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BACKGROUND: Relationships and sexuality education (RSE) programmes are widely taught in schools, however for children and young people with intellectual disabilities, these programmes appear to be limited regarding information on relationships, informed choices and decision making. The purpose of this study was to seek the views and understanding of children and young people with intellectual disabilities, and those involved in their care and education, to identify best practice and approaches to the delivery on relationships and sexuality education. METHODS: This study used a qualitative design with 37 pupils from five special schools from across the United Kingdom (UK) participating. In-depth semi-structured interviews were held online, or in person. All interviews were recorded and transcribed verbatim. Transcripts were anonymised, assigned a pseudonym and subjected to inductive thematic analysis. FINDINGS: Four themes emerged from the data: (i) enthusiasm and inquisitiveness to acquire knowledge; (ii) dynamics of positive friendships; (iii) experiences and understanding of supportive relationships and sexuality; and (iv) valuing the exchange of knowledge and information. The findings highlight that children and young people with intellectual disabilities want education, support and information on matters relating to their relationships and sexuality. CONCLUSIONS: This is the largest study to date providing a voice to children and young people with intellectual disabilities regarding their relationships and sexuality. While special schools provide relationships and sexuality education, there is a requirement for a programme and resources specific to the needs of pupils with intellectual disabilities to be developed and evaluated. Such education should continue beyond school and be embedded in adult services.

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Introduction: A subgroup of severe Traumatic Brain Injury (TBI) patients, known as ultra-severe (us-TBI), is most commonly defined as a post-resuscitation Glasgow Coma Scale (GCS) of 3-5. There is uncertainty on whether these critically injured patients can benefit from neurosurgical intervention. Research question: The available evidence regarding the decision-making and outcome following management of us-TBI patients is critically reviewed. Material and methods: Selected databases (PubMed, Google Scholar, Scopus and Cochrane Library) were searched from 1979 to May 2024 for publications on us-TBI patients, with a focus on treatment strategy, mortality and functional outcomes. Inclusion criteria were adult patients >18 years old with closed head trauma and admission post-resuscitation GCS 3-5. Studies were independently assessed for inclusion by two reviewers, and potential disagreements were solved by consensus. Results: Where such data could be extracted, mortality rate was 27-100%, and favorable outcome was observed in 4-30% of us-TBI patients. While early aggressive neurosurgical management was associated with decreased mortality, a high proportion of patients survived with unfavorable functional status. Discussion and conclusion: With supportive care only, outcome of patients with us-TBI is almost universally poor. Early and aggressive neurosurgical intervention in addition to best medical management can lead to favorable functional outcome in selected cases particularly in younger patients with an initial GCS>3 and traumatic mass lesions. There is insufficient data regarding the effectiveness of neurosurgical management on the outcome of us-TBI patients. and the decision to initiate treatment should be based on an individual basis.

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OBJECTIVE: Aim: The article analyzes the health-saving technologies of Ukrainians in Eastern Galicia (the end of the XIX century - 1939). PATIENTS AND METHODS: Materials and Methods: In the investigation a number of scientific methods are used: chronological, historical, specific-search, content analysis, providing selection, analysis of the source base, allowing to identify general trends, directions of development, achievements and gaps in the movement for the health of children and adults in Galicia; sources of Ukrainian and Polish authors of different generations in the field of health protection and preservation, physical education and sports, education and upbringing were used, their views and research results were presented. CONCLUSION: Conclusions: A component of the health-saving philosophy of Ukrainians (children, youth and adults) of Eastern Galicia in the late XIX - 30s of the XX century was the idea of physical education. Through traveling and camping, playing sports, improving children, youth and adults in places of active recreation (≪dwellings,≫ ≪half-dwellings,≫ ≪cuttings,≫ etc.), the philosophy of health conservation took a leading position in the interwar period of the XX century. The physical education movement had particular successes when a wide circle of Ukrainian youth joined it. There was an original Plast method of physical education of a Ukrainian - physically, spiritually, morally, mentally healthy person, for whom health preservation is a way and philosophy of life, a vital need. All this actualizes the problem of health-oriented public initiatives, which should be creatively used in the current challenges in Ukraine.

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BACKGROUND: Assessing pupil size and reactivity is the standard of care in neurocritically ill patients. Anisocoria observed in critically ill patients often prompts further investigation and treatment. This study explores anisocoria at rest and after light stimulus determined using quantitative pupillometry as a predictor of discharge modified Rankin Scale (mRS) scores. METHODS: This analysis includes data from an international registry and includes patients with paired (left and right eye) quantitative pupillometry readings linked to discharge mRS scores. Anisocoria was defined as the absolute difference in pupil size using three common cut points (> 0.5 mm, > 1 mm, and > 2 mm). Nonparametric models were constructed to explore patient outcome using three predictors: the presence of anisocoria at rest (in ambient light); the presence of anisocoria after light stimulus; and persistent anisocoria (present both at rest and after light). The primary outcome was discharge mRS score associated with the presence of anisocoria at rest versus after light stimulus using the three commonly defined cut points. RESULTS: This analysis included 152,905 paired observations from 6,654 patients with a mean age of 57.0 (standard deviation 17.9) years, and a median hospital stay of 5 (interquartile range 3-12) days. The mean admission Glasgow Coma Scale score was 12.7 (standard deviation 3.5), and the median discharge mRS score was 2 (interquartile range 0-4). The ranges for absolute differences in pupil diameters were 0-5.76 mm at rest and 0-6.84 mm after light. Using an anisocoria cut point of > 0.5 mm, patients with anisocoria after light had worse median mRS scores (2 [interquartile range 0-4]) than patients with anisocoria at rest (1 [interquartile range 0-3]; P < .0001). Patients with persistent anisocoria had worse median mRS scores (3 [interquartile range 1-4]) than those without persistent anisocoria (1 [interquartile range 0-3]; P < .0001). Similar findings were observed using a cut point for anisocoria of > 1 mm and > 2 mm. CONCLUSIONS: Anisocoria after light is a new biomarker that portends worse outcome than anisocoria at rest. After further validation, anisocoria after light should be considered for inclusion as a reported and trended assessment value.

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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.

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From February to May 2022, the war in Ukraine prompted Poland to accommodate 3.37 million refugees from conflict zones, in addition to 850 thousand Ukrainian economic migrants already residing in the country. A substantial proportion of these refugees, primarily mothers with children, swiftly integrated into the Polish educational system, with some children commencing schooling within a week of their arrival. This influx significantly diversified the then predominantly monolingual landscape of Polish schools. Given the uniqueness of this situation and the fact that Poland has historically remained mono-national and monolingual for decades, Polish teachers suffered from a lack of preparedness, resources and expertise to effectively navigate their teaching practices in multilingual classes. To understand the specificity of this situation, taking especially into account the perspective of educators, we have designed a qualitative study drawing on focus group and individual interview reports. We were particularly interested in determining how teachers' agency was activated in times of crisis. The findings reveal how the newly-emerging linguistic and cultural heterogeneity is perceived by teachers, how it is manifested in school and home environments, and the extent to which possibilities for synergies exist between the two. The findings also highlight the fact that, despite teachers' inexperience and unpreparedness for the new educational context, they instantly responded to the challenges that emerged. This can be exemplified by teachers' collaboration in material design as well as the willingness to participate in courses sensitizing to migrant students' needs (e.g., linguistic, educational, or emotional ones).

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From the time of Galen, examination of the pupillary light reflex has been a standard of care across the continuum of health care. The growing body of evidence overwhelmingly supports the use of quantitative pupillometry over subjective examination with flashlight or penlight. At current time, pupillometers have become standard of care in many hospitals across 6 continents. This review paper provides an overview and rationale for pupillometer use and highlights literature supporting pupillometer-derived measures of the pupillary light reflex in both neurological and non-neurological patients across the health care continuum.

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INTRODUCTION: This paper aimed at observing the impact of dysphonic voice on children's reception of a linguistic message by evaluating their reaction times (RTs) to instructions given by functional dysphonic and control female schoolteachers (STs). METHODS: French minimal pairs such as /muʃ/ ("mouche" fly) versus /buʃ/ ("bouche" mouth) embedded in a carrier sentence "click on the drawing of…" were produced by two groups of 10 dysphonic and control female ST, matched in age and year of experience. The phonemical contrasts observed are voicing, nasality, consonantal place of articulation, vowel roundedness, and vowel place of articulation. The experimentation was presented in the form of a computer game to children from 7 to 10 years old. Two images illustrating the target words were presented, accompanied by the oral instructions recorded by ST. With a two-button box created for the experiment, children had to click as quickly as possible on the image corresponding to the instruction. RESULTS: Our results show that the RTs of all children are affected by the ST's dysphonia, regardless of their age and that they have significantly longer RT when discriminating minimal pairs contrasting in voicing when the instruction is given by a dysphonic speaker compared to the same instruction given by a control speaker. CONCLUSION: These observations could be explained by the fact that functional dysphonia is associated with improper use of the vocal folds and thus an alteration of voicing.

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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.

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INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic had many direct and indirect effects, including lifestyle changes in all subpopulations, including children and adolescents. The aim of the study was to identify: 1) attitudes of students aged 7-12 years and their parents towards food, nutrition, and physical activity; 2) changes in the consumption of basic food products during the COVID-19 pandemic. MATERIAL AND METHODS: A qualitative survey was conducted among students and their parents using the Focus Group Interview method, as well as quantitative research among parents and schoolchildren aged 10-12 years. RESULTS: During the pandemic, changes were demonstrated in the eating habits of primary schoolchildren which were both positive and negative. Positive changes include a greater number of meals and their regularity, especially in relation to meals prepared at home, and a greater consumption of mainly fruit, and to a lesser extent vegetables and whole grain products. Among the negative changes observed were an increased consumption of salty snacks and sweets, including those prepared at home. Moreover, limiting physical activity during isolation may have resulted, as a long-term effect, in excessive body weight and obesity-related non-communicable diseases in children and adolescence, and later in adulthood. CONCLUSIONS: There is a need to develop post-pandemic support strategies addressed to both schoolchildren and their parents regarding adequate eating behaviours and physical activity.

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Background: Glasgow coma scale (GCS) score is the most widely used clinical score for the initial assessment of neurologically injured patients and is also frequently used for prognostication. Other scores such as the Full Outline of UnResponsivness (FOUR) score and the Glasgow Coma Scale-Pupils (GCS-P) score have been more recently developed and are gaining popularity. This prospective cohort study was conducted to compare various scores in terms of their ability to predict outcomes at 3 months in patients with traumatic brain injury (TBI). Materials and methods: The study was carried out between October 2020 and March 2022. Patients who presented to the hospital with TBI were assessed for inclusion. Initial coma scores were assessed in the emergency department and again after 48 hours of admission. Outcome was assessed using the extended Glasgow outcome score (GOSE) at 3 months after injury. The receiver operating curve (ROC) was plotted to correlate coma scores with the outcome, and the area under the curve (AUC) was compared. Results: A total of 355 patients with TBI were assessed for eligibility, of which 204 patients were included in the study. The AUC values to predict poor outcomes for initial GCS, FOUR, and GCS-P scores were 0.75 each. The AUC values for 48-hour coma scores were 0.88, 0.87, and 0.88, respectively. Conclusion: The GCS, FOUR, and GCS-P scores were found to be comparable in predicting the functional outcome at 3 months as assessed by GOSE. However, coma scores assessed at 48 hours were better predictors of poor outcomes at 3 months than coma scores recorded initially at the time of hospital admission. How to cite this article: Chawnchhim AL, Mahajan C, Kapoor I, Sinha TP, Prabhakar H, Chaturvedi A. Comparison of Glasgow Coma Scale Full Outline of UnResponsiveness and Glasgow Coma Scale: Pupils Score for Predicting Outcome in Patients with Traumatic Brain Injury. Indian J Crit Care Med 2024;28(3):256-264.

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BACKGROUND: Physical activity (PA) and dietary habits (DH) play a crucial role on quality of life and health outcomes from various aspects. METHODS: This study aims to investigate the relations between recommended daily levels of moderate to vigorous physical activity (MVPA) in 8 to 9 year old pupils, and their body mass index (BMI), DH, cognitive functions and attention problem scores by network analysis. Study participants were split into two groups based on their MVPA levels on weekdays. RESULTS: Our findings suggest that children who reach recommended MVPA levels consume more vegetables and fruits, eat breakfast more frequently, have better motor speed and lower impulsivity score. CONCLUSIONS: The number of interlinkages between various parameters in network structure for children who do not reach recommended MVPA levels is greater and more intense, highlighting the differences between the groups and suggesting that different interventions and approaches to improve/change lifestyle habits might be used.

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Our research letter investigates the potential, as well as the current limitations, of widely available text-to-image tools in generating images for medical education. We focused on illustrations of important physical signs in the face (for which confidentiality issues in conventional patient photograph use may be a particular concern) that medics should know about, and we used facial images of hypothyroidism and Horner syndrome as examples.

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Archive documents and sources in scientific electronic databases were analyzed in order to study the historical origins of the health resort business in terms of children's health resort medicine in the Samara government. It has been established that the period of origin and intensive development of balneology for children in the Samara region occurred at the beginning of the 20th century and the first children's sanatoriums began to function thanks to the initiative of the Society of Governmental Physicians for charitable funds of the Samara nobility and merchantry in territories with natural and climatic therapeutic factors, namely Sernovodsky resort, Barboshina glade and Postnikov ravine. A comparative analysis of the dynamics of morbidity structure of children admitted for sanatorium treatment, as well as general education institutions, from which information on the health of school pupils is received, has been conducted over a period of 120 years. Despite the change of years and generations, there is a general concept of sanatorium health improvement of school pupils as a future social and economic pillar of society, with the formation of a healthy generation for both the region and the country in general.

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Background: Childhood overweight and obesity represent serious public health concerns in several countries worldwide, including Italy, where the highest prevalence in Europe of overweight and obesity among primary school children was recorded. Among others, primary schools represent suitable social environments for health education projects. In this perspective, to optimize resources and plan successful activities, it is necessary, first of all, to analyze the context of the intervention. Study design: A pilot survey involving children and teachers was conducted in a primary school in Jesi (Le Marche Region, Italy). Methods: A questionnaire was submitted by teachers between May and June 2023 to 104 pupils (aged 6-11) from the five different primary school system classes. A qualitative questionnaire was also filled out by the same teachers (n = 5) who were present while the children were filling the eating/lifestyle questionnaire. Results: Most of the children (96.1%) had breakfast before school, with milk and cereal (51.5%) representing the preferred com-bination. During recess, 59.2% of pupils usually have a sandwich, 23.3% usually have sweet snacks, whereas only 2.9% have a fruit. Over 55% of the sample preferred drinking high-sugar beverages to water, and 15.5% declared going to a fast-food restaurant more than once a week. Over 17% of children did sport only once a week or less often. Over 64% of children habitually played videogames, and 77.6% normally watched TV or played with a tablet/smartphone while eating. Finally, the teachers' interview highlighted that there were no active health-related projects addressed to the pupils, and the school did not normally organize me-etings with health professionals to increase children's and their parents' knowledge and awareness about healthy eating habits. Conclusions: This preliminary investigation analyzed the context for a future health and nutrition education project and will assist researchers in planning successful activities and increasing the efficiency of the intervention.

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According to previous research results and our systematic review on this topic (Kovács et al., 2022), the positive impact of parental involvement on academic achievement was revealed. However, it is unclear how parental involvement in sports contributes to sports performance and academic achievement. In this study, our main questions are about the differences in academic achievement, in participation in sports activity, and in sports results among pupils of parents involved or not involved in sports and education. To answer these questions, a questionnaire survey was conducted among 7th and 8th-grade students learning in three primary schools in a Hungarian city (N = 121). Based on the scale of parental involvement, three groups were differentiated: 1) children of parents not involved in either education or sports (N = 33), 2) children of parents involved in education only (N = 38), and 3) children of parents involved in both education and sports (N = 47). In order to examine this data, cluster and factor analysis, a Chi-square test and ANOVA, and linear regression were used. Our results showed, children of parents involved in both sports and education are overrepresented among students who received awards because of their sports performance (59.6%), among members of sports talent management programs (29.8%), and among those who achieved first place in national sports competitions (47.8%). They also seem to be the ones most intent on staying engaged, in the future, in regular and competitive sport activities (57.4% and 55.3%). On the contrary, the highest percentage of children of parents involved in education belongs to those who were given awards because of excellent academic achievement (71.1%). As far as personality traits are concerned, obsessive passion (OP) is the most characteristic of pupils with non-involved parents (M = 0.37, SD = 0.95) and least characteristic of children with parents involved in education (M = -0.17, SD = 0.94). Belonging to both groups with involved parents can be considered a negative predictor of OP (ßt = -0.259* [-1.019, -0.078], ßt + s = -0.237* [-0.930, -0.030]). In conclusion, it can be detected that there exists a positive interrelation between parental involvement in sports and education, and the academic and sports performance of their children.

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Background: Missing school impacts both education and health. The purpose of this study was to address sickness absence in primary schools by adjusting the 'Medical Advice for Sick-reported Students' intervention for secondary schools. This was necessary because of fundamental differences in relation to the children's age and in the schools' organizational structure. Methods: The intervention mapping approach steps 1 through 4 were used to adapt 'Medical Advice for Sick-reported Students' to primary schools (MASS-PS), including a literature search, stakeholder interviews, establishing a planning group and pre-testing. Results: In step 1, a planning group was formed and a logic model of the problem was created. In step 2, a logic model of change was created. In step 3, a theoretical basis and practical strategies were determined. In step 4, practical support materials were designed, and two pre-tests of the materials were performed. Conclusion: Intervention mapping was successfully used to adapt MASS to primary schools. The main changes were the lowering of the threshold for extensive sickness absence, consultations between teacher and attendance coordinator, and addition of two experts. With MASS-PS, sickness absence can be addressed as a "red flag" for underlying problems.

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In contemporary global society, largely because of climate change and other natural and human-induced hazards, disasters are an almost daily occurrence. The nutritional impact of disasters on children results in long-term physical and mental health problems. As children are one of the most vulnerable demographic groups, they must be empowered with disaster preparedness nutrition knowledge, and the skills and motivation to survive, prevent/reduce malnutrition, and maintain good health during disasters. A disaster preparedness nutrition education program (DPNEP) was developed in this study to improve children's nutrition in daily life and during disasters through student-centered education. A consultative approach was used to synthesize the knowledge of a diverse group of four experts in disaster medicine and management, public health, education, and food and nutrition sciences to reach a consensus through discussion. A model DPNEP was developed by targeting grade 4 and 5 students and using interactive teaching methods. This can lead to the implementation of continuous nutrition education to empower children to make healthy food choices in daily life and reduce the risk of disaster-nutrition-related morbidity and mortality. Furthermore, once children acquire the necessary information, they are likely to share this knowledge with their families and communities, thereby enhancing society's resilience.

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This study aimed to explore the effect of the motor game, "Clock Motor Games", on the improvement of "Reading and Recording of Time" (RRT) in children with Grade 1 mathematical learning difficulties (MLDs). A within-school cluster-randomized intervention study was conducted with 232 children (aged 6-7 years) with limited physical education experience (0.7 ± 0.3 years). The participants were divided into two groups: a control group, which received conventional teaching on time without any additional motor activities, and an experimental group, which incorporated the concept of time with the "Clock Motor Game", for 3 weeks. The Clock-Reading Test was administered before the intervention (T0), immediately after each session (T1), and five weeks after the intervention (T2) in both groups. The results demonstrated that the experimental group exhibited significantly greater improvements in RRT performance compared to the control group (U = 4416.5; p < 0.001; r = 0.3; medium effect). Additionally, the experimental group was more likely to show progress and less likely to experience regression or stagnation compared to the control group (25% vs. 38.4%). The findings suggest that practicing "Clock Motor Games" can positively contribute to the RRT ability in children with Grade 1 MLD.