School-level variation in children's moderate to vigorous intensity physical activity before and after COVID-19: a multilevel model analysis.

Background and objectives: Schools play a crucial role in facilitating physical activity among children, but the COVID-19 pandemic has affected both children's physical activity and the school environment. It is essential to understand between-school differences in children's physical activity post lockdown, to determine if and how the role of schools has changed. Design and participants: Active-6 is a natural experiment comparing postlockdown accelerometer-estimated physical activity to a pre-COVID-19 comparator group. Accelerometer and individual data were collected on 1296 children aged 10-11 pre-COVID-19 (2017-8), with school characteristics collected from the 50 schools they attended. Post lockdown, we collected accelerometer, individual and school data from 393 children in 23 of the same schools and 436 children in 27 of the same schools in 2021 (Wave 1) and 2022 (Wave 2), respectively. Methods: Sources of variation (between-school, between-pupil and within-pupil) in child weekday moderate to vigorous physical activity at each wave were modelled using linear mixed-effects models with school-level wave random coefficients. We extended the model to estimate the proportion of between-school variation explained by school policy, curriculum and physical environment factors and school-aggregated pupil characteristics. We also explored the extent to which postlockdown differences in moderate to vigorous physical activity were mediated by individual or school factors. Results: Between-school variation comprised 13% of the total variation pre-COVID-19, 7% in Wave 1 and 13% in Wave 2. School factors associated with moderate to vigorous physical activity were the following: whether physical education was compromised due to space (often: 9 minutes lower moderate to vigorous physical activity; sometimes: 5.4 minutes lower); high after-school club attendance (7 minutes higher moderate to vigorous physical activity for each additional club attended on average in the school); cycle training policy (4 minutes higher moderate to vigorous physical activity); and higher prevalence of active travel (1 minute higher moderate to vigorous physical activity for each 10% point increase in prevalence). These factors explained 22% of the between-school variation pre-COVID-19, and 72% at Wave 2. The relative importance changed, with cycle training policy and active travel being the most important pre-COVID-19 and cycle training policy, active after-school clubs and compromised physical education space most important in Wave 2. No factors were found to mediate the postlockdown differences in moderate to vigorous physical activity, except compromised physical education space, which had a suppressor effect in Wave 2. Limitations: Only 27 of the initial 50 schools participated post lockdown, limiting our ability to make comparisons across waves. Sample sizes were additionally affected by missing data for some variables. Conclusions and future work: While schools continue to play an important role in facilitating children's physical activity, the factors that contribute to this have changed post-COVID-19, with cycle training, active after-school clubs and ensuring physical education is prioritised even when space is limited now explaining nearly three-quarters of the between-school variation in children's moderate to vigorous physical activity. School-level interventions that focus on these areas, and policies that support them, may offer the potential to increase children's physical activity. Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847.

Schools are important in helping children to be physically active. How active children are differs between schools. We wanted to know whether this has changed after the COVID-19 lockdowns. We also looked at features of the school, like equipment in the playground or being active in lessons, that might explain these differences. We collected activity data from 10- to 11-year-olds from 50 schools around Bristol (United Kingdom) before and after the COVID-19 lockdowns. Children also told us about how they travelled to school and whether they went to after-school sports or exercise clubs. We asked schools about their policies and lessons. Finally, we collected data on the playground and surroundings. In the first 6 months after lockdowns, schools had a much smaller role in children's activity. But after a year, schools were once again an important influence on how active children were. We found that the school features that affected children's activity had changed. Before the pandemic, the things that helped children most to be active were learning to ride a bike at school, and walking or cycling to school. After the pandemic, offering lots of after-school sports clubs was more important. Schools that struggled with physical education lessons because of a lack of space had fewer active pupils. Schools continue to play an important role in helping children be active. But this role has changed after the lockdowns. In the future, schools could help keep children active by offering plenty of after-school clubs and help children to learn to ride a bike. Also, it is important to make sure that physical education lessons are a priority, even when there is not much space.

Physical activity intensity and older adolescents' stress: The 'STress-Reactivity after Exercise in Senior Secondary EDucation' (STRESSED) 3-arm randomised controlled trial.

OBJECTIVES: Late adolescence (15-19 years) is a period of heightened susceptibility to stress, but regular physical activity may attenuate reactivity to stressors. We aimed to explore the effects of physical activity intensity on older adolescents' stress-reactivity and self-reported mental health. DESIGN: and methods. Three-arm randomised controlled trial in New South Wales, Australia (April-June, 2021). Thirty-seven older adolescents (16.1±0.2 years, 59.5% female) were randomised to: i) non active control (CON), ii) light-intensity physical activity (LPA), or iii) moderate-to-vigorous-intensity physical activity (MVPA). Physical activity groups participated in 2 x 20-min sessions/week for 6 weeks. Salivary cortisol (sCort) reactivity to induced stress was assessed using the Trier Social Stress Test for Groups and quantified as area under the curve (sCortAUC; Primary outcome). Secondary outcomes included peak cortisol (sCortPeak), subjective-reactivity, perceived stress, and non-specific psychological distress. Group differences were assessed using multiple linear regression and quantified using Cohen's d. RESULTS: No effects were observed for sCortAUC or sCortPeak and the pattern of effects for subjective-reactivity was inconsistent. Effects for self-reported mental health were also non-significant (p > .05 for all) but of meaningful magnitude, favouring LPA and MVPA over CON (d's = -0.38 to -0.54). Delivery fidelity was high, satisfaction was moderate-to-high, and there was no evidence of harm. However, recruitment, retention for sCort measures, and adherence were lower than expected. CONCLUSION: Suboptimal recruitment, retention, and adherence limited our ability to conclude on the effect of physical activity intensity on older adolescents' sCort-reactivity to induced stress. We observed potentially meaningful effects on self-reported mental health irrespective of intensity, which could be confirmed in a future powered trial.

Shaping teachers' organizational citizenship behavior through self-efficacy and trust in colleagues: moderating role of collective efficacy.

BACKGROUND/PURPOSE: The aims of this study are: (1) to examine the mediating effect of teacher self-efficacy on the relationship between trust in colleagues and organizational citizenship behavior (OCB); and (2) to evaluate the moderating effect of collective efficacy on the relationships between teachers' self-efficacy and OCB, as well as between trust in colleagues and OCB. DESIGN/METHODOLOGY/APPROACH: The cross-sectional data were based on 408 sets of usable questionnaires collected from teachers who worked in government schools in Malaysia. The partial least square structural equation modeling technique was used to test the model and hypotheses. FINDINGS: The results indicate that trust in colleagues is positively related to organizational citizenship behavior (OCB) and teacher self-efficacy. Additionally, teacher self-efficacy and OCB are also positively related. Furthermore, the relationship between trust in colleagues and OCB is partially mediated by teacher self-efficacy. Moreover, collective efficacy significantly moderates the path between teacher self-efficacy and OCB but not between trust in colleagues and OCB. ORIGINALITY/VALUE: Despite earlier studies examining the relationship between trust, teacher self-efficacy, and OCB, little is known about the mediating mechanism of teacher self-efficacy and the moderating effect of collective efficacy. Thus, this present study makes significant contributions in both theoretical and practical aspects.

Poly-bullying victimisation in Indonesia: Prevalence and factors related to children exposure to multiple bullying incidents, and its correlation to subjective well-being.

Research on bullying in Indonesia remains limited, revealing significant gaps in understanding its prevalence and underlying factors specific to the Indonesian context. This study addresses these gaps through a three-pronged approach: (a) assessing the prevalence of poly-bullying victimisation, (b) identifying factors associated with poly-bullying experiences, and (c) evaluating subjective well-being (SWB) in cases of poly-bullying by comparing it with uninvolved children. Cummins' theory of SWB homeostasis was employed to interpret the findings. The study included 10,051 children aged 10 and 12 years (50% girls) who reported experiencing poly-bullying in the past month. Data were analysed using descriptive statistics and linear regression. Poly-bullying was measured across five indicators: physical, verbal, and emotional bullying by siblings and other children at school. The analysis considered five independent variables: sociodemographic factors, perceptions of family, friends, and school, and reported fights among students. The results were statistically significant (p < 0.000), though the model explained only 5.1% of the variance in poly-bullying victimisation. Poly-bullying was prevalent in both public and non-religious schools. Significant contributors included the frequency of fights among students (ß = 0.129) and the belief that friends would help (ß = 0.045). The study's implications for preventing poly-bullying victimisation were also discussed.

Reflection on Five Months Rural District Hospital Posting of Final Year MBBS Students.

ABSTRACT: Patan Academy of Health Sciences has been sending its undergraduate medical students to rural postings aligning with the national health system of Nepal to produce competent and empathetic healthcare professionals as a part of its social accountability. One such rural posting is a 20-week long district posting where students are posted at district hospital and district health office. We were final-year students posted at Gulmi district for this purpose in the year 2021/22. We learned the functioning of a district hospital along with different clinical skills. We also learned to use the district health information system and different qualitative tools in drafting district health reports and strategic planning under the guidance of the District Health Office. Such exposure of medical students is essential to develop competent and empathetic health professionals and similar provisions should be included in the undergraduate curriculum of other universities.

The Positive School Safety Program (PSSP) for School Officers: Implementation Processes and Outcomes.

Approximately 50% of U.S. students attend a school with a school officer. The Positive School Safety Program (PSSP) is a 16-session, manualized peer-to-peer coaching program that teaches school officers positive approaches to behavioral management (e.g., trauma-informed reinforcement strategies) to enhance interactions with students, improve school climate, and reduce school-based arrests. A convergent, mixed methods longitudinal design was used to investigate the implementation process and outcomes of the PSSP among school safety officer coaches in the School District of Philadelphia (SDP) who were trained in the 2020-2021 school year. Via surveys, officer coaches (n = 25) provided quantitative data at three time points regarding their knowledge, attitudes, and confidence in utilizing positive approaches to behavioral management and trauma-informed skills, as well as their mindset toward coaching. These data were analyzed using mixed effects modeling. Perceptions of program acceptability, appropriateness, and feasibility were assessed post-training and analyzed descriptively. Qualitative interviews, informed by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, were conducted with coaches and untrained school officers and were analyzed via thematic analysis. Significant changes over the course of training were detected in coaches' knowledge, confidence, and their willingness to use the skills, which aligned with coaches' qualitative self-reports. Coaches agreed that the PSSP was acceptable, appropriate, and feasible. School districts interested in improving school climate and reducing school-based arrests by using the PSSP, or similar peer-to-peer coaching programs, should consider how they will target identified determinants to support successful implementation in their unique contexts.

Positive behavior support in school - a quasi-experimental mixed methods study and a randomized controlled trial.

BACKGROUND: While positive school climate is important for students' well-being and mental health, school personnel may experience challenges in creating a nurturing school climate. School-Wide Positive Behavioral Interventions and Supports (SW-PBIS) has shown positive effects on school climate and children's prosocial behaviors, but fewer studies have been conducted in a European context. AIM: This project aims to investigate the effectiveness of SW-PBIS program for students' social-emotional skills and academic achievement as well as teachers' and students' perceptions of classroom learning environment. Furthermore, the study intends to evaluate how school-level factors mediate or moderate the effects of the intervention. In addition, the study includes a qualitative evaluation of the dynamic interaction processes that occur during program implementation in local school contexts. METHODS: Data on school- and individual-level measures are collected in intervention and control schools. With regard to challenges in retaining control groups over extended time periods, two waves of recruitment are used. In the first wave, an active control group is used and data are collected during three time points. In the second wave, a wait-list control group will be used and data will be collected during two time points during one school year. Hierarchical regression analyses will be conducted to explore the effects of SW-PBIS on the outcomes of the study. An ethno-methodological approach will be applied to provide a detailed examination of the social interactional and meaning-making practices of different school implementation teams, and the negotiation of normative expectations and rules of conduct in peer-teacher-student interactions in different classrooms. DISCUSSION: The study is expected to contribute to knowledge on the effects of the SW-PBIS program and how these effects may be mediated or moderated by school-level factors. Combining quantitative and qualitative methods to explore the significance of school contexts in the implementation of the SW-PBIS program constitutes the strength of the study. The challenge in the study is the extended period of implementation of SW-PBIS, which entails difficulties in retaining a control group over the required time period. Therefore, two waves of recruitment are used, encompassing different procedures of allocation to intervention or control group. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06270914 on the 22nd of February, 2024 (retrospectively registered).

Building Bridges! Children with Autism Spectrum Disorder and Their Transition from Kindergarten to School - A Scoping Review.

Purpose: The goal of this study was to map the research on the transition from kindergarten to school for children with autism spectrum disorder (ASD). Further, the goal was to identify the elements influencing the transition process as well as the variables that would promote a smooth and positive transition experience for the children in question. The study also aimed to identify knowledge gaps on the subject and the current practice in the field. Methods: The study is a scoping review that includes peer reviewed articles from the databases ERIC, Google scholar, PsycINFO and Web of Science and the search was restricted to articles in English from 2019 to 2024. The search terms used were autism spectrum disorder, autism, transition, preschool, ECEC, inclusion, education intervention, early childhood, early education and kindergarten. After identifying and screening current articles from the databases, the articles were ascertained for relevance in three stages. In phase one, the title was considered. Phase two consisted of reviewing the abstract, and the final stage was to review the full text. At each stage, articles that did not prove relevant to the goal of the study were excluded. This left us with thirteen articles for inclusion in this article. Results: In the selected articles the following elements are necessary for children with autism to have a positive transition from kindergarten to school: 1) School readiness skills and school inclusiveness, 2) Comparable educational opportunities and psychological support, 3) Collaboration and professional competence, 4) A balance to ensure a better transition, and 5) Inclusion and support and 6) Children's perspectives. Conclusion: The research gaps identified were: 1) that few studies take the child's perspective into account and 2) that there is an overemphasis on subjective experiences of effectiveness, and a lack of focus on measurable effects within studies on transition and inclusive education.

Academic stress among students in Vietnam: a three-year longitudinal study on the impact of family, lifestyle, and academic factors.

Objective: Academic stress is associated with mental health disorders, notably depression and anxiety among students. Mitigating stress can decrease the incidence of mental health disorders and improve student well-being. This study explored factors influencing academic stress among secondary school students in Vietnam. Materials and Methods: A three-year longitudinal study was conducted using a self-reported questionnaire with 611 students from four secondary schools in Hue City, Vietnam. Academic stress was evaluated using the Educational Stress Scale for Adolescents (ESSA). Family factors, including the number of siblings and parental educational levels; lifestyle factors, including physical activity and sleep; and academic factors, including grade point average and attending extra classes were evaluated. Linear regression models were used to analyze the associations between the ESSA scores at follow-up and family, lifestyle, and academic factors at baseline. Results: A total of 341 students completed both the baseline and follow-up surveys and answered the questions required for this analysis. The mean ESSA score of 341 students increased from 46.4 ± 7.6 (mean ± SD) to 53.5 ± 10.8, from 2018 to 2021. The multivariate model revealed that the number of siblings, higher father's educational attainment level, female gender, lower academic scores, and attending extra classes were associated with overall academic stress. In contrast, no associations were observed between the variables of lifestyle, parental concentration, and parental acceptance and overall academic stress. Conclusion: The findings highlight the impact of family factors and study workload on academic stress, emphasizing the need for proper care from family and school to reduce or prevent student academic stress and provide them with a comfortable and healthy learning environment.

Outdoor recess is associated with more positive attitudes toward physical activity among pre-adolescent students and their parents.

Introduction: School day structure has the potential to increase students' physical activity (PA) levels and form positive attitudes about PA. Including various PA opportunities and free play possibilities in the school schedule, especially outdoor recess, can improve students' moderate-to-vigorous PA (MVPA) levels during school time. Therefore, the main aim of the study was to investigate students' and their parents' attitudes about outdoor recess and PA opportunities in schools with different recess opportunities. Methods: Students from grades three to six (9-13-year-olds) and their parents responded to a questionnaire about the effect of outdoor recess and opportunities for PA during the school day. Schools were divided into three groups based on the recess opportunities during the school day: (1) "outdoor recess", (2) "outdoor recess on some days", (3) "indoor recess". Results: Students and parents of the "outdoor recess" group had significantly more positive attitudes about outdoor recess and PA opportunities in school. Students of the "outdoor recess" group stated being significantly more active during their leisure-time compared to other groups. Parents of the "outdoor recess" group stated that the school has asked their opinion regarding PA opportunities during the school day significantly more compared to the other two groups. Discussion: These findings emphasize the positive effect outdoor recess can have on students' PA beliefs and habits. Parents of the "outdoor recess" group also had more positive attitudes toward PA which is important as parents most likely convey their attitudes and beliefs to their children. In addition, involving and informing parents is critical when changing the school schedule and introducing new school culture, to make the changes last.

Touch of Medical Ethics at the Beginning of Medical School.

ABSTRACT: There comes a great responsibility to make patients feel better with the title of doctor. Often we meet certain moral and ethical dilemmas that cannot be solved by our medical textbook alone. It requires a certain assistance which can only be provided by medical ethics. Medical ethics is the guiding moral that guides Health Care Workers to provide a holistic approach while treating a patient. Medical ethics is the soul that can not only prevent future dilemmas but can overall make a healthcare worker 'feel' and have empathy for the patient. From the story of Paul and the true life stories of patients we encountered during our visit to the Leprosy center, we got a sense of empathy. Ethical practice and empathy are the pillars that can play a vital role in the rapidly increasing level of violence against the Health care professionals. So it is an emerging need to have medical ethics as a part of the curriculum among medical students.

The importance of pathway programs in increasing diversity in dermatology: Efforts made by the American Academy of Dermatology.

Our country's population continues to diversify, highlighting the need for an equally diverse physician workforce to care for patients. Unfortunately, the percentage of underrepresented minority residents in dermatology has remained relatively unchanged over the past several years. To address this disparity, the American Academy of Dermatology created the Pathways Programs to focus on early exposure to dermatology, skill-building workshops, research, and mentorship. The overarching goal is to increase the number of underrepresented minority dermatologists, which will result in improved patient care and mitigation of healthcare disparities.

Effects of perceived variety-support on middle school students' learning engagement in physical education: the mediating role of motivation.

Introduction: High engagement in physical education (PE) could effectively develop students' motor competence and promote physical activity, which was significantly important for students' physical and mental health. Researches had shown that motivation was an important factor in explaining students' learning engagement, and variety-support as the fourth independent psychological need was a potential factor influencing students' learning motivation. However, there was a lack of empirical research evidence on the effect of perceived variety-support on middle school students' learning engagement in PE and the influencing mechanisms. This study aimed to investigate the direct effect of perceived variety-support on learning engagement in PE and the mediating effect of motivation in PE on the relationship. Methods: A cross-sectional study was conducted and 587 middle school students from Liaoning province filled the paper-and-pencil questionnaires adopting perceived variety-support in PE scale (PVSPES), utrecht work engagement scale-student (UWES-S), and perceived locus of causality in PE scale, which had been proved to have good reliability and validity (294 boys and 293 girls, Mage=13.47 ± 0.94). Results: The results showed three variables were significantly positively correlated with each other (r = 0.323-0.562 p < 0.01) and perceived variety-support in PE could not only directly promote middle school students' learning engagement in PE but also indirectly through the mediating effect of motivation in PE. Discussion: Therefore, in order to better promote students' participation in PE class, we should pay more attention to satisfy students' varied PE learning needs and stimulate students' autonomous learning motivation.

Financial strain among West-Javanese parents: its association with marital satisfaction and quality of life, and the role of dyadic coping.

In the past decade, the concept of dyadic coping as a buffer against stress in romantic relationships has received much attention in Western countries, but it has rarely been studied in non-Western countries and among parents with school-aged children. The aim of the present study was to investigate the moderating effect of dyadic coping on the link between financial strain and marital satisfaction, as well as the mediating effect of marital satisfaction on the relationship between financial strain and quality of life. There were 751 heterosexual couples whose eldest child aged 7-12 years in West Java, Indonesia (mean age husband = 37.53 SD = 5.09; mean age wife = 34.42 SD = 4.85) fulfilled the paper and pencil questionnaires in the study. The moderated mediated model illustrated that (1) greater levels of dyadic coping weakened the negative association between financial strain and marital satisfaction for husbands and for wives (2) for both husbands and wives, there were no mediation effect (3) for both husbands and wives, financial strain was negatively associated with quality of life; and marital satisfaction was positively associated with quality of life. We discuss both the theoretical and practical implications of these findings.

Identifying precondition configurations of mathematics anxiety among middle school students in China: using NCA and QCA approaches.

Introduction: Addressing mathematics anxiety is important to ensure that students achieve good academic performance and maintain their mental health during the critical middle school period. However, previous studies have focused on the separate effects of the preconditions for mathematics anxiety, ignoring the interaction of factors. Therefore, this study aims to identify the determinants of mathematics anxiety from the perspective of complex systems via necessary condition analysis (NCA) and qualitative comparative analysis (QCA). To the best of our knowledge, this is the first study to identify configurations of preconditions of mathematics anxiety among middle school students. Methods: A total of 183 middle school students aged 16 to 19 years (M age = 17.47, SD = 0.89) in China participated in this cross-sectional study. The outcome variable of the study is mathematics anxiety, and the condition variables include mathematics grade, parental support, learning motivation, learning planning, and learning interest. Results: The necessity condition analysis shows that not all the condition variables constitute the necessity condition of mathematics anxiety alone. Four paths for the influence of multiple condition variables on mathematics anxiety are identified via the configuration analysis. Notably, even students with high mathematics scores and learning interest still experience mathematics anxiety due to a lack of practical parental support and learning motivation. High levels of parental support can exacerbate the mathematics anxiety of students under two conditions: 1) a lack of learning motivation and learning plans, and 2) interest in learning but low mathematics scores and unclear learning plans. Discussion: This study highlights the need to consider the comprehensive impact of mathematics anxiety, and the findings will help educators and researchers identify the different characteristics of mathematics anxiety in student populations.

Effective Clinical Externships for International Medical Students: A Qualitative Study.

BACKGROUND: International student exchanges are a significant part of medical education, and experiences of North American and European medical students abroad have been extensively examined. By contrast, knowledge of visiting medical students in the United States (US) is limited largely to surveys of administrators and course directors. OBJECTIVE: To understand US attending physicians' thoughts on visiting international student clinical externships. DESIGN AND PARTICIPANTS: Three clinician-educator physician focus groups were conducted across two US medical schools with broad representation of training backgrounds, clinical disciplines, and career stages. Focus groups and constant comparison analysis of transcripts were performed iteratively to identify emerging themes. MAIN MEASURES: Qualitative themes and subthemes. KEY RESULTS: Two main themes emerged from the data: (1) administrative requirements for success: hosting international students requires careful planning and coordination, which is daunting amidst demanding faculty responsibilities. Externships must address experiences of the people directly involved in the clinical setting, leadership, communication, and institutional, financial, physical, and personnel resources. (2) Impact of student qualities: When working with international students, the importance of administrative details and student characteristics increases due to higher student variability overall, inconsistent language and cultural fluency, and the consequent recognition of the student as an ambassador for their home institution and country. CONCLUSIONS: Amidst already busy schedules, clinician educators identify the hosting of international medical students as a commitment resembling that for their own trainees. Linguistic and cultural distances, and the overall variability of international students amplify the importance of effective administration. The findings have influenced related processes at the University of Pittsburgh.

The Status of Food and Nutrition Literacy and its determinants among Elementary School students in Egypt: community nursing-led design.

AIM: To assess food and nutrition literacy status and its determinants among elementary school students in El-Beheira Governorate, Egypt. BACKGROUND: Developing strategies to enhance food and nutrition literacy necessitates a deeper understanding of the food and nutrition literacy situation among elementary school students and associated factors. DESIGN: A cross-sectional descriptive research design was adopted. METHODS: A final sample of 400 primary school students (aged 6-12 years) at Itay El Barud public elementary schools in El-Beheira Governorate were administered (1) a socio-demographic characteristics and anthropometric measurements questionnaire developed by the researchers, and (2) the Food and Nutrition Literacy Scale. The derived data were analyzed using descriptive and non-parametric tests. RESULTS: The majority (61%) of students had low food and nutrition literacy scores. The results have shown that overall socio-demographic variables were significant in predicting understanding food and nutrition information, nutritional health knowledge, interactive functional and nutritional literacy, critical food and nutritional literacy, and food labeling. CONCLUSION: The study reveals that elementary school students in Egypt have poor knowledge and skills in food and nutrition literacy, largely due to a lack of nutrition education and family awareness. Factors like residential location, income, and education level also contribute to this disparity. IMPLICATIONS FOR THE PROFESSION: To improve nutrition literacy among students, a nursing approach involving community stakeholders and school nurses is recommended. This includes integrating nutrition-related topics into the school curriculum, organizing workshops, and conducting age-appropriate health education sessions. Active engagement between community health and school nurses is crucial for raising awareness about healthy nutritional choices. IMPACT: These findings hold an important impact on the education system and those designing curricula, emphasizing the need for significant incorporation of knowledge and skills related to food and nutrition within schools. REPORTING METHOD: Compliance with the STROBE checklist for cross-sectional studies was maintained throughout the research. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Developmental trajectories of students' beliefs about social success: Differences between students with and without a middle school transition.

INTRODUCTION: Attaining social success is a significant concern during early adolescence. The characteristics that youth believe will bring social success are known to change over time and vary across contexts, especially over the transition to middle school. METHODS: The analytic sample included 614 students (52% girls, 48% boys; 53% Black, 47% White) from the Midwestern United States. At yearly intervals during grades 6-8, participants completed self-report surveys assessing their endorsement of five characteristics (sincerity, academic responsibility, dominance, disingenuity, athleticism/attractiveness) that described peers in their grade who have lots of friends and get along well with others (i.e., social success). The sample included students who attended the same school from kindergarten-eighth grade (K8) and students who made a transition from an elementary to a middle school after 6th grade (ESMS). RESULTS: Multigroup longitudinal growth models revealed some concerning trends over time. For both ESMS and K8 students, their endorsement of sincerity decreased, their endorsement of disingenuity increased, and their endorsement of athleticism/attractiveness was high and stable. ESMS students' endorsement of academic responsibility decreased over time and their endorsement of dominance showed increasing trends. K8 students' endorsements of academic responsibility and dominance were stable. However, across contexts, compared to the other characteristics, sincerity was most often ranked the highest. CONCLUSIONS: The findings highlight that some changes in students' beliefs about social success may be unique to students who experience a school transition whereas others may be developmentally normative. Implications for the education of young adolescent students are discussed.

Socio-demographic and other factors contributing to excessive leisure screen time in preadolescent children.

OBJECTIVES: Excessive screen use in early school age is associated with worsened health habits and negative child development in later age. We aimed to assess the time spent on modern and traditional screen-based devices and examine its associations with socio-demographic characteristics. METHODS: This population-based cross-sectional observation study was conducted in Czechia, Slovakia and Finland between April and June 2021. Participants (N = 1,915) were parents/caregivers of children attending elementary school grades 1 to 3, selected by stratified random sampling. Children's daily leisure screen time (LST) based on parental reports was the main outcome. Descriptive statistics, mean comparison and linear regression analysis were used for the analysis. RESULTS: The average daily LST was found to be as high as 3.5 hours and significantly associated with most socio-demographic variables. Eighty percent of children exceeded the threshold of two hours of LST per day, which was formerly introduced by the American Academy of Pediatrics. The most important predictor of LST in children was having their screen-based device(s) for their exclusive personal use (EPU). Linear regression with all predictors assessed together confirmed the significant effect of the screen-based devices' EPU, the child's sex and grade, the child's birth order and the parent's education, even when controlled for media parenting practices. CONCLUSIONS: Given the widespread availability of smartphones for exclusive personal use among young children, the regulation of EPU and the reinforcement of effective media parenting practices, particularly in families with lower education and income, are critical public health strategies to mitigate the negative impact of excessive screen time on child development and overall well-being.

Developing an initial explanatory theory for Partnering for Change using realist evaluation.

INTRODUCTION: Partnering for Change (P4C) is an innovative practice model for school-based occupational therapy developed in Canada and informed by a program of research spanning nearly two decades. National and international interest in P4C necessitated development of an explanatory theory to guide implementation in varied contexts. The purpose of this study is to document the process of theory development and to provide an overview of the initial P4C explanatory theory. METHODS: Realist evaluation was used to construct an initial explanatory theory of P4C drawing on P4C developers' conceptualisations of the model, document analysis, and analysis of transcripts from interviews and focus groups. CONSUMER AND COMMUNITY INVOLVEMENT: No consumers were involved in the study design or analysis. FINDINGS: Four sets of premises expressed as context-mechanism-outcome configurations (CMOCs) comprise the initial explanatory theory of P4C. An abstracted summary of these four sets along with contexts, mechanisms, and outcomes central to the P4C initial explanatory theory is presented. An exemplar CMOC is shared to illustrate how theoretical premises are developed and expressed using realist evaluation. CONCLUSION: This study advances knowledge regarding the hypothesised core elements of P4C and provides an example of using realist evaluation to advance knowledge in occupational therapy. Preliminary implications for clinical practice are discussed. PLAIN LANGUAGE SUMMARY: Partnering for Change (P4C) is a way of providing occupational therapy services in schools that helps all children to learn and participate successfully. P4C was created in Ontario, Canada, and has been researched for almost 20 years. People in different parts of Canada and other countries are interested in trying P4C. As the researchers who created P4C, we think there is a need to explain how it works so it can be used in different places. This study explains how we created a theory to describe P4C. To develop this theory, we used a method called realist evaluation that would help us explain how, why, and in what situations P4C works best. To do this, we analysed documents and transcripts of interviews and focus groups. Our findings are organised into four main ideas, each explained in terms of contexts (the situations), mechanisms (how and why P4C works), and outcomes (the impacts of P4C). One detailed example is given to show how these ideas were formed and work together. In conclusion, our study helps us understand the key parts of P4C and shows how realist evaluation can be used to improve knowledge in occupational therapy. The study also suggests some early ideas on how P4C can be used in practice.