Study on the Reliability and Accuracy of Scolioscope, a New Digital Scoliometer

Early detection of scoliosis with school screening and quick, easy, and reliable assessment of its progress are of paramount importance in the management of patients. There have been several tools described, with the most common being the analog scoliometer. Most recently, smartphone applications have entered this area with and without the use of sleeves for the device. There is no research that has evaluated the accuracy of measurements both left and right in either digital or analog devices. In this study, we evaluated the reliability and validity of a new digital scoliometer called the Scolioscope. Thirty subjects were included for the intra-rater reliability study. ICC values >0.9 were calculated both for same-day and between-day measurements. The device was highly accurate with an average difference from the ones set on the sine bar of 0.03° for right-side measurements and 0.18° for the left. These measurements suggest a highly accurate and reliable tool.

“Scuola Sicura”: a school screening program to prevent the spread of COVID-19 among students in Piedmont, Italy

ObjectivesAims of “Scuola Sicura” (SS) were to monitor the rate of COVID-19 and to contain its spread within the school population through early case isolation. We report the initial process and outcome evaluation results.DesignDescriptive study of an experimental screening testing program in children in Piedmont in the period January-March 2021. We used data from the COVID-19 platform and the Local Health Units, the archives of birth certificates (CedAP) and hospital discharge files (SDO).Setting and participantsThe screening program targeted second and third grade students in first level secondary schools. Participants were subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresWe calculated:1. number of positive cases detected vs. total number of students tested in the SS program;2. number of positive cases detected outside the SS program vs. total number of students in the target population.We detected the number of quarantines due to SS and no-SS case identification. To investigate the spread of COVID-19 in households, the mother-child pairs were identified through record linkage between the CedAP and SDO archives, and positive mothers were identified.ResultsSixty-nine percent of schools and 19.5% of the students participated in the program. SS detected 114 positives cases for SARS-CoV-2. On 08.03.2021, the target classes started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. We were able to identify the mothers of 61 out of 69 of those students (88%); 46 mothers had performed a swab test after the positivity of their child with a positive result in 11 cases. Asymptomatic cases identified at screening during in-class learning period accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for SARS-CoV-2 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs.

The scenario of childhood blindness and its remedy in Nepal

Childhood blindness represents one of the most common disabling and for children. There are approximately 1.4 million blind children worldwide and two-thirds live in the developing countries like Nepal. In Nepal more than 80% of the causes of childhood blindness are preventable. The main causes of blindness are diseases related to cornea, retina, lens optic nerve, refractive errors, amblyopia and hereditary. Most of the cases of unilateral childhood blindness are due to corneal causes. To decrease the burden of blindness, awareness program about various ocular diseases, nutritional blindness, ocular trauma, refractive errors, strabismus and amblyopia should be provided to the community health workers and parents. School screening programs and free eye camps should be conducted and motivate the community for regular eye checkup and follow up. Eye services should reach to rural areas and for poor socio-economic condition. Eye health education should focus on proper nutrition of children and harmful effects of traditional eye medicines. The objective of this study was to investigate the magnitude of childhood blindness in Nepal along with their possible causes. Similarly, this study is aimed to highlight the best possible modalities for the remedy of childhood blindness in the developing countries like Nepal.

“Scuola Sicura”: a school screening program to prevent the spread of COVID-19 among students in Piedmont, Italy

ObjectivesThe regional government of Piedmont approved an experimental screening testing program entitled “Scuola Sicura” with the aim to: rapidly contain thes spread of COVID-19 in the school population together with general mitigation strategies such as contact tracing, and case isolation, and to monitor the transmission rate in this population. In this paper we report the initial process and outcome evaluation results and the criticalities encountered during program rollout.DesignDescriptive study of the trend in the period Janaury-March 2021.The evaluation of the preventive capacity of the program is limited to the period of in-class learning. The data sources used are the COVID-19 platform Piedmont, the archives of the local health Departments and the CedAP-SDO archive. Setting and participantsThe screening program targeted second and third grade students in first level secondary schools throughout Piedmont. Each class was subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresThe following indices were calculated with a 95% confidence interval: 1. number of positive cases detected vs. total number of students tested in the “Scuola Sicura” program;2. number of positive cases detected outside the “Scuola Sicura” program vs total number of students enrolled in the 2nd and 3rd grades of first-level secondary schools in Piedmont.To evaluate the preventive capacity, quarantines were detected. In order to investigate the spread of COVID-19 in households, the mother-child pair was tracked and cases of positivity among mothers were identified. Results69% of schools in Piedmont participated in the program; the actual participation was 19.5% of the total number of students enrolled in second and third grades of first-level secondary schools. SS detected 114 positives cases for SARS-CoV-2, yielding a prevalence of 0.52% (95%CI 0.42-0.61) when calculated for the total number of students tested by the program. Starting from 08.03.2021, the target classes have started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. For 61 of the 69 cases (88%) identified by SS before 8 March, the mother-child couple was reconstruncted through record linkage between the CedAP and SDO archives. Forty-six mothers perfomed a swab test after that of the child with a positive result in 24% of cases (n=11). Asymptomatic cases identified at screening accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for COVID-19 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs. When well organized and implemented jointly with other transmission prevention measures and contact tracing, school screening may be a viable strategy to keep schools open when high levels of the virus are circulating in the community.

Anxious Solitude, Reciprocated Friendships with Peers, and Maternal Overcontrol from Third through Seventh Grade: A Transactional Model

Guided by a Transactional Model of anxious solitude development, we tested friend and maternal influences on continuity and change in youth anxious solitude from 3rd through 7th grade, as well as the influence of youth anxious solitude on decreased friendship participation and increased maternal overcontrol over time. Participants were 230 American youth (57% girls) selected for longitudinal study from a public-school screening sample (n = 688). Peers reported on anxious solitude, both peers and youth reported on reciprocated friendship, and youth reported on their mother’s overcontrol annually. Stability and incremental change in youth, friend, and maternal factors were tested in an autoregressive cross-lagged panel analytic model. Having few mutual friendships predicted incremental increase in youth anxious solitude in mid-elementary school, then youth anxious solitude predicted the loss of friendships after the middle school transition. Additionally, youth anxious solitude in third grade evoked increased maternal overcontrol in fourth grade, but the reverse direction of effect was not supported. Youth’s participation in few friendships also evoked mothers’ overcontrol, which exacerbated their child’s loss of friendships in elementary school. Taken together, having few mutual friends contributed to youth anxious solitude and maternal overcontrol, and subsequently these factors further exacerbated youth’s loss of friendships.

A smartphone ocular alignment measurement app in school screening for strabismus

Background Strabismus is the leading risk factor for amblyopia, which should be early detected for minimized visual impairment. However, traditional school screening for strabismus can be challenged due to several factors, most notably training, mobility and cost. The purpose of our study is to evaluate the feasibility of using a smartphone application in school vision screening for detection of strabismus. Methods The beta smartphone application, EyeTurn, can measure ocular misalignment by computerized Hirschberg test. The application was used by a school nurse in a routine vision screening for 133 elementary school children. All app measurements were reviewed by an ophthalmologist to assess the rate of successful measurement and were flagged for in-person verification with prism alternating cover test (PACT) using a 2.4Δ threshold (root mean squared error of the app). A receiver operating characteristic (ROC) curve was used to determine the best sensitivity and specificity for an 8Δ threshold (recommended by AAPOS) with the PACT measurement as ground truth. Results The nurse obtained at least one successful app measurement for 93% of children (125/133). 40 were flagged for PACT, of which 6 were confirmed to have strabismus, including 4 exotropia (10△, 10△, 14△ and 18△), 1 constant esotropia (25△) and 1 accommodative esotropia (14△). Based on the ROC curve, the optimum threshold for the app to detect strabismus was determined to be 3.0△, with the best sensitivity (83.0%), specificity (76.5%). With this threshold the app would have missed one child with accommodative esotriopia, whereas conventional screening missed 3 cases of intermittent extropia. Conclusions Results support feasibility of use of the app by personnel without professional training in routine school screenings to improve detection of strabismus.