Escuelas de salud para personas mayores. Espacios que sanan, personas que curan / Health Schools for the elderly. Spaces that heal, people who cure

Las escuelas de salud son proyectos comunitarios con un bagaje y una evidencia científica ya conocidos y demostrados. Su influencia en la mejora de la calidad de vida de las persones mayores con soledad no deseada es uno de sus grandes beneficios. Por este motivo, como equipo de Atención Primaria apostamos por ella. El objetivo principal de la escuela es promover el envejecimiento activo y mejorar el estado de salud percibido por las persones mayores de 60 años participantes. Las escuelas de salud son espacios sanadores. Su repercusión es bidireccional, ya que influye en todas las personas que participan, mejorando su calidad de vida y dotándolas de herramientas útiles y sencillas para su día a día a través de los conocimientos adquiridos y las experiencias compartidas. Generar puntos de encuentro en el barrio enriquece y aporta salud más allá de los centros sanitarios. Salir a la calle, hablar de igual a igual, fomentar las redes de apoyo y vincularse a una red, son elementos que fortalecen y mejoran la vertiente social de las personas, ayudándolas a curar heridas de vida. Apostar por la salud comunitaria, es apostar por la salud en todas sus dimensiones. (AU)

Health schools are community projects with a well-known and proven scientific past and background. Their influence in improving the quality of life for elderly individuals experiencing unwanted loneliness is one of their significant benefits. That's why we, as a primary health care team, decided to support it. The main aim of the school is to promote active aging and enhance the perceived health status of participants aged over 60. Health schools are healing spaces. Their impact is bidirectional, which has an impact on all participants. Our quality of life improves as we share knowledge and experiences, providing us with healing, useful and straightforward tools for our daily lives. Creating meeting points in the neighbourhood enriches us and contributes to our well-being beyond healthcare centres. Going out into the community, having peer to peer conversations, fostering support networks, and connecting with others sustain us and make us socially stronger, healing life's wounds. To take a chance on the community is in essence to bet on health in all its dimensions. (AU)

A Successful Gap-Year Clinical Research Technician (CRT) Program at an Academic Anesthesiology Department.

BACKGROUND: Many students elect to take gap years in between graduating college and matriculating into medical school. At an academic institution, investigators can be limited in conducting research due to clinical endeavors. Utilizing a structured, clinical research, gap-year program with students called clinical research technicians (CRTs) can aid both investigators conducting research and students applying to graduate health programs. In this original article, we sought to understand CRT and investigator perceptions of and experiences in the program. METHODS: We distributed a survey to past and present CRTs and the investigators with whom they worked at Atrium Health Wake Forest Baptist Medical Center. We conducted thematic and sentiment analyses of the survey results. We also collected data on grant approvals, research funding awards, and CRT, clinical research nurse, and clinical research coordinator salaries. RESULTS: We received responses from 20/29 investigators and 21/22 CRTs. We identified five themes for the investigator survey, including research accuracy and precision; research output; alleviating responsibilities; cost; and likelihood of referral. We identified five themes for the CRT survey, including future career assistance; physician career insights; mentorship; likelihood of referral; and other. The majority of respondents strongly agreed or agreed with the survey statements. The majority of comments were coded as positive. All of CRTs were accepted into a graduate health profession program. CONCLUSIONS:  Our program's success demonstrates how a structured, clinical research, gap-year program for premedical students can serve as a new educational tool and important research infrastructure resource for hospitals.

Reproductive health education: a qualitative study of health seeking behaviour of in-school female adolescents

Introduction: adolescents in developing countries are often vulnerable to sexually transmitted diseases (STDs) and unplanned pregnancies. It is estimated that about 13 million adolescent girls have unplanned births each year in developing countries. This study examined the scope of the School Health Education Programme (SHEP) and health-seeking behaviours of female adolescents in Junior High School (JHS). Methods: this qualitative research used the narrative approach. Group discussions were conducted among 100 female adolescents aged 12-19 years. Interviews were conducted among five community health workers in five health centres that provide reproductive health services. The in-depth interviews and group discussions were documented, transcribed and analyzed using NVivo 11, whilst thematic analysis was used in analyzing data. Results: the mean age of adolescents was 15.5 years, with 74% reporting having knowledge of STDs. It was observed that the SHEP offers various information on health issues such as menstrual hygiene, STDs, personal hygiene, contraceptives, personal development and unsafe abortion practices. Adolescent reproductive health services were also available in the health centres but patronage was low as a result of perceived negative attitude of health workers and trust. Knowledge on issues of reproductive health is insufficient among JHS female adolescents, with many of them relying on the media and peers for reproductive health support. Conclusion: in this study, female adolescents are generally involved in risky sexual behaviour due to their low level of knowledge on reproductive issues and their unwillingness to patronize available reproductive health services because of the health system and cultural barriers.

Investigation and analysis on an outbreak of norovirus infection in a health school in Guangdong Province, China.

Our objective was to describe the epidemiological features of an outbreak of norovirus infection in a health school in Guangdong province, China, to identify the cause of such a large scale outbreak of norovirus among older students, to simulate the transmission dynamics, and to evaluate the effect of intervention measures of GII.17 [P17] genotype norovirus infection. We identified all cases during the outbreak. Descriptive epidemiological, analytical epidemiological and hygiene survey methods were used to described the outbreak epidemic course and identify the cause of the outbreak of norovirus infection. We also used dynamical model to simulate the transmission dynamics of norovirus infection and evaluate the effect of intervention measures. Norovirus genotyping was assigned to the newly obtained strains, with a maximum likelihood phylogenetic analysis conducted. There were 360 cases of 42 classes in five grades with a 12.99% attack rate. Proportionally, more students were in contact with sick students and vomit in the suspected case group than the control group (χ2 = 5.535, P = 0.019 and χ2 = 5.549, P = 0.019, respectively). The basic reproduction number was 8.32 before and 0.49 after the intervention. Dynamical modeling showed that if the isolation rate was higher or case isolation began earlier, the total attack rate would decrease. Molecular characterization identified the GII.17 [P17] genotype in all stains obtained from the health school, which were clustered with high support in the phylogenetic tree. This was an outbreak of norovirus infection caused by contact transmission. The main reasons for the spread of the epidemic were the later control time, irregular treatment of vomit and no case isolation. The transmission dynamics of contact transmission was high, more efficient control measures should be employed.

Attitude and practice on human papilloma virus infection and vaccination among students from secondary occupational health school: a cross-sectional study.

Cervical cancer (CC) is reported as the second-most common female cancer worldwide, of which 99% is caused by persistent human papillomavirus (HPV) infection. HPV vaccine protects against HPV infection and most cases of CC, which has only been introduced for a short time in mainland China. This study aimed to evaluate the attitude and practice related to HPV infection and vaccination among students at secondary occupational health school (SOHS) in China. We conducted a cross-sectional study in Southern China where data of 2248 participants were collected through questionnaires to estimate attitude and practice of students. Only 4.1% believed they were easily infected by HPV, 38.2% were willing to receive HPV vaccine and 30.8% intended to do regular screening of HPV infection in the future. Students in the second grade (OR = 1.51, 95%CI [1.25, 1.81]) and third grade (OR = 3.99, 95%CI [2.53, 6.27]) were more willing to take HPV vaccine compared to students in the first grade. Among the non-vaccinated participants, the most frequent reason for not receiving HPV vaccine was insufficient knowledge about HPV (91.1%). Characteristics of higher grade, personal education before enrollment and academic performance, medical specialty, history of sex experience and HPV vaccine and family history of other cancers were associated with higher attitude scores (p < .05). Considering the increasing prevalence of HPV infection and the need of improvement in attitude and practice toward HPV, more education about HPV infection and vaccination should be incorporated into school curriculum.

Awareness and Knowledge about Human Papilloma Virus Infection among Students at Secondary Occupational Health School in China.

Cervical cancer (CC) is one of the most common causes of cancer-related deaths worldwide. CC is mainly caused by human papilloma virus (HPV), which can be prevented by vaccination. We conducted a cross-sectional study in secondary occupational health school (SOHS) through a questionnaire aimed to assess the awareness and knowledge regarding HPV infection of students. A total of 2248 students participated in the survey, 45.3% of them had heard about CC, while only 21.9% of them had heard about HPV; and 74.2% had no idea of the causal link between HPV infection and CC. Most participants displayed poor awareness and knowledge about HPV infection. The results suggested that age, grade, major, academic performance, etc. were correlated with higher awareness of CC, HPV and HPV infection (p < 0.05). In multivariable logistic analysis, third-grade students had the most increased awareness of CC (OR = 17.13, 95%CI: [8.11, 36.15]), HPV (OR = 6.59, 95%CI: [4.16, 10.43]) and HPV vaccine (OR = 2.78, 95%CI: [1.78, 4.32]) when compared to first-grade. Awareness and knowledge regarding HPV infection were insufficient among students in SOHS. As the future healthcare providers, these results highlight the need to supplement targeted education to improve their awareness and knowledge of HPV and vaccination.

Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017.

INTRODUCTION: Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017. METHODS: We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure. RESULTS: Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status. CONCLUSIONS: Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.

The User-Program Interaction: How Teacher Experience Shapes the Relationship Between Intervention Packaging and Fidelity to a State-Adopted Health Curriculum.

Intervention effects observed in efficacy trials are rarely seen when programs are broadly disseminated, underscoring the need to better understand factors influencing fidelity. The Michigan Model for Health™ (MMH) is an evidence-based health curriculum disseminated in schools throughout Michigan that is widely adopted but delivered with limited fidelity. Understanding implementation determinants and how they influence fidelity is essential to achieving desired implementation and behavioral outcomes. The study surveyed health teachers throughout Michigan (n = 171) on MMH implementation, guided by the Consolidated Framework for Implementation Research. We investigated relationships between context, intervention and provider factors and dose delivered (i.e., the proportion of curriculum delivered by teachers), a fidelity dimension. We also examined whether intervention factors were moderated by provider factors to influence fidelity. Our results indicated that program packaging ratings were associated with dose delivered (fidelity). We also found that this relationship was moderated by teacher experience. The strength of this relationship diminished with increasing levels of experience, with no relationship among the most experienced teachers. Intervention adaptability was also associated with dose delivered. We found no association between health education policies (context), provider beliefs, and dose delivered. Intervention factors are important determinants of fidelity. Our results suggest that providers with more experience may need materials tailored to their knowledge and skill level to support materials' continued usefulness and fidelity long-term. Our results also suggest that promoting adaptability may help enhance fidelity. Implementation strategies that focus on systematically adapting evidence-based health programs may be well suited to enhancing the fidelity of the MMH curriculum across levels of teacher experience.

Sentidos atribuídos pelos alunos com deficiência e pelos professores às aulas de educação física escolar / Meanings conferred by impaired students and teachers to physical education classes in schools

A educação física relaciona-se com a promoção de saúde no âmbito escolar. Foi verificado que ainda faltam estudos que visam o levantamento dos sentidos atribuídos pelos alunos com deficiência e professores de Educação Física às aulas de EFE, principalmente a partir das políticas de inclusão de crianças com deficiência em escolas regulares. Trata-se de um estudo qualitativo de caráter exploratório, com o objetivo de analisar como as aulas de educação física em que participam alunos com deficiência são significadas pelos professores de Educação física e pelos alunos com deficiência destes professores. O estudo foi realizado em cinco escolas públicas municipais em uma cidade do interior de São Paulo, por meio de entrevistas semiestruturadas, com oito professores de Educação Física e dez alunos com deficiência. Os resultados evidenciaram que os professores gostam de desenvolver aulas com crianças com deficiência, pois para eles isto se torna muito compensador ao ver estes alunos com deficiência estão conseguindo realizar as atividades. Por outro lado, poucos professores tiveram acesso aos conteúdos sobre o trabalho com a criança com deficiência na sua formação inicial ou tiveram oportunidades de formação continuada. Assim, o sentido da realização do trabalho desenvolvido pelo professor de Educação Física na escola com crianças com deficiência acaba sendo predominantemente o de falta: falta de formação, falta de recursos educacionais adaptados, falta de auxiliares. Em relação às condições de trabalho, ainda faltam melhorias que poderiam facilitar o trabalho do professor de educação física em vários aspectos, sendo eles, espaço físico, materiais, uma maior parceria com as famílias, maior apoio da rede de ensino, principalmente na oferta de uma formação direcionada ao trabalho com crianças com deficiência. Um aspecto fragilizador no trabalho destes professores se refere ao planejamento, visto que os professores participantes não trazem muitos detalhes deste planejamento ou fazem um planejamento geral que pode não estar indo ao encontro das reais necessidades destes alunos com deficiência, com uma intencionalidade de tornar sua aula mais inclusiva e trabalhando com a zona de desenvolvimento proximal dos alunos com deficiência. Para as crianças com deficiência entrevistadas, os sentidos da aula de educação física estão ligados ao bem estar, possibilidade de jogar e de brincar, o que evidencia também que os sentidos para as crianças com deficiência podem ser diferentes dos sentidos para os professores

Physical Education is related to the promotion of health in the school environment. In addition, studies aiming at surveying the meanings impaired students and teachers confer to Physical Education classes are scarce, especially with the implementation of inclusion policies for impaired children in regular schools. This is a qualitative exploratory study which aimed at analyzing how Physical Education classes in which participate impaired students are meant by Physical Education teachers and by their impaired students. This study was conducted in five public municipal schools in the countryside of São Paulo, by means of semistructured interviews, with eight Physical Education teachers and ten impaired students. Results showed that the teachers like to develop classes with impaired children, because it is very rewarding for them to realize that these students are able to perform the proposed activities. In contrast, few teachers had access to contents regarding the work with impaired children during their initial formation, or continuous training opportunity. Thus, the meaning of the work developed by these teachers is, predominantly, the lack of formation, lack of adapted educational resources, lack of helpers. Regarding the work conditions, some improvement which could facilitate the theachers' work is still missing concerning physical space, materials, a better partnership with families, better support of the educational network, mainly by offering a formation directed to working with impaired children. A debilitating aspect regarding the work of these teachers is related to planning, since the participant teachers do not provide details of this planning, or conduct a general planning which may not meet the real needs of these impaired students, aiming at making their classes more including and also working with the zone of proximal development of the impaired students. For the interviewed impaired children, the meanings of the Physical Education classes are linked to the well-being and the possibility of playing, which also highlights that the meanings for impaired children may be different from the teachers'

[Technical assistance in crisis times: Brucelosis in the country programs for Spain of the world health organization (1951-1972)]. / Ayuda técnica en tiempos de crisis: la brucelosis en los programas país para España de la organización mundial de la salud (1951-1972).

OBJECTIVE: Brucellosis was one of the most important health problems in post-Civil War Spain and in subsequent years. The objective of the study was to reconstruct the first programs that the WHO set up in this country, to address this problem, between 1951 and 1972 and their main outcomes. METHODS: On the basis of primary sources of diverse origin, especially unpublished reports on Spain from foreign experts, from the WHO Historical Archive, the contents related to the disease were analyzed, contextualizing them within the framework of both the history of Spanish Public Health during the period studied and the international public health strategies for the prevention and control of brucellosis between 1951 and 1972. RESULTS: Spain 0001 (E1), Spain 0012 (E12) programs were located. The first of them (E1), dedicated to the problem of endemoepidemic diseases (brucellosis, rabies and Q fever), developed between 1952 and 1956, offered assistance in the work of control of these diseases carried out by public health laboratories. The second was preceded by visits of experts between 1956-1958 and formally started in 1969 and ended in 1972. This program was specifically devoted to the fight against brucellosis and included the start-up of laboratory and epidemiological work, the training of specialists, vaccination experiences in goats and sheep and the initiation of studies on immunizations in humans. CONCLUSIONS: The presence of consultants and experts from the WHO, from the highest scientific authority in the field of brucellosis such as Sandford Elberg or Martin Kaplan, was decisive in, at least, two aspects: first, to have an external view that would allow to know the reality of the Spanish health situation in the matter of the control of this zoonosis and, secondly, to start up and develop laboratory techniques and training of specialists with the aim of creating, at least, a center of reference for the preparation of vaccines, which the experts placed, ideally, in the National School of Health in Madrid.

OBJETIVO: La brucelosis fue uno de los más importantes problemas de salud en la España de la postguerra civil y en los años posteriores. El objetivo del estudio fue reconstruir los primeros programas que la OMS puso en marcha en este país, para abordar dicho problema, entre 1951 y 1972 y sus consecuencias. METODOS: Sobre la base de fuentes primarias de diversa procedencia, en especial, informes inéditos sobre España de expertos extranjeros, procedentes del Archivo Histórico de la OMS, se analizaron los contenidos relativos a la enfermedad, contextualizándolos tanto en el marco de la historia de la salud pública española del periodo objeto de estudio como en el de las estrategias a nivel internacional desarrolladas en este campo. RESULTADOS: Se localizaron los programas España 0001 (E1) y España 0012 (E12). El primero de ellos (E1), dedicado al problema de las enfermedades endemo-epidémicas (brucelosis, rabia y fiebre Q), desarrollado entre 1952 y 1956, ofreció asistencia en las labores de control de estas enfermedades llevadas a cabo por los laboratorios de salud pública. El segundo, precedido de visitas de expertos, entre 1956-1958, se inició formalmente en 1969 y finalizó en 1972, se consagró específicamente a la lucha contra la brucelosis e incluyó la puesta en marcha de trabajos de laboratorio y epidemiológicos, formación de especialistas, experiencias vacunales en ganado caprino y ovino e inicios de estudios sobre inmunizaciones en humanos. CONCLUSIONES: La presencia de consultores y expertos de la OMS de la máxima autoridad científica en el campo de la brucelosis, como Sandford Elberg o Martin Kaplan, fue decisiva en dos aspectos al menos, en primer lugar, para poder disponer de una mirada externa que permitiera conocer la realidad de la situación sanitaria española en el tema del control de dicha zoonosis y, en segundo lugar, para la puesta en marcha y el desarrollo de técnicas de laboratorio y de formación de especialistas con el objetivo de crear, al menos, un centro de referencia para la confección de vacunas, que los expertos situaban, de forma idónea, en la Escuela Nacional de Sanidad en Madrid.

The effectiveness of the Brush Day and Night programme in improving children's toothbrushing knowledge and behaviour.

BACKGROUND: Regular twice-daily toothbrushing with a fluoridated toothpaste is widely recommended for schoolchildren. The '21-day Brush Day and Night (BDN) programme' includes an educational approach for children and school staff, with a consistent practice of toothbrushing at school for 3 weeks. OBJECTIVE: This study aims to evaluate the improvement in oral hygiene knowledge and behaviour in schoolchildren involved in BDN, the sustainability of this after 6-12 months, and if any particular age group was more receptive to it than others. MATERIALS AND METHODS: Ten countries and 7,991 children, 2-12 years old, participated in this longitudinal study, with two BDN interventions at the beginning and 6-12 months afterward. Data were collected via a self-reported questionnaire at baseline/first intervention (T0), 21 days after first intervention (T0D21), at the second intervention (T1), and 21 days after second intervention (T1D21). Improvement in knowledge and behaviour was compared using the chi-square test with an alpha level of 5%. The final data sample of 5,148 schoolchildren was evaluated, and the analysis revealed that 25% more of the schoolchildren brushed their teeth twice a day after the first intervention. The programme was more effective among the 7-9 years age group. The BDN intervention increased brushing-frequency in children at the first intervention, and this was sustained after 6-12 months. Therefore, this programme illustrated a sustainable approach to improve children's oral health knowledge and behaviour.

Bullying o intimidación escolar: aportes desde la evidencia de investigación en enfermería / Bullying ou intimidação escolar: contribuições a partir da evidência da pesquisa em enfermagem / Bullying or intimidation at school: contributions from the evidence of research in nursing

RESUMEN Objetivo: analizar aspectos teóricos y metodológicos relevantes desde la evidencia científica en enfermería relacionada con la intimidación escolar. Metodo: revisión integrativa de la literatura de estudios de enfermería en ocho bases de datos: PubMed, MEDLINE, Academic Search Complete, Ovid nursing, SciELO, ScienceDirect, Redalyc y Embase, con las palabras clave: bullying, nursing, child school bullying, peer aggression, adolescent y límite de tiempo entre 2004 a 2016. Se encontraron 30 estudios de los cuales se eligieron 19 estudios que cumplieron los criterios de selección. El análisis se desarrolló en seis etapas: búsqueda de estudios, selección, crítica de estudios cualitativos y cuantitativos, comparación de hallazgos/agrupación por temas, interpretación, conclusiones por niveles de evidencia de enfermería. Resultados: se identificaron cuatro temas prevalentes: consecuencias en la salud, causas, intervenciones de enfermería y afrontamiento. El principal aporte en la temática desde la evidencia de investigación en enfermería permitio identificar desarrollos investigativos tanto en el paradigma cualitativo y cuantitativo, diferentes abordajes metodológicos en los niveles de evidencia VII, VI, V, IV, III. Conclusiones: se requieren políticas de salud que intervengan em la prevención del fenómeno, conocer las causas y consecuencias relacionadas, además deben diseñarse estrategias de identificación de los escolares en riesgo para evitar consecuencias en su salud, igualmente generar estudios de intervención y apoyar los procesos de afrontamiento en escolares que reciben burla o son intimidados.

RESUMO Objetivo: analisar aspectos teóricos e metodológicos relevantes a partir das evidências científicas em enfermagem relacionadas ao bullying escolar. Método: revisão integrativa da literatura de estudos de enfermagem em oito bases de dados: PubMed, MEDLINE, Academic Search Complete, Ovid Enfermagem, SciELO, ScienceDirect, Redalyc, e Embase com palavras-chave: assédio moral, enfermagem, bullying escolar infantil, agressão entre pares, adolescentes; limite de tempo de 2004 a 2016. Trinta estudos foram encontrados; sendo que 19 estudos preencheram os critérios de seleção. A análise foi desenvolvida em seis etapas: busca dos estudos, seleção, reflexão crítica de estudos qualitativos e quantitativos, a comparação dos resultados-agrupamento por assunto, interpretação, conclusões por níveis de evidência em enfermagem. Resultados: foram identificados quatro temas prevalentes: consequências para a saúde, causas, intervenções de enfermagem e enfrentamento. A principal contribuição no tema permitiu identificar desenvolvimento investigativo tanto no paradigma qualitativo e quantitativo, diferentes abordagens metodológicas em níveis de evidência VII, VI, V, IV, III. Conclus as políticas de saúde que envolvem a prevenção do fenômeno são necessários, as causas e consequências relacionadas e estratégias devem ser projetados para identificar as escolas em risco, visando evitar consequências para a saúde, bem como gerar estudos de intervenção e apoiar processos de enfrentamento em crianças em idade escolar que são provocadas ou intimidadas.

ABSTRACT Objective: to analyze relevant theoretical and methodological aspects from the scientific evidence in nursing related to school bullying. Method: Integrative review of nursing studies' literature in eight databases: PubMed, MEDLINE, Academic Search Complete, Ovid nursing, SciELO, ScienceDirect, Redalyc and Embase, with the keywords: bullying, nursing, child school bullying, peer aggression, adolescent and time span from 2004 to 2016. There were 30 studies of which 19 that met the selection criteria were selected. The analysis was developed in six stages: search of studies, selection, and criticism of qualitative and quantitative studies, comparison of findings/grouping by themes, interpretation, conclusions by levels of nursing evidence. Results: Four prevalent themes were identified: consequences in health, causes, nursing interventions and coping. The main contribution in the theme from the evidence of research in nursing allowed to identify research developments in both the qualitative and quantitative paradigm, different methodological approaches in the levels of evidence VII, VI, V, IV, III. Conclusions: health policies that intervene in preventing the phenomenon, know the causes and related consequences are needed; in addition, strategies for identifying schoolchildren at risk should be designed to avoid consequences to their health, also generate intervention studies and support coping processes for schoolchildren who are mocked or bullied.

Self-esteem level of Brazilian teenagers victims of bullying and its relation with the need of orthodontic treatment / Nível da autoestima de adolescentes brasileiros vítimas de bullying e sua relação com a necessidade de tratamento ortodôntico

ABSTRACT Objective: The aim of this study was to analyze self-esteem among Brazilian adolescents and also verify possible associations between the variables: the need for orthodontic treatment and bullying. Methods: The cross-sectional, population-based epidemiological study consisted of a sample composed of adolescents from 11 to 16 years of age, enrolled in the public school system of a medium-sized municipality in the northwest of the State of São Paulo, Brazil. A dental examination was performed using the Dental Aesthetic Index (DAI) in order to verify the need for orthodontic treatment and a self-administered questionnaire containing the Global Self-Evaluation (GSE) indices to identify the level of self-esteem and Kidscape in order to detect bullying. Data analysis was performed using descriptive statistics, association analysis and multivariate logistic regression. Results: A total of 815 adolescents participated in the study. There was a statistically significant association between self-esteem and the variables: sex (p <.0001), willingness to straighten teeth to improve appearance (p = 0.0006), bullying victim (p <.0001), frequency of bullying = 0.0111) and consequences of bullying (p <.0001). A significant risk factor for non-white adolescents' very negative self-esteem (OR = 1.914) was present together with bullying victims who had had negative consequences after the episode (OR = 3.343). Conclusion: There was an association between the self-esteem and bullying variables. Those who reported negative consequences on bullying were three times more likely to present very negative self-esteem, and the chances of non-white adolescents to show negative self-esteem were almost twice as high. There was no statistically significant association between self-esteem and the need for orthodontic treatment.

RESUMO Objetivo: Analisar o nível da autoestima de adolescentes brasileiros e verificar as possíveis associações de desfecho com a necessidade de tratamento ortodôntico e bullying. Métodos: Estudo epidemiológico transversal de base populacional. A população foi composta por adolescentes de 11 a 16 anos, matriculados na rede pública de ensino de um município de médio porte do noroeste paulista. Foi realizado um exame bucal utilizando o índice Dental Aesthetic Index (DAI), para verificar a necessidade de tratamento ortodôntico, e um questionário autoaplicável, contendo os índices Global Self-Evaluation (GES), para identificar o nível de autoestima, e o Kidscape, para detecção de bullying. A análise dos dados foi feita utilizando estatística descritiva, análises de associação e regressão logística multivariada. Resultados: No total, 815 adolescentes participaram da pesquisa. Houve associação estatisticamente significante entre autoestima e as variáveis: sexo (p<.0001), vontade de corrigir os dentes para melhorar a aparência (p=0.0006), vítima de bullying (p<.0001), frequência com que sofreu bullying (p=0.0111) e consequências do bullying (p<.0001). Apresentaram-se como fator de risco significante para uma autoestima muito negativa a cor da pele não branca (OR=1.914) e vítimas de bullying que tiveram consequências negativas após o episódio (OR= 3.343). Conclusão: Houve associação entre as variáveis autoestima e bullying. Aqueles que relataram consequências negativas sobre o bullying apresentaram chances três vezes maiores de ter autoestima muito negativa, já as chances dos adolescentes com cor da pele não branca foram quase duas vezes maiores. Não houve associação estatisticamente significante entre autoestima e necessidade de tratamento ortodôntico.

As principais causas de cegueira e baixa visão em escola para deficientes visuais / The main causes of blindness and low vision in school for blind

RESUMO Objetivo: Identificar e analisar as principais causas de cegueira e baixa visão em escola para deficientes visuais. Métodos: Foram revisados 165 prontuários de alunos portadores de deficiência visual em instituição especializada no ensino de cegos, atendidos no período de agosto de 2013 a maio de 2014. As variáveis analisadas foram: idade, gênero, acuidade visual, diagnóstico principal e secundário, tratamento, recursos ópticos prescritos e prognóstico. Resultados: Dos 165 alunos avaliados, 91 alunos (55%) são legalmente cegos e apenas 74 (45%) dos alunos são enquadrados como baixa visão. As principais causas identificadas foram: retinopatia da prematuridade (21%), atrofia de nervo óptico (18%), glaucoma congênito (16%), distrofias retinianas (11%) e neoplasias (8%). As causas de baixa visão foram: catarata congênita (18%), glaucoma congênito (15%) e cicatriz de retinocoroidite (12%). As causas de cegueira evitáveis (preveníveis ou tratáveis) no estudo perfizeram um total de 52%. Conclusão: As principais causas de cegueira e baixa visão nos alunos do Instituto Benjamin Constant são por doenças evitáveis.

ABSTRACT Objective: Identify and analyze the main causes of blindness and low vision in school for blind. Methods: One hundred sixty-five medical records of visually impaired students were reviewed in an institution specialized in teaching the blind, treated between august 2013 and may 2014. The variables analyzed were age, sex, visual acuity, primary and secondary diagnoses, treatment, optical prescription features and prognosis. Results: 165 students were evaluated, 91 students (55%) are legally blind and only 74 (45%) of the students are classified as low vision. The main causes of blindness were: retinopathy of prematurity (21%), optic nerve atrophy (18%), congenital glaucoma (16%), retinal dystrophy (11%) and cancer (8%). The causes of low vision were: congenital cataract (18%), congenital glaucoma (15%) and retinochoroidal scarring (12%). Conclusions: The main causes of blindness and low vision in the Benjamin Constant Institute are from preventable diseases.

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.

Oral Health Condition of School Children in Nawalparasi District, Nepal.

BACKGROUND: Oral diseases and feeding habits are inextricably linked. Significance of assessing oral health conditions among the school children therefore exists. The current study investigated the oral health condition among 5-6 years and 12-13 years children in Nawalparasi district, Nepal. METHODS: Recruiting 1,000 school children aged (5-6) and (12-13) years in Nawalparasi district, a cross-sectional study was carried out from November to December, 2014. Data assembled from standard instrument was entered in Epi-Data 3.1, cleaned in SPSS version 16.0, and analyzed in Epi Info 3.5.4. RESULTS: Of 12-13 years children, three out of ten (32.0%, 95% CI: 27.8-36.4) suffered from occasional dental discomfort and pain, and 8.1% (95% CI: 5.9-11.0) often experienced dental discomfort and pain during the last 12 months. It was 73.6% (95% CI: 69.3-77.4) who brushed teeth at least once a day, while another 20.7% (95% CI: 17.2-24.7) brushed twice a day. Among all children, 86.1% (95% CI: 82.6-89.1) used toothpaste to brush the teeth. A three-fourth (73.8%, 95% CI: 69.5-77.7) drank tea with sugar daily. Dental caries was visible on 42.2% (95% CI: 37.7-46.8) (mean DMFT score 2.3 ± 1.5). Likewise, a quarter (24.1%, 95% CI: 20.3-28.3) had gingival bleeding, 10.9% (95% CI: 8.3-14.1) questionable enamel fluorosis, 4.5% (95% CI: 2.9-6.9) dental trauma, and 1.7% (95% CI: 0.8-3.5) oral mucosal lesion. Referral for preventive/routine treatment was observed in 40.5% (95% CI: 36.145.1). Among 5-6 years old children, a remarkable proportion of dental caries (64.4%, 95% CI: 59.2-69.4 and mean DMFT score 4.4 ± 3.0) was noted. Statistics of enamel fluorosis, dental trauma, and oral mucosal lesions in this age group were: 3.1% (95% CI: 1.6-5.6), 1.7% (95% CI: 0.7-3.8), and 1.1% (95% CI: 0.4-3.0) respectively. About 40.1% (95% CI: 35.0-45.4) were referred for preventive treatment, and the rest for prompt treatment. CONCLUSIONS: Oral health of the children was poor, chiefly dental carries remained widespread. Dental hygiene awareness should be promoted in schools in active coordination and collaboration with education authorities.

Programa saúde na escola: estratégia promotora de saúde na atenção básica no Brasil / The health school programme: a health promotion strategy in primary care in Brazil

The Health School Programme (HSP) should be understood as a permanent development process. In this context, the actions of a policy aimed at children and adolescentsare paramount in the HSP OBJECTIVE: to identify and describe the actions developed by the Family Health Group in the HSP, from the National Programme for ImprovingAccess and Quality of Primary Care (PIPCAQ METHODS: this cross-sectional research used secondary data collected fromthe 17,202 groups who joined PIPCAQ in 2012 RESULTS: all regions showed significant results concerning the execution of school activities. the Northern region was the one that performed most school actions (80.5%), followed by the Northeast, Midwest, South and Southeast, respectively. However, some items, such as professional training in education and health work need to be streng the ned CONCLUSION: HSP in Brazil has mobilised significant actions, even though it has not happened in homogeneously in all Brazilian regions...

A promoção da saúde no cenário escolar deve ser entendida como um processo em permanente desenvolvimento. Nesse contexto, destacam-se as ações do Programa Saúde na Escola, como política voltada para crianças e adolescentes OBJETIVO: identificar e descrever as ações desenvolvidas pelas Equipes de Saúde da Família (ESF) no Programa Saúde na Escola (PSE), participantes do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ MÉTODO: trata-se de uma pesquisa transversal que utilizou dados secundários coletados junto a 17.202 equipes que aderiram ao PMAQ em 2012 RESULTADO: todas as regiões apresentaram resultados expressivos acerca da realização de atividades na escola. A região Norte é a que mais executa ações ao escolar (80,5%), seguidas das regiões Nordeste, Centro-Oeste, Sul e Sudeste respectivamente. Contudo, alguns itens como a capacitação dos profissionais para trabalhar com educação e saúde precisam ser fortalecidos CONCLUSÃO: o PSE no Brasil tem mobilizado ações relevantes, mesmo que isto não tenha se dado de forma homogênea em todas as regiões brasileiras...

The health school programme: a health promotion strategy in primary care in Brazil / Programa saúde na escola: estratégia promotora de saúde na atenção básica no Brasil

INTRODUCTION: the Health School Programme (HSP) should be understood as a permanent development process. In this context, the actions of a policy aimed at children and adolescentsare paramount in the HSP OBJECTIVE: to identify and describe the actions developed by the Family Health Group in the HSP, from the National Programme for ImprovingAccess and Quality of Primary Care (PIPCAQ METHODS: this cross-sectional research used secondary data collected fromthe 17,202 groups who joined PIPCAQ in 2012 RESULTS: all regions showed significant results concerning the execution of school activities. the Northern region was the one that performed most school actions (80.5%), followed by the Northeast, Midwest, South and Southeast, respectively. However, some items, such as professional training in education and health work need to be streng the ned CONCLUSION: HSP in Brazil has mobilised significant actions, even though it has not happened in homogeneously in all Brazilian regions.(AU)

INTRODUÇÃO: a promoção da saúde no cenário escolar deve ser entendida como um processo em permanente desenvolvimento. Nesse contexto, destacam-se as ações do Programa Saúde na Escola, como política voltada para crianças e adolescentes OBJETIVO: identificar e descrever as ações desenvolvidas pelas Equipes de Saúde da Família (ESF) no Programa Saúde na Escola (PSE), participantes do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ MÉTODO: trata-se de uma pesquisa transversal que utilizou dados secundários coletados junto a 17.202 equipes que aderiram ao PMAQ em 2012 RESULTADO: todas as regiões apresentaram resultados expressivos acerca da realização de atividades na escola. A região Norte é a que mais executa ações ao escolar (80,5%), seguidas das regiões Nordeste, Centro-Oeste, Sul e Sudeste respectivamente. Contudo, alguns itens como a capacitação dos profissionais para trabalhar com educação e saúde precisam ser fortalecidos CONCLUSÃO: o PSE no Brasil tem mobilizado ações relevantes, mesmo que isto não tenha se dado de forma homogênea em todas as regiões brasileiras.(AU)

Intervenção educativa sobre violência com adolescentes: possibilidade para a enfermagem no contexto escolar / Intervención educativa sobre la violencia con adolescentes: posibilidad para la enfermería en el contexto escolar / Educational intervention using the life activity of breathing with adolescents

Este estudo objetivou realizar uma intervenção educativa com adolescentes sobre a violência no contexto escolar, utilizando a metodologia de Círculos de Cultura. Métodos: Pesquisa-ação, de abordagem qualitativa, realizada em outubro de 2011. A coleta de dados incluiu: observação participante com diário de campo, registro fotográfico e filmagem, e, como produção do grupo, teatro de fantoches. Participaram 12 adolescentes de uma escola pública do Recife-PE. Para análise, recorreu-se à triangulação de dados em diálogo com a literatura. Resultados: A problematização proporcionada pelo Círculo de Cultura permitiu aos adolescentes desvelar as diversas faces de manifestação da violência, mediante situações de agressão física e verbal entre os membros escolares, ameaças contra o professor e violência contra o patrimônio, até aquelas formas simbólicas envolvendo práticas de constrangimento. Conclusão: A intervenção de educação em saúde abriu possibilidades para inserção da(o) enfermeira(o) no cenário escolar a fim de fortalecer articulações em rede para o trabalho de prevenção à violência. .

Objetivo:Realizar una intervención educativa con adolescentes sobre la violencia en la escuela, utilizando la metodología de Círculos de Cultura.Métodos:Investigación-acción, de abordaje cualitativo, realizada en octubre de 2011. La recolección de datos incluyó: observación participante con diario de campo, registro fotográfico y filmación, y como producción del grupo, teatro de títeres. Participaron 12 adolescentes de una escuela pública de Recife-PE. Para el análisis, se utilizó la triangulación de datos en diálogo con la literatura.Resultados:La problematización proporcionada por el Círculo de Cultura permitió a los adolescentes revelar las diversas formas de manifestación de la violencia, mediante situaciones de agresión física y verbal entre los miembros escolares, amenazas contra el profesor y violencia contra el patrimonio, además de prácticas de Bullying.Conclusión:La intervención de la Educación en Salud propició la inserción del enfermero en el escenario escolar para fortalecer articulaciones en red para la prevención de la violencia.

La Escuela de Salud Pública de México: su fundación y primera época, 1922-1945 / The Mexican School of Public Health: its founding and first years: 1922-1945

Este artículo reconstruye la historia fundacional de la Escuela de Salud Pública de México, inaugurada como Escuela de Salubridad en marzo de 1922. Con base en el contexto histórico y educativo de la época, se presentan las diferentes causas que orillaron a las autoridades sanitarias del momento a apoyar su creación y promoción. El combate de las enfermedades y la promoción de una cultura de la prevención entre los mexicanos de antaño hicieron necesaria la formación de salubristas que contribuyeran al llamado periodo de reconstrucción nacional. Esta premisa se prolongó hasta 1945 con la instauración de la medicina social como bandera de acción en el terreno de la prevención de enfermedades, lo cual promovió acciones y políticas enfocadas a las comunidades rurales de México.

This article analyzes the foundation of the Public Health School of Mexico, which first opened its doors in March 1922. It presents the different circumstances which obliged the sanitary authorities to create and promote the School, based on the historic and educational context of the time. The struggle for disease eradication and the promotion of a culture of prevention among the Mexican population of the time made it necessary to train sanitarians who would contribute to the National Reconstruction period. This trend continued until 1945, when social medicine started to be considered as a flag of action in the field of disease prevention, which promoted actions and policies focused on the rural communities of Mexico.