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Shkalim Zemer V, Cohen HA, Richenberg Y, Gerstein M, Atias I, Gur S, Laks Y, Levinsky Y, Dvir O, Brown I, Cohen M, Ben Meir D. Personal hygiene, environmental conditions, and toilet use of children in primary schools: A cohort study. J Pediatr Urol 2023; 19:721-727. [PMID: 37357079 DOI: 10.1016/j.jpurol.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/07/2023] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Many primary school children withhold urine and stool whilst at school for various reasons. Limited toilet access and the failure to provide safe, sanitary toilets are putting children at risk for toilet avoidance behavior. OBJECTIVE We aimed to examine personal hygiene, environmental conditions, the perception of these on children, and their toilet use in primary schools. STUDY DESIGN Children aged 6-12 and their parents were asked to complete a self-report questionnaire regarding toilet behavior and the perception of school toilet standards. RESULTS The main findings are listed below using the data from the questionnaire. DISCUSSION We found that 9% and 63% of the children avoided urination and defecating at school, respectively. Similar results were reported previously. The participants' perceptions regarding the environmental conditions of school toilets and conditions revealed that 34% of the children felt that the toilets were dirty or very dirty. Around one-third of them reported a lack of toilet paper sometimes or most of the time. These unsatisfying hygienic conditions of school toilets can be easily solved. Unfortunately, 46% of the children in our study experienced bullying in school toilets. These worrisome data are seldom reported in other studies. The urination habits of the girls, who mostly preferred to partially squat or stand may lead to dysfunctional voiding and incomplete bladder emptying. Our study was limited by the relatively small population, the subjectiveness of the self-reporting questionnaire, and the voiding and defecation habits of the investigated children during school hours. These hours do not necessarily reflect the children's habits after school hours and during the weekends. Despite these limitations, the discussed issues regarding personal hygiene and the environmental conditions in the sampled primary schools are extremely important. CONCLUSION Nearly half of the school children had negative perceptions of school toilets. This should raise awareness and concern for school staff to consider and investigate potential facilities improvement in light of the impact observed here. Implementation of appropriate education and a better environment of toilet facilities and security is important for the children's well-being.
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Affiliation(s)
- Vered Shkalim Zemer
- Clalit Health Services, Dan-Petach-Tikva District, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel.
| | - Herman Avner Cohen
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
| | | | - Maya Gerstein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Petach Tikva, Israel.
| | - Ifat Atias
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Neve Gan Clinic, Petach Tikva 4926040, Israel.
| | - Shmuel Gur
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Kfar Saba 4422941, Israel.
| | - Yoseph Laks
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Ambulatory Community Clinic, Ramat Aviv, Tel Aviv 6905234, Israel.
| | - Yoel Levinsky
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Or Dvir
- Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Iris Brown
- Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
| | - Moriya Cohen
- Microbiology Unit, Ariel University, Ariel 98603, Israel.
| | - David Ben Meir
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel; Pediatric Urology Unit, Schneider Children's Medical Center of Israel, Petach Tikva 49420235, Israel.
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de Beaufort CMC, Derikx JPM, Voskeuil ME, Atay J, Kuijper CF, de Beer SA, de Jong JR, de Bos A, Vennink S, van Heurn LWE, Gorter RR. Children with an Anorectal Malformation Going to Primary School: The Parent's Perspective. CHILDREN (BASEL, SWITZERLAND) 2023; 10:924. [PMID: 37371156 DOI: 10.3390/children10060924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Continence problems occur often in children with anorectal malformations (ARM). The aim of this study was to evaluate parental experiences with toilet facilities at Dutch primary schools and their experience with how schools deal with ARM children. METHODS This survey was developed in collaboration with the national patient advocacy group (PAG). Recruitment for participation was conducted by the PAG (email listing and social media) and one expertise center for ARM. Participants were parents of school-attending ARM children aged 3 to 12 years. RESULTS Sixty-one participants (31.9%) responded to the survey. The median age of the children was 7.0 years (IQR 5.0-9.0). Schools were often located in a village (63.9%) and encompassed 100-500 children (77.0%). In total, 14 parents (23.0%) experienced difficulties in finding a primary school. Experiences with the school were described as solely positive (37.7%), solely negative (9.8%), positive and negative (34.4%), and neither positive nor negative (16.4%). Regarding school toilet facilities, 65.6% of the toilets were reported clean and 78.7% were easily accessible. CONCLUSIONS About 25% of parents reported difficulties in enrolling their children into primary school, and 45% reported negative experiences. This highlights the need for improved guidance and the optimization of education in schools when dealing with ARM children.
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Affiliation(s)
- Cunera M C de Beaufort
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Joep P M Derikx
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Marijke E Voskeuil
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Josef Atay
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Caroline F Kuijper
- Department of Pediatric Urology, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Sjoerd A de Beer
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Justin R de Jong
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Arnout de Bos
- Vereniging Anusatresie, 1273 ST Huizen, The Netherlands
| | | | - L W Ernest van Heurn
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Ramon R Gorter
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
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Muhati-Nyakundi LI. Teachers' perceptions of children's access to toilets in urban ECDE institutions, and the psychosocial consequences. Glob Public Health 2022; 17:3785-3801. [PMID: 35388740 DOI: 10.1080/17441692.2022.2059693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
ABSTRACTAccess to clean and functional toilet is quintessential in meeting children's physiological and psychosocial needs in a learning environment. However, little is known on experiences of children's access to quality toilets while in preschool institutions within urban settings of sub-Saharan Africa countries. This paper draws from a study that explored experiences of vulnerable children in early childhood development education (ECDE) institutions in underserved and informal urban settings of Kenya and South Africa. 11 urban ECDE centres were purposively selected and 17 teachers were recruited as key informants. Data was collected using an adapted infrastructural checklist, observation and conversational interviews. Findings indicated that a majority of toilets in ECDE centres were inadequate, inappropriate, poorly maintained, or had structural weaknesses which affected children's experiences of access and use of the facilities. Scheduled toilet visits as a control measure and toilet avoidance potentially exposed them to psychosocial and health risks. Insights into children's toilet facilities, managing their access in institutions located within informal and low resourced areas, and investment policies that target preschool children' sanitary facilities are given. Suggestions are made for interventions for children's positive toilet experiences in poor urban areas.
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Affiliation(s)
- Linet Imbosa Muhati-Nyakundi
- Department of Educational Studies, Faculty of Education - Siyabuswa Campus, University of Mpumalanga, Mpumalanga, South Africa
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Pizzoferrato AC, Arzel O, Reboursière E, Rousseau M, Blanchard V. Impact de sessions d’éducation périnéale chez des adolescentes. Prog Urol 2022; 32:735-743. [DOI: 10.1016/j.purol.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 10/15/2022]
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Klar K, Knaack D, Kampmeier S, Hein AK, Görlich D, Steltenkamp S, Weyland U, Becker K. Knowledge about Hand Hygiene and Related Infectious Disease Awareness among Primary School Children in Germany. CHILDREN 2022; 9:children9020190. [PMID: 35204911 PMCID: PMC8870042 DOI: 10.3390/children9020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/07/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022]
Abstract
Hand hygiene is a cornerstone of infection prevention. However, few data are available for school children on their knowledge of infectious diseases and their prevention. The aim of the study was to develop and apply a standardized questionnaire for children when visiting primary schools to survey their knowledge about infectious diseases, pathogen transmission and prevention measures. Enrolling thirteen German primary schools, 493 questionnaires for grade three primary school children were included for further analyses, comprising 257 (52.1%) girls and 236 (47.9%) boys with an age range of 8–11 years. Out of 489 children, 91.2% participants indicated that they knew about human-to-human transmissible diseases. Of these, 445 children responded in detail, most frequently mentioning respiratory and gastrointestinal diseases, followed by childhood diseases. Addressing putative hygiene awareness-influencing factors, it was worrisome that more than 40.0% of the children avoided visiting the sanitary facilities at school. Most of the children (82.9%) noted that they did not like to use the sanitary facilities at school because of their uncleanliness and the poor hygienic behavior of their classmates. In conclusion, basic infection awareness exists already in primary school age children. Ideas about the origin and prevention of infections are retrievable, however, this knowledge is not always accurate and adequately contextualized. Since the condition of sanitary facilities has a strong influence on usage behavior, the child’s perspective should be given more consideration in the design and maintenance of sanitary facilities.
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Affiliation(s)
- Kristin Klar
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (K.K.); (D.K.)
| | - Dennis Knaack
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany; (K.K.); (D.K.)
| | - Stefanie Kampmeier
- Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany;
| | - Anna Katharina Hein
- Institute of Education, Westphalian Wilhelms-University of Münster, 48143 Münster, Germany; (A.K.H.); (U.W.)
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, Westphalian Wilhelms-University of Münster, 48149 Münster, Germany;
| | | | - Ulrike Weyland
- Institute of Education, Westphalian Wilhelms-University of Münster, 48143 Münster, Germany; (A.K.H.); (U.W.)
| | - Karsten Becker
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, 17475 Greifswald, Germany
- Correspondence: ; Tel.: +49-3834-86-5560
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Jørgensen CS, Breinbjerg AS, Rittig S, Kamperis K. Dissatisfaction with school toilets is associated with bladder and bowel dysfunction. Eur J Pediatr 2021; 180:3317-3324. [PMID: 33999258 DOI: 10.1007/s00431-021-04111-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/24/2022]
Abstract
Poor quality of school toilets is reportedly an issue in many countries and has been correlated with toilet refusal in children. The aim of this study was to evaluate the association between perceived school toilet quality, behaviour regarding toilet visits, and symptoms of bladder and bowel dysfunction (BBD). Pupils in Danish schools were invited to complete online questionnaires regarding toilet behaviour, perception of school toilet standards/quality, and symptoms of BBD. Teachers at the same schools were asked about the quality of the toilets. We recruited 19,577 children from 252 different schools. More than half of the children (50% boys and 60% girls) were dissatisfied with the toilet facilities. One-fourth of the children (28% of girls, 23% of boys) reported avoiding the use of school toilets. We found a strong correlation between being dissatisfied with school toilets, toilet avoidance, and symptoms of BBD.Conclusion: The majority of Danish children are unhappy with their school toilet facilities. Symptoms of BBD are associated with subjective toilet dissatisfaction and toilet visit postponement. Because children spend a significant part of their day at school, access to satisfactory toilet facilities is of utmost importance for their well-being. What is Known • Bladder and bowel dysfunction is common in childhood with urinary incontinence, constipation, and faecal incontinence being cardinal symptoms. • Behaviour regarding toilet visits contributes to the aetiology, and we know that toilet avoidance can lead to abnormal bladder and bowel function. What is New • Most children are not satisfied with their school toilets, and many avoid toilet visits. • Dissatisfaction with the school toilets is related to toilet avoidance and bladder and bowel dysfunction in school children regardless of age and gender.
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Affiliation(s)
- Cecilie S Jørgensen
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Aarhus N, Denmark.
| | - Anders S Breinbjerg
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Aarhus N, Denmark
| | - Søren Rittig
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Aarhus N, Denmark
| | - Konstantinos Kamperis
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus, Aarhus N, Denmark
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Akinci A, Baklaci CU, Oğuz ES, Kubilay E, Sanci A, Aydoğ E, Hajiyev P, Soygür T, Burgu B. Can lockdown and homeschooling change the outcome of urotherapy for lower urinary tract dysfunction in children? J Pediatr Urol 2021; 17:651.e1-651.e7. [PMID: 34183271 DOI: 10.1016/j.jpurol.2021.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/18/2021] [Accepted: 06/04/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Lower urinary tract dysfunction (LUTD) are still important for both children and pediatric urologists. Urotherapy is recommended in LUTD treatment management. In our country, all citizens under the age of 20 were banned from going out of their homes due to Covid-19 and the homeschooling system has been adopted The aim of this study is to investigate the effect of lockdown and homeschooling on the effectiveness of urotherapy used for LUTD treatment. METHODS 83 patients were included in the study group. Besides 306 patients were determined as the control group (pre-Covid). The patients in the study group and the control group were compared in terms of improvement in Dysfunctional voiding and incontinence scoring system (DVISS), quality of life scores, bladder diary, Bristol stool scale, and treatment responses at 3rd and 6th months. RESULTS The study group and control group were compared in terms of DVISS, voiding frequency and incontinence in the voiding diary, quality of life score, and Bristol stool scale at admission visit and the group characteristics were similar. During the 6th month visit, the mean DVISS of the study group was found to be significantly lower (7.12 ± 3.48; 8.58 ± 4.06 respectively (p 0.002)). Daily voiding frequency was similar in the study group and the control group during the 2nd and 3rd visit. The study group's mean number of daily incontinence was significantly lower at visit 3 (0.57 ± 0.9; 0.94 ± 0.27, respectively (p 0.02).After six months of treatment, 13.3% of the study group patients had a complete response, 44.6% had a partial response, whereas 42.2% non-responders. In the control group, the response rates were as 5.9%, 39.2% and 54.9% respectively (p 0.02). CONCLUSIONS LUTD is still very common in pediatric urology. Standard urotherapy is widely used in treatment management. According to our results, the success of standard urotherapy increases with lockdown and homeschooling. We have shown that the success of standard urotherapy can be improved by regulating environmental conditions. In terms of LUTD management, environmental conditions can be regulated to provide a better quality of life and a better cure in a more economical way.
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Affiliation(s)
- Aykut Akinci
- Department of Pediatric Urology, Ankara University School of Medicine, Cebeci Children's Hospital, Ankara, Turkey.
| | - Can Utku Baklaci
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Efe Semetey Oğuz
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Eralp Kubilay
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Adem Sanci
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ezel Aydoğ
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Perviz Hajiyev
- Department of Pediatric Urology, Guven Klinik Hospital, Baku, Azerbaijan
| | - Tarkan Soygür
- Department of Pediatric Urology, Ankara University School of Medicine, Cebeci Children's Hospital, Ankara, Turkey
| | - Berk Burgu
- Department of Pediatric Urology, Ankara University School of Medicine, Cebeci Children's Hospital, Ankara, Turkey
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Knowledge, Practice of Personal Hygiene, School Sanitation, and Risk Factors of Contracting Diarrhea among Rural Students from Five Western Provinces in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189505. [PMID: 34574432 PMCID: PMC8468795 DOI: 10.3390/ijerph18189505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Diarrhea is a global public health issue and a leading cause of childhood malnutrition, growth disturbances, and mortality. The spread of diarrhea is closely linked to the knowledge and maintenance of personal hygiene and quality of drinking water and sanitation facilities. However, there are few such investigations and analysis in rural areas of China. This study aims to determine the association between the risk of contracting diarrhea and knowledge and practices of personal hygiene and school sanitation among rural students as well as provide a scientific basis for preventing the spread of diarrhea and other infectious diseases. A stratified cluster sampling method was used to randomly select 12 rural primary schools in each of 5 counties where the Water, Sanitation and Hygiene (WASH) Plus Program has been implemented. The counties are located in the Guangxi Zhuang autonomous region, Chongqing municipality, Guizhou province, Yunnan province, and Xinjiang Uygur autonomous region. A single fourth-grade class was randomly chosen from each of the 60 schools for observation and a questionnaire survey. The study involved a total of 2330 students. The logistic regression method was adopted to determine the factors contributing to diarrhea in rural students. The results show that male students accounted for 49.40% (n = 1151) of the 2330 research subjects; the average age of the students was 9.9 ± 0.3 years. Approximately 33.09% of the students suffered from diarrhea in the three months leading up to the survey. The odds ratios (ORs) of students who did not know that "diarrhea can be prevented by washing fruits before eating them raw and not drinking untreated water" (OR: 1.303, 95% confidence interval [CI]: 1.063, 1.597) and that "the disease can be prevented by washing hands before meals and after going to the toilet" (OR: 1.522, 95% CI: 1.207, 1.920) were higher than those who knew the above stated facts. Students who "have drunk untreated water at school" (OR: 1.584, 95% CI: 1.268, 1.978), "have drunk untreated water at home" (OR: 1.643, 95% CI: 1.319, 2.048), and "did not wash hands before every meal" (OR: 1.490, 95% CI: 1.120, 1.983) were at a higher risk of contracting diarrhea than those who drank treated water at school and at home and washed their hands before every meal. Diarrhea was more likely to affect students who attended schools with unclean and poorly maintained toilets (OR: 1.586, 95% CI: 1.261, 1.995) or toilets with flies (OR: 1.383, 95% CI: 1.114, 1.717) and without adequate drinking water facilities (OR: 1.407, 95% CI: 1.009, 1.962). The knowledge of methods to maintain personal hygiene, general hygiene practices, and school sanitation are the three major risk factors that account for the spread of diarrhea among rural students from five western provinces (municipalities and autonomous regions) of China. Therefore, to prevent such diseases and maintain health, it is important to provide students with health education, help them develop good hygiene habits, ensure the provision of clean water at schools, and improve the overall school environments.
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Cardoso SG, Paixão Argollo B, Nascimento Martinelli Braga AA, Barroso U. Urgency in children with overactive bladder or voiding postponement: What's the difference? J Pediatr Urol 2021; 17:448.e1-448.e8. [PMID: 33839033 DOI: 10.1016/j.jpurol.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 02/02/2021] [Accepted: 03/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) and voiding postponement (VP) can share the same symptom of urgency, but with different pathophysiology, including the cerebral interpretation of bladder filling. The objective of the present study was to compare the clinical, psychological and sociodemographic features of children with urgency for OAB with those who presented urgency for VP (UrVP). METHODS A retrospective cross-sectional study with an analytical component was conducted with patients of 5-14 years of age with urinary urgency between January, 2014, and January, 2019. Urinary symptoms were evaluated using the Dysfunctional Voiding Scoring System (DVSS) questionnaire, constipation using the Rome IV criteria and psychological symptoms using the Strengths and Difficulties Questionnaire (SDQ). All the patients had bell-shaped or tower-shaped curves at uroflowmetry and no significant post-void residual volume at ultrasonography. Patients were classified as having OAB or UrVP depending on whether they voided >3 or ≤3 times/day, respectively. RESULTS Median age of the 101 children/adolescents included was 9 years, with no significant difference between the groups. The prevalence of OAB was 60.4%. Girls constituted 57.4% of the sample but 67.5% of the postponement group, although no independent association was found between sex and diagnosis. The prevalence of constipation was 75.2%, with no difference between the groups. The children with OAB had higher behavioral hyperactivity scores and more intense externalizing symptoms, although there was no significant difference between the groups for the SDQ total difficulties score. In the multivariate analysis, the independent clinical factors associated with a diagnosis of OAB were behavioral hyperactivity (OR = 5.134), urge incontinence (OR = 4.694) and MVV/EBC (%) (OR = 0.983). CONCLUSION More behavioral problems, particularly hyperactivity, were found in children with OAB compared to those with UrVP. No statistically significant difference was found between the groups evaluated insofar as their sociodemographic characteristics are concerned. Furthermore, as expected, there was a strong association between the symptom of urge incontinence and lower MVV/EBC in the children and adolescents with OAB compared to those with voiding postponement.
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Affiliation(s)
- Samuel Gomes Cardoso
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
| | - Beatriz Paixão Argollo
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
| | | | - Ubirajara Barroso
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
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Shoham DA, Wang Z, Lindberg S, Chu H, Brubaker L, Brady SS, Coyne-Beasley T, Fitzgerald CM, Gahagan S, Harlow BL, Joinson C, Low LK, Markland AD, Newman DK, Smith AL, Stapleton A, Sutcliffe S, Berry A. School Toileting Environment, Bullying, and Lower Urinary Tract Symptoms in a Population of Adolescent and Young Adult Girls: Preventing Lower Urinary Tract Symptoms Consortium Analysis of Avon Longitudinal Study of Parents and Children. Urology 2021; 151:86-93. [PMID: 32679271 PMCID: PMC8074340 DOI: 10.1016/j.urology.2020.06.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/22/2020] [Accepted: 06/28/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female lower urinary tract symptoms (LUTS) at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and LUTS in adolescent girls. METHODS The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children. At age 13, participants reported on 7 school toilet environment characteristics and a range of LUTS items. At age 19, participants completed the Bristol Female Lower Urinary Tract Symptoms questionnaire. RESULTS All toilet environmental factors were associated with at least 1 LUTS outcome at age 13. Holding behavior was associated with all school toilet environmental factors, with odds ratios ranging from 1.36 (95% confidence interval [CI]: 1.05, 1.76) for dirty toilets to 2.38 (95% CI: 1.60, 3.52) for feeling bullied at toilets. Bullying was associated with all daytime LUTS symptoms and nocturia; odds ratios ranged from 1.60 (95% CI: 1.04, 2.07) for nocturia to 2.90 (95% CI: 1.77, 4.75) for urgency. Associations between age 13 school toilets and age 19 LUTS were in the same direction as age 13 LUTS. CONCLUSION This is the first examination of associations between school toilets and LUTS. Toileting environments were cross-sectionally associated with LUTS in adolescent girls. While further work is needed to determine whether these associations are causal, school toilet environments are modifiable and thus a promising target for LUTS prevention.
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Affiliation(s)
- David A Shoham
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL.
| | - Zhenxun Wang
- Department of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Sarah Lindberg
- Department of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Haitao Chu
- Department of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Linda Brubaker
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA
| | - Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Tamera Coyne-Beasley
- Division of Adolescent Medicine, University of Alabama at Birmingham Medical School, Birmingham, AL
| | - Colleen M Fitzgerald
- Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Chicago, IL
| | - Sheila Gahagan
- Division of Academic General Pediatrics, University of California San Diego School of Medicine, San Diego, CA
| | | | | | - Lisa Kane Low
- University of Michigan School of Nursing, Women's Studies, Dept. Obstetrics and Gynecology, Ann Arbor, MI
| | - Alayne D Markland
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham School of Medicine and Birmingham VA Medical Center, Birmingham, AL
| | - Diane K Newman
- Department of Surgery, Division of Urology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Ariana L Smith
- Department of Surgery, Division of Urology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Ann Stapleton
- Department of Medicine, University of Washington, Seattle, WA
| | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Amanda Berry
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA; Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, University of Minnesota, Minneapolis, MN
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11
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Shao T, Zhao J, Hu H, Zhang Q. Analysis of factors affecting students going to school toilets in a rural primary school in China. BMC Public Health 2021; 21:32. [PMID: 33407296 PMCID: PMC7789347 DOI: 10.1186/s12889-020-10099-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 12/20/2020] [Indexed: 11/17/2022] Open
Abstract
Background Several factors may affect students going to school toilets, but a few studies have analyzed the reasons for students using toilets. This study aimed to use a structural equation model to understand the factors that impacted children’s toilet behavior. Methods This study was performed in 12 rural nonboarding primary schools (6 schools in the northern and 6 schools in the southern regions of China). All students of the third and sixth grades (761 students) were examined. A questionnaire on students’ toilet behavior was used. The questionnaire included 33 perceptual items based on 5 factors: toilet facilities, cleanliness, hygiene practices, peer relationship, and experience. The questionnaire also covered the frequency of voiding and defecating by themselves. The exploratory factor analysis, confirmatory factor analysis, and pathway analysis were used to analyze the causes of students’ toilet behavior. Results A statistically significant correlation coefficient of 0.300 indicated that cleanliness impacted the toilet frequency of students. The visual experience of the overall cleanliness of the toilet had the most significant impact on students’ toilet behavior (path coefficient, 0.81). Washing facilities and convenient handwashing had the least impact on toilet use (path coefficient, 0.52). Conclusion Cleanliness was the primary consideration for students’ toilet use on campus. The visual experience of the overall cleanliness of toilets had the most significant impact when students used toilets. No pre-survey was conducted to test the reliability and validity of the questionnaire. Using self-reported data might be associated with potential recall errors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10099-4.
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Affiliation(s)
- Tang Shao
- National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention, 13 Government Street, Changping District, Beijing, China
| | - Jingjing Zhao
- National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention, 13 Government Street, Changping District, Beijing, China
| | - Haijuan Hu
- National Center for Rural Water Supply Technical Guidance, Chinese Center for Disease Control and Prevention, 13 Government Street, Changping District, Beijing, China
| | - Qi Zhang
- Chongqing Center for Disease Control and Prevention, 8 Changjiang Second Road, Yuzhong District, Chongqing, China.
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12
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Laffolie J, Ibrahimi G, Zimmer KP. Poor Perception of School Toilets and Increase of Functional Constipation. KLINISCHE PADIATRIE 2020; 233:5-9. [PMID: 33036055 DOI: 10.1055/a-1263-0747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE A suggested mechanism of functional constipation (FC) is the refusal against painful bowel movements and a vicious circle of holding back stool, hardening, colonic dilatation and further painful defecation. The aim of this study is to describe perception of school toilets, prevalence of functional abdominal pain (FAP) and constipation in elementary schools. DESIGN AND SETTING All elementary schools in Giessen County, Germany were contacted. Parents received a questionnaire on perception of toilets and criteria of functional abdominal pain and constipation in two consecutive years. RESULTS 212 (76.5%) families responded the child would use the school toilet for passing urine always, commonly or regularly (ACR), only 92 (33.2%) did so for passing stool. 46 (16.6%) were always disgusted by their school toilets, further 145 (52.3%) reported to be disgusted commonly or regularly. 126 parents reported their child would retain stool to avoid using the school toilet (45.5%). Children who were disgusted by and avoided using the school toilet showed significant higher prevalence of abdominal pain ACR (23.6% vs. 11.2%, p=0.0103) CONCLUSIONS: Prevalence of abdominal pain and constipation is high and increased after one year. Negative perception of school toilets with consecutive avoidance behavior could be an important and improvable influence.
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Affiliation(s)
- Jande Laffolie
- Department of General Pediatrics and Neonatology, Pediatric Gastroenterology, University of Giessen, Giessen
| | - Gentiana Ibrahimi
- Department of General Pediatrics and Neonatology, Pediatric Gastroenterology, University of Giessen, Giessen
| | - Klaus-Peter Zimmer
- Department of General Pediatrics and Neonatology, Pediatric Gastroenterology, University of Giessen, Giessen
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13
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Chometon T, Cortey C, Marchand-Tonel C, Saunders L, Cicchelero V, Lang T, Bouali O, Claudet I. [Voiding dysfunction and access to toilets among elementary school children: A Toulouse school district study]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2020; 32:441-449. [PMID: 33723949 DOI: 10.3917/spub.205.0441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED Not urinating regularly, voluntarily restraining oneself at school promotes the occurrence of voiding disorders. AIM To determine the prevalence of such disorders in elementary schools (students from 1st to 5th grade) and analyze the role of access to school toilets on voiding habits. METHOD Observational, descriptive epidemiological study during the 2017-2018 school year by electronic questionnaire with parents of pupils attending elementary school. RESULTS 2119 questionnaires were analyzed. The graders sex ratio was 1.07 (1087 boys). 410 families (19%) were classified as "popular" class. First, second and third graders represented 60% of the enrollment (N = 1273). Overall use of school toilets was 87% and 69% of students had appropriate use for urine. The main obstacles to their use were lack of hygiene and comfort (51%), lack of security or privacy (33%), limited accessibility (28%). The overall prevalence of urinary elimination disorders was 9%. Girls had more inappropriate use of the toilet for urine (36% vs 27%, OR 1.5, P = 0.0004). The factors associated with urinary elimination disorders were: not using the toilet (13% vs 9 %, OR 1.5, P = 0.04), being a girl (14% vs 5%, OR 3.5, P < 0.0001), belonging to the working class (14% vs 8% OR 1.8, P = 0.0008). CONCLUSION This situation, which is a long-denounced major public health problem, mainly affects girls and also reveals social inequalities in the use of school toilets.
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14
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McMichael C, Vally H. Children's perspectives on water, sanitation and hygiene in schools: A case-study from the Philippines. Health Place 2020; 62:102290. [PMID: 32479367 DOI: 10.1016/j.healthplace.2020.102290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Celia McMichael
- School of Geography, Faculty of Science, The University of Melbourne, VIC, Australia.
| | - Hassan Vally
- School of Psychology & Public Health, La Trobe University, VIC, Australia.
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Camenga DR, Brady SS, Hardacker CT, Williams BR, Hebert-Beirne J, James AS, Burgio K, Nodora J, Wyman JF, Berry A, Low LK. U.S. Adolescent and Adult Women's Experiences Accessing and Using Toilets in Schools, Workplaces, and Public Spaces: A Multi-Site Focus Group Study to Inform Future Research in Bladder Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3338. [PMID: 31510038 PMCID: PMC6765808 DOI: 10.3390/ijerph16183338] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 01/02/2023]
Abstract
The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women's lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by "gatekeepers" (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.
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Affiliation(s)
- Deepa R Camenga
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT 06519, USA.
| | - Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA.
| | - Cecilia T Hardacker
- Department of Education, Center for Education, Research and Advocacy, Howard Brown Health, Chicago, IL 60613, USA.
| | - Beverly R Williams
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
| | - Jeni Hebert-Beirne
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Aimee S James
- Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO 63110, USA.
| | - Kathryn Burgio
- Department of Medicine, University of Alabama at Birmingham and Department of Veterans Affairs, Birmingham, AL 35233, USA.
| | - Jesse Nodora
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine & Moores Cancer Center, La Jolla, CA 92093, USA.
| | - Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Amanda Berry
- Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
| | - Lisa K Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA.
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Nieuwhof-Leppink AJ, Schroeder RPJ, van de Putte EM, de Jong TPVM, Schappin R. Daytime urinary incontinence in children and adolescents. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:492-501. [DOI: 10.1016/s2352-4642(19)30113-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/21/2019] [Accepted: 03/06/2019] [Indexed: 01/21/2023]
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17
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Michels N, Van den Bussche K, Vande Walle J, De Henauw S. School Policy on Drinking and Toilets: Weaknesses and Relation With Children's Hydration Status. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:32-40. [PMID: 30146453 DOI: 10.1016/j.jneb.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate school policies and practices related to drinking fluids and toileting and test their association with children's hydration status and toilet behaviors. DESIGN Cross-sectional study in 2014. SETTING Seventeen Belgian primary schools. PARTICIPANTS A total of 416 children (aged 7-13 years). MAIN OUTCOME MEASURES Hydration was measured by urinary osmolality in a pooled school-day sample and by impedance-based body water percentage. Children reported how much they liked school toilets. School policy and practices were reported by schools on 59 items over 10 policy components. ANALYSIS Multilevel logistic regression analyses adjusted for age, sex, region and socioeconomic status. RESULTS School's weaknesses were the lack of policy participation by parents and children; official agreements (only in 11%); organizing education on drinking and toilet visits; and toilet infrastructure. Children's hydration was higher in schools that (1) made water available, (2) organized toilet and drinking related education, (3) had formal agreements on drinking and toilet visits, and (4) had good toilet maintenance. Children liked school toilets more in schools that (1) organized toilet and drinking related education, (2) had an official policy on drinking, (3) had good toilet infrastructure, and (4) allowed policy participation by parents and children. CONCLUSIONS AND IMPLICATIONS Specific action points for school management and government to improve children's hydration at school were detected by focusing on both drinking and toilet practices/infrastructure.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Karen Van den Bussche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Johan Vande Walle
- Department of Pediatric Nephrology and Urology, University Hospital Ghent, Ghent, Belgium
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Health Sciences, Vesalius, University College Ghent, Ghent, Belgium
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18
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Whale K, Cramer H, Joinson C. Left behind and left out: The impact of the school environment on young people with continence problems. Br J Health Psychol 2017; 23:253-277. [PMID: 29228510 PMCID: PMC5900927 DOI: 10.1111/bjhp.12284] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 10/27/2017] [Indexed: 11/30/2022]
Abstract
Objectives To explore the impact of the secondary school environment on young people with continence problems. Design In‐depth qualitative semi‐structured interviews. Methods We interviewed 20 young people aged 11–19 years (11 female and nine male) with continence problems (daytime wetting, bedwetting, and/or soiling). Interviews were conducted by Skype (n = 11) and telephone (n = 9). Transcripts were analysed using inductive thematic analysis. Results We generated five main themes: (1) Boundaries of disclosure: friends and teachers; (2) Social consequences of avoidance and deceit; (3) Strict and oblivious gatekeepers; (4) Intimate actions in public spaces; and (5) Interrupted learning. Conclusion Disclosure of continence problems at school to both friends and teachers was rare, due to the perceived stigma and fears of bullying and social isolation. The lack of disclosure to teachers and other school staff, such as pastoral care staff, creates challenges in how best to support these young people. Young people with continence problems require unrestricted access to private and adequate toilet facilities during the school day. There is a need for inclusive toilet access policies and improved toilet standards in schools. Addressing the challenges faced by young people with continence problems at school could help to remove the barriers to successful self‐management of their symptoms. It is particularly concerning that young people with continence problems are at higher risk of academic underachievement. Increased support at school is needed to enable young people with continence problems to achieve their academic potential. Statement of Contribution What is already known on this subject? Continence problems are among the most common paediatric health problems Self‐management of continence problems requires a structured schedule of fluid intake and bladder emptying Inadequate toilet facilities and restricted access make it difficult for young people to manage their incontinence
What does this study add? Improvement is needed in teacher understanding of the needs of young people with continence problems Young people are reluctant to disclose continence problems due to perceived stigma and fear of social isolation Young people with continence problems may be at increased risk of academic underachievement
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Affiliation(s)
- Katie Whale
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
| | - Helen Cramer
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, UK
| | - Carol Joinson
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
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19
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Yıldırım JG. Behaviours of students who have repeated urinary tract infections. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2017. [DOI: 10.1111/ijun.12133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Julide Gulizar Yıldırım
- Faculty of Health Sciences, Department of Public Health Nursing; Izmir Katip Celebi University; Izmira Turkey
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20
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Psychological and Physical Environmental Factors in the Development of Incontinence in Adults and Children: A Comprehensive Review. J Wound Ostomy Continence Nurs 2017; 44:181-187. [PMID: 28267126 DOI: 10.1097/won.0000000000000308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim of this review was to identify etiological environmental factors related to incontinence in children and adults. A variety of etiological environmental factors for the development of incontinence were identified. In children, these encompass stressful life events and trauma, family dysfunction, parental psychopathology, school-related stressors, toilet or "potty" training, fluid consumption habits, housing conditions, and the availability of toilets. In adults, physical exercise, obesity, working conditions, fluid intake, and the availability of toilets play a role. Intervening variables such as hormonal variations due to work shifts have also been identified as influencing the likelihood of incontinence. Current research suggests that environmental factors influence the development of incontinence in children and adults. The interactions between biological factors, the immediate environment, and intervening variables need to be explored in greater detail. Practical solutions to reduce barriers to adequate fluid intake and healthy toileting habits should be implemented in school and work settings.
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21
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Akça ÖF, Aysev A, Aycan İÖ. Familial Features and Comorbid Psychiatric Disorders in Children with Encopresis. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20110502050441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Ayla Aysev
- University of Ankara School of Medicine Child Psychiatry Clinic, Ankara-Turkey
| | - İrem Öker Aycan
- University of Ankara School of Medicine Child Psychiatry Clinic, Ankara-Turkey
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Tatlow-Golden M, O'Farrelly C, Booth A, Doyle O. "Bursting" to Go and Other Experiences. J Sch Nurs 2016; 33:214-222. [PMID: 27177551 DOI: 10.1177/1059840516646422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Children's use of the toilet at school, although rarely explored, is an important facet of school experience with consequences for physical and psychological health. A mixed methods study investigated views of 25 children (4-5 years) regarding potential stressors in the first school year, including views of toileting, in Dublin, Ireland. Despite very positive responses to school, most responses to toileting (15 of 25) were mixed or negative. Although some liked to go, or noted the toilets were clean, most indicated delayed toilet use ("bursting" to go) and ambivalent or negative experiences such as fear of not identifying the right toilet, fear of being alone, lack of privacy, and potential bullying. Many children did not expect to receive help from the teacher. As delaying toilet use can have lasting health consequences, teacher-nurse collaboration could be used to develop whole-school policies to support children's early adjustment in this sensitive area of functioning.
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Affiliation(s)
- Mimi Tatlow-Golden
- 1 UCD School of Medicine and Medical Science, University College Dublin, Belfield, Ireland
| | - Christine O'Farrelly
- 2 Department of Medicine, Centre for Mental Health, Imperial College London, London, United Kingdom
| | - Ailbhe Booth
- 3 UCD School of Psychology & UCD Geary Institute for Public Policy, University College Dublin, Belfield, Ireland
| | - Orla Doyle
- 4 UCD School of Economics & UCD Geary Institute for Public Policy, University College Dublin, Belfield, Ireland
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23
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Lundblad B, Johansson R, Wigert H, Hellström AL. Satisfying Toilet Needs in Pre-School <br/>—Experiences of 5 - 6 Years Old. Health (London) 2016. [DOI: 10.4236/health.2016.815164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Tatlow-Golden M, O’Farrelly C, Booth A, O’Rourke C, Doyle O. ‘Look, I have my ears open’: Resilience and early school experiences among children in an economically deprived suburban area in Ireland. SCHOOL PSYCHOLOGY INTERNATIONAL 2015. [DOI: 10.1177/0143034315613777] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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25
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Norling M, Stenzelius K, Ekman N, Wennick A. High School Students' Experiences in School Toilets or Restrooms. J Sch Nurs 2015; 32:164-71. [PMID: 26475260 DOI: 10.1177/1059840515611476] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Previous research about school toilets is based on studies of children in elementary school. Thus, the aim of this study was to explore the experiences when using the school toilets reported by students aged 16-18 years. Qualitative interviews with 21 students were conducted and analyzed using content analysis. The data revealed that the toilets were considered insecure, dirty, and unpleasant. Additionally, students refrained from drinking during school hours and remained in constant movement or jumped up and down to withhold urine and stool. This was illustrated in the following categories: assessing the toilet environment, coping with the situation, and feeling exposed Hence, there is an urgent need to improve the school toilet environment in order to respect the rights of all students to void or defecate when necessary, a process which will require involvement of students, teachers, and other school staff as well as the School Health Service.
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Affiliation(s)
- Maja Norling
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Karin Stenzelius
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Nina Ekman
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Anne Wennick
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Johansen A, Denbæk AM, Bonnesen CT, Due P. The Hi Five study: design of a school-based randomized trial to reduce infections and improve hygiene and well-being among 6-15 year olds in Denmark. BMC Public Health 2015; 15:207. [PMID: 25886286 PMCID: PMC4351932 DOI: 10.1186/s12889-015-1556-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 02/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infectious illnesses such as influenza and diarrhea are leading causes of absenteeism among Danish school children. Interventions in school settings addressing hand hygiene have shown to reduce the number of infectious illnesses. However, most of these studies include small populations and almost none of them are conducted as randomized controlled trials. The overall aim of the Hi Five study was to develop, implement and evaluate a multi-component school-based intervention to improve hand hygiene and well-being and to reduce the prevalence of infections among school children in intervention schools by 20% compared to control schools. This paper describes the development and the evaluation design of Hi Five. METHODS/DESIGN The Hi Five study was designed as a tree-armed cluster-randomized controlled trial. A national random sample of schools (n = 44) was randomized to one of two intervention groups (n = 29) or to a control group with no intervention (n = 15). A total of 8,438 six to fifteen-year-old school children were enrolled in the study. The Hi Five intervention consisted of three components: 1) a curriculum component 2) mandatory daily hand washing before lunch 3) extra cleaning of school toilets during the school day. Baseline data was collected from December 2011 to April 2012. The intervention period was August 2012 to June 2013. The follow-up data was collected from December 2012 to April 2013. DISCUSSION The Hi Five study fills a gap in international research. This large randomized multi-component school-based hand hygiene intervention is the first to include education on healthy and appropriate toilet behavior as part of the curriculum. No previous studies have involved supplementary cleaning at the school toilets as an intervention component. The study will have the added value of providing new knowledge about usability of short message service (SMS, text message) for collecting data on infectious illness and absenteeism in large study populations. TRIAL REGISTRATION Current Controlled Trials ISRCTN19287682 , 21 December 2012.
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Affiliation(s)
- Anette Johansen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A 2., København K, DK-1353, Denmark.
| | - Anne Maj Denbæk
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A 2., København K, DK-1353, Denmark.
| | - Camilla Thørring Bonnesen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A 2., København K, DK-1353, Denmark.
| | - Pernille Due
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A 2., København K, DK-1353, Denmark.
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27
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Ching CB, Lee H, Mason MD, Clayton DB, Thomas JC, Pope JC, Adams MC, Brock JW, Tanaka ST. Bullying and Lower Urinary Tract Symptoms: Why the Pediatric Urologist Should Care about School Bullying. J Urol 2015; 193:650-4. [DOI: 10.1016/j.juro.2014.08.103] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Christina B. Ching
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Haerin Lee
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Matthew D. Mason
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Douglass B. Clayton
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - John C. Thomas
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - John C. Pope
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Mark C. Adams
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - John W. Brock
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
| | - Stacy T. Tanaka
- Division of Pediatric Urology, Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee
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Factors associated with pupil toilet use in kenyan primary schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:9694-711. [PMID: 25233014 PMCID: PMC4199044 DOI: 10.3390/ijerph110909694] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/09/2014] [Accepted: 09/10/2014] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to quantify how school sanitation conditions are associated with pupils’ use of sanitation facilities. We conducted a longitudinal assessment in 60 primary schools in Nyanza Province, Kenya, using structured observations to measure facility conditions and pupils’ use at specific facilities. We used multivariable mixed regression models to characterize how pupil to toilet ratio was associated with toilet use at the school-level and also how facility conditions were associated with pupils’ use at specific facilities. We found a piecewise linear relationship between decreasing pupil to toilet ratio and increasing pupil toilet use (p < 0.01). Our data also revealed significant associations between toilet use and newer facility age (p < 0.01), facility type (p < 0.01), and the number of toilets in a facility (p < 0.01). We found some evidence suggesting facility dirtiness may deter girls from use (p = 0.06), but not boys (p = 0.98). Our study is the first to rigorously quantify many of these relationships, and provides insight into the complexity of factors affecting pupil toilet use patterns, potentially leading to a better allocation of resources for school sanitation, and to improved health and educational outcomes for children.
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Impact of toilet hygiene training program: results from 11- to 16-year-old secondary school Turkish children. Int J Public Health 2014; 59:799-807. [PMID: 25173963 DOI: 10.1007/s00038-014-0595-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/17/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022] Open
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Senior E. We love our school toilets: involving primary school students in improving their school toilets. Glob Health Promot 2014; 21:23-8. [DOI: 10.1177/1757975913508420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reports on the planning, implementation and evaluation of an intervention to improve school students’ experience of using the school toilet in a primary school in Melbourne, Australia. 20 students from grades 2–6 participated in focus groups, to discuss what they valued about the school and raise awareness of issues they were not happy about. A common theme from all of the focus groups was that students reported avoiding use of the school toilets. Using the ideas generated from the focus groups, the student council (with input from staff), developed a self-administered pre- and post-test questionnaire. This was given to 220 students in grades 1–4, aged 6–10 years. Improvements suggested by the students were made to the toilet block, and then a post-test was administered. Independent t tests were conducted. The pre-test indicated that 71% of girls and 65% of boys feared the behaviour of other students in the toilet. Overwhelmingly, the qualitative comments focused on poor student behaviour in the toilets, with lack of privacy due to student misbehaviour mentioned in 90% of the comments. After the toilets were revamped, the greatest gains were made in students’ attitudes toward the toilets, with a 37% increase in students who indicated they now liked the toilet facility. Incidents of vandalism also decreased; however, student misconduct in the toilets was still regarded as a problem. Involving students in refurbishing their toilets improved how students viewed the toilets and reduced vandalism; however, a different intervention is required to change inappropriate behaviours in the toilet.
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Chatterley C, Javernick-Will A, Linden KG, Alam K, Bottinelli L, Venkatesh M. A qualitative comparative analysis of well-managed school sanitation in Bangladesh. BMC Public Health 2014; 14:6. [PMID: 24397540 PMCID: PMC3890631 DOI: 10.1186/1471-2458-14-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 12/17/2013] [Indexed: 11/10/2022] Open
Abstract
Background Continued management of sanitation and hygiene services, post-intervention, is a global challenge, particularly in the school-setting. This situation threatens anticipated impacts of school sanitation and hygiene investments. To improve programming and policies, and increase the effectiveness of limited development resources, we seek to understand how and why some schools have well-managed sanitation post-intervention, while others do not. Methods Based on in-depth qualitative data from 16 case schools in Meherpur, Bangladesh, we employ fuzzy-set qualitative comparative analysis to identify the necessary and sufficient conditions, or combinations of conditions (referred to as pathways), that lead to either well-managed or poorly managed school sanitation. We include posited sustainability determinants from the literature and factors that emerged from the cases themselves in the analysis. Results We identified three distinct pathways sufficient to support well-managed services, providing multiple options for how well-managed school sanitation could be encouraged. Two of these are applicable to both government and non-government schools: (1) quality construction, financial community support and a champion; and (2) quality construction, financial government support, a maintenance plan and school management committee involvement. On-going financial support for operations and maintenance was identified as a necessary condition for continued service management, which was absent from many schools with poorly managed services. However, financial support was insufficient alone and other conditions are needed in conjunction, including quality construction and incentivizing conditions, such as school management committee involvement in sanitation specifically, a sanitation champion, and/or one teacher clearly responsible for toilet maintenance. Surprisingly, the number of students per toilet (ranging from 18–95 students) and toilet age (ranging from 8–32 months) had no significant effect on sanitation conditions. Conclusions Findings corroborate those from a similar study in Belize, and comparison suggests the need for financial community support and the possibly tenuous reliance on local champions in the absence of adequate government support for operations and maintenance. Sub-determinants to the necessary conditions are also discussed which have implications for school sanitation in Bangladesh and may have broader relevance for other low-income countries though further research is needed.
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Affiliation(s)
- Christie Chatterley
- Department of Civil, Environmental and Architectural Engineering, University of Colorado, Boulder, USA.
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Hoarau B, Vercherin P, Bois C. Toilettes au collège : moins j'y vais... et mieux je me porte ? SANTE PUBLIQUE 2014. [DOI: 10.3917/spub.144.0421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Ellsworth P, Marschall-Kehrel D, King S, Lukacz E. Bladder health across the life course. Int J Clin Pract 2013; 67:397-406. [PMID: 23574100 DOI: 10.1111/ijcp.12127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 01/07/2013] [Indexed: 12/22/2022] Open
Abstract
Influences on bladder health begin during infancy and continue throughout the lifespan. Bladder anatomy and physiology change as individuals age, and the risk and propensity for bladder conditions, including lower urinary tract symptoms, throughout life are related to factors specific to age, sex, and life events. Bladder habits and dysfunctions at one stage of life may affect bladder health in subsequent stages. However, bladder problems are neither a normal part of aging nor inevitable at any stage of life. Many of the factors that negatively impact bladder health at all ages may be modifiable, and healthy bladder habits may prevent or reverse bladder dysfunctions that can occur naturally or in response to life events. There are opportunities to further define and promote healthy bladder habits through focused research and heightened public awareness of the importance of bladder health, which may lead to improvements in overall health and quality of life. It is our hope that this paper will inform and encourage public health initiatives and research programs aimed at this goal.
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Affiliation(s)
- P Ellsworth
- University Urological Associates Inc., Brown University, Providence, RI 02905, USA.
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Nguyen TKA, Vernon SJ, Bengtson A, Hellström AL. Toilet habits in kindergarten children in a kindergarten in Hanoi. Health (London) 2013. [DOI: 10.4236/health.2013.511237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Palmer MH, Athanasopoulos A, Lee KS, Takeda M, Wyndaele JJ. Sociocultural and environmental influences on bladder health. Int J Clin Pract 2012; 66:1132-8. [PMID: 23163494 DOI: 10.1111/ijcp.12029] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- M H Palmer
- Institute on Aging, University of North Carolina, Chapel Hill, NC, USA.
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Jasper C, Le TT, Bartram J. Water and sanitation in schools: a systematic review of the health and educational outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:2772-87. [PMID: 23066396 PMCID: PMC3447586 DOI: 10.3390/ijerph9082772] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 07/14/2012] [Accepted: 07/17/2012] [Indexed: 11/30/2022]
Abstract
A systematic review of the literature on the effects of water and sanitation in schools was performed. The goal was to characterize the impacts of water and sanitation inadequacies in the academic environment. Published peer reviewed literature was screened and articles that documented the provision of water and sanitation at schools were considered. Forty-one peer-reviewed papers met the criteria of exploring the effects of the availability of water and/or sanitation facilities in educational establishments. Chosen studies were divided into six fields based on their specific foci: water for drinking, water for handwashing, water for drinking and handwashing, water for sanitation, sanitation for menstruation and combined water and sanitation. The studies provide evidence for an increase in water intake with increased provision of water and increased access to water facilities. Articles also report an increase in absenteeism from schools in developing countries during menses due to inadequate sanitation facilities. Lastly, there is a reported decrease in diarrheal and gastrointestinal diseases with increased access to adequate sanitation facilities in schools. Ensuring ready access to safe drinking water, and hygienic toilets that offer privacy to users has great potential to beneficially impact children's health. Additional studies that examine the relationship between sanitation provisions in schools are needed to more adequately characterize the impact of water and sanitation on educational achievements.
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Affiliation(s)
- Christian Jasper
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7431, Chapel Hill, NC 27599, USA;
| | - Thanh-Tam Le
- Department of Biology, University of North Carolina at Chapel Hill, 120 South Road, Chapel Hill, NC 27599, USA;
| | - Jamie Bartram
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7431, Chapel Hill, NC 27599, USA;
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Abstract
Human defecation involves integrated and coordinated sensorimotor functions, orchestrated by central, spinal, peripheral (somatic and visceral), and enteric neural activities, acting on a morphologically intact gastrointestinal tract (including the final common path, the pelvic floor, and anal sphincters). The multiple factors that ultimately result in defecation are best appreciated by describing four temporally and physiologically fairly distinct phases. This article details our current understanding of normal defecation, including recent advances, but importantly identifies those areas where knowledge or consensus is still lacking. Appreciation of normal physiology is central to directed treatment of constipation and also of fecal incontinence, which are prevalent in the general population and cause significant morbidity.
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Affiliation(s)
- Somnath Palit
- Academic Surgical Unit (GI Physiology Unit), Barts and the London School of Medicine and Dentistry, Blizard Institute, Queen Mary University, London, UK.
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Le TTX, Luu NH, Rheinländer T, Dalsgaard A, Konradsen F. Sanitation behavior among schoolchildren in a multi-ethnic area of Northern rural Vietnam. BMC Public Health 2012; 12:140. [PMID: 22353490 PMCID: PMC3305623 DOI: 10.1186/1471-2458-12-140] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 02/21/2012] [Indexed: 11/17/2022] Open
Abstract
Background In Vietnam, efforts are underway to improve latrine use in rural and remote areas with particular focus on increasing coverage of sanitation in schools. However, there is a lack of information on how the school program affects latrine use by schoolchildren and at community level. This paper analyzes sanitation use among schoolchildren in a multi-ethnic area to inform future school-based sanitation promotion programmes. Methods A combination of quantitative and qualitative methods was applied during a 5 months period in six primary and secondary schools and in the homes of schoolchildren in four different ethnic villages in Northern rural Vietnam. Using a structured questionnaire, 319 children were interviewed face-to-face to collect quantitative data. Qualitative methods included extensive observations at schools and in the homes of 20 children, a single day's diary writings of 234 children, in-depth interviews with children (20), their parents (20) and school staff (10), and focus group discussions with parents (4) and teachers (6), and picture drawing with children (12). Results All surveyed schools had student latrines. However, the observed schoolchildren most commonly urinated and defecated in the open. Main barriers for latrine use included inadequate number of latrines, limited accessibility to latrines, lack of constant water supply in latrines and lack of latrine maintenance by school management. Programs promoting latrine use for children were not conducted in either schools or communities and were not established as a preferred social norm in such settings. Children perceived existing school latrines as unappealing and expressed a wish to have basic, functional, clean, and colorful school latrines with privacy. Conclusions The paper shows that the current school based sanitation promotion is insufficient to change sanitation behavior of school children irrespective of their ethnicity. It is important that schools, households and communities work more closely together to increase use and uptake of latrine use among schoolchildren. Also, the contractors of latrine facilities must work more closely with local school management when constructing latrines, including identifying location, design and appropriate systems of water supply. A separate budget needs to be allocated to allow the school to maintain the sanitation infrastructure and keep it hygienic and appealing for users.
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Affiliation(s)
- Thi Thanh Xuan Le
- Department of Environmental Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
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Abstract
A panel of experts in urology, urogynecology, nursing, and behavioral therapy convened in 2010 to discuss the importance of a healthy bladder on overall health. They determined that a consensus statement was necessary to raise awareness among the general public, healthcare providers, payors, and policymakers, with the goals of minimizing the impact of poor bladder health and stimulating primary prevention of bladder conditions. In this statement, 'healthy' bladder function is described, as well as internal and external factors that influence bladder health. It is suggested that primary prevention strategies should be aimed at providing education regarding normal lower urinary tract structures and functioning to the public, including patients and healthcare providers. This education may promote the achievement of optimal bladder health by increasing healthy bladder habits and behaviors, awareness of risk factors, healthcare seeking, and clinician engagement and reducing stigma and other barriers to treatment. Promoting optimal bladder health may reduce the personal, societal and economic impact of bladder conditions, including anxiety and depression and costs associated with conditions or diseases and their treatment. While adopting healthy bladder habits and behaviors and behaviors may improve or maintain bladder health, it is important to recognize that certain symptoms may indicate the presence of conditions that require medical attention; many bladder conditions are treatable with a range of options for most bladder conditions. Lastly, the authors propose clinical directives based on persuasive and convergent research to improve and maintain bladder health. The authors hope that this statement will lead to promotion and achievement of optimal bladder health, which may improve overall health and help minimize the effects of bladder conditions on the public, healthcare professionals, educators, employers, and payors. The advisors are in consensus regarding the recommendations for improving and maintaining bladder health presented herein.
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Affiliation(s)
- E S Lukacz
- University of California, San Diego, San Diego, CA 92037, USA.
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McMahon S, Caruso BA, Obure A, Okumu F, Rheingans RD. Anal cleansing practices and faecal contamination: a preliminary investigation of behaviours and conditions in schools in rural Nyanza Province, Kenya. Trop Med Int Health 2011; 16:1536-40. [PMID: 21906214 DOI: 10.1111/j.1365-3156.2011.02879.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To learn how children in rural schools in Nyando District, Kenya clean themselves after defecation. METHODS Six focus group discussions were held with boys and girls ages 12-15 in three rural schools in mid-2009. Parents were interviewed in one setting. In early 2010, a survey of head teachers was conducted in 114 schools in Nyanza Province, Kenya, to assess the provision of anal cleansing materials and handwashing water and soap in schools. RESULTS Anal cleansing behaviour is linked with access to materials, age, social pressure, perceived personal risk of illness and emotional factors. Materials used for anal cleansing include schoolbook paper, leaves, grasses, stones, corncobs and one's own hands. Students have knowledge gaps in terms of personal hygiene. They were forthcoming with information on their anal cleansing practices. Almost no schools budgeted for or provided anal cleansing materials regularly. CONCLUSION Anal cleansing is a necessary human activity. However, because of social taboos, there are few articles on the topic. School health plans overlook it as well. Researchers need to determine if and how current practices could harm child health to inform policy.
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Affiliation(s)
- Shannon McMahon
- Center for Global Safe Water, Emory University, Atlanta, GA, USA
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Atuyambe LM, Ediau M, Orach CG, Musenero M, Bazeyo W. Land slide disaster in eastern Uganda: rapid assessment of water, sanitation and hygiene situation in Bulucheke camp, Bududa district. Environ Health 2011; 10:38. [PMID: 21569594 PMCID: PMC3118126 DOI: 10.1186/1476-069x-10-38] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 05/14/2011] [Indexed: 05/22/2023]
Abstract
BACKGROUND On 1st March 2010, a major landslide occurred on Mt. Elgon in Eastern Uganda. This was triggered by heavy rains that lasted over three months. The landslide buried three villages in Bududa district, killing over 400 and displacing an estimate of 5,000 people. A comprehensive assessment of water, sanitation and hygiene was urgently needed to inform interventions by the Ministries of Health, and Relief, Disaster Preparedness and Refugees, Uganda. METHODS This was a cross-sectional study where both qualitative and quantitative data were collected two weeks after the disaster. Quantitative interviews involved 397 heads of households and qualitative methods comprised of 27 Key Informant interviews, four focus group discussions and observations. The survey quantified water safety (collection, treatment, storage) and hygiene practices. This was supplemented and triangulated with qualitative data that focused on community perceptions and beliefs regarding water and sanitation needs and practices. Quantitative data was entered in Epi-Info Version 3.2.2 software and then exported to SPSS Version 12 for analysis. Summary statistics and proportions were generated and bi-variable analysis performed for selected variables. Associations were assessed using odds ratios at 95% confidence intervals. Qualitative data was analyzed using content analysis. RESULTS Qualitative results showed that there were strong traditional beliefs governing water use and human excreta disposal. The use of river Manafwa water for household consumption was observed to potentially lead to disease outbreaks. Water from this river was reported tastier and the community culturally saw no need to boil drinking water. Latrines were few (23 for 5000 people), shallow, dirty (70% reported flies, 60% fecal littering), not separated by sex and had limited privacy and no light at night. This affected their use. Males were 3 times more likely to wash hands with soap after latrine use than females (OR = 3.584, 95%CI: 1.658-7.748). Of the 90% respondents who indicated that they always washed hands after latrine use, 76% said they used water and soap. Observations showed that water and soap were inconsistently available at the hand washing facilities. This situation influenced people's sanitation and hygiene behaviours. Nearly half (48%) indicated that at least a member of their household had fallen sick at least once since arrival at the camp. CONCLUSION There was inadequate access to safe water in the camp. Pit-latrines were inadequate, poorly maintained and not user-friendly for most people. Responsible authorities should design means of increasing and sustaining access to safe water, increase sanitation facilities and continuously educate the public on the need to observe good hygiene practices.
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Affiliation(s)
- Lynn M Atuyambe
- Makerere University School of Public Health, Department of Community Health and Behavioural Sciences, P.O. Box 7072, Kampala, Uganda
| | - Michael Ediau
- Makerere University School of Public Health/CDC Fellowship Program, Kampala, Uganda
| | - Christopher G Orach
- Makerere University School of Public Health, Department of Community Health and Behavioural Sciences, P.O. Box 7072, Kampala, Uganda
| | - Monica Musenero
- Ministry of Health Uganda, Integrated Disease Surveillance, Kampala, Uganda
| | - William Bazeyo
- Makerere University School of Public Health, Department of Disease Control and Environmental Health, Kampala, Uganda
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Families' perspectives on the effect of constipation and fecal incontinence on quality of life. J Pediatr Gastroenterol Nutr 2010; 51:747-52. [PMID: 20706148 DOI: 10.1097/mpg.0b013e3181de0651] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Understanding families' quality of life can be important for interdisciplinary treatment planning. The present study examined child and parent perspectives about how constipation and fecal incontinence affect families' quality of life. PATIENTS AND METHODS Semistructured interviews were conducted with 8 children/adolescents and 8 caregivers. All of the children met Rome II criteria for functional constipation. Interviews were analyzed by an interdisciplinary team using a content analysis approach, which included developing a coding manual that described emergent themes from the interview transcripts. RESULTS Qualitative and quantitative responses revealed the varied experiences of participating families. Child and parent views may be misaligned, which can affect treatment planning and effectiveness. Families described variable satisfaction with the treatment recommendations they had been offered and experienced difficulty finding appropriate care. Children's social and family functioning were significantly affected by constipation and fecal incontinence difficulties. Both children and parents described the challenges of discussing the problems with others. CONCLUSIONS Multiple domains of individual and family functioning are affected by children's constipation and fecal incontinence difficulties, thereby affecting the quality of life of both children and their parents. The findings underscore the need for providers to consider the influence of symptoms on adjustment to both the medical condition and treatment adherence and discuss concerns with children and parents. The results provide the foundation for developing a standardized tool for quantitative assessment of quality of life for children with constipation.
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Lopez-Quintero C, Freeman P, Neumark Y. Hand washing among school children in Bogotá, Colombia. Am J Public Health 2008; 99:94-101. [PMID: 19008513 DOI: 10.2105/ajph.2007.129759] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed hand-washing behaviors and intentions among school children in Bogotá, Colombia, to help identify and overcome barriers to proper hygiene practices. METHODS Data on hand-washing behavior and intentions and individual and contextual factors were collected from 2042 sixth- through eighth-grade students in 25 schools in Bogotá via anonymous questionnaires. A member of the school administration or teaching staff completed a questionnaire about the school environment. Site inspections of bathroom facilities were conducted. RESULTS Only 33.6% of the sample reported always or very often washing hands with soap and clean water before eating and after using the toilet. About 7% of students reported regular access to soap and clean water at school. A high level of perceived control was the strongest predictor of positive hand-washing intentions (adjusted odds ratio [AOR]=6.0; 95% confidence interval [CI]=4.8, 7.5). Students with proper hand-washing behavior were less likely to report previous-month gastrointestinal symptoms (OR=0.8; 95% CI=0.6, 0.9) or previous-year school absenteeism (OR=0.7; 95% CI=0.6, 0.9). CONCLUSIONS Scarcity of adequate facilities in most schools in Bogotá prevents children from adopting proper hygienic behavior and thwarts health promotion efforts. The current renovation program of public schools in Bogotá provides a unique opportunity to meet the challenges of providing a supportive environment for adoption of healthy behaviors.
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Affiliation(s)
- Catalina Lopez-Quintero
- Braun School of Public Health & Community Medicine, Hebrew University, Hadassah, PO Box 12272, Jerusalem, Israel
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Abstract
AIM Most children are continent of urine by the time they are in primary school. Balanced micturition and paradoxically dysfunctional voiding (DV) are acquired behaviour. Children need easy access to toilets at school, to comply with timed voiding which is part of the treatment for DV. This study investigated children's access to primary school toilets in Auckland. METHODS A questionnaire was sent to 97 primary schools listed on the New Zealand ministry of education (MoE) website for the Auckland region. Information regarding the school decile rating, population, rota, toilet facilities and toilet policy was requested. Six randomly selected schools were visited to verify the facilities available there. RESULTS Eighty-four percent of the schools in our sample complied with the prescribed statutory minimum for both boys and girls toilets. There was a median ratio of 11 children per facility. The median duration to use a facility during the first recess was 2 min. CONCLUSION In general, the toilet facilities and utilization ratios in primary schools in the Auckland region appear to provide a healthy environment for urination. Schools must be encouraged to draft and adhere to a toilet policy to ensure a uniform toilet environment.
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Affiliation(s)
- Vipul Upadhyay
- University of Auckland, Starship Children's Hospital, Grafton, Auckland 1001, New Zealand.
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Birch J, Curtis P, James A. Sense and Sensibilities: In Search of the Child-Friendly Hospital. ACTA ACUST UNITED AC 2007. [DOI: 10.2148/benv.33.4.405] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Inan M, Aydiner CY, Tokuc B, Aksu B, Ayvaz S, Ayhan S, Ceylan T, Basaran UN. Factors associated with childhood constipation. J Paediatr Child Health 2007; 43:700-6. [PMID: 17640287 DOI: 10.1111/j.1440-1754.2007.01165.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM To evaluate factors associated with constipation, determine its risk factors and identify common methods of managing constipation among schoolchildren from ages 7-12 in Edirne, Turkey. METHODS This was a cross-sectional and descriptive study and 1900 children were stratified by the school population, age and gender. The questionnaire collected information from parents about the prevalence of constipation and associated factors as well. It asked about bowel movements, socio-demographic data, personal and family stressors, parental concern about constipation, and treatment methods. RESULTS The overall prevalence of constipation was 7.2%. It was 7.3% in boys and 7.2% in girls (P > 0.05). The parameters of siblings with health problems, constipation history in family members, abnormal oral habits, and little regular sporting activity were more common in constipated children than in non-constipated ones (P < 0.05). In the logistic regression analysis, never having used school toilets (OR: 5.9) and having problem to control their bowel after 2 years of age (OR: 3.1) were found to be major risk factors for constipation in schoolchildren ages 7-12 years. Constipated children had a lower consumption rate of fruits and vegetables and a higher consumption rate of milk-group foods, biscuits and macaroni than non-constipated children. Parental concern was at 90% and the rate of medical consultation was 23.2% for constipated children. CONCLUSIONS The risk factors for childhood constipation may be genetic, psychological or organic. Bowel functions may be affected by dietary habits. Parents, health and education professionals should give special attention to childhood constipation.
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Affiliation(s)
- Mustafa Inan
- Department of Pediatric Surgery, Trakya University Faculty of Medicine, Edirne 22030, Turkey.
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van Dijk M, Benninga MA, Grootenhuis MA, Nieuwenhuizen AMOV, Last BF. Chronic childhood constipation: a review of the literature and the introduction of a protocolized behavioral intervention program. PATIENT EDUCATION AND COUNSELING 2007; 67:63-77. [PMID: 17374472 DOI: 10.1016/j.pec.2007.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Revised: 02/05/2007] [Accepted: 02/06/2007] [Indexed: 05/14/2023]
Abstract
OBJECTIVE To release a newly protocolized behavioral intervention program for children with chronic constipation aged 4-18 years with guidance from literature about underlying theories from which the treatment techniques follow. METHODS Articles until July 2006 were identified through electronic searches in Medline, PsychInfo and Picarta. There was no limit placed on the time periods searched. Following keywords were used: constipation, encopresis, fecal incontinence, psychotherapy, emotions, randomized controlled trials, parent-child relations, parents, family, psychology, behavioral, behavioral problems, psychopathology, toilet, social, psychosocial, pain, retentive posturing, stool withholding, stool toileting refusal, shame, stress, anxiety. A filter was used to select literature referring to children 0-18 years old. Key constructs and content of sessions for a protocolized behavioral intervention program are derived from literature. RESULTS Seventy-one articles on chronic childhood constipation are critically reviewed and categorized into sections on epidemiology, symptomatology, etiology and consequences, treatment and effectivity, and follow-up on chronic childhood constipation. This is followed by an extensive description of our protocolized behavioral intervention program. CONCLUSION This is the first article on childhood constipation presenting a full and transparent description of a behavioral intervention program embedded in literature. In addition, a theoretical framework is provided that can serve as a trial paradigm to evaluate intervention effectiveness. PRACTICE IMPLICATIONS This article can serve as an extensive guideline in routine practice to treat chronically constipated children. By releasing our protocolized behavioral intervention program and by offering a theoretical framework we expect to provide a good opportunity to evaluate clinical effectivity by both randomized controlled trials and qualitative research methods. Findings will contribute to the implementation of an effective treatment for chronic constipation in childhood.
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Affiliation(s)
- Marieke van Dijk
- Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Lundblad B, Berg M, Hellström AL. Experiences of children treating functional bladder disturbances on schooldays. J Pediatr Urol 2007; 3:189-93. [PMID: 18947732 DOI: 10.1016/j.jpurol.2006.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Accepted: 08/02/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE After clinical urotherapeutic guidance, schoolchildren suffering from functional bladder disturbances are expected to manage treatment at school. To comply with treatment instructions the children have to visit the toilet at least every 3 h, find the sitting position facilitating relaxation of the pelvic floor, and then empty the bladder as completely as possible. They often blame failing to comply on their experiences of the school toilet. We describe the experiences of children treating functional bladder disturbances on schooldays. METHOD The study consisted of open-ended interviews of 20 schoolchildren aged 8-14 years undergoing treatment for functional bladder disturbances, and qualitative content analysis was performed. RESULTS Conflicting rules, a risky toilet environment and uncertainty concerning social support at school were experienced. The children had difficulty in reconciling treatment compliance with their psychological needs. They used various tricks to avoid disclosing their bladder disturbances and enabling postponement of toilet visits. Most children gave their psychological needs priority over carrying out treatment. CONCLUSION The physical and social school environment was not adapted to these children's needs.
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Affiliation(s)
- Barbro Lundblad
- Sahlgrenska Academy, Göteborg University, Institute of Health and Care Sciences, Göteborg University, 405 30 Göteborg, Sweden.
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Ojmyr-Joelsson M, Nisell M, Frenckner B, Rydelius PA, Christensson K. High and intermediate imperforate anus: psychosocial consequences among school-aged children. J Pediatr Surg 2006; 41:1272-8. [PMID: 16818062 DOI: 10.1016/j.jpedsurg.2006.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/PURPOSE Imperforate anus is an unusual malformation, which, even after surgical intervention, usually entails constipation and fecal incontinence. This study aimed to evaluate ongoing psychosocial effects of this birth defect in school-aged children. METHODS Twenty-five children born with high and intermediate imperforate anus participated in the study, along with their parents and classroom teachers. One group of healthy children and 1 group of children with juvenile chronic arthritis, along with their parents, served as controls. Children and parents individually answered a questionnaire devised for this study. Parents filled out the Child Behavior Checklist and the children's teacher filled out the Teacher's Report Form. RESULTS According to test results, children with imperforate anus were happy and optimistic. They liked school better and reported better relationships with schoolmates than the other children. The index group reported statistically significantly more frequent constipation. According to parental responses, the imperforate-anus children suffered from fecal incontinence and odor, as well as constipation (P < .001). Index-group parents reported on the Child Behavior Checklist that their children had more emotional and behavioral problems. On the Teacher's Report Form, teachers reported few problems for the same children. CONCLUSIONS Patients with imperforate anus did not experience psychosocial impairment despite significant functional problems.
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Affiliation(s)
- Maria Ojmyr-Joelsson
- Division of Pediatric Surgery, Q2:03, Astrid Lindgren Children's Hospital, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
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Comas Vives A, Polanco Allué I. [Case-control study of risk factors associated with constipation. The FREI Study]. An Pediatr (Barc) 2005; 62:340-5. [PMID: 15826563 DOI: 10.1157/13073247] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Children represent one of the patient groups most affected by constipation. Our objective was to identify and describe the risk factors associated with childhood constipation. PATIENTS AND METHODS The study had a case-control, retrospective, open and multicenter design. Clinical data on possible risk factors were collected through an ad-hoc questionnaire. Two groups were studied: children with and without constipation. RESULTS Nine hundred twenty-one children were recruited; of these, 898 (97.6%) were included in the statistical analysis. There were 408 (45.4%) children in the constipated group and 490 (54.5%) in the non-constipated group. Most of the children with constipation (53.6%) had a maternal history of constipation compared with 21.4% of children without constipation (p < 0.05). More than half (53.2%) of the constipated children reported a lack of regularity in their toilet habits while 64.9 % of the children without constipation went to the toilet regularly. Toilet training started slightly earlier (at 3 years) in children without constipation (93.2%) than in those with the disorder (83.8%) (p < 0.05). At school, 57.4% of the children with constipation never used the toilet compared with 26.8% of those without constipation (p < 0.05). A total of 73.4% of children with constipation drank less than four glasses of water per day compared with 47.1% of those without constipation (p < 0.05). Consumption of vegetables and legumes in the diet was significantly lower in children with constipation than in those without (p < 0.05). The risk factors linked to childhood constipation found in this study were a familial history of constipation, irregular toilet habits, low dietary fiber contents and no fruit intake. The main preventive factors against constipation were water and vegetable consumption and training on the use of the toilet at school. CONCLUSIONS Daily toilet training and dietary changes are needed to prevent constipation among children and to achieve regular defecation. This preventive intervention should be reinforced at school.
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Affiliation(s)
- A Comas Vives
- Departamento Médico Solvay Pharma, Barcelona, España
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