Current teachers' perceptions and students' perspectives regarding activities modalities, instructional settings during primary school physical education classes in China: a cross-sectional observational study.

Introduction: This study set out to understand the association between teaching practices, teacher confidence, competence, self-efficacy, and the resulting student outcomes. Methods: Data regarding teaching behaviours were collected via video recording and then evaluated using the MASTER Observation Tool. The information about demographics, self-reported teaching confidence, competence, self-efficacy, and student outcomes was collected using questionnaires. The association between teacher characteristics, and teacher and/or student outcome variables were tested using a one-way analysis of variance (ANOVA). Results: A total of ten primary schools were involved, including 597 children (age range: 10-12 years, grade 4-6) and 16 grade 4-6 PE teachers (with 16 PE classes). Most of the Physical Education (PE) lesson time was spent in training-form activities (60.2% ± 9.1), followed by instructional time (33.1% ± 8.6%), reflection (3.4% ± 2.3%), and warm-up (2.9% ± 2.0 %). It was observed that teaching behaviours and student outcomes were significantly better in urban than rural areas. Smaller class sizes (21-30 children) were found to have more positive feedback than larger ones (41-50 children). PE teachers with more than 10 years of teaching experience reported more teaching competence and self-efficacy than teachers with less than 10 years of experience. PE teachers with class sizes of 21-30 children enjoyed significantly better scores in self-efficacy than classes with 41-50 children. They also scored more highly in confidence and competence than classes with 41-50 and 51-60 pupils. Conclusion: The current study confirmed that teachers dedicated a large proportion of lesson time to PE delivering training-form activities, followed by instructional time. Teaching behaviour and student outcomes were associated with location and class size, but not gender. The study contributes to our understanding of PE instruction in Chinese primary schools and offers preliminary evidence to improve future PE teaching strategies in the country.

Physical and psychological health consequences of intimate partner violence among married primary school teachers in Delta South Senatorial Zone of Delta State, Nigeria: Implication for marital stability.

Background: Intimate Partner Violence (IPV) is a serious health issue among couples which is recorded more among married partners. Dishearteningly, IPV among couples who are teachers is underreported due to shame, thereby increasing the prevalence of IPV in the area of the study. Objectives: The study examined physical and psychological health consequences of IPV on married primary school teachers. Methods: The design was a cross-sectional descriptive survey conducted on married primary school teachers in Delta South Senatorial zone of Delta State, Nigeria from 22nd February - 29th November, 2021. Three hundred and thirteen 313 (207 women and 106 men who have experienced various forms of IPV) who were identified as victims of IPV were used as participants in the study. Structured questionnaire was used to elicit information on physical and psychological health consequences of IPV on married teachers. Conclusion: The researchers concluded that there are severe and serious physical and psychological health consequences associated with IPV among married primary school teachers in Delta South Senatorial zone of Delta State, Nigeria. Urgent interventions such as public enlightenment, campaigns, workshops, seminars, community health talk-shows should be organized by government stakeholders, non-governmental organizations, community leaders on the prevention of IPV and its dare consequences for marital stability.

The Efficacy of Voice Therapy via Hybrid Group Telepractice Program with Asynchronous Components for Primary School Teachers: A Pilot Study.

PURPOSE: To determine the efficacy of a hybrid group telepractice program in voice therapy for primary school teachers. METHOD: The participants, consisting of 12 teachers with voice disorders (three males and nine females), participated in 11 sessions of the telepractice program, divided into one training session on vocal hygiene, five practice sessions by themselves, and five group practice sessions in 5weeks. Data on the vocal handicap index (VHI) measure was obtained pre- and post-intervention. The voice analysis included fundamental frequency (local), jitter (local), shimmer (local), harmonic-to-noise ratio (local), and maximum phonation time assessed by Praat software. RESULT: The VHI assessment revealed a statistically significant difference (P < 0.05) in the emotional domain. There was no statistically significant difference (P > 0.05) in physical, functional, and total scores. Both males and females had no statistically significant difference (P > 0.05) in mean fundamental frequency. However, there was a statistically significant difference (P < 0.05) in jitter (local), shimmer (local), harmonics-to-noise ratio (local), and the maximum phonation time. CONCLUSION: The group telepractice program in voice therapy for primary school teachers was effective. It could be utilized for voice therapy to prevent voice disorder problems in teachers.

Associated factors of dietary diversity among schoolchildren in Plateau Central region of Burkina Faso: a cross-sectional study.

CONTEXT: School-age is a dynamic period of growth and development, leading to good health and a productive adult life. Adequate dietary intake provides essential nutrients for growth, health and cognition. However, the practices of adequate nutrition is still not a matter of course for schoolchildren in many countries. The aim of this study was to identify associated factors of dietary diversity among students in public primary school in the Central Plateau Region. METHOD: Multi-stage sampling was used to select schoolchildren. A semi-structured questionnaire was used to collect information's of food consumption at home and at school using a 24-h dietary recall method. Binary logistic regression was used to identify variables associated with students' dietary diversity scores (DDS) with statistical significance at p < 0.05, after performing Chi-square test of independence to identify candidates variables at p < 0.25. RESULTS: The study involved 560 pupils aged 6 to 14 older, including 52.9% girls and 47.9% boys. Dietary diversity was divided into three classes: low (DDS ≤ 4), medium (DDS = 5) and high (DDS ≥ 6). Thus, 13.4% of students have a low DDS and average in 48.9%, versus 37.7% high. Students in Ganzourgou were twice as likely to have a low DDS (AOR = 2.01, 95% CI:1.00-4.04) compared to those in Oubritenga. Household drinking water source, pupil status and father's occupation were significantly associated with pupils' dietary intake. CONCLUSION: Primary schoolchildren don't have good dietary practices in the Plateau Central Region. Promoting dietary diversification in households and balanced meals in school canteens would be necessary to improve the DDS of schoolchildren. TRIAL REGISTRATION: Clinical Trial Number: 2022_33_/MS/MESRSI/CERS of 02/14/2022.

Burden of Goitre and Urinary Iodine Status among Primary School Children in Kashmir, India-Evidence from a Population-Based Iodine Deficiency Disorder Survey.

Introduction: Iodine deficiency is the leading cause of preventable brain damage, with 30% of the world's population suffering from iodine deficiency disorders (IDDs). The objectives of the study are to estimate the prevalence of goitre among schoolchildren in the age group of 6-12 years, to find out the proportion of households with adequately iodised salt, and to assess the dietary iodine intake by measuring urinary iodine levels in the urine samples of school-going children. Methods: A cross-sectional study was conducted in four pre-selected districts of the Kashmir division of Jammu and Kashmir in school-going children aged 6 to 12 years. Multi-stage 30 cluster sampling was used to select the study sample. For the selection of 30 clusters in each district, probability proportional to size (PPS) was employed. From each cluster, 90 children were selected. From a sub-sample of children in each district, 540 salt samples and 270 urine samples were also collected. Results: A total of 10,800 children aged 6-12 years were examined. Grade I goitre was present in 1382 (12.8%) and 116 (1.07%) which were having Grade II goitre. The weighted prevalence of goitre for four districts was 12.6%, lowest for district Ganderbal and highest for district Shopian. Half of the population in all the districts consumed salt with iodine levels of <15 ppm. Urinary iodine levels <99.9 mg/L were present in 15.7% indicating mild to moderate iodine deficiency. Conclusion: Though the present survey showed some decline in the total goitre rate (TGR) from a prevalence of 14.8% in 2017 to 12.6% in 2022, it continues to be a public health problem of mild to moderate intensity in Kashmir. The salt consumed at the household level was inadequately iodised. Hence, efforts in IDD elimination activities need to be scaled up further with emphasis on iodised salt quality control and intensive education at the community level.

Prevalence of vitamin B 12 deficiency and associated factors among primary school children: North East Ethiopia: multicenter cross-sectional study.

BACKGROUND: The prevalence of Vitamin B12 deficiency is common and is more frequent in low- and middle-income countries with a poor or inadequate diet of animal foods. In Ethiopia, researches related to the status of micronutrients in children are limited. Therefore, this study aimed to assess the prevalence of vitamin B12 deficiency and associated factors among primary school children. METHODS: A cross-sectional study design was conducted from January 10-February 30/2023. A total of 514 students were selected using a systematic random sampling technique. Face-to-face interviews using a structured questionnaire, document review, anthropometric measurement, and laboratory studies were implemented to collect data. Data was analyzed by STATA version 14 and summarized by using frequency tables and graphs. Logistic regression analysis was done to identify factors associated with vitamin B12 Deficiency. RESULTS: About 34% of the students were found to have vitamin B12 deficiency. Not Consuming animal products (AOR = 1.83, 95% CI:1.20-2.79) and low body mass index (AOR = 1.62, 95% CI:1.05-2.47) were associated with vitamin B12 deficiency. CONCLUSIONS: The study revealed a notable high deficiency of vitamin B12 in primary school students. Consumption of animal products and BMI were identified as statically significant associated factors with serum concentration of vitamin B12.

Perspectives of primary school teachers on the capacity of schools to support post-pandemic health needs emerging among school-age children.

BACKGROUND: This study aimed to explore the impact of the COVID-19 pandemic on capacity building for health promotion in primary schools from the perspectives of primary school teachers. METHODS: A cross-sectional observational study was conducted via an anonymous online survey between February and May 2022. Three-quarters (n2460) of all schools in the Republic of Ireland were invited to participate. Demographics such as gender, teaching experience, school type and delivering equality of opportunity in schools (DEIS) designation were collected. Perceived capacity for health promotion was measured on a 10-point Likert scale. Facilitators and barriers related to health promotion and aspects of child health prioritised for health promotion in the 2 years after restrictions eased were explored via closed- and open-ended questions. RESULTS: Of the 595 responses, 493 were eligible for analysis. Participants were based in schools in every county in the Republic of Ireland, with most (85.4%, n421) being female. Almost a third (30.5%, n150) were 11-20 years post-qualification, and a quarter (25.2%, n124) had over 30 years' teaching experience. Mean capacity for school-based health promotion pre-pandemic was moderate, at 6.6 ± 2.2 on a 10-point scale. Mean capacity in spring 2022 decreased significantly (p < 0.001) to 4.1 ± 2.4, indicating poor capacity. Capacity ratings did not significantly differ by school type (p = 0.31), socioeconomic designation (p = 0.27) or years post-qualification (p = 0.08). Capacity decrements were most frequently (49.7%, n245) attributed to organisational factors, while individual and community-level factors were cited by 27.6% (n136) and 21.5% (n106) of respondents, respectively. Healthy eating significantly (p < 0.001) decreased as a priority for health promotion between pre-pandemic times (76.3%, n376) and spring 2022 (23.1%, n114). Mental health significantly (p < 0.01) increased as a priority, being listed by 38.1% (n188) as a priority pre-pandemic and doubling to 72.6% (n358) in spring 2022. CONCLUSIONS: Fostering a holistic approach to health promotion in schools remains a challenge. Further efforts are needed to support schools to implement sustainable and balanced systems of health promotion.

Aquaponics in schools: Hands-on learning about healthy eating and a healthy planet.

Our food system is giving rise to a growing social, health and environmental crisis. Much of the food consumed in the United Kingdom is cheap, nutrient-poor and highly processed, leading to under-consumption of essential foods such as grains, beans, vegetables and fruit. This has contributed to a rise in diet-related diseases, with approximately 22% of primary school leavers being overweight or obese. Food production is unsustainable with agriculture responsible for 10% of the UK's greenhouse gas emissions and intensive farming practices have led to a significant loss of soil carbon and a decline in biodiversity. COVID-19 increased inequalities in our food system. Therefore, there is an urgent need for interventions to counteract these adverse social, health and environmental impacts. Education can play a crucial role as an intervention to address challenges in the food system. We tested an innovative school initiative using portable aquaponic pods and aligned to the national curriculum, to engage pupils in food production and foster learning about sustainability, climate change and healthy eating. The evaluation, based on teacher surveys, aquapod chart data, student blogs and postcards and feedback from the development team, revealed positive impacts on students' environmental awareness, as well as sustainability and practical food production knowledge. However, the programme encountered logistical challenges and we therefore highlight future improvements to produce a curriculum programme that can be delivered at scale to enhance food education and empower pupils to drive the agenda on tackling food sustainability and climate change.

The interplay between ego-resiliency, math anxiety and working memory in math achievement.

Previous research has suggested that math anxiety may contribute to poor math performance by interfering with working memory. However, only a limited number of studies investigated the mediating role of working memory in the math anxiety-math performance link in school-aged children. Unlike math anxiety, ego-resiliency is a personality resource that promotes the management of challenges and has been positively associated with math performance and negatively with anxiety. Nevertheless, there is still limited understanding regarding the specific role of ego-resiliency in math learning and how it relates to math anxiety. This study aimed to investigate conjunctly the interplay between primary school children's ego-resiliency, math anxiety, working memory, and performance on two different math tasks (i.e., arithmetic task and word problem-solving task), after controlling for general anxiety and age. The study involved 185 Italian children from grades 3 to 5. Serial multi-mediational analyses revealed that: (1) ego-resiliency has a positive indirect effect on math achievement through two paths - math anxiety, and math anxiety and working memory; (2) the study replicated previous findings showing that working memory partially mediated the relationship between math anxiety and math performance; (3) similar patterns of results were found for both math skills. The study identifies ego-resiliency as a possible protective factor in the development of math anxiety and suggests that ego-resiliency could be worth considering when designing interventions aimed at reducing negative emotions towards mathematics.

Attitudes of 10-12-year-old primary school pupils towards food and nutrition: insights from Qualitative FGI Research - Junior-Edu-Zywienie (JEZ) Project.

INTRODUCTION AND OBJECTIVE: Primary school pupils aged 10-12 years constitute an interesting consumer group due to their greater autonomy in the area of nutrition, compared to the younger group of children, among other things, due to their 'pocket money' and the greater influence of their peer group. However, this is an age group at high risk of inadequate nutrition, eating disorders, including those related to obesity and underweight. Hence, the aim of the study was to explore the attitudes of pupils aged 10-12 years towards food and nutrition. MATERIAL AND METHODS: A qualitative study was conducted using the Focus Group Interview (FGI) technique among 84 primary school pupils from different localities in Poland. RESULTS: Pupils had moderate knowledge of food and nutrition but did not consistently apply this knowledge in practice. Four pupils' profiles were identified, categorized as 'engaged,' 'obedient,' 'rebels,' and 'indifferent,' based on their level of involvement and awareness of proper nutrition. Lunch was the most regularly consumed meal, sometimes eaten twice a day (at school and at home), while first breakfast was skipped the most frequently, mainly because of lack of time and morning rush. Pupils accurately identified recommended and not recommended food products, but lacked an understanding of their importance for health. Pupils' emotional state increased the consumption of salty snacks, sweets, and fast food, and to a lesser extent, seeds, vegetables, and fruit. Pupils reported engaging in moderate physical activity, although they also spent a significant amount of time on the internet or watching TV. CONCLUSIONS: Primary school pupils aged 10-12 years represented a relatively good level of knowledge about adequate nutrition; nevertheless, they did not follow these recommendations in practice.

A systematic review of primary school teachers' wellbeing: room for a holistic approach.

Although the investigation of mental health and wellbeing in education has shown an exponential increase on an international scale, attention has primarily been paid to students, leaving the concept of teacher wellbeing comparatively overlooked. Extant literature offers numerous divergent descriptions, with some academics even avoiding an explicit definition of the term. Thus, there are limitations and inconsistencies in understanding teacher wellbeing as a unique construct. The aim of the current study was three-fold; (1) to assess the extent to which existing research reflects the multidimensional nature of the term teacher wellbeing, (2) to determine whether a holistic construct of teacher wellbeing could be justified, and (3) to evaluate the methodological quality of studies identified. A systematic review following the PRISMA statement was applied to peer-reviewed papers published between 2016 and 2021. Following the screening of 1,676 studies, this paper reports on findings drawn from a final sample of 61 articles conceptualizing teacher wellbeing. Studies were organized by their dominant discourses, namely negativity/ deficiency, positivity/ flourishing, and/or professionalism. Findings illustrate that teacher wellbeing was primarily conceptualized with a professionalism approach (with 18 of the identified studies taking solely this perspective). This is not completely consistent with the prior work that focused on stress and burnout (negativity/ deficiency approach) while exploring teachers' mental health and wellbeing. More importantly, there were only 6 studies that considered all three discourses together. This paper argues that important information is lost through neglecting alternative lenses, requiring further attention in order to address teacher wellbeing comprehensively. Such an endeavor is essential for shaping interventions and strategies aimed not only at enhancing teacher wellbeing but also at improving student outcomes and, ultimately, the overall quality of education. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278549PROSPERO, CRD42021278549.

The impact of family socioeconomic status on parental involvement and student engagement during COVID-19 in promoting academic achievement: A longitudinal study in Chinese children.

With a three-wave longitudinal design, the current study examined the impact of family socioeconomic status (SES) on parental involvement and student engagement in promoting children's academic achievement during the coronavirus disease 2019 (COVID-19) pandemic. We recruited data from 246 mother-primary school student dyads, and the mean age of children at Wave 1 was 10.57 ± 0.97 years (range = 9-13 years). The academic achievement of these children was measured both before and after school closures. Family SES, parental involvement, and student engagement were assessed during the school closures. The results indicated that family SES could predict children's later academic achievement after accounting for their prior academic achievement and other demographics (i.e., the significant total effect in the model). Moreover, parental involvement and student engagement played chain-mediating roles in the effect of family SES on children's later academic achievement. Neither parent involvement nor student involvement alone mediated the relationships between family SES and subsequent academic achievement. Suggestions are provided to minimize the negative impact of low family SES on children's academic achievement during pandemics.

Physically active learning for children with learning disorders attending special-needs schools: A program evaluation.

BACKGROUND: Physically active learning (PAL) is a potentially valuable method to stimulate academic performance and physical activity (PA) in children with learning disorders (LD) attending special-needs schools. It is yet unknown whether PAL can be successfully implemented in special-needs schools. AIMS: This study aimed to evaluate a PAL-program in special-needs schools by examining teacher's dose delivered, children's dose received, and associations of children's characteristics with dose received. METHODS: Children (N = 37) from two special-needs schools participated in a six-week PAL-program. Dose delivered was evaluated based on PAL-lessons' implementation rate and duration. Dose received was assessed through time-on-task observations (n = 23) and PA (n = 37). To assess the association between dose received and children's characteristics (sex, behavioral disorders, motor skills, and physical fitness), Mann-Whitney U tests and Spearman's rho correlations were used. RESULTS: For teacher's dose delivered, the implementation rate exceeded 95%, and the PAL-lessons lasted the intended 12 minutes. For dose received, children's on-task behavior was above 79%, and children spent 43% of the time in moderate-to-vigorous PA during PAL. Motor skills were positively related to on-task behavior related to the movements, and physical fitness was positively related to moderate-to-vigorous PA. CONCLUSIONS: PAL was successfully implemented in terms of dose delivered and dose received for children with LD attending special-needs schools.

Relationship Between School Food Environment and Eating Behaviors of Primary School Children in Dodoma: A Cross-Sectional Study.

This cross-sectional study assesses the relationship between school food environment and eating behaviors of primary school children in Dodoma among 248 primary school children aged 6-13 years. School characteristics information and socio-demographic characteristics were collected. Multilevel modeling was employed to assess the individual-level variance in eating behaviors. Most of the variances in the investigated eating behaviors were at the personal level. Significant associations (p < .05) were between protein-rich food intake and fats and sugar-rich food with the death of either parent. And association between intake of vitamin and mineral-rich foods and the number of people living in household.

Investigating young children's physical activity through time and place.

BACKGROUND: Previous research indicates the start of primary school (4-5-year-old) as an essential period for the development of children's physical activity (PA) patterns, as from this point, the age-related decline of PA is most often observed. During this period, young children are exposed to a wider variety of environmental- and social contexts and therefore their PA is influenced by more diverse factors. However, in order to understand children's daily PA patterns and identify relevant opportunities for PA promotion, it is important to further unravel in which (social) contexts throughout the day, PA of young children takes place. METHODS: We included a cross-national sample of 21 primary schools from the Startvaardig study. In total, 248 children provided valid accelerometer and global positioning (GPS) data. Geospatial analyses were conducted to quantify PA in (social) environments based on their school and home. Transport-related PA was evaluated using GPS speed-algorithms. PA was analysed at different environments, time-periods and for week- and weekend days separately. RESULTS: Children accumulated an average of 60 min of moderate-to-vigorous PA (MVPA), both during week- and weekend days. Schools contributed to approximately half of daily MVPA during weekdays. During weekends, environments within 100 m from home were important, as well as locations outside the home-school neighbourhood. Pedestrian trips contributed to almost half of the daily MVPA. CONCLUSIONS: We identified several social contexts relevant for children's daily MVPA. Schools have the potential to significantly contribute to young children's PA patterns and are therefore encouraged to systematically evaluate and implement parts of the school-system that stimulate PA and potentially also learning processes. Pedestrian trips also have substantial contribution to daily MVPA of young children, which highlights the importance of daily active transport in school- and parental routines.

Effects of school nurse-led health education to reduce malnutrition among primary school children in Bangladesh: Cluster nonrandomized controlled trial.

Background: Malnutrition is a major health concern among children especially in low and middle-income countries. However, there are limited studies on school health in Bangladesh. This study aimed to reduce malnutrition among primary school children in Bangladesh by increasing awareness and knowledge through school nurse-led health education. Methods and Materials: A prospective, open-label, parallel-group (1:1), cluster nonrandomized controlled trial on primary school children conducted in rural Bangladesh. The study lasted 13 months between September 2021 and September 2022. Four schools were selected and assigned to the intervention and control groups (CGs). Next, school nurses provided evidence-based health education to the children in the intervention group (IG) for 9 months to improve awareness and knowledge of malnutrition. Data were collected at baseline, midline, and endline. Results: Overall, 604 children were enrolled at the baseline; among them, 455 (CG, n = 220; IG, n = 235) completed the study. Changes in the malnutrition rate-the primary outcome-were not significant (P = 0.225). However, after adjusting the endline data with baseline and sociodemographic data, the children's body mass index improved significantly in the IG than in the CG (P < 0.05). Changes in eating behavior, and awareness and knowledge of malnutrition-the secondary outcomes-significantly differed between the groups (P < 0.001). Conclusion: The school nurse-led health education program significantly improved primary school children's awareness and knowledge of malnutrition. This study revealed the effectiveness of school nurses in reducing malnutrition among children, which may decrease future morbidity and mortality rates in children.

Analysis of risk factors associated with pre-myopia among primary school students in the Mianyang Science City.

Objectives To find out the prevalence rate of pre-myopia among primary school students in the Mianyang Science City Area, analyze its related risk factors, and thus provide a reference for local authorities to formulate policies on the prevention and control of myopia for primary school students. Methods From September to October 2021, Cluster sampling was adopted by our research group to obtain the vision levels of primary school students employing a diopter test in the Science City Area. In addition, questionnaires were distributed to help us find the risk factors associated with pre-myopia. Through the statistical analysis, we identify the main risk factors for pre-myopia and propose appropriate interventions. Results The prevalence rate of pre-myopia among primary school students in the Science City Area was 45.27% (1020/2253), of which 43.82% were boys and 46.92% were girls, with no statistically significant difference in the prevalence rate of myopia between boys and girls (2 =2.171, P=0.141). The results of the linear trend test showed that the prevalence rate of pre-myopia tends to decrease with increasing age (Z=296.521, P=0.000). Logistic regression analysis demonstrated that the main risk factors for pre-myopia were having at least one parent with myopia, spending less than 2 hours a day outdoors, using the eyes continuously for more than 1 hour, looking at electronic screens for more than 2 hours, and having an improper reading and writing posture. Conclusion The Science City Area has a high prevalence rate of pre-myopia among primary school students. It is proposed that students, schools, families, and local authorities work together to increase the time spent outdoors, reduce digital screens and develop scientific use of eye habits.

The Relationship between Parental Autonomy Support and Children's Self-Concept in China-The Role of Basic Psychological Needs.

This study aimed to investigate the relationship between parental autonomy support and children's self-concept, and to explore the role of basic psychological needs in Chinese primary schools from the perspective of self-determination theory. A total of 3109 children aged 6-13 years participated in eastern China. The results indicated a significant correlation between parental autonomy support, basic psychological needs, and children's self-concept. Basic psychological needs play a partial mediating role between parental autonomy support and children's self-concept. Specifically, autonomy support varied by need types whereas parental control steadily played a negative predictive role. Parental autonomy support and control predicted children's self-concept differently through three basic psychological needs, with differences across gender and grades. Boys and elder children had stronger relationships to competence needs, while girls were sensitive to autonomy needs; in addition, both of them were sensitive to relatedness needs. The mediating effects model and cross-group analyses revealed the complex predictive role of parental autonomy support on children's self-concept in China, providing an effective entry point for cross-cultural research and family education to improve children's psychological well-being.

Improving alcohol and substance use screening in school-age children: translation, adaptation and psychometric evaluation of the CRAFFT tool for Lumasaaba, Uganda.

BACKGROUND: Children at risk of substance use disorders (SUD) should be detected using brief structured tools for early intervention. This study sought to translate and adapt the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool to determine its diagnostic accuracy, and the optimum cut-point to identify substance use disorders (SUD) risk in Ugandan children aged 6 to 13 years. METHODS: This was a sequential mixed-methods study conducted in two phases. In the first qualitative phase, in Kampala and Mbale, the clinician-administered CRAFFT tool version 2.1 was translated into the local Lumasaaba dialect and culturally adapted through focus group discussions (FGDs) and in-depth interviews, in collaboration with the tool's authors. Expert reviews and translations by bilingual experts provided insights on linguistic comprehensibility and cultural appropriateness, while pilot testing with the target population evaluated the tool's preliminary effectiveness. In the second phase, the CRAFFT tool, adapted to Lumasaaba, was quantitatively validated against the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) for diagnosing SUD in Mbale district, through a survey. Participants, chosen randomly from schools stratified according to ownership, location, and school size, were assessed for the tool's reliability and validity, including comparisons to the MINI KID as the Gold Standard for diagnosing SUD. Data were analyzed using STATA-15. Receiver-operating-characteristic analysis was performed to determine the sensitivity, specificity, and criterion validity of the CRAFFT with the MINI-KID. RESULTS: Of the 470 children enrolled, 2.1% (n = 10) had missing data on key variables, leaving 460 for analysis. The median age and interquartile range (IQR) was 11 (9-12) years and 56.6% were girls. A total of 116 (25.2%) children had consumed alcohol in the last twelve-month period and 7 (1.5%) had used other substances. The mean CRAFFT score for all the children (n = 460) was 0.32 (SD 0.95). The prevalence of any alcohol use disorder (2 or more positive answers on the MINI KID) in the last 12 months was 7.2% (n = 32). The Lumasaaba version of the CRAFFT tool demonstrated good internal consistency (Cronbach's α = 0.86) and inter-item correlation (Spearman correlation coefficient of 0.84 (p < 0.001). At a cut-off score of 1.00, the CRAFFT had optimal sensitivity (91%) and specificity (92%) (Area Under the Curve (AUC) 0.91; 95% CI 0.86-0.97) to screen for SUD. A total of 62 (13.5%) had CRAFFT scores of > 1. CONCLUSION: The Lumasaaba version of the CRAFFT tool has sufficient sensitivity and specificity to identify school-age children at risk of SUD.

Prevalence of Cerumen Impaction and Associated Factors Among Primary School Pupils at an Urban District in Northern Tanzania.

Purpose: Cerumen impaction is a public problem of great concern due to associated hearing impairment. Despite cerumen impaction being one of the commonest causes of hearing loss among primary school children, there is no any published study to date from northern Tanzania focused on this topic. This study aimed to address this gap. Methods: A cross-sectional study design was used where 307 primary school pupils were recruited using a multistage cluster sampling technique and it was conducted from January to July 2023. Data was collected using Swahili translated semi-structured questionnaires. Results: The prevalence of cerumen impaction was 10.7% with the right ear being mostly affected (57.6%). A statistically significant association was found between prevalence of cerumen impaction and mother's education level though no association was found between sex, residence, father's education level and mother's occupation status. Predisposing factors like history or presence of ear infection, habit of cleaning ears and using hearing aids or earphones showed a statistically significant association The commonest clinical presentation was otalgia (36.4%) and washing ears with water (71.5%) was the commonly applied method of cleaning the ears apart from hospital based interventions. The commonest method of wax removal for those who visited health facilities was ear syringing (42.9%). Conclusion: Lesser prevalence of cerumen impaction was found in this study though majority had previous history of impacted wax. Cotton bud was the commonest predisposing factor for cerumen impaction. The commonest clinical presentation among those with impacted cerumen was otalgia though some pupils reported asymptomatic cerumen impaction.