Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer

AIM:To compare relative peripheral refraction(RPR)in Chinese school children with different refractive errors using multispectral refraction topography(MRT).METHODS:A total of 713 eyes of primary school children[172 emmetropia(E),429 low myopia(LM),80 moderate myopia(MM),and 32 low hypermetropia(LH)]aged 10 to 13y were analyzed.RPRs were measured using MRT without mydriasis.MRT results showed RPR at 0-15°(RPR 0-15),15°-30°(RPR 15-30),and 30°-45°(RPR 30-45)annular in the inferior(RPR-I),superior(RPR-S),nasal(RPR-N),and temporal(RPR-T)quadrants.Spherical equivalent(SE)was detected and calculated using an autorefractor.RESULTS:There were significant differences of RPR 15-30 between groups MM[0.02(-0.12;0.18)]and LH[-0.13(-0.36;0.12)](P<0.05),MM and E[-0.06(-0.20;0.10)](P<0.05),and LM[-0.02(-0.15;0.15)]and E(P<0.05).There were also significant differences of RPR 30-45 between groups MM[0.45(0.18;0.74)]and E[0.29(-0.09;0.67)](P<0.05),and LM[0.44(0.14;0.76)]and E(P<0.001).RPR values increased from the hyperopic to medium myopic group in each annular.There were significant differences of RPR-S between groups MM[-0.02(-0.60;0.30)]and E[-0.44(-0.89;-0.04)](P<0.001),and LM[-0.28(-0.71;0.12)]and E(P<0.05).There were also significant differences of RPR-T between groups MM[0.37(0.21;0.78)]and LH[0.14(-0.52;0.50)](P<0.05),LM[0.41(0.06;0.84)]and LH(P<0.05),and LM and E[0.29(-0.10;0.68),P<0.05].A Spearman’s correlation analysis showed a negative correlation between RPR and SE in the 15°-30°(P=0.005),30°-45°(P<0.05)annular(P=0.002),superior(P<0.001),and temporal(P=0.001)quadrants.CONCLUSION:Without pupil dilation,values for RPR 15-30,30-45,RPR-S,and T shows significant differences between myopic eyes and emmetropia,and the differences are negatively correlated with SE.

Improving school physical education to increase physical activity and promote healthy growth of Chinese school-aged children Time for action

Throughout its more than 5000-year history, China has a long tradition of encouraging active engagement in physical and sport activities This enduring tradition, however, has been facing some major headwinds as China continues to expe- rience demographic and environmental changes related to aging, urbanization, and lifestyle shifts.

Step it up： Promoting physical activity in school-aged children and adolescents in China

In this special issue of the Journal of Sport and Health Science, a series of articles describe the results of the 2016 Physical Activity and Fitness in China--The Youth Study. The results show a relatively high prevalence of sedentary behaviors, unhealthy weight, lower fitness levels, and lower levels of engagement in physical exercise and fitness activities than antici- pated.

Disparities in Oral Health among School-Aged Children in Kansas

Background: The effects of age, rural-urban geographic location, and percentage of Free and Reduced Price Meal Program (FRPMP) participation on children’s oral health outcome measures (untreated decay, treated decay, and sealants) have not been fully explored in Kansas. Methods: The current study utilized a surveillance sample of 140,217 children (grades K through 12) attending 200 schools in Kansas, which requested screening assistance from the Kansas Department of Health and Environment (KDHE) from 2012 to 2013. Multilevel logistic regression analysis was conducted to identify significant factors associated with oral health outcome measures. Results: Older children were associated with decreased odds of having untreated decay, and increased odds of having treated decay and sealants. Children attending very rural schools had increased odds of untreated and treated decay and decreased odds of presence of sealants. For every 5% increase in the school-level %FRPMP, the odds of having untreated and treated decay increased by 5% and 3%, respectively. However, %FRPMP was not statistically associated with the presence of sealants. Conclusions: Children attending schools in very rural and rural areas appear to have worse oral health outcomes, as measured by higher proportions of untreated and treated decay, and a smaller proportion of presence of sealants.

The Neurocognitive Assessment of HIV-Infected School-Aged Nigerian Children

Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Standard Progressive Matrices (RPM). The children were subdivided (Piaget’s developmental staging) into two sub-groups: the concrete operation stage (6 - 11 years) and the formal operation stage (12 - 15 years) for analysis. Result: The mean RPM score for the HIV positive children was 18.2 (8.0 - 47.0, SD 9.8) which was significantly lower than the score of 27.2 (8.0 - 52.0, SD 13.8) for the HIV negative children (p < 0.001). On the RPM grading and using the HIV negative children as the standard, 56.5% of the HIV positive children had cognitive performance at below average to intellectually defective range. Conclusion: School-aged HIV positive children had significantly lower cognitive scores compared with age and gender-matched HIV negative children. Routine neuropsychological evaluation of all school-aged HIV-infected children is recommended. Early detection of cognitive impairment will help in planning appropriate interventions.

Addressing the public health concerns of physical inactivity, low levels of fitness, and unhealthy weight among Chinese school-aged children

In China, sports and physical activity （PA） have tradition- ally been an integral part of school curricula to promote fitness and enhance healthy growth among children and ado- lescents. Three decades of economic reforms, however, have brought major changes in social, economic.

Prevalence and Risk Factors Associated with Tungiasis among School-Aged Children in the City of Port Gentil, Ogooué-Maritime Province, Gabon in Central Africa

Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortunately, in this country, no study has ever been undertaken on this disease. However, in both urban and rural areas of this country, it causes disfigurement and mutilation of the feet or hands in infested persons, and is sometimes responsible for the school dropout of many children. It is in this context that this timely and relevant research was conducted to assess the prevalence and risk factors associated with Tungiasis in school-aged children in the city of Port Gentil, Ogooué-Maritime province, Gabon in Central Africa. Materials and Methods: This prospective and cross-sectional study took place from May 22 to August 18, 2022, in two popular and underprivileged neighborhoods of the city of Port Gentil. It consisted of a physical diagnosis of the participants, and with the help of a questionnaire submitted to their parents/guardians, numerous data were collected. Entered into an Excel 2016 spreadsheet, the data were exported to the R software in its R Commander interface, for two types of analyses. A univariate and a multivariate analysis, using logistic regression, first on socio-demographic characteristics and then on habitual and environmental behavioral characteristics, was performed and the variables in this analysis reported odds ratios and their 95% confidence intervals. The results were statistically significant at p Results: A total of 637 school-aged children with a mean age of 12.73 years and a standard deviation of 5.44, were registered and examined for this study. Among them, Tunga penetrans infestation was found in 242 children, indicating an overall prevalence of 37.99% (95% CI [0.34 - 0.41]). Univariate and multivariate analyses, using logistic regression, first according to socio-demographic characteristics and then according to risk factors indicated that, the age groups of 5 to 9 years (Adjusted Odds Ratio = 9.27;95% CI: [6.66 - 12. 91]) and 10 - 14 years (Adjusted Odds Ratio = 0.16;95% CI: [0.10 - 0.25]), Eshira ethnicity (Adjusted Odds Ratio = 7.46;95% CI: [2.97 - 18.76]), child’s primary education level (Adjusted Odds Ratio = 0.008;95% CI: [0.006 - 0.011]), Father’s/Guardian’s education level (Adjusted Odds Ratio = 0.22;95% CI: [0.13 - 0.35]), homemaker status (Adjusted Odds Ratio = 4.89;95% CI: [3.51 - 6. 79]) and risk factors such as: promiscuity with dogs, cats or other animals around the house (Adjusted Odds Ratio = 38.30;95% CI: [22.13 - 66.26]), wearing shoes a few times (Adjusted Odds Ratio = 0.02;95% CI [0.01 - 0.03]), walking sometimes barefoot, on land or sand (Adjusted Odds Ratio = 0.28;95% CI: [0.18 - 0.42]), having other sources of water consumed than the tap (Adjusted Odds Ratio = 0.25;95% CI: [0.16 - 037]), living in a dwelling with soil or sand (Adjusted Odds Ratio = 6.8;95% CI: [4.58 - 10.09]), having average housing conditions (Adjusted Odds Ratio = 46.8;95% CI [24.29 - 90.16]), and the number of people living in the family that was greater than or equal to 6 (Adjusted Odds Ratio = 0.1;95% CI [0.07 - 0.13]), were significantly associated with the prevalence of Tungiasis. Conclusion: The results of this study will inform control programs and water and sanitation interventions for the Tunga penetrans epidemic in Port Gentil, Gabon.

Impacts of Types and Degree of Obesity on Non-Alcoholic Fatty Liver Disease and Related Dyslipidemia in Chinese School-Age Children?

Objective To explore the impacts of types and degree of obesity on non‐alcoholic fatty liver disease （NAFLD） and related lipids disturbance in Chinese school‐age children. Methods A total of 1 452 school‐age Children of 7 to 17 years were recruited in Beijing with representative cluster sampling method. Data of anthropometric measurements including weight, height and waist circumference were collected from March to May of 2007. Body mass index（BMI）was calculated. Blood samples were obtained and lipid profiles including triglyceride （TG）, total cholesterol （TC）, high‐density lipoprotein cholesterol （HDL‐C） and low‐density lipoprotein cholesterol （LDL‐C） were measured, while glutamate‐pyruvate transaminase （ALT） and glutamic‐oxalacetic transaminase （AST） were determined to evaluate liver function. The liver was also scanned by sonography, and abnormal hepatic sonograms were documented. NAFLD was diagnosed according to the criteria recommended by the Fatty Liver and Alcoholic Liver Disease Study Group under the Chinese Liver Disease Association. Analysis of covariance （ANOVA）, Chi‐square test for trend and binary logistic regression analysis were performed. Results The dyslipidemia and ultrasonographic fatty liver deteriorated with the degree of obesity defined either by BMI or waist circumference. Compared with BMI, waist circumference contributed more to the development of dyslipidemia, fatty liver and NAFLD. The highest levels of TG, TC, LDL‐C, and lowest level of HDL‐C were seen in the mixed obese group followed by abdominal obese, peripheral obese and non‐obese ones. Adjusted for gender and age, the odds ratios （ORs） and their 95% confidence intervals of peripheral obesity, abdominal obesity and mixed obesity were 0, 10.93 （0.98‐121.96） and 79.16 （10.95‐572.44） for predicting NAFLD; 12.61 （1.24‐127.78）, 19.39 （5.23‐71.85）, and 93.21 （29.56‐293.90） for predicting ultrasonographic fatty liver; 1.78 （0.59‐5.44）, 3.01 （1.91‐4.77）, and 4.64 （3.52‐6.12） for predicting dyslipidemia, respectively compared with the non‐obese control group. The trend of hazards over groups was statistically significant （P0.01）. Conclusion The levels of lipid profile and the prevalence of NAFLD and dyslipidemia increased in parallel with the degree of obesity; As compared with the non‐obese control, the mixed obesity had the strongest association with NAFLD and dyslipidemia, followed by abdominal obesity and peripheral obesity in Chinese school‐age Children.

Visual problems: a review of prevalence studies on visual impairment in school-age children

Childhood visual impairment(VI) have a significant impact on the educational achievement, career choices and social life of affected individual, and in children, is mainly due to either preventable or treatable causes. Reliable data on the prevalence and causes of VI in children will guide the development of a systematic vision screening program for its early detection and successful treatment of possible causes. The purpose of this literature review is to summarize the available data on prevalence and causes of VI in school-age children from various regions globally. A discussion on the major findings highlighting the definition criteria, classifications and limitations for further studies is also presented.

SARS-CoV-2 Antibody Seroprevalence in Children and Workers from Belgian French-Speaking Primary Schools

Purpose: During the COVID-19 pandemic, closing schools was discussed to limit the virus transmission, despite a lack of evidence on the role of young children in the virus spread. We undertook a study among Belgian primary schools to assess the SARS-CoV-2 antibody seroprevalence and its relationship with local incidence, school size, and socioeconomic status (SES). Methods: Schools were purposively selected using three criteria: an area with either a low or a high COVID-19 incidence, either a small or a large size, and either a low or a high SES. 932 (/2488, 38%) children and 242 (/444, 55%) staff signed informed consent. COVID-19 antibodies were tested using rapid finger prick tests. Results: Children participation was positively correlated with staff (r = +0.33;95% CI [−0.34;0.78]), and strongly with SES (r = +0.81;95% CI [0.40;0.95]). Seroprevalence was 21% in children (191/922) and 25% in staff (61/240). Seroprevalence did not correlate with local cumulative incidence (children: r = +0.06;95% CI [−0.59;0.67];staff: r = +0.26;95% CI [−0.40;0.74]). In staff, seroprevalence was higher in schools with higher SES (r = +0.37;95% CI [−0.29;0.79]), but not in children (r = −0.10;95% CI [−0.66;0.53]). Conclusion:The lower seroprevalence in children suggests they are lower transmitters than adults, but poor socioeconomic levels were less representative.

Children and Workers Well-Being in Belgian French-Speaking Primary Schools during the COVID-19 Pandemic

Purpose: During the COVID-19 pandemic, a significant number of measures were taken worldwide to limit the transmission of SARS-CoV-2, and in many ways, changed human life. All these measures had harmful consequences and impacted the well-being of many people. Children were one of the most vulnerable groups. We conducted the present study to assess children’s and staff’s well-being in French-speaking primary schools in Belgium during the COVID-19 pandemic. Methods: A 37-question questionnaire for each child based on the Revised Children’s Manifest Anxiety Scale (RCMAS), and a 14-question questionnaire for each staff based on the Hospital Anxiety and Depression (HAD) scale was undertaken in order to assess the well-being. Multiple logistic regressions were performed to assess the relationship between RCMAS or HAD and other explanatory variables. Staff reported their perception of their current life and their future life in 5 years on a Visual Analogue Scale (VAS). Results: A total of 231 children and 221 staff in 11 primary schools answered the well-being questionnaire between January and May 2021. 53% (122/231) of children had symptoms of anxiety. Girls reported more anxiety symptoms than boys (≥10: 59%;Adj OR = 2.25;95% CI [1.28;4.03]). 52% (120/231) of children had a definite state of social desirability. According to age, the youngest (6 - 7 years) children were more likely to have social desirability (≥5: 71%;Adj OR = 3.44;95% CI [1.53;8.09]) compared to the oldest (10 - 12 years). Children who did not practice outdoor/street activities were more likely to have social desirability (≥5: 60%;Adj OR = 2.59;95% CI [1.38;4.99]). In schools with a higher local incidence of SARS-CoV-2, children were more likely to have social desirability (≥5: 64%;Adj OR = 2.15;95% CI [1.13;4.17]). In schools with a lower socioeconomic status, children were more likely to have social desirability (≥5: 72%;Adj OR = 2.74;95% CI [1.23;6.37]). Higher RCMAS anxiety (r = −0.18;p −0.23;p −0.20;p Conclusion: Our results showed that the well-being of children was impacted during the COVID-19 pandemic. Special attention must be focused on the most vulnerable groups, as the consequences can be catastrophic in the long term.

Prevalence and Sensitization and Intestinal Parasitic Infestation of Vernal Keratoconjunctivitis in School Children of Kinshasa

Background: There is no study that estimates the prevalence of vernal keratoconjunctivitis and the association between vernal keratoconjunctivitis and intestinal parasitic infestation in our setting. Purpose: This study aimed to estimate the vernal keratoconjunctivitis prevalence, describe the profile of sensitization and determine the association between vernal keratoconjunctivitis disease and intestinal parasitic infestation in school children of Kinshasa during the scholar year from 2022 to 2023. Methods: An observational, cross-sectional study was performed from September 2022 to June 2023. The children with vernal keratoconjunctivitis were recruited by using the four-stage probability sampling technique. Children attending in the school children of Kinshasa with vernal keratoconjunctivitis were enrolled in the classroom and underwent a clinical examination and skin prick test for 11 allergens and stool examination direct with microscope in the Laboratory. Data were entered in Microsoft Sheets using SPSS version 20.0. The Chi-square test was used to compare the sex, age groups, home environment (grow trees and/or flowers around the yard), dampness in the house, keeping pets (cat and/or dog), number of people per household, number of people sharing a bedroom and intestinal parasitic infestation. The significant level was set to a value of p Results: A total of 28,800 students from four-stage probabilist sampling technique in school of Kinshasa were included, and 2100 students had symptoms according to the vernal keratoconjunctivitis-related symptom questionnaire. Children with vernal keratoconjunctivitis were enrolled and the mean age ± standard was 7.2 ± 3.7 years, with a prevalence of 7.2% and gender was three boys for one girl. All vernal keratoconjunctivitis children recruited in urban and rural part had 33.1% positive skin prick test (SPT) and 67.9% showed polysensitization. Children an urban part was more sensitized than rural respectively with Dermatophagoides pteronyssinus 28.1% vs 28.9%, p = 0.00001, Blomia tropicalis. 15.9% vs 14.9%, p = 0.00001 and cockroach 12% vs 13%, p = 0.00001 in both parts. Vernal keratoconjunctivitis children in rural part were more affected to the intestinal parasite than urban with Ascaris lumbricoides 14% vs 18.3%, p = 0.0006, followed by Ancylostoma duodenale 9.5% vs 12.5%, p = 0.003, Anguillule 7.9% vs 10.1%, p = 0.001, Oxyure 5.7% vs 8.2%, p = 0.0001 and Trichuris trichiura 2.6% vs 3.3%, p = 0.0009. Conclusion: This study outlines that the prevalence of vernal keratoconjunctivitis was 7.2% and 33.1% of children attending for vernal keratoconjunctivitis in school children had a positive skin prick test to at least one allergen, in particular for Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach. The most common intestinal parasitic infestation was Ascaris lumbricoides, Ancylostoma duodenale, Anguillule and Trichuris trichiura.

Report on Childhood Obesity in China (1) Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.

Report on Childhood Obesity in China (4) Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.

Waist Circumference Distribution of Chinese School-age Children and Adolescents

Background Waist circumference （WC）, a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China. Objective To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160 225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, noah rural, south rural, and Hong Kong, for analyzing the distribution of WC. Results A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A or Netherlands demonstrated the necessary of setting up China＇s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method. Conclusion The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.

The effects of increased dietary fiber intake on the self-reported quality of life of school-age children

The aim of this community-based, randomized-controlled prospective nutrition intervention study was to assess the impact of serving high-fiber snacks twice a day to a sample of school-age children on their dietary fiber intake and health-related quality of life (HRQOL) scores. Participants (n = 81) were children aged 7-11 years. Children were randomized to receive two high-fiber snacks per day for eight weeks (intervention) or to continue eating their regular snacks (control). At baseline and post-intervention, usual dietary intake data were collected via repeated 24-hour dietary recalls and HRQOL was assessed using the PedsQL? Pediatric Quality of Life Inventory. Statistical analysis to assess significant changes in dietary intake as well as self-reported quality of life was conducted using two-sided student’s t-tests;significance level was set at p < 0.05. Dietary fiber intake increased significantly by 2.41 grams/day in the intervention group. The mean increase in the physical scale score of the PedsQL from baseline to post-intervention was significantly greater for the intervention as compared to control group. This study indicates that providing high-fiber snacks to elementary-school children can effectively increase dietary fiber consumption and may lead to an improved physical quality of life. Further research is needed regarding the impact of nutrition on health-related quality of life.

Sports-Related Concussion in School-Age Children

Viewed through the lens of public health, sports-related concussion or mild traumatic brain injury is an epidemic health problem. This paper commences with a scoping review of sport-related concussion and mild traumatic brain injury considering its historical background, clinical definitions, epidemiology, and pathophysiology and treatment. The second section assesses the complex interplay of intrapersonal and interpersonal, community, and societal factors that influence sport-related concussion and mild traumatic brain injury. The third section concludes with recommendations for policy changes and further research to mitigate the health impact of sports-related concussion in adolescent school-age children. The optimal management of sports-related concussion requires care going beyond the acute injury, and into the school setting to maximize their academic and social outcomes. This is more likely to occur when healthcare and educational systems are optimally coordinated.

Mutual Experiences of Japanese Parents and Their Children When Late School-Age Children Engage in Meal-Related Family Routines: A Qualitative Analysis of Parent and Child Dyads

Purpose: The objective of the present study was to identify the type of experiences that parents and their children have with each other when late-school age children take on roles in family routines related to daily meals. Methods: A grounded theory approach was used. The participants were children in the 4th, 5th, and 6th grades of elementary school and their main caregivers. First, 10 parent and child dyads were interviewed using a semi-structured schedule. Next, online group interviews were conducted for 17 parent and child dyads to deductively confirm the categories. Results: The average age of the subjects was 41.9 years for parents and 10.4 years for children in parent-child interviews, and 41.1 years for parents and 9.6 years for children in group interviews. Six categories emerged with nineteen subcategories. Conclusions: Experiences mutually nurtured by parents and their children included experiences in which children used negotiation and conversation skills to consensually engage in family routines related to meals. It also included experiences that socialized the children in family life and fostered good communication. The six categories will be useful for healthcare professionals and school authorities in providing health guidance that addresses health functions of late school-age children and their families.

Prevalence and Factors Associated with Iron Deficiency Anemia among School-Age Children in Primary Schools in Burao City, Somaliland, 2020

Background: Anemia is a global public health problem affecting the majority of the population of the world in both developed and developing countries with major consequences on human health as well as social and economic development. It is the world’s second leading cause of disability of the whole global disease burden. It affects 1.62 billion (24.8%) of the population, among them, it is affecting 305 million (25.4%) school-age children (SAC). Objectives: The main objective of this study was to assess the prevalence and factors associated with anemia among school-age children in primary schools in Burao city, Somaliland, 2020. Materials & Methods: A school-based cross-sectional study design was done in four primary schools in Burao, Somaliland. About 285 school-age children in the age group between 6 - 14 years were selected with a respondent rate of 93.4%. Random sampling was used to select schools and systemic random sampling was used to identify children from the selected schools. Socio-demographic data was collected by using a questionnaire & interviews of respondents in addition to anthropometric measurements, hemoglobin measurement, and stool examination. Complete Blood Counting (CBC) was used to determine the mean corpuscular (kor-PUS-kyu-lar) volume (MCV) and hematocrit (HMC) levels to detect hemoglobin status of the children. Data was entered and analyzed using SPSS statistical software for Windows version 21. Anthropometric data was analyzed using ANTHRO Plus. Bivariate logistic regression and multivariable logistic regression were used to identify independent predictors of anemia in school adolescent girls. Statistical significance was set at p < 0.05. Results: A total of 285 school-age children were included in this study. The overall prevalence of anemia was (23.1%) (CI: 18.1%, 28.1%) with the mean and standard deviation of (12.7 ± 1.59). Out of the anemic children, 20.4% were mild and 2.3% and 0.4% of them were moderate and severe, respectively. Children’s from illiterate mothers (AOR = 2.37;95% CI: 1.14, 4.94. P-value = 0.020), consuming organ meat less than once a week (AOR = 2.19;95% CI: 1.05, 4.43. P-value = 0.036) and having parasites in stool (AOR = 5.21;95% CI: 1.10, 24.6. P-value = 0.037) were identified as statistically independent associated factors with prevalence of anemia in school-age children’s from Burao, Somaliland. Conclusion: Prevalence of anemia in Burao city, Somaliland primary schools was a moderate public health problem in the current study area. Nutrition education, iron folic acid supplementation program, deworming, good hygiene, and sanitation are playing an important role in the prevalence of anemia and we recommend to give them more attention from ministry of education and ministry of health in Somaliland.

Corneal Biomechanical Properties and Associated Factors in School-age Children

Purpose: To study and analyze the correlation among corneal biomechanical properties and associated factors including central corneal thickness (CCT), corneal curvature (CT), and intraocular pressure (IOP) in school-age children. Methods:A cross sectional investigation was conducted. An ocular response analyzer was utilized to assess the corneal biomechanical properties,such as corneal hysteresis and corneal resistance factors, in children of school age. Multivariate regression analysis was used to investigate the relationship between corneal biomechanical properties and other ocular parameters including CCT, corneal curvature (k1 and k2), and IOP. The right eyes of all subjects were selected for statistical analysis. Results: A total of 571 children were enrolled: 303 male and 268 female,with an average age of 10.47 ±1.0 years. The mean value of corneal hysteresis was 10.98 ±1.78 mmHg, corneal resistance factor was 11.46±1.69 mmHg,and CCT was 556.01±28.97 μm. Conclusion:The feasibility of corneal biomechanical detection in school age children was validated. This study provides fundamental data on corneal biomechanical properties in school-age children and associated factors. (Eye Science 2013; 28:34-39)