The Company of Drunk Youths

We conducted the third in a series of studies of the alcoholic behavior of youth in 1991 in the Moscow Oblast. We surveyed, by means of a questionnaire, 925 pupils, aged 14 to 18 years, in city schools and technical institutes. The principal purpose of the study was to determine changes in the extent of the attraction of alcohol for youth of the Moscow Oblast compared with 1984 and 1977. As the findings showed, there has been an increase in the social differentiation of drunkenness among the young: those who possessed adequate social resources less often turned to alcohol, but the group of youths who were experiencing general social hardship had started to abuse alcohol more frequently. There were also discernible negative tendencies in the pattern of alcohol consumption: young people had begun to drink more frequently outside the home and to consume stronger beverages. In risk groups, negative emotions began to assume more importance among the reasons for turning to alcohol. For any young person, social intercourse with one's peers is a necessary stage in socialization. In such a milieu, a young person not only tests the viability of adult norms conveyed to him by family and school but also works out his own rules of conduct, which, we assumed, would cause significant differences in the company in which regular use of alcohol was the norm.     

Brief intervention for alcohol misuse in people attending sexual health clinics: study protocol for a randomized controlled trial

ABSTRACT: BACKGROUND: Over the last 30 years the number of people who drink alcohol at harmful levels has increased in many countries. There have also been large increases in rates of sexually transmitted infections. Available evidence suggests that excessive alcohol consumption and poor sexual health may be linked. The prevalence of harmful alcohol use is higher among people attending sexual health clinics than in the general population, and a third of those attending clinics state that alcohol use affects whether they have unprotected sex. Previous research has demonstrated that brief intervention for alcohol misuse in other medical settings can lead to behavioral change, but the clinical- and cost-effectiveness of this intervention on sexual behavior have not been examined. METHODS: We will conduct a two parallel-arm, randomized trial. A consecutive sample of people attending three sexual health clinics in London and willing to participate in the study will be screened for excessive alcohol consumption. Participants identified as drinking excessively will then be allocated to either active treatment (Brief Advice and referral for Brief Intervention) or control treatment (a leaflet on healthy living). Randomization will be via an independent and remote telephone randomization service and will be stratified by study clinic. Brief Advice will comprise feedback on the possible health consequences of excessive alcohol consumption, written information about alcohol and the offer of an appointment for further assessment and Brief Intervention. Follow-up data on alcohol use, sexual behavior, health related quality of life and service use will be collected by a researcher masked to allocation status six months later. The primary outcome for the study is mean weekly alcohol consumption during the previous three months, and the main secondary outcome is the proportion of participants who report unprotected sex during this period. DISCUSSION: Opportunistic intervention for excessive alcohol use has been shown to be effective in a range of medical settings. The SHEAR study will examine whether delivering such interventions in sexual health clinics results in reductions in alcohol consumption and will explore whether this is associated with changes in sexual behavior.     

Trial protocol and preliminary results for a cluster randomised trial of behavioural support versus brief advice for smoking cessation in adolescents

Background

Many young people report they want to stop smoking and have tried to do so, but most of their quit attempts fail. For adult smokers, there is strong evidence that group behavioural support enhances quit rates. However, it is uncertain whether group behavioural support enhances abstinence in young smokers trying to quit.

Findings

A cluster randomised trial for young people trying to stop smoking to compare the efficacy of a school-based 9 week intensive group behavioural support course versus a school-based 7 week brief advice only course. Participants were assessed for evidence of tobacco addiction and nicotine replacement therapy (NRT) was used if it was deemed appropriate by the therapist. Both types of course aimed to recruit approximately one hundred participants from approximately ten schools.The primary outcome was successful quitting at 4 weeks after quit day judged according to the Russell standard. Had the trial been completed, abstinence at 6 months after quit day and the relationships between successful quit attempts and 1) psychological assessments of dependence prior to quitting 2) salivary cotinine concentration prior to quitting and 3) sociodemographic characteristics would also have been assessed. The proportion of participants who stopped smoking in each arm of the trial were compared using Chi square tests.The trial was stopped shortly after it had started because funding to support the therapists running the stop smoking group behavioural support programme was withdrawn. Only three stop smoking courses were completed (two group support courses and one brief advice pharmacotherapy course). Seventeen participants in total entered the trial. At the end of the courses, one participant (10%) attending the group support programme had stopped smoking and no participant attending the brief advice programme had stopped smoking.

Discussion

The trial was stopped so we were unable to determine whether group support helped more young people to stop smoking than brief advice. Engagement and recruitment of participants proved much more difficult than had been anticipated. Fifteen of the seventeen participants reported that quitting smoking was either pretty important or very important to them. Thus, the stop smoking success rate could, nevertheless, be considered disappointing.

Trial registration

Current Controlled Trials ISRCTN25181936

     

The role of school medicine doctors in health education in Croatia--past, present and future

Croatia never had a separate vocation (occupation) of a health educator. Health education is one of the main tasks in the long tradition of preventive work of doctors-school medicine specialists. Additionally, in the school curriculum in the Republic of Croatia the health-educational contents are integrated into various subjects, and are conducted by teachers. However, there are requests to introduce a new subject into schools called Health Education. We asked physicians of school medicine their opinion on the introduction of this new subject. 30% of the physicians were dissatisfied with the current condition, 10% were satisfied, while there were no very satisfied school medicine doctors. They believe that health education goals are oriented solely to passing on knowledge (facts), while efforts are not done to change habits and attitudes of young people. They recognize themselves as persons mostly involved in health education in schools. Half of the school medicine doctors believe that the school curriculum should contain both a separate subject as well as integration of health education into other subjects. Before introducing any changes into healthcare or education system, it is necessary to examine the attitudes of students and parents, to direct the changes towards the promotion of the cooperation between the healthcare system, education, civil society, school and community where investing into the health of young people is done through comprehensive and holistic programmes.     

Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis

Objective To determine the effectiveness of programmes of screening in general practice for excessive alcohol use and providing brief interventions.Design Systematic review and meta-analysis of randomised controlled trials that used screening as a precursor to brief intervention.Setting General practice.Main outcome measures Number needed to treat, proportion of patients positive on screening, proportion given brief interventions, and effect of screening.Results The eight studies included for meta-analysis all used health questionnaires for screening, and the brief interventions included feedback, information, and advice. The studies contained several sources of bias that might lead to overestimates of the effects of intervention. External validity was compromised because typically three out of four people identified by screening as excessive users of alcohol did not qualify for the intervention after a secondary assessment. Overall, in 1000 screened patients, 90 screened positive and required further assessment, after which 25 qualified for brief intervention; after one year 2.6 (95% confidence interval 1.7 to 3.4) reported they drank less than the maximum recommended level.Conclusions Although even brief advice can reduce excessive drinking, screening in general practice does not seem to be an effective precursor to brief interventions targeting excessive alcohol use. This meta-analysis raises questions about the feasibility of screening in general practice for excessive use of alcohol.     

Assessing and reporting heterogeneity in treatment effects in clinical trials: a proposal

Background

This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP) program by investigating pre-conceptual health and risk behaviours, teen pregnancy and the resultant birth outcomes, early child health and maternal health.

Methods and Design

Fifty-seven schools (86% of 66 eligible secondary schools) in Perth, Australia were recruited to the clustered (by school) randomised trial, with even randomisation to the intervention and control arms. Between 2003 and 2006, the VIP program was administered to 1,267 participants in the intervention schools, while 1,567 participants in the non-intervention schools received standard curriculum. Participants were all female and aged between 13-15 years upon recruitment. Pre and post-intervention questionnaires measured short-term impact and participants are now being followed through their teenage years via data linkage to hospital medical records, abortion clinics and education records. Participants who have a live birth are interviewed by face-to-face interview. Kaplan-Meier survival analysis and proportional hazards regression will test for differences in pregnancy, birth and abortion rates during the teenage years between the study arms.

Discussion

This protocol paper provides a detailed overview of the trial design as well as initial results in the form of participant flow. The authors describe the intervention and its delivery within the natural school setting and discuss the practical issues in the conduct of the trial, including recruitment. The trial is pragmatic and will directly inform those who provide Infant Simulator based programs in school settings.

Trial registration

ISRCTN24952438     

Auge in Auge mit dem Wasserfloh

The Experimental‐Lab Biology FLOX The Experimental‐Lab Biology FLOX of the University of Kassel is a competence‐oriented School Laboratory that focuses on the autonomous experimentation of pupils. Currently water fleas (Daphnia magna) are the preferred experimental object. Student teachers learn to mentor those pupils in their process of knowledge acquisition offering support and advice. Simultaneously, the contradiction between the given and fixed experimental instructions and unstructured experiments is solved by work instructions in form of V‐diagrams. Feedback of pupils and teachers reveal that this is a concept worth pursuing and developing.     

Understanding the mental health needs of secondary school children in Manchester

Background In a time of limited resources and the need for cohesive services, understanding levels of need and prevalence is key. Manchester has a diverse range of cultures and socio-economic groups; national data is valuable but not always representative of local need.Aim To assess the prevalence of mental health needs in secondary school pupils in Manchester.Method Parents and teachers in three secondary schools were invited to complete the Strengths and Difficulties Questionnaire (SDQ) and a tool examining unmet needs.Results Initially, 560 pupils were chosen. Having excluded families that opted out, 503 questionnaires were distributed. Teachers returned 200 questionnaires and parents returned 127. Higher than average levels of need were identified with teachers reporting that 18% of pupils scored abnormally on the SDQ. Parent rates were also higher than the national average at 13.4%.Discussion Parents and teachers wanted children to be seen at home and at school, the need for consultation and outreach from mental health into schools is emphasised.     

Studying phenological phenomena in subarctic biomes with international school pupils as citizen scientists

Citizen science can facilitate in‐depth learning for pupils and students, contribute to scientific research, and permit civic participation. Here, we describe the development of the transnational school‐based citizen science project Phenology of the North Calotte. Its primary goal is to introduce pupils (age 12–15; grades 7–10) in northern Norway, Russia, and Finland to the local and global challenges of climate change resulting in life cycle changes at different trophic and ecosystem levels in their backyards. Partnerships between regional scientists and staff from NIBIO Svanhovd, State nature reserves, national parks, and teachers and pupils from regional schools aim to engage pupils in project‐based learning. The project uses standardized protocols, translated into the different languages of participating schools. The phenological observations are centered around documenting clearly defined life cycle phases (e.g., first appearance of species, flowering, ripening, leaf yellowing, snow fall, and melt). The observations are collected either on paper and are subsequently submitted manually to an open‐source online database or submitted directly via a newly developed mobile app. In the long term, the database is anticipated to contribute to research studying changes in phenology at different trophic levels. In principle, guided school‐based citizen science projects have the potential to contribute to increased environmental awareness and education and thereby to transformative learning at the societal level while contributing to scientific progress of understudied biomes, like the northern taiga and (sub)arctic tundra. However, differences in school systems and funding insecurity for some schools have been major prohibiting factors for long‐term retention of pupils/schools in the program. Project‐based and multidisciplinary learning, although pedagogically desired, has been partially difficult to implement in participating schools, pointing to the need of structural changes in national school curricula and funding schemes as well as continuous offers for training and networking for teachers.     

Artenkenntnis einheimischer Vögel

Knowledge of common bird species As the ability of young people to identify common bird species is very low, we tried to create teaching materials to improve the pupils' knowledge in an interdisciplinary approach in schools. Therefore we created online tutorials, that contain hints and clues how to identify birds as well as playful exercises. Another important part of the project was to educate pupils in observing visible details by drawing birds and displaying the paintings at an observation post within the school yard. These actions should enable students to do their own observations and document their sightings with an online observation tool, so that pupils get into emotional contact with the wildlife in their near surroundings, which is required to take action against the loss of species all over the world.     

Education for sexuality—the rˆle of the school

Education for sexuality and healthy relationships should be viewed within a broad context of health education and social education in schools. However, this is not merely a matter for the formal curriculum of a school, but relates to the totality of the experience that young people receive there. The concept of the health promoting school encapsulates tfie formal curriculum, the ‘hidden curriculum’, and the interaction of the school with parents, the community, and other agencies, which can affect the health and well-being of all school users. One cannot view a school's rôle in this area out of the societal context. Research indicates that young people, as they move through their teenage years, get most of their information relating to sexuality from friends and yet they acknowledge that this is not a reliable source. Examples of current knowledge levels and attitudes relating to sexuality and HIV/AIDS are given. The strengths and weaknesses of schools as settings for sex education are explored, and 10 key points for consideration within a school policy on education for sexuality and relationships are proposed.     

Feeding of school children in a London borough.

A survey of 12 schools in a London borough showed that the protein and energy content of the average school meal was below the standard set by the Department of Health and Social Security for all age groups. Failure to meet the standards resulted from inadequate food purchases, poor menu planning and portion control, and several management problems. A 24-hour recall questionnaire showed that 5% of the pupils were "poorly" fed. These pupils were, however, no worse off than their "adequately" fed peers with regard to absences from school or academic attainment measured by reading quotient, but there was some slight difference in height and weight. The percentage of children having no breakfast increased from 4% in the infant schools to 21% in the senior schools. Two per cent of the senior pupils regularly ate no lunch.     

London Education and Inclusion Project (LEIP): Exploring Negative and Null Effects of a Cluster-Randomised School-Intervention to Reduce School Exclusion—Findings from Protocol-Based Subgroup Analyses

This paper presents subgroup analyses from the London Education and Inclusion Project (LEIP). LEIP was a cluster-randomised controlled trial of an intervention called Engage in Education-London (EiE-L) which aimed to reduce school exclusions in those at greatest risk of exclusion. Pupils in the control schools attended an hour-long employability seminar. Minimisation was used to randomly assign schools to treatment and control following baseline data collection. The study involved 36 schools (17 in treatment—373 pupils; 19 in control—369 pupils) with >28% free school meal eligibility across London and utilised on pupil self-reports, teacher reports as well as official records to assess the effectiveness of EiE-L. Due to multiple data sources, sample sizes varied according to analysis. Analyses of pre-specified subgroups revealed null and negative effects on school exclusion following the intervention. Our findings suggest that the design and implementation of EiE-L may have contributed to the negative outcomes for pupils in the treatment schools when compared to those in the control schools. These findings call into question the effectiveness of bolt-on short-term interventions with pupils, particularly those at the highest risk of school exclusion and when they are faced with multiple problems. This is especially pertinent given the possibility of negative outcomes.Trial Registration: Controlled Trials: ISRCTN23244695     

Helminthiasis and hygiene conditions of schools in Ikenne, Ogun State, Nigeria

Background

A study of the helminth infection status of primary-school children and the hygiene condition of schools in Ikenne Local Government Area of Ogun State, Nigeria was undertaken between November 2004 and February 2005 to help guide the development of a school-based health programme.

Methods and Findings

Three primary schools were randomly selected: two government-owned schools (one urban and the other rural) and one urban private school. No rural private schools existed to survey. A total of 257 schoolchildren aged 4–15 y, of whom 146 (56.8%) were boys and 111 (43.2%) were girls, took part in the survey. A child survey form, which included columns for name, age, sex, and class level, was used in concert with examination of stool samples for eggs of intestinal helminths. A school survey form was used to assess the conditions of water supply, condition of latrines, presence of soap for handwashing, and presence of garbage around the school compound. The demographic data showed that the number of schoolchildren gradually decreased as their ages increased in all three schools. The sex ratio was proportional in the urban school until primary level 3, after which the number of female pupils gradually decreased, whereas in the private school, sexes were proportionally distributed even in higher classes. The prevalence of helminth infection was 54.9% of schoolchildren in the urban government school, 63.5% in the rural government school, and 28.4% in the urban private school. Ascaris lumbricoides was the most prevalent species, followed by Trichuris trichiura, Taenia species, and hookworm in the three schools. Prevalence of infection in the government-owned schools was significantly higher than in the private school (χ ² = 18.85, df = 2, p<0.0005). A survey of hygiene conditions in the three schools indicated that in the two government schools tapwater was unavailable, sanitation of latrines was poor, handwashing soap was unavailable, and garbage was present around school compounds. In the private school, in contrast, all hygiene indices were satisfactory.

Conclusions

These results indicate that burden of parasite infections and poor sanitary conditions are of greater public health importance in government-owned schools than in privately owned schools. School health programmes in government-owned schools, including deworming, health education, and improvement of hygiene conditions are recommended.     

Experimental Activities in Primary School to Learn about Microbes in an Oral Health Education Context

Experimental science activities in primary school enable important cross-curricular learning. In this study, experimental activities on microbiology were carried out by 16 pupils in a Portuguese grade-4 classroom (9–10?years old) and were focused on two problem-questions related to microbiology and health: (1) do your teeth carry microbes? (2) why should you brush your teeth after meals? To solve problem-question (1), children’s samples of dental plaque were prepared and observed under the microscope. For question (2), culture medium plates were inoculated with children’s dental plaque either before or after tooth brushing and the colonies were counted. Results showed that pupils easily recognised the presence of microorganisms in the mouth and verified the effectiveness of the process of teeth-brushing. Pupils understood that microorganisms were potentially responsible for the onset of dental caries. These practical activities on microbiology in primary school were very effective in ensuring young children easily understand the causes of dental caries and how they can be prevented. Pupils became aware that the act of brushing their teeth is not only a socially correct behaviour or a simple rule to meet, but also a matter of preventing illness and promoting health.     

Influence of the Monitored Youth Mentoring Program for adolescents with behavioural problems and behavioural disorders

This aimed to measure the influence of the Monitored Youth Mentoring Program (MYMP) for adolescents with behavioural problems and behavioural disorders. The MYMP commenced in 1997 and was completed in 2003. The model of the program was for one university student of Pedagogy to mentor one pupil between the ages of 13 and 17 years, demonstrating risk seeking behaviours for a whole school year. The specimen group was made up of 141 pupils, approximately 20 pupils from each year level. The short-term goal was to influence positive change in participants demonstrating risk seeking behaviour. The long-term goal was to enhance the respective school's programs to enable preventative approaches to lessen negative and risk seeking behaviours amongst pupils with behavioural problems and behavioural disorders. The research results demonstrate statistically significant success of the applied program in two measured variables. Firstly, learning success (p < 0.05), and secondly a decrease in truancy and disciplinary misdemeanours (p < 0.05). Both of which were observed in participants with behavioural problems. The program was not as successful for participants with behavioural disorders, but not without some effect. Although the program can be generally described as achieving a medium level of success, the fact that there was a lack of progressive worsening in participant's behaviour is a substantial bi-product of the program. The mentors involved in the program made it extremely clear by their feedback that, MYMP positively enhanced their formal Pedagogy training, through hands-on practise that they otherwise would not have received through their academic programs. They were provided with vital exposure to a preventative program and managed to gain insight into the possibilities of introducing early intervention and prevention into Croatian schools.     

Acne in schoolchildren: no longer a concern for dermatologists.

OBJECTIVE--To determine the prevalence and severity of acne among schoolchildren in Glasgow. DESIGN--Secondary schools in Glasgow were divided by postcode into five socioeconomic cluster groups. Different numbers of schools were selected at random from the five groups to ensure proportional representation. One class from each registration year of the chosen schools was selected at random and the whole class recruited into the study. SETTING--15 Secondary schools in Glasgow. SUBJECTS--2014 Randomly selected schoolchildren aged 12-17 (5% of total secondary school roll). INTERVENTIONS--None. END POINT--Assessment of facial acne by two independent examiners by a recognised acne scoring system. MEASUREMENTS AND MAIN RESULTS--The prevalence of acne in boys increased from 40% (75/189) at age 12 to 95% (108/114) at age 16, and in girls it increased from 61% (114/187) at age 12 to 83% (136/164) at age 16. On a scale of 0 to 10 only 18 boys (1.8%) and three girls (0.3%) had grades of acne of 1.0 or greater; most of the pupils had grade 0.05-0.375 (minimal) acne. Nine per cent of boys (88/973) and 14% of girls (145/1041) had visited their general practitioner specifically for advice on and treatment for acne; only five pupils (0.3%) had been referred to a dermatologist. CONCLUSIONS--Both the prevalence and severity of acne have decreased over the past 20 years. This has probably been due to improvement of treatment for acne by primary care doctors and the greater availability and use of over the counter preparations for acne.     

Drinking,smoking, and illicit drug use among 15 and 16 year olds in the United Kingdom.

OBJECTIVE: To examine patterns of self reported drinking, smoking, and illicit drug use among a representative United Kingdom sample of people born in 1979. DESIGN: Cross sectional, single phase survey based on a stratified cluster sample of 70 United Kingdom secondary schools during March and April 1995. Pupils completed a 406 item standardised questionnaire under examination conditions. SETTING: United Kingdom state and private secondary schools. SUBJECTS: 7722 pupils aged 15 and 16. MAIN OUTCOME MEASURES: Reported use of alcohol, tobacco, and illicit drugs. RESULTS: Almost all the pupils had drunk alcohol, 36% (2772/7689) had smoked cigarettes in the past 30 days, and 42.3% (3264/7722) had at some time used illicit drugs, mainly cannabis. 43% (1546/3546) of boys and 38% (1529/4009) of girls had tried cannabis. Higher levels of smoking were associated with poorer school performance (20.4% (783/3840) with average performance v 44.1% (214/486) with below average performance, F = 79.06, P < 0.01). Levels of drug use in 15 and 16 year olds in 1995 were higher in Scotland than in England, Wales, or Northern Ireland. CONCLUSIONS: Drug experimentation was high among 15 and 16 year olds, and use of cannabis was particularly high among smokers. Cigarette smoking was more common among girls than boys.     

Schoolchildren's Self-education

The social demands that our society is making on our schools have posed the problem of self-education in secondary school. This means that we must not only transmit a sum total of knowledge to pupils but also cultivate in them the ability to replenish their knowledge independently, and independently to make their way in the rapid flow of scientific and political information (see: [Proceedings of the XXV session of the Communist Party Central Committee]). This means that even under conditions of universal mandatory secondary education, the school ceases to be the final stage of self-education, and becomes the foundation, or starting point, for constant, ongoing self-education, an education that continues after completion of elementary school and even after completion of secondary or higher education.