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HEALTH RISKS SCHOOL HEALTH PROMOTION

HEALTH RISKS SCHOOL HEALTH PROMOTION. Dagmar Schneidrová Dep. of Child and Youth Health 3rd Faculty of Medicine Charles University in Prague. School stress. Interaction between demands put on a child and his/her capacity to cope with demands Demands intensity

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HEALTH RISKS SCHOOL HEALTH PROMOTION

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  1. HEALTH RISKSSCHOOL HEALTH PROMOTION Dagmar Schneidrová Dep. of Child and Youth Health 3rd Faculty of Medicine Charles University in Prague

  2. School stress Interaction between demands put on a child and his/her capacity to copewith demands Demands intensity duration Capacity to copewith demands inborn preconditions learned skills and experience Conditions of the school environment

  3. Eustress - Distress • Eustress (positive stress) School demands are adequate to the capacity of the child to master them • Distress (negative stress) School demands are inadequate (higher or lower) than the capacity of the child

  4. Sources of stress Personality of a child Learning process Personality of a teacher Social role of a student School as an institution Family attitudes to education, school

  5. Personality of a child • Development (school readiness) • Personality and intellectual capacity • Health handicap (sensory, physical, mental) • Learning disorders (e.g. dyslexia, ADHD) • Behaviour disorders (e.g. bullying)

  6. School readiness SR is an important precondition for effective school functioning. SR is evaluated at the 5th year (pediatric preventive examination). SR is assessed at different levels of functioning: • Physical (growth charts, physical, auditory, vision examination); • Cognitive (Jirasek screening test - figure drawing test, copying a sentence, a figure); • Verbal fluency and capacity (screening interview); • Social and emotional (observation, interview with the child, parent, teacher). Delay in the development may require postponing school attendance and specific interventions (educational, psychological, etc.).

  7. Learning process • Content of instruction amount of knowledge comprehensibility, logic link up • Form of instruction sustained concentration time pressure induced rhythm of work length and form of recreation daily, weekly changes in efficiency

  8. Teacher´s personality • demands vs. capacity of students • evaluation of students (competitive vs. collaborative environment) • relationships, support of students • psychodiagnostic skills • stress management skills

  9. WHO (HBSC, 2004)

  10. Social relationships at school • schortcomings in communication • shortcomings in behaviour • unjust treatment • aggressive behaviour • bullying

  11. WHO (HBSC, 2004)

  12. School - institution • conditions for school work organisation, equipment indoor environment • conditions for leisure time activities • communication between school and parents

  13. Parents attitudes towards education • inappropriate demands age capacity health status of a child • lack of time • lack of concern, support

  14. Parents concern about school problems of their children % Encouraging 87,4 Helping 78,9 Communicating with teachers 61,0 Rewarding 32,8 Punishing 8,2 Putting high demands 32,9 Not interested 6,0

  15. WHO International SurveyHealth Behaviour in School-aged Children(HBSC) 2001/2002 HBSC survey in 35 countries in the WHO European Region and North America 2002/2004 survey in the Czech Republic: 5187 children - 11, 13, 15 years old 80 randomly selected elementary schools

  16. WHO questionnaire • Socioeconomic data, conditions • school environment, workload • leisure time • family • nutrition, eating habits • harmful behaviour • satisfaction with life • health and psychosomatic status

  17. Subjective evaluation • Concern of the family • Relationship to school • Relationships among peers • Teachers behaviour • Mood and emotions in last months

  18. Morning fatigue once a week or more boys % girls % 11 years 32,7 31,0 13 years 33,7 32,4 15 years 39,1 32,5

  19. Physical and mental symptoms x subjective perceptions Feelings of satisfaction exclusion helplessness Headache - *** +*** +*** Stomachache - *** +*** +*** Backache - *** +*** +*** Feeling down - *** +*** +*** nervous - *** +*** +*** tense - *** +*** +*** Sleeping problems - ** +*** +*** Weariness - *** +*** +***

  20. Using medicaments in the last month (%) head stomach sleep nervousness ache ache problems tension Boys 11 years 26,1 18,1 11,4 13,4 13 years 21,8 11,2 4,5 7,1 15 years 22,2 8,0 3,4 4,1 Girls 11 years 26,8 17,9 8,5 12,2 13 years 31,5 21,2 6,8 7,4 15 years 36,6 35,2 3,7 7,8

  21. CONSEQUENCES OF SCHOOL STRESS LOSS OF MOTIVATION FOR SCHOOL WORK LOW ACHIEVEMENT, SCHOOL FAILURE LOW SELF-CONFIDENCE SENSITIVITY TO EVALUATION FEELINGS OF EXCLUSION, HELPLESSNESS SCHOOL AVOIDANCE (ANXIETY, PHOBIA) BEHAVIOURAL DISORDERS (MISBEHAVIOUR) HEALTH PROBLEMS

  22. HEALTH PROBLEMS RECURRENT RESPIRATORY INFECTIONS AND COMPLICATIONS STOMACHACHE, NAUSEA, VOMITING HEADACHE, BACKACHE, ILL POSTURE HIGH BLOOD PRESSURE DISORDERS OF TERMOREGULATION FATIGUE EATING DISORDERS SLEEPING DISORDERS, NIGHTMARES, ENURESIS TICS, STUTTERING DISORDERS OF CONCENTRATION, MEMORY, INEFFICIENCY IRRITABILITY, RESTLESSNESS, IMPULSIVE AND AGGRESSIVE BEHAVIOUR ISOLATION, APATHY, PASSIVE BEHAVIOUR SCHOOL, SOCIAL ANXIETY, DEPRESSION LACK OF SOCIAL SKILLS RISK TAKING BEHAVIOUR IN PEER GROUPS (SMOKING, DRUGS, VIOLENCE)

  23. POSSIBLE CONSEQUENCES IN ADULTHOOD • LACK OF COMMUNICATION SKILLS • SOCIAL ANXIETY, SOCIAL BEHAVIOUR • LOW SELF-CONFIDENCE, EMOTIONAL PROBLEMS • LACK OF STRESS MANAGEMENT SKILLS • HEALTH PROBLEMS

  24. Prevention of Health ProblemsRole of the Teacher • Early identification of a child at risk (observation, teachers scales of school anxiety and behaviour) • Cooperation with parents • Cooperation with school psychologist, pediatrician, child psychiatrist, social worker, etc. • Providing specific educational intervention • (e.g. extra classes for children with dyslexia, ADHD)

  25. Prevention of Health ProblemsRole of the Pediatrician/Practicioner • Assessment of school readiness (preventive examination at the 5th year ) • Early detection of school related health and mental problems and referal to a specialist (psychologist, psychiatrist, neurologist, ortophonist, etc.) • Medical consultant to school health promotion programmes • Cooperation with parents, teachers

  26. Prevention of Health ProblemsRole of the Public Health Officer • Regular assessment of school environment according to hygienic standards and regulations (microclimate – temperature, ventilation, illumination, noise, cleanliness of the facility, etc.) • Consultant or coordinator of school health promotion programmes

  27. I. Construction, technical and microclimatic conditions • Law No.183/2006 on district planning and construction regulations • Directive No.268/2009 on general technical requirements on buildings • CSN 73 4108 – cloakrooms, washrooms and toilets • CSN 730580-1,2,3- daily illumination • CSN EN 12464-1 – artificial illumination • Law No.258/2000 on public health protection

  28. Directive No.6/2003 on hygienic limits of chemical, physical and biological indicators for ambient environment (related to §6 of Law No.258/2000) • Government directive No.272/2011 on health protection against adverse effects of noise and vibrations (related to §30 – §34 Law No.258/2000)

  29. Air quality • Directive No. 268/2009 - max. concentration of CO2 acceptable for ambient environment - 1000ppm. - Increased values - fatigue, lack of concentration, low achievement, headaches. - Health risk limit - 5000ppm (Survey in the classroom - 6700 ppm) • Regular ventilation recommended!

  30. Ambient temperature • Direct. No. 343/2009 – defines measures in higher values (ventilation, heating regulation) and lower values in the classroom (3 days below 18oC or 1 day below 16oC – school attendance is stopped)

  31. Illumination • CSN EN 12464-1 – recommended values for white boards 300lx and blackboards 500lx) - Recommended light fitting placement

  32. II. Health aspects and risks of a pedagogical process Prevention of overload/distress: • respecting daily and weekly biorhytms (efficiency increasing during the morning with the peak between 9 and 11 hours, then decreasing with the minimum between 13 and 15 hours, afternoon increasing with the peak around 18 hours) • Weekly efficiency is decreasing from Monday to Friday • Adapt the schedule to the efficiency, do not start before 8:00, include relaxation activities, Wednesday without homework

  33. Design of the lesson: • First half – examine and explain new knowledge • Divide the lesson to parts respecting age related capacity to concentrate - the youngest pupils - 10-15min. - 1st graders up to 25 min. - 2nd graders up to 30 min. • Change regularly working position

  34. Working position • 40% pupils have ill posture • Increase between 7 and 11 years • RF = an ergonomically not suitable working place not respecting growth of pupils • Manipulation with heavy bags • Insufficient compensation of static load

  35. Guidelines for working place/height

  36. Physical exercise during the lesson • short physical exercise (2 – 3 minutes) should be included into every lesson (at least once) Functions: • compensation of static overload during sitting (stretching muscles around backbone) • prevention of ill posture • relaxation (breathing exercise, eye movements) • Increasing capacity to concentrate

  37. Recreations/breaks Purpose: • Relaxation of pupils and teachers • Spontaneous PA outside, inside (space for exercise, stretching) • Time for eating and drinking • DO NOT SHORTEN!! • Lunch break min. 1 hour

  38. Physical activity • Use efficiently regular hours of physical activity (2 hours/week) • Offer space and opportunities for physical activities in leisure time esp. using outside facilities

  39. School Health Promotion

  40. Health education curriculum • Personal health care – incl. hygiene and dental health • Personal and human relationships incl. sexual education • Nutrition education/healthy eating • The use and abuse of medicaments and drugs – tobacco, alcohol, illegal drugs • Environment and health (e.g. nuclear energy) • Safety education and accident prevention incl. first Aid • Consumer education • Community health care and its use • Family life • Prevention and control of disease (HIV/AIDS/STDs) • Violence and injuries

  41. References • Bencko, V. et al.: Hygiene and Epidemiology. Charles University in Prague. Selected Chapters. The Karolinum Press, Prague 2011. • Mangham, C.: Health Promotion and Education. International Summer School on Prevention of Noncommunicable disease. Halifax, Nova Scotia, 1993. • Mental Health Promotion and Mental Disorder Prevention. A policy for Europe. Radboud University Nijmegen, the Netherlands, 2005. (http://www.imhpa.net) • Pencheon, D., Guest, Ch., Melzer, D., Gray Muir J.A.: Oxford Handbook of Public Health Practice. Oxford University Press, 2001. • Schools for Health in Europe – http://www.schoolsforhealth.eu

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