Background: Yogo teachers (school nurses) face difficulties in dealing with children's unidentified complaints. In general, the Yogo teachers support children in aspects of identifying the causes and accepting children in order to encourage them to resolve their problems independently. However, Yogo teachers often feel difficulties in listening to children and paying attention to their signs of danger. In particular, when Yogo teachers deal with children's unidentified complaints, they also feel difficulties in identifying the causes and returning them to the classroom.

Objective: The purpose of study was to elucidate the difficulties that Yogo teachers faced in dealing with children's unidentified complaints.

Methods: A 20-item questionnaire was designed based on data from interviews with Yogo teachers. Seven hundred seventy Yogo teachers were surveyed. Data collected from 304 Yogo teachers were conducted on exploratory, confirmatory factor analyses, and compared for attributes.

Results: The results of the factor analysis revealed two potential factors for the difficulties of Yogo teachers in dealing with children's unidentified complaints. One was that they felt unable to help children to resolve their problems independently, and the other was that they felt unable to help children aware of the cause for the unidentified complaint. Confirmatory factor analysis revealed that the goodness-of-fit of this model was generally acceptable (GFI=.95, AGFI=.92, CFI=.96, RMSEA=.08). It was found that younger Yogo teachers with less age or experience were likely to face difficulties in supporting children.

Conclusion: The results suggest that Yogo teachers felt more difficulty in aspects of accepting children in order to encourage them to resolve problems independently rather than identifying the causes of unidentified complaints. There is a need to investigate the practical knowledge of experienced Yogo teachers in supporting children.

Background: Health checks at schools are increasingly important due to the spread of COVID-19 infections. However, although actual use of teachers' health examination results has been investigated, no studies have examined actual use by schoolchildren.

Objective: The objectives of this study were (1) to understand the actual status of health checks among schoolchildren, (2) to understand how health check results are utilized in daily life, and factors promoting their use.

Method: The survey was conducted in December 2020 in 2 public elementary schools and 3 public junior high schools with a total of 1177 participants, 353 elementary students (grades 5 and 6) and 824 junior high students (grades 1 to 3), using an anonymous, self-administered questionnaire. The content was designed with the dependent variables as four items related to health checkup use: “useful for daily life,” “considering how to spend today,” “considering future life,” and “telling family members about poor health,” and the independent variables as “benefit,” “burden,” “social support,” and “health literacy” of the health checkup, with adjustment variables designed as “grade” and “gender”. For the association analysis, we used binomial logistic regression analysis, dividing “benefit”, “burden”, “social support”, and “health literacy” into high and low groups, respectively, for the presence or absence of each item of utilization status. We received approval from the Ethical Review Committee of Tokushima University.

Results: The data used in the analysis were 778 responses excluding missing values (valid response rate: 68.9%). Utilization of the health check differed by item, with “useful for daily life” and “telling family members about poor health” having the highest rates. The utilization status was significantly higher for elementary students than for junior high students. The associations are as follows.

・Third graders in junior high were cutting down their use more than fifth graders in “Useful for daily life” and “Considering how to spend today”.

・The high-benefit group showed strong implementation in use of all 4 daily use items

・The high friend support group showed strong implementation in using “considering how to spend today,” while the high adult support group showed strong implementation in using “useful for daily life” and “telling family members about poor health.”

・In health literacy, “considering how to spend today” and “considering my future life” showed strong implementation in the high daily health care group.

Conclusion: When “benefits” in using health checks increases, the practical use of health checks is broadly related to all items, but “social support” and “health literacy” are only partially related.

Background: Unsuitable lifestyle habits such as lack of exercise and over-eating can cause an imbalance between energy intake and expenditure in children and expose them to obesity, which is a risk factor for lifestyle related diseases. To reduce the risk of obesity, it is necessary to understand the status of energy balance and corresponding lifestyle habits of children. Additionally, as children are influenced by the eating habits of their parents, understanding parents' food awareness becomes essential.

Objective: This study aimed to 1) clarify the status of energy balance in pre-school children and 2) examine the relationship between energy balance, lifestyle habits such as eating behavior and physical activity, and parents' food awareness.

Methods: The participants were 15 healthy boys and girls (boys: n=7, girls: n=8, Age: 72.1±8.3 months) attending a nursery school. We determined energy expenditure using the doubly labeled water method, energy intake using the habitual dietary intake questionnaire, and energy balance by comparing total energy expenditure and energy intake. Dietary habits, physical activity and parents' food awareness was determined using questionnaire surveys.

Results: The mean energy balance values of all participants were in the appropriate range; however there were variations among individuals. Excessive energy intake and less physical activity were found to cause positive energy balance. Intakes of carbohydrates and fats were linked to excessive energy intake. Parents' food awareness influenced children's excessive energy intake.

Conclusion: We suggested that low physical activity and excessive energy intake influenced excessive positive energy balance. Hence, paying attention to food intake of children and adjusting the proportions of carbohydrates and fats are important in preventing childhood obesity.