COVID-19 and Schools Closure: Implications for School Nurses

[Excerpt] We are in a complex and massive crisis. In December 2019, in Wuhan, China, a new coronavirus (SARS-CoV-2) has emerged in humans along with the associated disease COVID-19. The disease is already widespread in 213 countries with about 1.9 million cases reported by April 16, 2020. Most schools around the world have implemented physical isolation measures to prevent the spread of the infection and minimize the impact of the novel virus, while the effectiveness of school measures in coronavirus outbreaks is still unclear (Bayham & Fenichel, 2020; Viner et al., 2020). Evidence suggests that most children with COVID-19 have mild symptoms or are asymptomatic (Lu et al., 2020). In addition, 91% of students in the world (more than 1.5 billion) are out of school, deprived of face-to-face classes (The United Nations Educational, Scientific and Cultural Organization, 2020). Therefore, it seems clear that one of the greatest challenges from COVID-19 to children is outside health care settings. [...](undefined

Excesso de peso e obesidade em crianças: implementação e avaliação de um programa de intervenção na escola

Tese de doutoramento Estudos da Criança (área de especialização em Saúde Infantil)A investigação que aqui apresentamos estudou o impacte de um programa de intervenção, transmitido e intervencionado por professores com formação no âmbito da nutrição, na antropometria e consumo alimentar em crianças com idades compreendidas entre os 6 e os 12 anos de Guimarães. Participaram neste estudo randomizado quatrocentas e sessenta e quatro crianças de sete escolas primárias, três (cluster) das quais constituíram aleatoriamente o grupo de intervenção e quatro (cluster) o controlo. Desenvolvemos e implementámos um programa de intervenção entre Outubro de 2008 e Março de 2009 que incluiu formação para professores sobre ensino da alimentação saudável a crianças, de forma a que pudessem posteriormente, intervir como educadores junto das crianças. Os professores intervencionados tiveram doze sessões de formação de três horas cada ministradas quinzenalmente durante seis meses, cujos conteúdos foram os seguintes: nutrição e alimentação saudável (quatro sessões, doze horas); a importância da água (uma sessão, três horas); estratégias para potenciar o consumo de fruta e produtos hortícolas, bem como reduzir o consumo de alimentos de baixo valor nutricional e elevada densidade energética (três sessões, nove horas); estratégias para aumentar a atividade física (duas sessões, seis horas) e, atividades de culinária saudável (duas sessões, seis horas). Após cada sessão, os professores foram encorajados a desenvolver atividades com as crianças com base nos conteúdos abordados. A recolha de dados antropométricos, a avaliação alimentar e de atividade física, bem como o perfil sociodemográfico, foi concretizada nos grupos controlo e de intervenção antes e depois da implementação do programa. A investigação foi aprovada pelo conselho executivo das escolas onde decorreu, pela Comissão Nacional de Proteção de Dados, e foi registada no clinicaltrials.gov, NCT01397123. Os resultados mostram que ao longo do tempo: I) o aumento médio do IMC (z-score) das crianças do grupo de intervenção, foi significativamente inferior ao do grupo controlo, após ajuste para confundidores. Em consonância, a incidência do excesso de peso foi significativamente inferior no grupo de intervenção comparativamente com o controlo. II) Avaliada a ingestão alimentar, o consumo de produtos hortícolas (total e de folha verde), fruta (total) e, fruta e produtos hortícolas foi significativamente superior no grupo de intervenção em relação ao controlo. A magnitude do efeito (effect sizes) do programa variou de baixo (cohen´s d=0.12 em “outros vegetais”) a médio (0.56 em “Fruta e vegetais”). III) A ingestão de alimentos sólidos de baixo valor nutricional e elevada densidade energética diminuiu no grupo de intervenção e aumentou no controlo. Esta diferença é significativa após ajuste para confundidores. Salientamos a eficácia do programa de intervenção na antropometria e consumo alimentar em crianças e mais investigação será necessária para saber se estes resultados podem ser reproduzidos ou melhorados, e eventualmente disseminados a outras escolas deste e de outros distritos escolares. A elevada prevalência do excesso de peso e obesidade observada na faixa etária em estudo interroga-nos sobre a necessidade de se intervir em idades inferiores a 6 anos. Em conclusão, o nosso programa e o envolvimento dos professores numa intervenção de educação alimentar com as crianças, apresenta resultados positivos no controlo do excesso de peso e na exibição de um consumo alimentar mais favorável à prevenção da obesidade.The research presented here studied the impact of an intervention program, delivered and taught by trained teachers in nutrition, on anthropometry and dietary intake in children aged 6 to 12 years of Guimarães. Four hundred and sixty four children participated in this randomized trial, from seven elementary schools. Three of them (cluster) were randomly selected to intervention and four (cluster) to control group. We developed an intervention program between October 2008 and March 2009, which was implemented over two terms with teachers training delivered by researchers and an intervention delivered by trained teachers to children. Intervened teachers had twelve sessions of three hours each biweekly along six monthts, in accordance with the following contents: nutrition and healthy eating for children and families (four sessions, twelve hours); the importance of water (one session, three hours); strategies to enhance fruit and vegetable consumption and reduce low-nutrition energy-dense foods (three sessions, nine hours); strategies to increase physical activity (two sessions, six hours); and healthy cooking activities (two sessions, six hours). After each session, teachers delivered the learnt contents and developed creative and engaging classroom activities about the addressed topic. Sociodemographic, anthropometric, dietary, and physical activity assessments were performed to control and intervention´s schools before and after the implementation of the program. The study was approved by the schools where it was carried, by the Portuguese Data Protection Authority and it was registered in the clinical trials registry clinicaltrials.gov, NCT01397123. The results show that throughout time: I) The mean increase in BMI (z-score) in children in the intervention group was significantly lower than in the control group, when adjusted for confounders. The incidence of overweight was significantly lower in the intervention group compared to the control. II) After assessing the dietary habits, the consumption of vegetables (total and green leaf), fruit (total) and fruit and vegetables was significantly higher in the intervention group compared to control. The effect sizes of the differences between intervention and control groups ranged between small (cohen´s d=0.12 on “other vegetables”) to medium (0.56 on “Fruit and vegetables”). III) Consumption of low-nutrition energy-dense solid foods decreased in the intervention group and increased in the control group. This difference is significant after adjusting for confounders. We emphasize the effectiveness of the intervention program on children food intake and anthropometry and we believe that more research is needed to find out if these results can be repeated or improved and evenly disseminated to other schools from this or others districts. Given the already high prevalence of overweight in children with this age, prevention programs should begin earlier than 6 years. In conclusion, our program and the involvement of classroom teachers in a nutrition education intervention with children, had positive results in overweight control and in the consumption of foods which are able to prevent obesity

Editorial: Dietary intake, eating behavior and health outcomes

[Excerpt] Dietary intake and eating behaviors are important determinants of non-communicable diseases (NCDs) and have been widely investigated (1). The association between dietary intakes (e.g., fruits, vegetables, processed meat, and trans-fat) and NCDs (e.g., obesity, cardiovascular diseases (CVD), diabetes, and cancer) have been described. The associations varied by socioeconomic and the burden differed by demographic conditions (2, 3). Nevertheless, due to the complexity of measuring exposures related to dietary intake, the evidence base is mainly observational and lacking experimental designs. Additionally, there is scant evidence on the effectiveness of health promotion strategies focusing dietary consumption and behavior, on health outcomes. Bring in mind the complexity of studying dietary intake and its effects in health, the Frontiers in Nutrition dedicated a specific topic to Dietary intake, eating behavior and health outcomes. A total of 105 studies were submitted with 35 being selected for publication after peer-review. [...]- (undefined

Reopening ECEC services for children under three amidst the pandemic: investigating the association of health measures with pedagogical practices and children's well-being

In Portugal, early childhood education and care services for children under-three were the first educational services to reopen after periods of lockdown. COVID-19 prevention and control measures had to be implemented nationwide, but no knowledge was yet produced on their impact in educational settings. This study aimed to map the implementation of COVID-19 prevention and control measures and examine associations among prevention and control measures, perceived changes to pedagogical practices and children's well-being in early childhood education and care services for children under three. In this study, 1098 early childhood education and care professionals from all districts completed an online survey during January and February 2021. Results indicated that prevention and control measures were widely implemented. Furthermore, early childhood education and care professionals who started to implement prevention and control measures more frequently were more likely to perceive a reinforcement of their pedagogical practices at the level of adult-child interaction, emotional climate, and interaction with families, and reported higher levels of children's well-being. Findings highlighted the potential role of pedagogical practices in mitigating the effects of COVID-19 in early childhood education and care services for children under-three.Open access funding provided by FCT vertical bar FCCN (b-on). This work was supported by the Social Observatory of "la Caixa" Foundation under Grant number LL20-03. The inED is funded by National Funds through the FCT - Fundacao para a Ciencia e a Tecnologia, I.P., under the scope of the project UIDP/05198/2020

Impacto de um programa de atividade física na saúde da grávida e do recém-nascido

A importância da criação de hábitos de vida saudáveis durante a gravidez é atualmente um facto indiscutível na melhoria da saúde quer da grávida quer do recém-nascido. Tendo em atenção que a prática de atividade física tende a diminuir durante a gravidez, torna-se essencial informar e incentivar as grávidas a adquirirem estilos de vida saudáveis, que lhes permitam melhorar o seu bem-estar físico e psicológico. Neste contexto, o principal objetivo deste estudo é avaliar o impacto de um programa de atividade física dirigido a grávidas no ganho de peso gestacional, sintomatologia depressiva e na composição corporal do recém-nascido. O estudo será realizado com cerca de 400 grávidas do concelho de Guimarães, que através do hospital ou centros de saúde serão informadas e convidadas a participar no projeto. As grávidas que não possuam qualquer contraindicação médica ou obstétrica para a prática de exercício físico e que consintam a sua participação serão divididas aleatoriamente pelos grupos de controlo e intervenção. Ao grupo de intervenção será aplicado um programa específico de atividade física e ao grupo de controlo serão dadas as informações básicas que normalmente são disponibilizadas pelos profissionais de saúde. A recolha de dados será realizada em 2 momentos: Etapa 1 (3 meses de gestação) e Etapa 2 (pós-parto). Será avaliado o perfil sociodemográfico através de questionário, a anamnese por análise da informação clínica, a antropometria da grávida e do recém-nascido pelos investigadores através de procedimentos internacionalmente aceites, o nível de atividade física pelo Pregnancy Physical Activity Questionnaire e acelerometria e a sintomatologia depressiva através do Edinburgh Postnatal Depression Scale. Com este programa, espera-se contribuir com evidência para a melhor prática no âmbito de intervenções dirigidas a grávidas e com impacto na saúde da díade mãe e recém-nascido.CIEC - Centro de Investigação em Estudos da Criança, IE, UM (UI 317 da FCT

Monitoring weight and physical activity using an amI setting

We have an increasingly sedentary population without the care to make a healthy diet. Therefore, it becomes necessary to give the population the opportunity, despite living a very busy and tiring life, to have control over important aspects to their health. This work aims to present a model of an ambient intelligence system for monitoring the weight and physical activity in active individuals. To accomplish this objective we have developed a mobile application that allows users to monitor their weight over a period of time, identify the amount of food they consume and the amount of exercise they practice. This mobile application will give information to users about dietary and physical activity guidelines in order to improve their lifestyles. It is expected that students improve their lifestyles.(undefined

Association between health and levels of health literacy in 13- to 16-year-old adolescents during the COVID-19 pandemic: the case of Lebanon

The study assessed health literacy (HL) in Lebanese adolescents and its associations with health during the COVID-19 pandemic. A sample of 228 adolescents (63.1% female), 15.5 ± 1.5 years, took the survey. Data was collected between May and September 2020. The questionnaire consisted of the Health Literacy for School-Aged Children (HLSAC) scale, the Generalized Anxiety Disorder (GAD-7) assessment, sociodemographic characteristics, and health-related variables. Around 84.6% had low to moderate HL. Adolescents with moderate HL were more likely to spend more than 2 hours on sedentary behavior (OR = 0.3, 95% CI [0.1, 0.9]) and smoke (OR = 0.3, 95% CI [0.1, 0.8]). Adolescents with high HL had lower odds of having moderate to severe anxiety (OR = 0.2, 95% CI [0.1, 0.8]) and excess body weight (OR = 0.1, 95% CI [0.4, 0.5]). Adolescents with high HL had higher odds of having good to excellent health (OR = 1.2, 95% CI [0.4, 3.7]). Interventions to strengthen HL must be implemented with a focus on at-risk adolescents.- (undefined

Roles of the interaction with children and families in mediating the association between digital health literacy and well-being of early childhood teachers in Portugal: A cross-sectional study

Data Availability Statement: All DHL descriptive files are available from the https://doi.org/10.34622/datarepositorium/LF7URM.AIM: To analyze the associations between early childhood education (ECE) teachers´ digital health literacy (DHL) and well-being, and to determine whether the ECE teachers´ interaction with children and family mediated these associations. METHODS: A total of 853 early childhood teachers, predominantly women (99.4%) participated in this cross-sectional study. The participants had a mean age of 39.9 years (standard deviation SD = 8.2). Data was collected through an online survey. DHL was assessed using five subscales adapted to the new coronavirus context, and the professionals´ well-being was measured using the WHO-5 well-being scale. Binary logistic regression and mediation analysis were used to analyze the data. RESULTS: ECE teachers' DHL in dimensions of "information searching" and "determining relevance" had both direct and indirect effect on their well-being. Specifically, higher DHL in these dimensions was associated with better well-being. The dimension "evaluating reliability" had an indirect positive effect on well-being by promoting interaction with children. CONCLUSION: These findings suggest that improving ECE teachers´ DHL could have a positive effect on their well-being and their interactions with children. Therefore, it is recommended to develop health promotion practices aimed at enhancing DHL among ECE teachers. Additionally, integrating DHL contents and competencies more prominently into the qualification, further education and training of ECE teachers may help equip them with the necessary skills to access and apply health information effectively. This, in turn, can enhance interactions with children and contribute to their overall well-being.This study was supported by Fundación la Caixa-Social Research Call Covid-19 LL20-3. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Estilos de vida saudáveis na escola: um Programa de Educação e Formação de Professores

A prevalência do excesso de peso e obesidade continua a aumentar e a assumir dimensões preocupantes em Portugal e no mundo. Este problema de saúde tem sérias implicações na vida das crianças, na medida em que está associado à asma, diabetes tipo II, patologia cardiovascular, hepática e vesicular, bem como estigma e outros problemas de saúde. São múltiplos e complexos os fatores que concorrem para o ganho de peso, contudo, o estado ponderal é, em larga medida, regulado pela energia ingerida e gasta pelo organismo ao longo do dia e no decorrer do tempo. A atualidade é caracterizada por um ambiente promotor de sedentarismo, as escolas potenciam o número de horas de teoria em detrimento da expressão física e motora. Os canais televisivos e os jogos eletrónicos estão a ocupar as atividades de lazer das crianças. Neste contexto, é premente a implementação de programas de intervenção eficazes, principalmente em crianças, com o objetivo de melhorar os seus hábitos alimentares e de atividade, bem como o seu estado ponderal. Entretanto, são escassos os estudos que incluem e reconhecem o programa de intervenção para prevenir a obesidade infantil, dinamizado pelo professor, integrado na sua própria progressão da carreira docente. O objetivo deste capítulo é descrever o programa de educação e formação de professores que foi desenvolvido de forma detalhada, por entendermos que ele é essencial para quem o pretenda replicar em outros estudos. A educação e formação de professores, “materializada” na ação de formação Estilos de vida Saudáveis, engloba sessões no âmbito da nutrição, alimentação e atividade física, promoção do consumo de fruta e produtos hortícolas, bem como redução da ingestão de alimentos de baixo valor nutricional e elevada densidade energética. No final de cada sessão, os docentes implementam ações, baseados nos conhecimentos e competências desenvolvidos (intervenção), junto das crianças da turma do ensino básico do 1º ciclo da sua responsabilidade.Apoio financeiro do CIEC (Centro de Investigação em Estudos da Criança, IE, UMinho; UI 317 da FCT, Portugal) através do Projeto Estratégico UID/CED/00317/2013, financiado através dos Fundos Nacionais da FCT (Fundação para a Ciência e a Tecnologia), cofinanciado pelo Fundo Europeu de Desenvolvimento Regional (FEDER) através do COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) com a referência POCI-01-0145-FEDER-007562info:eu-repo/semantics/publishedVersio