Health improvement and educational attainment in secondary schools: complementary or competing priorities? Exploratory analyses from the School Health Research Network in Wales

Background. Implementing health improvement is often perceived as diverting resource away from schools’ core business, reflecting an assumption of a “zero-sum game” between health and education. There is some evidence that health behaviors may affect young people’s educational outcomes. However, associations between implementation of school health improvement and educational outcomes remains underinvestigated. Methods. The study linked school-level data on free school meal (FSM) entitlement, educational outcomes, and school attendance, obtained from government websites, with data from the School Environment Questionnaire (SEQ) on health improvement activity collected in Wales (2015/2016). Spearman’s rank correlation coefficients and linear regression models tested the extent of association between health improvement activity and attendance and educational outcomes. Results. SEQ data were provided by 100/115 network schools (87%), of whom data on educational performance were obtained from 97. The percentage of pupils entitled to FSM predicted most of the between-school variance in achievement and attendance. Linear regression models demonstrated significant positive associations of all measures of health improvement activity with attainment at Key Stage (KS) 3, apart from mental health education in the curriculum and organizational commitment to health. Student and parent involvement in planning health activities were associated with improved school attendance. There were no significant associations between health improvement and KS4 attainment. Conclusion. Implementing health improvement activity does not have a detrimental effect on schools’ educational performance. There is tentative evidence of the reverse, with better educational outcomes in schools with more extensive health improvement policies and practices. Further research should investigate processes by which this occurs and variations by socioeconomic status

Testing the ‘zero-sum game’ hypothesis: An examination of school health policies and practices and inequalities in educational outcomes

Background There is recognition that health and education are intrinsically linked through, for example, WHO's Health Promoting Schools (HPS) framework. Nevertheless, promoting health via schools is seen by some as a zero-sum game—ie, schools have nothing to gain, and may experience detriments to the core business of academic attainment because of focusing resources on health. Crucially, there is a paucity of evidence around the impacts of health and wellbeing policy and practice on attainment, with recent Cochrane reviews highlighting this gap. This study explored the zero-sum game hypothesis among schools with varying levels of deprivation—ie, the role of health and wellbeing interventions in schools in reducing or widening socioeconomic inequality in educational attainment. Methods Wales-wide, school-level survey data on health policies and practices, reflective of the HPS framework, were captured in 2016 using the School Environment Questionnaire. Questionnaire data were linked with routinely collected data on academic attainment. Primary outcomes included attendance and attainment at Key stages 3 (children aged 12–14 years) and 4 (15–16). Interaction terms were fitted to test whether there was an interaction between free school meals, overall HPS activity, and outcomes. Linear regression models were constructed separately for schools with high uptake of free school meals (>15% of pupils) and low uptake (<15%), adjusting for confounders. Findings The final analyses included 48 schools with low uptake of free school meals and 49 with high uptake. Significant interactions were observed between free school meals and overall HPS activity for Key stage 3 attainment (β=0·28, 95% CI 0·09–0·47) and attendance (0·05, 0·02–0·09), reflecting an association between health improvement activities and education outcomes among high, but not low, free school meal schools. There was no significant interaction for Key stage 4 attainment (0·18, −0·22 to 0·57). Interpretation Our findings did not support the zero-sum game hypothesis; in fact, among more deprived schools, there was a tendency for better attendance and attainment at Key stage 3. Schools must equip students with the skills required for good physical and mental health and wellbeing in addition to academic and cognitive skills. The study included a large, nationally representative sample of secondary schools; however, the cross-sectional nature has implications for causality

Lower Limb Muscle Activation in Young Adults Walking in Water and on Land

Previous research has shown that exercise interventions requiring increased activation of the tibialis anterior (TA), the primary ankle dorsiflexor, can improve walking performance in individuals with foot drop. Correspondingly, heightened drag forces experienced during walking performed in water may augment TA activation during the swing phase of gait, potentially leading to improved walking gait on land. Therefore, this study aimed to compare surface electromyographic (sEMG) activation in the TA and medial gastrocnemius (GM) during gait performed in water versus on land. Thirty-eight healthy, recreationally active young adults, comprising 18 females and 20 males, participated in the study. Each participant completed 2 min walking trials under five conditions: land 2.5 mph, land 3.5 mph, water 2.5 mph, water 3.5 mph, and water 3.5 mph with added jet resistance. Stride kinematics were collected using 2-dimensional underwater motion capture. TA and GM, muscle activation magnitudes, were quantified using sEMG root-mean-square (RMS) amplitudes for both the swing and stance phases of walking. Additionally, TA and GM co-activation (Co-A) indices were estimated. Two-way within-subjects repeated measures analyses of variance were used to evaluate the main effects of and interactions between the environment and walking speed. Additionally, paired sample t-tests were conducted as a secondary analysis to investigate differences between walking in water at 3.5 mph with and without added jet resistance. Main effects and interactions were observed across various stride kinematics and sEMG measures. Notably, TA sEMG RMS during the swing phase of walking gait performed at 2.5 mph was 15% greater in water than on land (p \u3c 0.001). This effect increased when walking gait was performed at 3.5 mph (94%; p \u3c 0.001) and when jet resistance was added to the 3.5 mph condition (52%; p \u3c 0.001). Furthermore, TA Co-A was increased during the stance phase of gait in water compared to on land (p \u3c 0.001), while GM Co-A was reduced during the swing phase (p \u3c 0.001). The findings of this study offer compelling evidence supporting the efficacy of aquatic treadmill walking as a potential treatment for individuals suffering from foot drop. However, further research is needed to evaluate whether a causal relationship exists between heightened TA activation observed during aquatic treadmill walking and improvements in voluntary dorsiflexion during gait

Mosaic Amplification of Multiple Receptor Tyrosine Kinase Genes in Glioblastoma

SummaryTumor heterogeneity has been implicated in tumor growth and progression as well as resistance to therapy. We present an example of genetic heterogeneity in human malignant brain tumors in which multiple closely related driver genes are amplified and activated simultaneously in adjacent intermingled cells. We have observed up to three different receptor tyrosine kinases (EGFR, MET, PDGFRA) amplified in single tumors in different cells in a mutually exclusive fashion. Each subpopulation was actively dividing, and the genetic changes resulted in protein production, and coexisting subpopulations shared common early genetic mutations indicating their derivation from a single precursor cell. The stable coexistence of different clones within the same tumor will have important clinical implications for tumor resistance to targeted therapies

Testing the 'zero-sum game' hypothesis: An examination of school health policy and practice and inequalities in educational outcomes

Background: There is recognition that health and education are intrinsically linked, through for example the World Health Organizations' Health Promoting Schools' (HPS) framework. Nevertheless, promoting health via schools is seen by some as a 'zero-sum game'; that is, schools have nothing to gain, and in fact may experience detriments to the core business of academic attainment as a result of focussing resources on health. Crucially, there is a paucity of evidence around the impacts of health and well-being policy and practice on attainment, with recent Cochrane reviews highlighting this gap. This study explored the 'zero-sum game' hypothesis among schools with varying levels of deprivation; that is, the role of health and wellbeing interventions in schools in reducing, or widening, socioeconomic inequality in educational attainment. Methods: Wales-wide, school-level survey data on health policies and practices, reflective of the HPS framework, were captured in 2016 using the School Environment Questionnaire (SEQ). SEQ data were linked with routinely collected data on academic attainment. Primary outcomes included attendance and attainment at Key Stages 3 and 4. Interaction terms were fitted to test whether there was an interaction between FSM,overall HPS activity, and outcomes. Linear regression models were constructed separately for high (>15% of pupils) and low (<15%) Free School Meal (FSM) schools, adjusting for confounders. Findings: The final analyses included 48 low and 49 high FSM secondary schools. Significant interactions were observed between FSM and overall HPS for KS3 attainment (b=0.28; 95% CI: 0.09, 0.47) and attendance(b=0.05; 95% CI: 0.02, 0.09), reflecting an association between health improvement activities and education outcomes among high, but not low FSM schools. There was no significant interaction for KS4 attainment (b=0.18; 95% CI: -0.22, 0.57).Interpretation: Our findings did not support the 'zero-sum game' hypothesis; in fact, among more deprived schools, there was a tendency for better attendance and attainment at Key Stage 3. Schools must equip students with the skills required for good physical, mental health and well-being in addition to academic and cognitive skills. The study included a large, nationally representative sample of secondary schools;however, the cross-sectional nature has implications for causality

Dating and relationship violence victimization and perpetration among 11–16 year olds in Wales: a cross-sectional analysis of the School Health Research Network (SHRN) survey

Background This study examines the prevalence of dating and relationship violence (DRV) victimization, perpetration and joint victimization and perpetration, and associations between DRV and socio-demographic characteristics. Methods Cross-sectional self-report data from 74 908 students aged 11–16 from 193 schools across Wales were collected and analysed using generalized estimating equations to examine prevalence and predictors of emotional and physical DRV victimization, perpetration and joint victimization and perpetration. Results More girls reported emotional victimization (28%) and perpetration (18%) than boys (20% and 16%, respectively). More girls (8%) than boys (7%) reported physical perpetration. However, boys (17%) reported more physical victimization than girls (12%). Age-related trajectories of DRV victimization and perpetration were stronger in girls than in boys. Students from single or step parent homes, those in care, and certain ethnic minority groups had increased odds of DRV. No association was found between socioeconomic status and DRV. Conclusions Age-related trajectories and the lack of social patterning by socioeconomic status point to the value of early, universal interventions, while some evidence of ethnic patterning and family structure-related risk factors suggest areas for further research and targeted interventions. DRV continues to be a major public health problem for which little UK-specific intervention evidence exists

Nurses Alumni Association Bulletin, Fall 1995

1995-1996 Meeting Dates Calendar 1996 Annual Luncheon-Meeting Notice Officers and Committee Chairs Bulletin Publication Committee 1995-1996 Meeting Dates Calendar The President\u27s Message Financial Report What\u27s New Fiftieth Anniversary Resume of Minutes of Alumni Association Meetings Scholarship Funds at Work CAHS Alumni Board/Diploma School Alumni Office News Jefferson Health System Oldest Veteran Dies 1OOth Anniversary Pearl Harbor Remembered Memories Janet Hindson Retires Happy Birthday Scholarship Fund donors for 1994 Committee Reports By-Laws Development Bulletin Relief Fund Satellite Social Scholarship In Memoriam, Names of Deceased Graduates Class News Luncheon Photos Jefferson Alumni Identification Card The Diploma School of Nursing Alumni Association-Mabel C. Prevost Letter of Appreciation Tribute To a Mother An End Must Come Stuff For Senior Citizens to Chuckle Over Membership Application Relief Fund Application To Order: A Chronological History and Alumni Directory From TJU Bookstore Scholarship Fund Application Pins, Transcripts, Class Address List, Change of Address Forms, Alumni Identification Card Campus Map Picture - Class of 1893-189

In-reach specialist nursing teams for residential care homes : uptake of services, impact on care provision and cost-effectiveness

Background: A joint NHS-Local Authority initiative in England designed to provide a dedicated nursing and physiotherapy in-reach team (IRT) to four residential care homes has been evaluated.The IRT supported 131 residents and maintained 15 'virtual' beds for specialist nursing in these care homes. Methods: Data captured prospectively (July 2005 to June 2007) included: numbers of referrals; reason for referral; outcome (e.g. admission to IRT bed, short-term IRT support); length of stay in IRT; prevented hospital admissions; early hospital discharges; avoided nursing home transfers; and detection of unrecognised illnesses. An economic analysis was undertaken. Results: 733 referrals were made during the 2 years (range 0.5 to 13.0 per resident per annum)resulting in a total of 6,528 visits. Two thirds of referrals aimed at maintaining the resident's independence in the care home. According to expert panel assessment, 197 hospital admissions were averted over the period; 20 early discharges facilitated; and 28 resident transfers to a nursing home prevented. Detection of previously unrecognised illnesses accounted for a high number of visits. Investment in IRT equalled £44.38 per resident per week. Savings through reduced hospital admissions, early discharges, delayed transfers to nursing homes, and identification of previously unrecognised illnesses are conservatively estimated to produce a final reduction in care cost of £6.33 per resident per week. A sensitivity analysis indicates this figure might range from a weekly overall saving of £36.90 per resident to a 'worst case' estimate of £2.70 extra expenditure per resident per week. Evaluation early in implementation may underestimate some cost-saving activities and greater savings may emerge over a longer time period. Similarly, IRT costs may reduce over time due to the potential for refinement of team without major loss in effectiveness. Conclusion: Introduction of a specialist nursing in-reach team for residential homes is at least cost neutral and, in all probability, cost saving. Further benefits include development of new skills in the care home workforce and enhanced quality of care. Residents are enabled to stay in familiar surroundings rather than unnecessarily spending time in hospital or being transferred to a higher dependency nursing home setting

School, peer and family relationships and adolescent substance use, subjective wellbeing and mental health symptoms in Wales: a cross sectional study

Positive relationships with family, friends and school staff are consistently linked with health and wellbeing during adolescence, though fewer studies explore how these micro-systems interact to influence adolescent health. This study tests the independent and interacting roles of family, peer and school relationships in predicting substance use, subjective wellbeing and mental health symptoms among 11–16 year olds in Wales. It presents cross-sectional analyses of the 2013 Health Behaviour in School-aged Children survey, completed by 9055 young people aged 11–16 years. Multilevel logistic regression analyses are used to test associations of family communication, family support, relationships with school staff, school peer connectedness, and support from friends, with tobacco use, cannabis use, alcohol use, subjective wellbeing and mental health symptoms. Positive relationships with family and school staff were consistently associated with better outcomes. Support from friends was associated with higher use of all substances, while higher school peer connectedness was associated with better subjective wellbeing and mental health. Better relationships with school staff were most strongly associated with positive subjective wellbeing, and fewer mental health symptoms where pupils reported less family support. Support from friends was associated with higher cannabis use and worse mental health among pupils with lower family support. Relationships with family and school staff may be important in protecting young people against substance use, and improving wellbeing and mental health. Interventions focused on student-staff relationships may be important for young people with less family support. Interventions based on peer support should be mindful of potential harmful effects for pupils with less support from family