levels of children and adolescents. The emotional regulation program based on a social skills training program is expected to have positive results in school-based mental health services. Future investigations are needed to validate the long term effects of this program.

Focus Group Interview on Opinion about the Design and Management of Toothbrushing Facilities / 치위생과학회지

This study collected opinions about the design and management of toothbrushing facilities from schoolteachers and the people in charge of public centers, through a focus group interview (FGI), for the development of guidelines. Four moderators conducted eight FGIs of 32 subjects in charge of toothbrushing facilities across all the regions. The qualitative data was analyzed by constant comparative analysis. The findings indicated that more students utilized the facility and brushed their teeth after the installation of toothbrushing facilities. To enhance students' accessibility and safety, guidelines for design and management guidelinesfor toothbrushing facilities need to be developed; the location, sink height and depth, drain size, etc. should be comprehensively considered in the development of the guidelines. This study can help to improve students' satisfaction by enhancing the accessibility, safety, and functionality of toothbrushing facilities, and by providing fundamental data for toothbrushing facilities' development. Finally, this study can maximize the effects of management of toothbrushing facilities management on the improvement of students' oral health and behaviors.

The Effect of Students' Mental Health School-Community Cooperative Model on the School Mental Health Awareness

OBJECTIVES: The purpose of this study was to examine the effect of the Students' Mental Health School-Community Cooperative Model on the school mental health awareness of the participants (school administrators, teachers, students). METHODS: Data were collected from 140 schools that participated in the project. The questionnaires were composed of items about the school mental health policy, climate and capacity. The data was analyzed through paired t-tests between pre and post, and a comparison was made between the 1st and 2nd phase regions. RESULTS: The total scores of the teacher and student groups increased significantly, whereas those of the school administrators did not. The awareness of the teachers showed more changes in the 1st phase regions, while those of the students changed more at the 2nd phase. CONCLUSION: Based on the results, the expansion of the Students' Mental Health School-Community Cooperative Model was proposed.