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PubMedDate not supplied

School nursing: not just band-aids any more!

ISSUES AND PURPOSE: School nursing has changed dramatically over the past 25 years. The complex social and physical needs of children require an expanded role with advanced knowledge and skills. The school nurse functions as health promoter, health educator, collaborator, and researcher. Issues related to advanced practice and policy development also affect school nursing practice. CONCLUSIONS/PRACTICE IMPLICATIONS: The current emphasis on educational accountability and improvement of standardized test scores has mandated close examination of resource allocation. There is a need to appreciate an expanded role for the school nurse, as the provision of healthcare services in the school will afford children an increased capacity to learn, thus improving school performance.

Child↗
PubMedDate not supplied

[Perceptions of cannabis effects a qualitative study among adolescents].

The aim of the study was to compare perceptions of cannabis use effects and risks of tolerance effect, withdrawal syndrome, dependence and repercussions on school, social, and familial functioning among adolescent cannabis users and non users. Subjects were 210 adolescents (121 boys, 89 girls; mean age=16.3 1.3) from the department of Pyrénées-Orientales, France. Subjects completed a questionnaire assessing the frequency of cannabis use, the method of using cannabis, and including open-ended questions (What are the different methods of cannabis use? What are their pleasant and unpleasant or negative effects? What are their risks? Do you think that cannabis effects decrease in intensity when you are used to it? When someone is used to cannabis and stop using it (or has no more of it), does she experience craving for cannabis and withdrawal symptoms? What do you think of cannabis use?). Among the subjects, 118 (56.2%) were cannabis users and 92 (43.8%) were non-users. Among users, 27% used cannabis once a Month or less than once a Month, 21%, more than once a Month; 24%, more than once a weeks; 6%, every day; 20%, more than once a day. The methods of using cannabis were joints (76%), bong (40%), pipe (23%), and ingestion (18%). Knowledge of methods of using cannabis was higher in users than non-users: joint (87% vs 64%, p<0.0001), bong (69% vs 21%, p<0.0001), pipe (38% vs 7%, p<0.0001), ingestion (41% vs 13%, p<0.0001). Fifty-four per cent of users reported that cannabis use induces pleasant affects versus 30% of non-users (p=0.0006). They were exhilaration (47% vs 9%), relaxation (40% vs 23%), cheerfulness (21% vs 10%). Twenty-seven percent of users reported that cannabis use reduces negative feelings versus 14% of non-users (p=0.02). To be more open to social relationships was mentioned by 13% of users versus 1% of non-users (p=0.0001). The negative effects that were reported were attention and cognitive impairment (13% of users vs 5% of non users, p=0.05), irritability (8% vs 8%), loss of control (8% vs 8%) and feeling faint (13% vs 6%, p=0.09). Users reported than bong has much quicker and stronger effects than joints. The effects of bong class cannabis as a hard drug. Physical negative effects or risk were reported by 35% of users versus 30% of non-users (p=0.44). Bong users described specific physical risks such as respiratory problems and fainting. No subjects reported the risk of road accidents. Most users and non-users considered that cannabis use causes dependence (60% vs 74%, p=0.03), tolerance (68% vs 60%, p=0.23), and withdrawal symptoms (76% vs 52%, p<0.001). A minority of users and non-users reported that cannabis use causes a deterioration in school functioning (42% vs 20%, p=0.69), in social activities (23% vs 14%, p=0.10) and in family relationships (29% vs 20%, p=0.14). Most of users (56%) had a global positive opinion of cannabis use whereas most non-users (66%) had a global negative opinion of cannabis use. The frequency and methods of use reported in this study compare with the results of a recent study carried out in another town of the south of France. These results suggest that a high proportion of French adolescents are using cannabis and that a high proportion of users utilize bongs. Perception of cannabis effects and risks of tolerance effect, withdrawal syndrome, dependence and repercussions on school, social, and familial functioning differed between users and non-users. Users have more positive beliefs and less negative beliefs about cannabis than non-users. Users reported more frequently pleasant effects and less frequently unpleasant or negative effects, physical risks, risks of dependence, deterioration in school, social, and familial functioning than non-users. However, only a minority of non-users reported negative effects or consequences of cannabis use. None subjects reported a risk of road accident. These results suggest that information on negative effects, risks and repercussions of cannabis use may be a target for prevention intervention.

Accidents, Traffic↗
PubMed1992

Use of descriptive and experimental analyses to identify the functional properties of aberrant behavior in school settings.

We conducted descriptive and experimental analyses of aberrant behavior in school settings with 2 children with autism, using teachers as assessors. Experimental functional analyses carried out by the investigators were followed by training teachers to conduct a descriptive analysis and a classroom experimental analysis. A comparison of the assessment procedures showed that each procedure identified negative reinforcement as a maintaining variable for aberrant behavior. The teacher implemented an intervention based on the assessment with mixed results. We then replicated the initial results by having the first teacher train a second teacher to carry out the two assessment procedures. The results of these analyses were also in agreement, again identifying negative reinforcement as a variable maintaining aberrant behavior. An intervention based on negative reinforcement was then successfully implemented. These results suggest the applicability and utility of functional analyses carried out in school settings.

Adolescent↗
PubMed2000

Severe bronchopulmonary dysplasia increases risk for later neurological and motor sequelae in preterm survivors.

Preterm children who develop severe chronic lung disease may be developmentally compromised by exposure to hypoxic episodes. This study aims to determine if children with severe bronchopulmonary dysplasia (BPD) who required home oxygen therapy were at greater risk for neurological and motor deficits at school age than preterm peers without BPD. This study evaluated 27 subjects with BPD and 27 preterm control infants matched for gestational age, birthweight, sex, and year of birth at a mean age of 9.9 years (2.0 SD) using standardized neuromotor outcome measures. Pair-matched comparisons and regression analyses were used to determine if subjects with BPD were at increased risk for neuromotor sequelae. Neurological abnormalities, including subtle neurological signs, cerebral palsy, microcephaly, and behavioral difficulties were highly prevalent in the BPD group (71% compared with 19% in control group, P<0.005). Over half the BPD cohort had difficulties in gross and/or fine motor skills. There were significant differences in postural stability between groups. Duration of hospitalization and home oxygen treatment, and decreased lung function at school age, markers of severity of illness, correlated with motor outcomes. The findings underline the importance of preventing the cardiorespiratory complications associated with chronic lung disease to minimize disability in preterm children. For children with severe BPD, better recognition and subsequent remediation of neuromotor impairments that manifest at school age may help maximize their functional potential.

Bronchopulmonary Dysplasia↗
PubMed2003

Psychosocial functioning and stress-processing of children with asthma in the school context: differences and similarities with children without asthma.

OBJECTIVE: To characterize children with asthma by their stress processing at school and their psychosocial functioning. To establish similarities and differences between children with and without asthma. METHODS: Participants were 79 children with asthma and 359 children without asthma (ages 8-12). Children completed questionnaires on stress processing and their well-being at school. Parents filled in a questionnaire on behavior problems, and teachers provided data on school performance and absence rate. RESULTS: Children with asthma had higher scores on absence rates, teacher-rated well-being, internalizing behavior problems, occurrence of "rejection by peers," and use of aggression when coping with "problems with school work." However, using discriminant analyses, the groups could not reliably be distinguished from one another by these variables. CONCLUSIONS: Children with asthma are similar to other children with regard to their stress processing at school and their psychosocial functioning. The value of conducting multivariate analysis over several univariate tests is underscored.

Adaptation, Psychological↗
PubMed2004

Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial.

OBJECTIVE: To evaluate the efficacy of cognitive behaviour therapy for adolescents aged 10-17 years with chronic fatigue syndrome. DESIGN: Randomised controlled trial. SETTING: Department of child psychology. PARTICIPANTS: 71 consecutively referred patients with chronic fatigue syndrome; 36 were randomly assigned to immediate cognitive behaviour therapy and 35 to the waiting list for therapy. INTERVENTION: 10 sessions of therapy over five months. Treatment protocols depended on the type of activity pattern (relatively active or passive). All participants were assessed again after five months. MAIN OUTCOME MEASURES: Fatigue severity (checklist individual strength), functional impairment (SF-36 physical functioning), and school attendance. RESULTS: 62 patients had complete data at five months (29 in the immediate therapy group and 33 on the waiting list). Patients in the therapy group reported significantly greater decrease in fatigue severity (difference in decrease on checklist individual strength was 14.5, 95% confidence interval 7.4 to 21.6) and functional impairment (difference in increase on SF-36 physical functioning was 17.3, 6.2 to 28.4) and their attendance at school increased significantly (difference in increase in percentage school attendance was 18.2, 0.8 to 35.5). They also reported a significant reduction in several accompanying symptoms. Self reported improvement was largest in the therapy group. CONCLUSION: Cognitive behaviour therapy is an effective treatment for chronic fatigue syndrome in adolescents.

Absenteeism↗
PubMed1998

Respiratory health, lung function, and airway responsiveness in school-age survivors of very-low-birth-weight.

The purpose of this study was to determine the respiratory symptoms, pulmonary function, and airway reactivity in school-age survivors of very-low-birth-weight and to describe the influence of birth weight and perinatal illness on their pulmonary function. Thirty (of 39) 10- to 11-year-old survivors of very-low-birth-weight (VLBW) recruited at birth into a prospective longitudinal study of development; 30 (of 32) normal-birth-weight peers recruited from the same school or census tract as the VLBW group at age 5; and 15 normal-birth-weight siblings of the VLBW group participated in the study. Outcome measures were mother's reports of respiratory health; forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1); FEV1/FVC; forced expiratory flow, midexpiratory phase (FEF25-75); peak expiratory flow rate (PEFR); and tolerance to methacholine. There were no differences between groups in mothers' reports of current respiratory health. Pulmonary function values were lower for the VLBW survivors but significant only for FEF25-75 (F = 4.13; P = 0.02). Number of days in the intensive care nursery correlated significantly with decreased FEV1 (r = -.40, df = 28, P = 0.03), FEV1/FVC (r = -.37, df = 28, P = 0.04, and FEF25-75 (r = -.39, df = 28, P = 0.03). Only the relationship between length of nursery stay and FEV1/FVC was independent of birth weight. Number of days on mechanical ventilation was significantly correlated with decreased FEV1 (-.44, df = 28, P = 0.01), FEV1/FVC (r = -.38, df = 28, P = 0.04), FEF25-75 (r = -.44, df = 28, P = 0.01, and PEFR (r = -.40, df = 28, P = 0.03). All of these relationships were independent of birth weight. There were no significant associations between perinatal risk factors and methacholine responsiveness. Differences between VLBW children and normal-birth-weight children in pulmonary function are modest even when statistically significant. Severity of perinatal illness influences pulmonary function parameters into late childhood.

Child↗
PubMed1990

England and Wales: perspectives in school health.

The main roots of health care and health education for young people in the United Kingdom are described. Contributions of the National Health Service to health screening and developmental assessment are described, primarily through the function of school health services. The development and future potential for effective school health education also is considered in the light of the impending introduction of a new national curriculum. The evaluation of the concept of the "health promoting school" is highlighted as a key area for future development, together with more emphasis on achieving a balance between health enhancement and educational outcomes to school health education. Greater priority for evaluation of school health education also is advocated.

Adolescent↗
PubMed2000

Pelvic pain. A SAFE approach.

The efficacy of a multidisciplinary approach for the treatment of chronic pain has been well documented. A recent randomized prospective trial by Peters and co-workers confirmed that multidisciplinary management of chronic pelvic pain resulted in greater improvement in pain severity, increased employment, and improved functional health scores when compared with a traditional medical approach. Unfortunately, many gynecologists do not have the luxury of working in these types of settings. The SAFE approach allows the busy practitioner to evaluate the nonorganic and organic nature of pelvic pain simultaneously to manage these difficult patients better. Initially, it is important to set up regular weekly visits with a prespecified time limit. During these sessions, one should focus on compliance to treatment recommendations. Components of management that have led to pain reduction should be defined. Over time, these short visits can be spaced to bimonthly and monthly intervals; however, this strategy should not be rushed. If possible, the gynecologist should coordinate the care of difficult patients with a physical therapist and mental health provider who can work in tandem on pain reduction strategies and focused psychotherapy. The gynecologist should focus the patient's attention on improvements in pain reports and in functioning at school or work and reinforce the consistent use of medications, even if the recommended dose is low. Small improvements in health beget larger improvements in daily functioning.

Adnexal Diseases↗
PubMed1997

The relation of family functioning to adolescent psychological well-being, school adjustment, and problem behavior.

The association between family functioning and adolescent adjustment was examined in 429 Chinese adolescents via children's and parents' reports. The ratings obtained from the different sources indicated that family functioning was significantly related to measures of (a) adolescent psychological well-being (general psychiatric morbidity, life satisfaction, purpose in life, hopelessness, and self-esteem), (b) school adjustment (perceived academic performance and school conduct), and (c) problem behavior (smoking and abusing psychotropic drugs). The findings suggest that there is an intimate link between family functioning and the psychosocial adjustment, particularly the positive mental health, of Chinese adolescents.

Achievement↗
PubMed2001

Role of school schedule, age, and parental socioeconomic status on sleep duration and sleepiness of Parisian children.

The aim of the study was to assess the duration and quality of sleep of prepubertal (Tanner Scale level 1) physically and mentally healthy children as a function of school schedule (4 versus 4.5 days per week), age and grade (median age of 9.5 years for 4th grade versus median age of 10.5 years for 5th grade), school district (wealthy versus nonwealthy) in Paris, France, and parental socioeconomic status (high, medium, or low). We studied 51 girl and 44 boy volunteer pupils with written parental consent. The study lasted 2 weeks during the month of March. During the first study week, the children attended school 4.5 days, and during the second week, they attended school only 4 days without difference in the length of the school day. A sleep log was used to ascertain time of lights off for sleep and lights on at awakening, nighttime sleep duration, and self-rated sleep quality. A visual analog scale (VAS) was also used by pupils to self-rate the level of perceived sleepiness at four specific times of the school day. Conventional statistical methods (e.g., t and chi2 tests) were used to examine differences in mean values. Sleep duration, self-rated sleepiness, and subjective sleep quality were comparable (P > .05) by gender, school schedule, school district, and parental socioeconomic status. Overall, the sleep of this sample of Parisian children around 10 years of age was rather stable in its duration and timing, suggesting flexibility to adjust to the different school schedules.

Age Factors↗
PubMed2005

A randomized controlled trial of a cognitive-behavioral family intervention for pediatric recurrent abdominal pain.

OBJECTIVE: To investigate whether the combination of standard medical care (SMC) and short-term cognitive-behavioral family treatment (CBT) in the treatment of recurrent abdominal pain (RAP) was more effective than SMC alone. METHODS: Children recently diagnosed with RAP via physician examination were randomized into SMC (n = 29) and SMC plus CBT (n = 40) groups. Outcome measures included multiple dimensions of child and parent reported child pain, somatization, and functional disability, and school absences and physician contacts. RESULTS: Children and parents participating in the combined SMC + CBT intervention reported significantly less child and parent reported child abdominal pain than children in the SMC intervention immediately following the intervention and up to 1 year following study entry, as well as significantly fewer school absences. Significant differences in functional disability and somatization were not revealed. CONCLUSIONS: These results, in combination with previous studies, add support to the effectiveness of CBT intervention in reducing the sensory aspects of RAP. Results are discussed with respect to the cost-benefit of integrated medical and short-term psychological services.

Abdominal Pain↗
PubMed1999

Continuity of depression during the transition to adulthood: a 5-year longitudinal study of young women.

OBJECTIVE: To characterize the clinical course and psychosocial correlates of unipolar depression in late adolescent women and to examine the continuity in affective disturbance from adolescence to early adulthood during the post-high school transition. METHOD: One hundred fifty-five women aged 17 or 18 years were recruited from 3 local public high schools and were followed at yearly intervals for 5 years for clinical and psychosocial outcomes. RESULTS: The 5-year incidence of first major depressive episode was 36.9%, and overall, 47% of the women had one or more episodes of major depression. Risk for recurrence was substantial, and those with onsets prior to the study were more likely to have depressive episodes during the post-high school period. The presence of nonaffective disorder also increased the risk for depression. Young women with major depression during the post-high school transition had more negative functional outcomes in school and intimate romantic relationships. CONCLUSIONS: These results suggest that there is substantial continuity in affective disturbance from adolescence to adulthood. The risk for both new onset of depression and recurrence is remarkably high during late adolescence, and the risk continues throughout early adult years, accompanied by notable interpersonal dysfunction.

Adolescent↗
PubMed1995

Metals and school learning: a review of investigative techniques.

A growing body of literature suggests a relationship between metals and a threatened health status among children, adolescents, and adults. Recently, several investigators have reported a direct link between exposure to metal and diminished affective, behavioral, and cognitive performance of school children. The purpose of the present study was to review and analyze methods and procedures used to understand the relationship between exposure to metals and cognitive, social, and motor functioning of school children.

Achievement↗