Health appraisal procedures

 Health appraisal procedures

Health appraisal is a series of procedures to assess or determine the health status of students. The health status of the student is determined through the use of teacher’s observation, screening test, health histories, and medical, dental, and psychological evaluations.

Procedures in health appraisal

1. screening – determines the potential health implications of the policy

2. scoping -  key health issues and public concerns are identified that should be considered the assessment. Health determinants that may be include factors such as the social, and physical environment (housing quality, crime rates, and social networks), personal or family circumstances (exercise, risky-behavior, and employment)

3. Appraisal – within the defined scopes, available evidence is gathered and used to estimate the potential health gains or losses.

Height and weight – is being monitored during puberty to know the growth of a child and also to get to its BMI to describe the body’s condition

Self breast examination – 

a procedure a woman can do to physically and visually examine her breasts and underarm areas for changes. It has not been shown that BSEs alone can accurately determine the presence of breast cancer.

Breast self-examination can be performed every month. Become familiar with how your breasts usually look and feel so that you may notice any change from what is normal for you:

• If you still menstruate, the best time to do BSE is when your breasts are least likely to be tender or swollen, such as a few days after your period ends.
• If you no longer menstruate, pick a certain day—such as the first day of each month—to remind yourself to do BSE.

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here's what you should look for: Breasts that are their usual size, shape, and color Breasts that are evenly shaped without visible distortion or swelling If you see any of the following changes, bring them to your doctor's attention: Dimpling, puckering, or bulging of the skin A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out) Redness, soreness, rash, or swelling	Breast Self-Exam — Step 1 Larger Version
Step 2: Now, raise your arms and look for the same changes.	Breast Self-Exam — Steps 2 and 3 Larger Version
Step 3: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood). Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.	Breast Self-Exam — Step 4 Larger Version
Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.	Breast Self-Exam — Step 5 La

Testicular examination for boys - help you learn the normal feel and appearance of your testicles. That may make it more likely that you'll notice subtle changes, should they occur. Changes in your testicles could be a sign of a common benign condition, such as an infection or a cyst, or a less common condition, such as testicular cancer.

A testicular exam is an inspection of the appearance and feel of your testicles. You can do a testicular exam yourself, typically standing in front of a mirror.

Routine testicular exams may give you a greater awareness of the condition of your testicles and help you detect when changes occur. Testicular exams may also help you identify potential testicular problems.

If you detect lumps or other changes during a testicular exam, make an appointment with your doctor.

testicular self-examination (TSE) is an easy way for guys to check their own testicles to make sure there aren't any unusual lumps or bumps — which can be the first sign of testicular cancer.

Although testicular cancer is rare in teenage guys, overall it is the most common cancer in males between the ages of 15 and 35. It's important to try to do a TSE every month so you can become familiar with the normal size and shape of your testicles, making it easier to tell if something feels different or abnormal in the future.

Here's what to do:

• It's best to do a TSE during or right after a hot shower or bath. The scrotum (skin that covers the testicles) is most relaxed then, which makes it easier to examine the testicles.
• Examine one testicle at a time. Use both hands to gently roll each testicle (with slight pressure) between your fingers. Place your thumbs over the top of your testicle, with the index and middle fingers of each hand behind the testicle, and then roll it between your fingers.
• You should be able to feel the epididymis (the sperm-carrying tube), which feels soft, rope-like, and slightly tender to pressure, and is located at the top of the back part of each testicle. This is a normal lump.
• Remember that one testicle (usually the right one) is slightly larger than the other for most guys — this is also normal.
• When examining each testicle, feel for any lumps or bumps along the front or sides. Lumps may be as small as a piece of rice or a pea.
• If you notice any swelling, lumps, or changes in the size or color of a testicle, or if you have any pain or achy areas in your groin, let your doctor know right away.

Lumps or swelling may not be cancer, but they should be checked by your doctor as soon as possible. Testicular cancer is almost always curable if it is caught and treated early.

Reviewed by: T. Ernesto Figueroa, MD

http://kidshealth.org/teen/sexual_health/guys/tse.html

Vision screening –  

Vision Screening: A First Step

School vision screenings are important and can help to detect eye conditions that are defined as “commonly occurring,” meaning that they occur in more than 1% of the target population. Early detection of vision problems has a demonstrated impact on quality of life for students, especially in the case of color-blindness, which is often not assessed “in any other venue except as necessary for entry into certain occupations.”  Although traditional school vision screenings have focused on myopia (nearsightedness, or lack of clear distance vision), children need to receive an eye exam by an eye doctor in a clinical setting that can detect issues with distance vision, close vision, color detection, and binocular vision.

 “Vision problems affect nearly 13.5 million children.  Rates for vision problems increase as children age…a quarter of adolescents 12-17 are reported to have eye problems”

"Poor vision in childhood affects performance in school or at work and has a negative influence on the future of the child"

Vision problems have been shown to adversely affect a child’s achievement in school.  Myopic children have trouble reading blackboard notes or other classroom presentation materials.  Hyperopic children will have trouble reading or doing any kind of close work.  Additionally, several types of eye disorders can lead to permanent visual impairment if not identified and treated early by an eye doctor.  Vision problems can and do adversely affect students’ ability to function in and enjoy learning.

Scoliosis test - Scoliosis is a condition in which the spine curves to the side. It is an abnormal lateral or side-to-side curvature of the spine. This condition commonly develops during growth spurt of adolescents. It affects girls more often. This condition can be corrected if treated early before the bones have fully developed. Early detection can prevent scoliosis from progressing.

Screening Procedure: Forward Bend Test:

1. Stand facing away from the screener.

2. Bend forward at the waist 90 degrees, feet 10 cm apart, knees  straight, and feet parallel to each other.

3. Palms of the hands are facing each other and arms hang down, and are relaxed. The head is down.

 It is normal if the screener observes the following:

a.  Both sides of upper and lower back are symmetrical.

b.  Hips level and symmetrical.

 There is possible scoliosis if the screener observes the following:

a. One side of rib cage and/or the lower back showing uneven symmetry.

b. Curve in the alignment of the spine

Malnutrition Effects

Malnutrition should be attended to immediately. 

Do you know that if this will not be checked early among adolescents, it will lead to serious problems? Some of these problems are:

 Slow growth and development
 Poor school performance
 Sluggishness and fatigue
 Poor nutrition in adulthood
 Delay in the onset of secondary sex characteristics

The Case of Micronutrient Deficiencies

Micronutrient deficiencies are diseases caused by deficiency of vitamins or minerals in the diet. The most common micronutrient deficiencies not only in our country but also in the whole world are Vitamin A deficiency, iron deficiency anaemia and iodine deficiency disorders.

Vitamin A deficiency (VAD) primarily affects children but the effects last a lifetime. It causes night blindness and, and later on, permanent blindness (xerophthalmia). The child suffering from VAD does not reach optimum physical growth and is prone to infections, that contributes to the high rates of sickness and
death among young children. VAD can be prevented by regular consumption of vitamin A-rich foods, such as animal products, and orange and yellow fruits and vegetables, dark green leafy vegetables, and palm oil.

Anaemia and iron deficiency Anemia is a condition in which the red blood cell count or hemoglobin is less than normal. It affects mostly adolescent girls women of child-bearing age and pre-school children. Anemia results in retarded physical growth, low resistance to infections and slow development of learning abilities. In
adults it causes fatigue and reduced work capacity and may cause reproductive impairment. Foods such as dark green leafy vegetables, legumes and red meat are rich in iron, as are iron-fortified food products.

Iodine deficiency disorder (IDD) results from lack of iodine in the diet. Iodine is needed for the
production of thyroid hormone. The body does not make iodine, so you should get iodine in your diet.

Iodine rich foods are—
Breads Iodized table salt
Cheese Saltwater fish
Cow’s milk Seaweed
Eggs Shellfish
Frozen yogurt Soy milk
Ice cream Soy sauce

Iodine deficiency can lead to enlargement of the thyroid or goiter, hypothyroidism and to
mental retardation in infants and children whose mothers lacked iodine when they were pregnant.

IDD is the most common cause of preventable mental retardation. In severe cases it can
lead to deaf-mutism, cretinism and other serious disorders, as well as reproductive impairment,
which results in miscarriage, stillbirth and birth defects.

Serving sizes for teens and Daily Servings for a Teen’s Diet

How Many Servings Do You Need as an Adolescent?

A serving is the size of food after it is cooked. Do you know that three ounces of cooked meat is about the size of a deck of cards?

The serving sizes below will guide you in measuring the amount of food and liquid you take daily.

 1-1/2 cups (12 ounces) of liquid is the size of a soda-pop can.
 1 cup (8 ounces) of food is the size of a large handful.
 1/2 cup (4 ounces) of food is about half of a large handful.
 1 ounce of cheese is about the size of a 1 inch cube.
 2 tablespoons (Tbsp) is about 2 times the size of the tip of your thumb (from the last crease).
 1 tablespoon (Tbsp) is about the size of the tip of your thumb (from the last crease).
 1 teaspoon (tsp) is about the size of the tip of your little finger (from the last crease).

Daily Servings for a Teen’s Diet
The table below is a food guide for adolescents. Adolescents can achieve
their energy and nutrient requirements by eating a variety of foods daily. This
guide may be used to ensure variety in foods eaten.

Bread and Starches 5 to 10 servings

 1 muffin
 2 slices bread
 1/2 cup cooked cereal, pasta, potatoes, or rice
 1 ounce or 3/4 cup dry cereal

 4 pcs. pan de sal

 1 small size root crop
 1 pack instant noodles

Fruits 2 to 3 servings

 1/2 cup canned fruit or fruit juice
 1 piece fresh fruit, such as an apple, orange, banana
 15 to 20 grapes
 1-1/2 cups fresh melon

Meat / Meat Substitutes 3 to 5 servings

 1/2 cup cottage cheese
 3/4 to 1 cup cooked dried beans or legumes
 1 egg
 1 ounce low-fat or regular cheese
 2 to 3 ounces meat, fish, or poultry
 2 to 3 Tbsps. peanut butter
 1/2 cup nuts

Milk or Yogurt  4 to 5 servings

 1 cup low-fat milk or yogurt
 one ounce of cheese
 1/2 cup of cottage cheese

Vegetables  2 to 3 servings

 1/2 cup cooked or 1 cup raw
vegetable
 2 cups salad greens
 1 cup vegetable or tomato juice

Fats  2 to 4 servings

 10 peanuts
 2 Tbsps. cream cheese, avocado, or low calorie salad dressing
 1 tsp oil, margarine, mayonnaise, or butter
 1 Tbsp salad dressing

Sweets and Desserts 1 to 3 servings per week

 1/8 of a pie
 1/2 cup ice cream
 3-inch pastry
 1/2 cup pudding,
 2 small cookies.

Too muchToo much sweets and dessert can aggravate skin problems, like pimples.

Water and Beverages 6 - 8 glasses (240 ml each)

Do you include food from the different food in your daily meal?

Puberty Nutritional Guidelines

Nutritional guidelines for Filipinos appropriate during puberty

 

For you to grow and develop to the fullest and to improve your

nutritional status, it is important to follow healthy eating guidelines such

as:

· Eat a variety of foods daily.

Foods contain combinations of nutrients and other healthful substances. No single food can supply all nutrients in the amounts you need. For example, oranges provide vitamin C but no vitamin B12; cheese provides vitamin B12 but no vitamin C. To make sure you get all of the nutrients and other substances needed for health, choose the recommended number of daily servings from each of the five major food groups

· Maintain a healthy weight.

Reaching and maintaining a healthy weight is important for overall health and can help you prevent and control many diseases and conditions. If you are overweight or obese, you are at higher risk of developing serious health problems, including heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. That is why maintaining a healthy weight is so important: It helps you lower your risk for developing these problems, helps you feel good about yourself, and gives you more energy to enjoy life. 

· Eat foods that are low in fat, saturated fat, and cholesterol.

• Choose foods with healthy fats, limit foods high in saturated fat, and avoid foods with trans fat.
• “Good” fats—monounsaturated and polyunsaturated fats—lower disease risk. Foods high in good fats include vegetable oils (such as olive, canola, sunflower, soy, and corn), nuts, seeds, and fish.
• “Bad” fats—saturated and, especially, trans fats—increase disease risk. Foods high in bad fats include red meat, butter, cheese, and ice cream, as well as processed foods made with trans fat from partially hydrogenated oil.

Cholesterol

Although it is still important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol isn’t nearly the villain it’s been portrayed to be. Cholesterol in the bloodstream, specifically the bad LDL cholesterol, is what’s most important. And the biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food.

· To lower the risk of heart diseases, avoid too much cholesterol in your diet.

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.

· Consume milk, milk products and other calcium-rich foods, such as small fish & dark green leafy vegetables daily.

· Eat plenty of vegetables, fruits, root crops, and grain products.

• Eating a diet rich in vegetables and fruits as part of an overall healthy diet may reduce risk for heart disease, including heart attack and stroke.
• Eating a diet rich in some vegetables and fruits as part of an overall healthy diet may protect against certain types of cancers.
• Diets rich in foods containing fiber, such as some vegetables and fruits, may reduce the risk of heart disease, obesity, and type 2 diabetes.
• Eating vegetables and fruits rich in potassium as part of an overall healthy diet may lower blood pressure, and may also reduce the risk of developing kidney stones and help to decrease bone loss.
• Eating foods such as vegetables that are lower in calories per cup instead of some other higher-calorie food may be useful in helping to lower calorie intake.

Root crops and legumes intake help maintain weight and prevent risk for diabetes mellitus.  The viscosity and fibrous structure of root crops and legumes slow down digestion and release of glucose in the blood.  This process maintains blood glucose in normal condition.

· Use sugar in moderation.

So what happens if you eat too much sugar? Here's a depressing rundown.

1. Cavities

Trust your dentist on this one: Sugar is such an enemy to dental health that one study way back in 1967 called it the "arch criminal" behind cavities. The connection between sugar and cavities is perhaps the best established. "Tooth decay occurs when the bacteria that line the teeth feed on simple sugars, creating acid that destroys enamel," Anahad O'Connor explains at The New York Times. Because acid is a key culprit, sour candies are especially nefarious.

Source: Journal of the American Dental Association, 2009; ISRN Dentistry, 2013; International Dental Journal, 2013

2. Insatiable hunger

Leptin is a hormone that lets your body know when you've had enough to eat. In people who develop leptin resistance, this "I'm full" signal is never received, presenting a major obstacle for weight control.

Some studies have raised the possibility that leptin resistance may be a side effect of obesity, not a contributing cause. But research in rats suggests that overconsumption of fructose can directly lead to higher-than-normal levels of leptin, which can reduce your body's sensitivity to the hormone. Removing fructose from the rats' diets generally reversed those effects.

"Our data indicate that chronic fructose consumption induces leptin resistance prior to body weight ... increases, and this fructose-induced leptin resistance accelerates high-fat induced obesity," concluded one 2008 study in rats. Still, more research is needed to test whether these effects hold true in humans as well.

Source: American Journal of Physiology, 2008; American Journal of Physiology, 2009; British Journal of Nutrition, 2011; Advances in Nutrition, 2012

3. Weight gain

Other than adopting a completely sedentary lifestyle, there are few routes to packing on the pounds that work as swiftly and assuredly as making large amounts of added sugars a staple of your daily diet. Sugary foods are full of calories but will do little to satiate your hunger. A 2013 review of 68 different studies found "consistent evidence that increasing or decreasing intake of dietary sugars from current levels of intake is associated with corresponding changes in body weight in adults." Want to lose weight? Cutting your sugar intake is a good place to start.

Source: British Medical Journal, 2013; American Journal of Clinical Nutrition, 2013

4. Insulin resistance

When you eat a lot of high-sugar meals — donuts for breakfast, anyone? — it can increase your body's demand for insulin, a hormone that helps your body convert food into usable energy. When insulin levels are consistently high, your body's sensitivity to the hormone is reduced, and glucose builds up in the blood. Symptoms of insulin resistance can include fatigue, hunger, brain fog, and high blood pressure. It's also associated with extra weight around the middle. Still, most people don't realize they are insulin resistant until it develops into full-blown diabetes — a much more serious diagnosis.

Source: The American Journal of Cardiology, 1999; American Journal of Clinical Nutrition, 2002; Nutrition & Metabolism, 2005

5. Diabetes

Between 1988 and 2008, the prevalence of diabetes in the U.S. increased by 128%. Diabetes now affects about 25 million people in the U.S. — that's 8.3% of the population.

One study that followed 51,603 women between 1991 and 1999 found an increased risk of diabetes among those who consumed more sugar-sweetened beverages — that's soda, sweetened ice tea, energy drinks, etc. And a massive review of previous research involving 310,819 participants supported this result, concluding that drinking lots of soda was associated not just with weight gain but with the development of type 2 diabetes.

Portion control may be especially crucial when it comes to sugar. "Duration and degree of sugar exposure correlated significantly with diabetes prevalence ... while declines in sugar exposure correlated with significant subsequent declines in diabetes rates" — even after controlling for other socioeconomic and dietary factors, concluded a 2013 study of eating habits and diabetes prevalence in 175 countries.

Source: JAMA, 2004; Diabetes Care, 2010; PLOS ONE, 2013

6. Obesity

Obesity is one of the most-cited risks of excess sugar consumption. Just one can of soda each day could lead to 15 pounds of weight gain in a single year, and each can of soda increases the odds of becoming obese, a JAMA study noted.

Sugar may well raise the risk of obesity directly, but the association could be mediated by diabetes, metabolic syndrome, or other diet and exercise habits associated with high-sugar diets. And it's possible that soda is uniquely pernicious, above and beyond other sugary foods.

o Eating too much sweet foods contributes to tooth decay.

· Eat clean and safe food, cook food in edible/cooking oil.

· Use iodized salt but avoid excessive intake of salty foods. Too much 

salt in the diet may increase the risk of having high blood pressure.

Remember, healthy eating will reduce your risk of suffering from fatal diseases, such as cancer, heart disease, stroke, and diabetes. 

Healthy eating is important for proper growth and development. It can also prevent health problems, such as obesity, dental caries, iron deficiency, and osteoporosis.

 Women are prone to osteoporosis, so teenage girls should eat enough foods rich in calcium. This will help build strong bones to protect them from osteoporosis later in life.

Eating a wide variety of foods in moderation daily is a good practice

Food Selection Based on Adolescents’ Nutritional Needs

Food Selection Based on Adolescents’ Nutritional Needs

Good nutrition is very important in enhancing your quality of life and in preventing diseases. It provides you with the needed calories and nutrients for your maximum energy and wellness.

Calories or kilocalories are units of heat that measure the energy used by the body and the energy that foods supply to the body. You need energy to fuel everything you do-- from playing, making assignments, talking to your friends, watching television, sleeping, and all your activities.

Nutrients, on the other hand, are substances in food that your body needs to grow, repair itself, and to supply you with energy. If you choose the right foods to eat, these will provide your body with the nutrients it needs to help you look and perform at your best. Nutritional needs vary for each stage of life, so it is important to eat a

healthy diet through all life stages. Adolescence is one of the fastest growth periods in a person’s life. The physical changes during this stage affect the body’s nutritional needs. Changes in your lifestyle as an dolescent may also affect your food choices and eating habits. With your active social life and busy schedules, you might often skip meals and just take snacks throughout the day. You might also often skip breakfast, not knowing that this important meal will give you the energy to make it through the day and to perform well in school. When you skip meals, you might resort to eating snacks in fast foods or “carinderias,” or not eating at all. When you eat outside, your choice of foods are often high in fats and sugar that provide less nutritional value. These practices are unhealthful and are major risk factors in developing chronic diseases, such as heart diseases, diabetes and even some types of cancer.

Protein

50 percent of our body is made up of protein so that is why adolescents get twice much protein as they needed. The densest source of protein include teenage favorites like beef, chicken, turkey, pork, fish, eggs and cheese. But a reminder, we should take protein groups moderately because it will to diseases if we increase our protein intake. It may result to kidney failure, cholesterol build, hypertension, and etc.

Carbohydrates
It is found in starches and sugars, get converted in the body's main energy: the simple sugar. Not all carbohydrates are formed equal. In planning meals we plan complex carbohydrates.  Marathon runners and other athletes take big bowls of pasta before competing.

Dietary Fat

Fatty foods contain cholesterol, a waxy substance that can obstruct an artery and finally cause it to harden. The danger of atherosclerosis is that the blockage will affect the blood vessels leading to the heart or to the brain, setting off a heart attack or stroke. Although these life-threatening events usually dont strike until until later in your adulthood. The time to start practicing intervention is now, by reducing the amount of fat in your family's diet.

To achieve your full growth potential, proper food selection and eating are very essential. You must know your physical need for food and follow the dietary guidelines appropriate for your age. You sometimes won’t eat a dish --- even if you know it is healthful because you don’t like its taste. Most often the desire for food or is stronger than the need to eat. Always remember that you need to eat foods that your body needs to support your growing body and to prevent future health problems.

Following certain guidelines will help you choosea balanced and healthful diet.

· Eat a variety of foods every day. Choosing and eating a variety of foods each day is important in building a healthy body.

· Consume fish, lean meat, poultry or dried beans. Eating these will give you protein, vitamin B, iron and zinc. These foods may contain high levels of fats but choosing lean meat and poultry without skin and limiting the egg yolks, nuts, and seeds can help limit fat intake.

· Eat more vegetables, fruits, and root crops. Vegetables and fruits are rich in vitamins and minerals and some are high in fiber. Eating a variety of food from this group will help you prevent chronic diseases and will keep you healthy.

· Eat foods cooked in edible/cooking oil in your daily meals. Eating foods cooked in edible/cooking oil daily prevents chronic energy deficiency. Fats and oils are also essential for absorption and utilization of fat-soluble vitamins, such as vitamin A. Olive oil is the best and healthiest oil and it's good for your health.

· Consume milk, milk products and other calcium-rich foods, such as small fish and dark leafy vegetables. These are good sources of protein and calcium.

· Use iodized salt, but avoid excessive intake of salty foods. Consuming less salt can reduce your chance of developing high blood pressure or can decrease your risk of cardiovascular disease.

· Eat clean and safe food. It is important to handle and prepare food safely by observing cleanliness. Wash hands and use clean utensils in preparing and cooking food.

· For a healthy lifestyle and good nutrition, exercise regularly, do not smoke, and avoid drinking alcoholic beverages.