This paper presents the lessons learned from the design and implementation of a whole school Health Promoting School (HPS) pilot on a high school in The Netherlands. This pilot aims to improve a range of health behaviours in adolescents via the Whole School Approach of Health Promoting Schools framework of the WHO-supported Schools for Health in Europe initiative (SHE). Eleven semi-structured interviews were held with key stakeholders in the intervention’s design and implementation. Results showed that becoming a HPS should be considered a comprehensive curriculum change that requires significant organizational investments. By integrating the intervention instead of implementing it “as is” into school’s existing infrastructure the additional burden to the curriculum was minimized; this was important for intervention relevance and it strengthens feelings of intervention ownership and motivation among teachers. Also, implementation should be led by a steering group of professionals from health sciences and education as well as parents, students and teachers from the school to combine knowledge on practical feasibility and evidence based practices. Teachers should be further educated to increase competence in their new role. Lastly, a central coordinator with proper personal competencies and power to get things done is necessary to steer these developments. Since not all schools are able to make the necessary investments, successfully becoming a HPS is not feasible for just any school at any point in time; it has to be considered a well-planned comprehensive system change. Schools with competing problems such as school violence or organizational struggles should postpone HPS developments.
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Australia’s National Action Plan for Promotion, Prevention and Early Intervention for Mental Health identifies increased well-being, quality of life and resilience as core outcome indicators for monitoring and evaluating mental health interventions in Australia. However, the best mecha- nism or approach to employ to achieve such improvements remains elusive. The results of this study suggest that for primary school aged children, the development of student resilience, the sense of feeling connected to adults and teachers, having good peer relationships and having a strong sense of autonomy and self capacity, and parental recognition of a supportive school environment, are influ- enced by the degree to which schools support and apply a ‘health promoting school’ environment and approach.
Copyright © 2013 Tracy Clelland et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The study sought to identify key issues regarding parental involvement within a health promoting school (HPS) approach directed at addressing children’s nutrition and physical activity. A case study research design was used, involving six primary schools in Auckland, New Zealand. Data were collected via six individual interviews with principals, six group interviews with a total of 26 teachers, 13 focus groups with a total of 92 children, and a survey of 229 parents. The study found that while schools agreed on the importance of schools and parents promoting the same healthy behaviours, there was a lack of agreement on the role of school staff in educating parents. School principals identified issues around managing the food brought from home and the extent to which they should regulate types of food. Parents stressed the importance of modelling healthy food and exercise practices in the home environment but identified factors that often made this difficult, a scenario that did not go unnoticed by their children. It is recommended that parental involvement be encouraged and supported so that schools and families can achieve consistency in health promotion practices across both school and home environments.
A complexity of objects requires us to consider the ontological. According to Rogers (2012) this means that “bricoleurs examine how socio-historical dynamics influence and shape an object of inquiry” (p. 10) and therefore research is not only about what it mean to be a HPS but also how the HPS persists and changes over time. Thus the bricoleur explores epistemologically how the HPS is neither a universal experience nor a static one and that any research needs to be sufficiently agile and critical to both capture and enable contextual understanding. Schools are social settings whose work is “carried on in the ordinary play of family and community life” (Dewey, 1902, p. 74) and the separation of school life from family/community is improbable as students navigate between them on a daily basis. It is here that Kincheloe’s second complexity on how human “being” is produced not only by the HPS experience but also by the bricoleur. Schools are spaces of situated social practice that builds students’ knowledge, experience and capacity for health and well-being – both their own and that of their community (Renwick, 2013). For the bricoleur their work requires attention to and deliberate seeking of those “knowledges that are usually silenced in dominant research narratives” (Rogers, 2012, p. 12) and therefore developing capability to disrupt dominant discourse and knowledge production (Kincheloe, 2005b).
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Almost all students and teachers unanimously suggested that it was better to have experts in various fields present in the school instead of having their counselors or teachers present in the subjects. The reason for their mentioned preference was that experts are more experienced and have expertise in a particular area. Additionally, the education provided by experts is necessarily more than and more extensive as they are able to present various effective solutions. For instance, one of student stated (Student 3), “Since their education is focused on one specific area, experts have more experience and are in a better position to guide and help us. It is best to learn things from the main source rather than from someone who has had to be trained first and has now decided to teach us. I think young experts understand us foremost and can be more useful.” In addition, teachers noted that “students interacted with strangers better than them, as they are more attracted to the strangers than the teachers.” A minority among the students argued for the superiority of peer education due to the slighter communication and education by the teachers, due to their easier availability. In contrast, teachers believed on peer training for its greater effectiveness.
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The Health – Promoting Schools need to go beyond the prevention model aspect, through the full organization potential of schools to be healthy environments in which to live, learn and operate. The intention of creating Health Promoting Schools brings about a sense of well-being and reduces preventable health problems and diseases in schools. Members of the community and the school have to work together to set up health priorities and play health actions. Through these actions, Health – Promoting Schools acknowledge the value of promoting physical, mental and social well-being along with efforts to reduce health problems and the health risks. Health-Promoting Schools serve as models in our world today to provide positive qualities that many individuals and communities can support. Individual schools and communities can do much on their own and for this to succeed many schools will need to model the kind of healthy and caring Zambian society that the country envisages to achieve. The purpose of Health Promoting Schools has been to enhance educational outcomes and to facilitate actions for health by building health knowledge and skills in the cognitive, social concept and behavioural domains This concept paper aims to provide the general information on strengthening Health Promoting Schools in Zambia and seek the impacts and recommendations particularly in terms of strengthening partnerships and also who can be potential sponsors supporting the Health Promoting School preference in Zambia.
For a cognitive behavioral program to be successful it has to be adapted to patients’ experiences. In order to adapt the HPM to the specific requirements of JIA patients, we reviewed the burden of living with JIA from the patients’ point of view and integrated this with the contents of R@W. Two qualitative studies reported on the impact of living with JIA and what patients required to manage their disease [30, 31]. Although the target population in these qualitative studies did not represent the target population of R@W, the experience of the pilot study are in concord- ance with the literature (personal experience). JIA has a major negative physical impact. Patients frequently experi- ence pain, fatigue, and disability. Reportedly, taking medi- cines is a problem because of the side effects. JIA patients sometimes encounter problems concerning their role in the family and their interaction with other children. To be able to increase their ability to manage the disease they feel the need for medical information and lifestyle management. They require strong social support and need to be actively involved in decisions concerning their own health.
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argue against increasing the safety of hospital workers and patients? Who could argue against greater microbio- logical safety and health for the crew of long term space flights who live at close quarters for months at a time ? If there were clear evidence for wider public health benefit, how could we not do this? Even in Ty- phoid Mary’s day (early 1900’s, See Table 1) asymptom- atic carriers of the typhoid bacillus could be identified through individual stool samples. Present and foresee- able technologies make us all candidates for routine high resolution screening. Future approaches to sampling in Precision Public Health will ideally be unobtrusive but consequences, i.e. how the information is used, are part and parcel of generalized changes to the practical as well as philosophical aspects of privacy, individual rights, and free will  that merit as much forethought with all the relevant stakeholders as the technology.
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Education Specialist notes, ‘We know that healthy children learn well. If they are healthy, young people can take full advantage of every opportunity to learn…. We can improve the yield of educational investments if we can help schools to become health-promoting schools’ (Australian Health Promoting Schools Association, 2001, p.2). The recognition that HPS are effective schools, which improve educational as well as health outcomes, underpins England’s National Healthy School Standard (NHSS), launched in 1999 to reduce health inequalities, promote social inclusion and raise student achievement. A review of school evaluations found that NHSS schools improved at a faster rate than schools not included in the program. Among the changes, NHSS was effective in improving learning environments, student concentration and performance, staff health and wellbeing, and raising student achievement (National Foundation for Educational Research and Thomas Coram Research Unit, 2004).
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The school is likely to meet all of the requirements for registration. A site visit was undertaken as part of this inspection visit and discussions held with the project manager. The headteacher has worked closely with the design team to ensure that the accommodation is well suited to the needs of students. Leaders demonstrated a robust appreciation of risk and understanding of health and safety procedures during a lengthy discussion with the project manager concerning the fire exit route from the first floor to the fire assembly point on the ground floor (which was judged suitable). The plans for the accommodation provide a mix of teaching rooms, suited to small groups and individuals. There will be specialist facilities to support the curriculum, including computer stations, music suite, art studio and a motor
et al on the women at early stages of gynecologic cancers, young people had a healthier lifestyle than middle-aged people (6). Rakhshani et al and Zhang et al respectively reported the same results in Iranian older adults and in retired workers in a city in the northeast of China (21,22). There was a significant statistical correlation between income level and lifestyle in this study to such a degree that the score of lifestyle increased with an increase in the income level. The same result was obtained in the study of Mirghafourvand et al on infertile couples referring to the infertility clinic of Alzahra اospital in Tabriz and women of reproductive age in Tehran, Iran (15,23). The study of Ay et al on lifestyle promoting behaviors for prevention of cancer also showed higher scores of lifestyle along with increases in the income level (9). Furthermore, the study of Zhang et al on retired workers in a city in the northeast of China showed more favorable lifestyle in accordance with high income levels (21).
(HSSP) I 2000/01 – 2004/05 and HSSP II 2005/06 – 2009/ 10 introduced a CHWs programme known as the Vil- lage Health Team (VHT) strategy as part of the Uganda National Minimum Health Care Package (UNMHCP). The UNMHCP is intended to provide every village in Uganda with the capacity to mobilize individuals and households for better health [19, 20]. The VHT com- prises of community volunteers who are selected from within their communities to provide accurate health in- formation, primary healthcare support and appropriate linkages to health services. They are the first point of contact for healthcare delivery in the community and have been incorporated by MOH into the health system as Health Centre I level. However, VHTs in Uganda are faced with various challenges that include inadequate training, minimal supervision and low motivation . In addition, like in many other developing countries where similar CHWs programmes exist, they are marred with high attrition levels  and poor performance . Our partnership therefore anticipated to create a significant impact on the country’s health system by focusing on this cadre. VHTs mobilize community members and help to increase community participation in local health pro- grammes. Other specific roles of VHTs include referring patients to health facilities, collecting household data, treating childhood diseases, conducting health education and acting as role models for community members.
1153 abstracts were retrieved. 27 systematic reviews met our inclusion criteria. Reviews were grouped pragmatically according to their focus. Most of the groupings were based on intervention aims (e.g. parenting, promotion of self esteem, violence prevention), and one was based on settings (school based programmes). The last group included general reviews of mental health promotion programmes. It is important to recognise the potential overlap between these groups. For example, some self-esteem promotion programmes are school-based, and one of the ways of preventing violence is to improve parenting.
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RESULTS: Themes were identified relating to HEW commitment and role, supervision and performance management. The Health Management Information System (HMIS) was seen as important by all participants, but with challenges of information quality, accuracy, reliability and timeliness. Participants’ perceptions varied by group regarding the purpose and benefits of HMIS and also the potential of an eHealth system. Mobile phones were used regularly by all participants. CONCLUSION: EHealth technology presents a new opportunity for the Ethiopian health system to improve data quality and community health. Empowering, supporting and responding to the challenges faced by frontline female HEWs who are a critical bridge between communities and health systems will be important part of ensuring the sustainability and responsiveness of eHealth strategies. Findings have informed the subsequent eHealth technology design and implementation, capacity strengthening approach, supervision and performance management approach.
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Durlak et al. (2011) completed a most recent and comprehensive analysis of the impact of universal SEL programs. Their research presents findings from a meta-analysis of 213 school-based and universal SEL programs, involving 270,034 students from kindergartens through high schools of different ages, from schools in urban, suburban, and rural settings, and from schools primarily serving ethnically and socio-economically diverse student bodies. Positive findings with statistically significant were obtained in all six outcome categories at post (CASEL, 2008). The students demonstrated positive impacts in more positive attitudes toward self and others such as self-concept, self-esteem, prosocial attitudes toward aggression, and comfortable feeling connected to school). Other positive impacts included increased social-emotional skills such self-control, decision- making, communication, and problem-solving skills; more positive social behaviors such as daily behaviors related to getting along with and cooperating with others; fewer conduct problems such as aggression, disruptiveness; lower levels of emotional distress such as anxiety, depressive symptoms; and significantly better academic performance in school grades and achievement test scores.
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OCA, neutropenia, natural killer cell dys- function, and frequent bacterial infec- tions. The diagnosis of CHS requires the presence of giant granules in neutrophils and other leukocytes; Griscelli syndrome is phenotypically similar to CHS, but without the presence of giant granules. To meet criteria for diagnosis, all patients with HPS must have (1) tyrosinase- positive OCA and (2) a speci ﬁ c platelet storage pool de ﬁ ciency (ie, absence of d granules). The hallmarks of OCA are diffuse hypopigmentation of the skin, hair, iris, and retina. OCA is, for all practical purposes, a clinical diagnosis and can ﬁ rst be suspected in the newborn nursery where there can be evidence of diminution of skin pig- mentation such that it appears pink or chalky white. The hair varies from silvery-white to light brown and the eyes are light blue, light green, or hazel. Ad- ditional eye ﬁ ndings are positive iris transillumination and ﬁ ndings consis- tent with retinal hypopigmentation. However, it is possible to encounter patients with HPS with less severe hypopigmentation and brown hair and eyes, particularly with the HPS-3, HPS-5, or HPS-6 subtypes (Fig 1). Iris trans- illumination is a simple bedside test that uses the direct ophthalmoscope; when light is shone into the pupil, the examiner notes light emanating through the iris. 8
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Family support, especially by the husband, support from health care providers and the existence of an in- centive environment, including education from the media, access to health facilities and other facilities specific to pregnant women was among the socio-environmental facilitators for health promoting behaviors. Family and social support is an important factor in enabling people to choose, adopt and keep up with healthy behaviors, which is also mentioned in other studies . The role of mass media in inform- ing and receiving information from the Internet were often emphasized by women in this study. The partic- ipants in Edvardsson et al. (2011) found communica- tion channels (face-to-face, telephone and Internet interviews) effective in changing their behaviors . In the qualitative study which has been conducted by Sanchez & Jones, the Internet, mass media (for ex- ample, TV), and health service providers have been reported as sources of information for health promo- tion, which is in agreement with the present study . It seems that by strengthening media education programs and creating valid internet sites for educa- tion, pregnant women can be supported in choosing appropriate behaviors.
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Health promotion is defined as the process of enabling people to increase control over, and to improve individual’s health (1). Generally, the ultimate goal of health promotion is to prevent illness, enhances well-being, and creates a healthy lifestyle at all stages of life (2). In Malaysia, health promotion had become the national agenda in combating non-communicable diseases. Health promotion programme delivered benefits for the community in promoting the wellbeing, reducing preventable illness and lowering overall health care expenditure (3). With a recent upward trajectory of healthcare costs in Malaysia (4), it requires a greater attention of the nation to provide a better healthcare at sustainable costs through early health promotion.
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The immunodeficiency associated with HPS-2, but not HPS-1, may result in an aggressive form of lung disease that pre- sents at an earlier age than the pul- monary fibrosis of HPS-1. Specifically, re- current lung injury from pulmonary infection may contribute to the initiation and development of interstitial lung dis- ease in patients with HPS-2. Investiga- tors have studied a possible etiological role of viral infection in idiopathic pul- monary fibrosis, and associations be- tween herpes viruses and idiopathic pul- monary fibrosis have been reported (30). To our knowledge, however, there is no known association between viruses and HPS pulmonary fibrosis. Notably, recur- rent infection alone is probably insuffi- cient to cause pulmonary fibrosis, be- cause fibrotic lung disease is not commonly found in patients with pri- mary human immunodeficiency disor- ders (31).
Characteristics of grade ﬁ ve students within intervention and comparison schools in 2009 and 2011 are presented in Table 1. In 2009, children accumu- lated a mean 6 SD of 12 311 6 3767 and 10 555 6 5491 steps per day on school days and non – school days, re- spectively. Students ’ mean age was 10.9 years, and 49.5% were girls. Ap- proximately 25% of children came from households of low income or low pa- rental education, and 33.8% of the en- tire cohort was overweight or obese. In 2011, the proportion of overweight students was slightly lower (31.9% vs 33.8%; x 2 = 0.75, P = .39) and household income (higher than $100 000: 45.1% vs 37.5%; x 2 = 7.26, P = .007) and parental education (university or graduate school: 34.8% vs 29.2%; x 2 = 6.25, P = .012) were higher. The distribution of boys and girls was identical in both the intervention and comparison schools. Compared with students who provided valid pedometer data, those who did not were more likely to be boys (44.6% vs 31.1%; x 2 = 36.09, P , .001) and overweight (38.5% vs 33%; x 2 = 4.33, P = .037). In addition, the failure to pro- vide valid pedometer data was more common in 2011 compared with 2009 (42.2% vs 34.9%; x 2 = 10.86, P , .001). In 2009, students from intervention schools achieved ∼ 2000 (12.9%) fewer steps daily than students from com- parison schools (10 707 vs 12 292 steps
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