Objective:
This study aimed to examine some common problems observed during school recess and translate findings to evidence-based, practical solutions that can be applied within schools on a more ...systematic level.
Design:
Observational study.
Setting:
Elementary schools in the USA.
Method:
Data were collected from 112 school recess periods at 25 public elementary schools in three distinct geographical regions of the USA (Midwest, Northwest, Southwest). The Great Recess Framework–Observational Tool (GRF-OT) guided observations and field notes. The GRF-OT measures safety and structure, student behaviour, adult supervision and engagement, transitions, and physical activity. Following data collection, inductive and deductive content analysis examined patterns in the data.
Results:
Analyses revealed how poorly designed and inadequately maintained schoolyard spaces contribute to common safety issues. A combination of insufficient play space planning and maintenance, lack of play equipment and game availability, and limited adult involvement in the schoolyard reinforced social hierarchies, leading to exclusionary practices. While recess is often deemed a child-led portion of the school-day, results highlighted the important role that adults play in recess.
Conclusion:
The following evidence-based solutions should be considered by school administrators and policy makers to mitigate problems observed during recess: (1) assess the schoolyard landscape, (2) assess patterns of play, (3) plan an intentional recess and (4) address the social climate. A high-quality recess promotes equitable access to play opportunities.
Longer duration of morbid obesity is associated with higher LV mass, poorer LV systolic function, and greater impairment of LV diastolic filling. Weight loss-induced decreases in LV mass and ...improvements in LV systolic function and diastolic filling are due in part to favorable alterations in LV loading conditions.
Active commuting to school (ACS) is an important source of physical activity among children. Recent research has focused on ACS and its benefits on cognition and academic achievement (AA), factors ...important for success in school. This review aims to synthesize literature on the relationship between ACS and cognition or AA among children and adolescents. Peer-reviewed articles in PubMed, Web of Science, PsycINFO and Cochrane Library assessing ACS with cognition and/or AA among children, until February 2019, were selected. Twelve studies across nine countries (age range 4-18.5 years) were included. One study used accelerometers, whereas all others used self-report measures of ACS. A wide range of objective assessments of cognitive functioning and AA domains were used. Five among eight studies, and four among six found a positive relationship between ACS and cognitive or AA measure, respectively. Four studies found dose-response relationships, and some studies found sex differences. The quantitative analysis found that ACS was not significantly associated with mathematics score (odds ratio = 1.18; CI = 0.40, 3.48). Findings are discussed in terms of methodological issues, potential confounders, and the strength of the evidence. Future studies should conduct longitudinal studies and use objective measures of ACS to understand this relationship further.
The purpose of this study was to test the responsiveness of the great recess framework-observational tool (GRF-OT) to detect changes in recess quality. GRF-OT data were collected at two time points ...(fall 2017 and spring 2018) in four geographically distinct regions of the United States. Following recommendations by Massey et al. (2018), a three-day average of recess observations was used for each data point. Data analysis was conducted on nine schools contracted to receive services from Playworks, a national non-profit organization specializing in recess implementation, for the first time; eight schools with returning Playworks services (i.e., multiple years of service) and five schools with no intervention services. Analysis of the change in GRF-OT scores from fall to spring revealed a large effect for first-year intervention schools (g = 1.19; 95% CI 0.13, 2.25) and multi-year intervention schools (g = 0.788; 95% CI -0.204, 1.78). GRF-OT scores decreased for schools not receiving an intervention (g = -0.562; 95% CI, -2.20, 1.07). New intervention schools (odds ratio= 21.59; 95% CI 4.27, 109.15) and multi-year intervention schools (odds ratio= 7.34; 95% CI 1.50, 35.97) were more likely to meet the threshold for meaningful positive change than non-intervention schools. The results of the current study suggest that GRF-OT is a responsive tool that researchers, practitioners, and policy makers can use to measure and assess changes in the quality of the recess environment.
•Association of Multiple lymphomatous polyposis with Diffuse Large B-cell Lymphoma.•Rare presentation of Multiple intussusceptions due to large Multiple Lymphomatous Polyposis.•Primary ...gastrointestinal (GI) lymphoma clinical presentation, diagnosis and treatment.•Review of literature on Multiple lymphomatous polyposis and Primary GI Lymphoma.
Multiple lymphomatous polyposis (MLP) is a distinctive and rare entity of primary gastrointestinal (GI) lymphoma characterized by polypoid lymphomatous tissue in long segments of the gut and a strong tendency for spread throughout the GI tract. Although many cases of MLP presenting as intussusceptions in adults have been reported, we report a rare case of multiple recurrent intussusceptions due to MLP associated with high-grade Diffuse Large B-cell lymphoma (DLBCL) of the entire GI tract in a 15-year-old child.
A 15-year-old child previously operated for acute intestinal obstruction, presented with intermittent abdominal pain, nausea and vomiting. Imaging studies confirmed the diagnosis of multiple small bowel intussusceptions. Patient was treated by exploratory laparotomy and multiple resection anastomosis. Histopathology confirmed the diagnosis of MLP due to DLBCL. The patient received chemotherapy following surgery. So far, at 6 months of follow-up, Patient is doing well.
Malignant tumors of the small intestine are unusual, with non-specific clinical presentation. Although ultrasound (US), CT, FDG-PET/CT and endoscopic evaluation are essential modalities for the diagnosis of intestinal polyposis. Final diagnosis of MLP can only be confirmed after histopathological examination and immunohistochemistry studies. Surgical resection followed by appropriate chemotherapy is the treatment of choice.
MLP due to DLBCL has rarely been described in young patients under the age of 18 years. We should keep a high index of suspicion for malignant GI lymphoma in cases of intussusception, especially in older children.
Although cardinal imaging features for the diagnostic criteria of the Dandy-Walker phenotype have been recently defined, there is a large range of unreported malformations among these patients. The ...brainstem, in particular, deserves careful attention because malformations in this region have potentially important implications for clinical outcomes. In this article, we offer detailed information on the association of brainstem dysgenesis in a large, multicentric cohort of patients with the Dandy-Walker phenotype, defining different subtypes of involvement and their potential clinical impact.
In this established multicenter cohort of 329 patients with the Dandy-Walker phenotype, we include and retrospectively review the MR imaging studies and clinical records of 73 subjects with additional brainstem malformations. Detailed evaluation of the different patterns of brainstem involvement and their potential clinical implications, along with comparisons between posterior fossa measurements for the diagnosis of the Dandy-Walker phenotype, was performed among the different subgroups of patients with brainstem involvement.
There were 2 major forms of brainstem involvement in patients with Dandy-Walker phenotype including the following: 1) the mild form with anteroposterior disproportions of the brainstem structures "only" (57/73; 78%), most frequently with pontine hypoplasia (44/57; 77%), and 2) the severe form with patients with tegmental dysplasia with folding, bumps, and/or clefts (16/73; 22%). Patients with severe forms of brainstem malformation had significantly increased rates of massive ventriculomegaly, additional malformations involving the corpus callosum and gray matter, and interhemispheric cysts. Clinically, patients with the severe form had significantly increased rates of bulbar dysfunction, seizures, and mortality.
Additional brainstem malformations in patients with the Dandy-Walker phenotype can be divided into 2 major subgroups: mild and severe. The severe form, though less prevalent, has characteristic imaging features, including tegmental folding, bumps, and clefts, and is directly associated with a more severe clinical presentation and increased mortality.
A unique transient leukemia (TL) has been described in newborns with Down syndrome (DS; or trisomy 21 mosaics). This leukemia has a high incidence of spontaneous remission; however, early death and ...subsequent development of acute megakaryoblastic leukemia (AMKL) have been reported. We prospectively evaluated 48 infants with DS and TL to determine the natural history and biologic characteristics of this disease, identify the clinical characteristics associated with early death or subsequent leukemia, and assess the incidence of subsequent leukemia. Blast cells associated with TL in DS infants exhibited FAB M7 morphology and phenotype. Most infants (74%) had trisomy 21 (or mosaicism) as the only cytogenetic abnormality in the blast cells. Most children were able to spontaneously clear peripheral blasts (89%), normalize blood counts (74%), and maintain a complete remission (64%). Early death occurred in 17% of infants and was significantly correlated with higher white blood cell count at diagnosis (P < .001), increased bilirubin and liver enzymes (P < .005), and a failure to normalize the blood count (P = .001). Recurrence of leukemia occurred in 19% of infants at a mean of 20 months. Development of leukemia was significantly correlated with karyotypic abnormalities in addition to trisomy 21 (P = .037). Ongoing collaborative clinical studies are needed to determine the optimal role of chemotherapy for infants at risk for increased mortality or disease recurrence and to further the knowledge of the unique biologic features of this TL.
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