Investigating the disjoint between education and health policy for infant feeding among teenage mothers in South Africa: a case for intersectoral work

Background Many low-and-middle-income countries, including South Africa, have high rates of teenage pregnancy. Following the World Health Organisation recommendations, South African health policy on infant feeding promotes exclusive breastfeeding until six months of age, with gradual weaning. At the same time, South Africa’s education department, in the interest of learners, promotes adolescents’ early return to school post-partum. Yet infant feeding at school is currently not perceived as a realistic option. Methods Recognising his this policy tension, we aimed to explore how policies are interpreted and implemented by the health and education sectors through interviews with key informants who produce, interpret and implement these policies. Using an interview guide developed for this study, we conducted in-depth interviews with 24 health policy makers, managers in both sectors, school principals and nursing staff who manage adolescent mothers (aged 16-19) and their babies. Data was analysed using thematic analysis. Results Informants from both sectors expressed discomfort at pregnant learners remaining in school late in pregnancy and were uncertain about policy regarding when to return to school and how long to breast-feed. Educators reported that new mothers typically returned to school within a fortnight after delivery and that breastfeeding was not common. While health professionals highlighted the benefits of extended breastfeeding for infants and mothers, they recognised the potential conflict between the need for the mother to return to school and the recommendation for longer breastfeeding. Additionally, the need for ongoing support of young mothers and their families was highlighted. Conclusions Our findings suggest educators should actively encourage school attendance in a healthy pregnant adolescent until delivery with later return to school, and health providers should focus attention on breastfeeding for the initial 4-6 weeks postpartum, followed by guided support of formula-feeding. We encourage the active engagement of adolescents’ mothers and extended families who are often involved in infant feeding and care decisions. Education and health departments must engage to facilitate the interests of both the mother and infant: some exclusive infant feeding together with a supported return to school for the adolescent mother.

Finally at school: the return to classes of vulnerable pupils. Results of the FocuScuola Inclusion research 20.20

The research FocuScuola 20.20 – promoted by the Centre for Studies and Research on Disability and Marginality of Università Cattolica del Sacro Cuore – aims at specifically understanding the state of the art of the inclusive processes at the return to school after the first lockdown period. This research is in line with the aims of national and international surveys that have analysed the challenges to which the school system has been called in this period of health and social emergency. The collected data show a picture that seems to confirm the critics linked to an ideological and reductive scenario. This view is although characterized by some positive elements in terms of reception and attention to students with greater vulnerability, but it is substantially distant from the realisation of educational pathways that assume educational differentiation as an authentic perspective and concrete working method. Quando tutto è ricominciato: il ritorno a scuola degli alunni più fragili. Esiti della ricerca FocuScuola Inclusione 20.20. La ricerca FocuScuola 20.20 – promossa dal Centro Studi e Ricerche sulla Disabilità e la Marginalità dell’Università Cattolica del Sacro Cuore – ha inteso comprendere in modo specifico lo stato dell’arte dei processi inclusivi al rientro a scuola dopo il primo periodo di lockdown. Lo studio è in linea con le finalità di indagini nazionali e internazionali che hanno analizzato le sfide a cui il sistema scolastico è stato chiamato in questo periodo di emergenza sanitaria e sociale. I dati raccolti evidenziano un quadro che, seppur caratterizzato da alcuni elementi positivi sul piano dell’accoglienza e dell’attenzione verso gli alunni con maggiore vulnerabilità, sembra confermare le criticità legate ad una visione per molti aspetti ideologica e riduttiva, sostanzialmente lontana dalla realizzazione di percorsi educativi che assumano la differenziazione didattica come autentica prospettiva e concreta modalità di lavoro.

Exploring the Outcomes and Experiences of Black and White Athletes Following a Sport-Related Concussion: A Retrospective Cohort Study

ObjectiveYoung American athletes, at risk of sport-related concussion (SRC), represent many races, however, it is unknown how race influences the experience and outcome of SRC. Our objective was to compare White and Black athletes' recovery and subjective experiences after SRC.BackgroundNA.Design/MethodsA retrospective study was performed using the Vanderbilt Sport Concussion registry. Self-reported White (n = 211) and Black (n = 36) athletes (ages 12–23) treated for SRC between 2012 and 15 were included. Athletes with learning disabilities or psychiatric conditions were excluded. Data was collected by EMR review and phone calls to athletes and parents/guardians. The primary outcomes were: (1) days to symptom resolution (SR), (2) days to return-to-school, (3) changes in any daily activity (binary), (4) and sport behavior (binary). Secondary outcomes were changes in specific activities such as sleep, schoolwork, television time, as well as equipment (binary), playing style (more reckless, unchanged, less reckless) and whether the athlete retired from sport. Descriptive analyses, multivariable Cox proportional hazards and logistic regression were performed.ResultsA retrospective study was performed using the Vanderbilt Sport Concussion registry. Self-reported White (n = 211) and Black (n = 36) athletes (ages 12–23) treated for SRC between 2012 and 15 were included. Athletes with learning disabilities or psychiatric conditions were excluded. Data was collected by EMR review and phone calls to athletes and parents/guardians. The primary outcomes were: (1) days to symptom resolution (SR), (2) days to return-to-school, (3) changes in any daily activity (binary), (4) and sport behavior (binary). Secondary outcomes were changes in specific activities such as sleep, schoolwork, television time, as well as equipment (binary), playing style (more reckless, unchanged, less reckless) and whether the athlete retired from sport. Descriptive analyses, multivariable Cox proportional hazards and logistic regression were performed.ConclusionsRacial differences appear to exist in the outcomes and experience of SRC for young athletes, as Black athletes reached symptom resolution and return-to-school sooner than White athletes. Race should be considered as an important social determinant in SRC treatment.

Variations in Time to Recovery from Pediatric Concussion Based on Differing Outcomes of Interest

ObjectiveTo quantify variability in pediatric concussion recovery across multiple outcomes of interest.BackgroundPediatric concussion studies are hindered by a common significant limitation: lack of agreement on a standard definition of “recovery.” A variety of clinical outcomes of interest utilized across studies, including symptom self-report, neurocognitive testing results, self-reported return to activity, and physician clearance for activity, leads to challenges for both research, as well as clinical concussion management.Design/MethodsWe enrolled concussed youth, ages 11–18 years, from a specialty sports medicine clinic = 28 days of injury. Patients were followed as part of clinical care for concussion for up to 13 weeks. At each visit, participants completed questionnaires and a battery of clinical measures. From these data, we constructed 10 potential definitions of recovery: 3 based on self-reported symptoms (change from pre-injury, no symptoms, below pre-determined thresholds), 2 based on visio-vestibular examination (VVE) deficits (none, = 1), 2 based on physician clearance (for return to school/sport), and 3 based on self-assessment (“back to normal”, return to school/exercise).ResultsOne hundred seventy-four concussed youth were enrolled (median age: 15 years, 54.6% female) with a median time from injury to initial visit of 12 days (IQR: 7, 20). Median number of visits was 2 (range: 1, 5). We observed a wide variation in the proportion of participants recovered across the 10 definitions. Depending on definition, between 4% and 45% were considered recovered within 4 weeks, and between 10% and 80% were considered recovered at the end of follow-up. The VVE-based definition (=1 deficit) consistently had the highest proportion recovered at all time points, while self-reported return to exercise had the lowest proportion.ConclusionsRecovery from concussion is not a single unitary point in time. These results will provide valuable guidance to clinicians in managing concussion and researchers in designing future observational and interventional trials of pediatric concussion.

Mixed Method Examination of the Brain Health of Former NCAA Division I Football Players and Former NFL Players

ObjectiveYoung American athletes, at risk of sport-related concussion (SRC), represent many races; however, it is unknown how race influences the experience and outcome of SRC. Our objective was to compare White and Black athletes' recovery and subjective experiences after SRC.BackgroundNA.Design/MethodsA retrospective study was performed using the Vanderbilt Sport Concussion registry. Self-reported White (n = 211) and Black (n = 36) athletes (ages 12–23) treated for SRC between 2012 and 15 were included. Athletes with learning disabilities or psychiatric conditions were excluded. Data was collected by EMR review and phone calls to athletes and parents/guardians. The primary outcomes were: (1) days to symptom resolution (SR), (2) days to return-to-school, (3) changes in any daily activity (binary), (4) and sport behavior (binary). Secondary outcomes were changes in specific activities such as sleep, schoolwork, television time, as well as equipment (binary), playing style (more reckless, unchanged, less reckless) and whether the athlete retired from sport. Descriptive analyses, multivariable Cox proportional hazards and logistic regression were performed.ResultsA retrospective study was performed using the Vanderbilt Sport Concussion registry. Self-reported White (n = 211) and Black (n = 36) athletes (ages 12–23) treated for SRC between 2012 and 15 were included. Athletes with learning disabilities or psychiatric conditions were excluded. Data was collected by EMR review and phone calls to athletes and parents/guardians. The primary outcomes were: (1) days to symptom resolution (SR), (2) days to return-to-school, (3) changes in any daily activity (binary), (4) and sport behavior (binary). Secondary outcomes were changes in specific activities such as sleep, schoolwork, television time, as well as equipment (binary), playing style (more reckless, unchanged, less reckless) and whether the athlete retired from sport. Descriptive analyses, multivariable Cox proportional hazards and logistic regression were performed.ConclusionsRacial differences appear to exist in the outcomes and experience of SRC for young athletes, as Black athletes reached symptom resolution and return-to-school sooner than White athletes. Race should be considered as an important social determinant in SRC treatment.

Concerns and mental health of teachers from digitally underdeveloped countries regarding the reopening of schools after the first wave of the COVID-19 pandemic

BACKGROUND: Torn between the decision to return to school classrooms or continue holding online classes during COVID-19, teachers around the world feel great uncertainty. OBJECTIVE: Bearing in mind that the study of mental health during the pandemic is of great importance for vulnerable categories, and given the role of teachers in society, the aim of this research is to assess teachers’ concerns and anxiety before the start of the school year, and also to examine the factors related to them and propose measures in line with the results. METHODS: The study was conducted as a cross-sectional study before the start of the 2020/2021 school year. The research sample consisted of 286 teachers. For the purposes of this research, a special questionnaire was constructed consisting of a general questionnaire and a Generalized Anxiety Disorder 7-item scale (GAD-7). RESULTS: The strongest predictor of a teacher’s answer that they were concerned about the reopening of schools was their concern for their own life and health and for the life and health of their family members, followed by the amount of information received about COVID-19, and, finally, older age. Only 2% of teachers had mild anxiety. CONCLUSIONS: This research indicated that it is necessary to examine in more detail the degree of teachers’ concern and its impact on their functionality and work process. It is also necessary to repeat the research on the mental health status of teachers and implement procedures in the form of a regular screening program of the mental health status of teachers or implement procedures of support in concern management.

¿Cómo ayudar a los estudiantes en la vuelta a la educación presencial después de la educación a distancia durante la pandemia? El papel de las actividades colectivas de interacción en los libros de texto de ELE seleccionados

The aim of the article is to reflect upon the tasks which might help students in the crisis caused by the return to school after distance learning connected with the pandemic. To start with, the data presented concern both mental and physical well-being, as well as the needs of Polish secondary school students during the pandemic (distance learning and the return to schools). Next, the author analyses the place of textbooks during the return to schools and suggests the typology of team tasks facilitating this process, with a special emphasis on the ones which develop the oral interaction and are in accordance with the processual approach to writing. Furthermore, in the research part, the tasks analysed proposed in the four textbooks of Spanish as a foreign language, destined for students aged 15-19 years, in order to state to what degree, they may facilitate the return to schools and what kind of adjustment to this situation they need. Finally, the conclusions were presented.

Long COVID—The New “Invisible” Illness: How School Nurses Can Support the Nursing and Educational Teams for Student Success

School-age children are not immune to COVID-19 or the pronounced and persistent symptoms associated with a long-COVID diagnosis. Students may present with a variety of symptoms affecting their physical, cognitive, and mental health. The school community should be educated on the school-based interventions and recommendations for creating an individualized safe and successful return to school plan. As we await approval for vaccinations in school-age children younger than 12 years and continue to reposition ourselves to the waves of this pandemic and new variants of the virus, understanding the medical and educational long-term effects on our students may be a long-term need.

Preparing for the Impact of COVID-19 on the Mental Health of Youth

The COVID-19 pandemic is continuing to have long-term and global effects that the vaccine may not ease. Children and adolescents endured unprecedented periods of loneliness, social isolation, financial stressors, in-home conflicts, changes in living circumstances, and variable access to healthcare, resulting in increased mental health sequelae. Timely recognition of students’ anxiety, depression, and disruptive behaviors will allow appropriate interventions to de-escalate these feelings and prevent suicidal ideations and attempts. As youth return to school, their mental health needs will not subside. School nurses and the multidisciplinary team have a vital role in impacting this population’s already surging increase of mental and behavioral health disorders.

The Role of Digital Application Literacy in Online Assessment

As educators and administrators look to countless mobile apps, software programs, and web-based learning tools to meet the demands of students in remote, virtual, and hybrid settings, risks and assumptions of online platforms and assessments must be considered. With the urgency of the COVID-response closure of many schools and the unusual methods employed during the return to school in Fall 2020, there is no better time to examine the digital application literacy which is necessary for students to effectively transition to online learning and assessment. “Digital application literacy” (DAppLit), a specific form of media literacy, involves the nimble use of an app (web-based) or application (computer-based) for education, including assessment. Learners with impaired DAppLit face academic consequences, when insufficient literacy in the platform is the culprit. This paper first explores various skills and strategies from both traditional and digital assessments that digital application literacy requires. Then, it presents the value of low-stakes assessment experiences with applications to introduce navigation techniques and troubleshoot barriers users may face before undertaking weighted assessments. The importance of skills instruction and practice of DAppLit methods is presented. A four-step process is introduced to: 1) set learning goals; 2) guide learners through the application with explicit instructions before use; 3) provide low-stakes explorations; and 4) debrief to address any issues which could represent a failing of application literacy and not content knowledge in an assessment.