bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual First Impressions
Authors: Bergren Martha Dewey
Published: July 2008

Frequently, a nurse’s first and only contact with a graduate school, legislator, public health official, professional organization, or school nursing colleague is made through e-mail. The format, the content, and the appearance of the e-mail create a virtual first impression. Nurses can manage their image and the image of the profession by communicating electronically in a manner appropriate for the professional role.
The United Kingdom National Healthy School Standard: A Framework for Strengthening the School Nurse Role
Authors: Wicklander Molly K.
Published: July 2008

The purpose of this review is to analyze the school nursing role within the National Healthy School Standard (NHSS) in the United Kingdom with a view toward clarifying and strengthening the role of school nurses globally. Within the National Healthy School Standard framework, school nurses serve an integral role in linking health and education partnerships to promote effective school health programs. School nurse contributions to the National Healthy School Standard, as well as barriers and supports, are discussed. Additionally, the methods school nurses implement to partner, to manage service delivery, and to work with schools are outlined. The central role of school nurses within the National Healthy School Standard framework provides a guide for school nurses in the United States to demonstrate their importance as key players in healthy schools that promote health and education. The framework deserves recognition as a foundational model to help strengthen both the school nurse role and school health programs around the world.
Caring for Children With Autism in the School Setting
Authors: Galinat Karen , Barcalow Kelly , Krivda Barbara
Published: July 2008

Children with autism present unique challenges related to communication, behavior, and social skills. Each child with an autistic spectrum disorder (ASD) exhibits individual characteristics of the disorder. Early identification of autistic spectrum disorder has been shown to improve the child’s benefit from educational interventions. There may be health issues related to autism including seizure disorders and dietary restrictions. Students with autism need special consideration when they come to the health office for screening, assessment of injuries, or administration of medication. Collaboration between educators and school nurses is needed to develop and implement Individual Education Plans and Individual Healthcare Plans. Community resources provide valuable assistance to families of children with this challenging disorder.
The Relationship Between Perceived and Ideal Body Size and Body Mass Index in 3rd-Grade Low Socioeconomic Hispanic Children
Authors: Fisher Allison , Lange Mary Anne , Young-Cureton Virginia , Canham Daryl
Published: July 2008

Very little is known about body satisfaction among minority children. This study examined the relationship between perceived and actual body size and Body Mass Index among 43 low-socioeconomic Hispanic 3rd-graders. Researchers measured participants’ Body Mass Index; students self-reported Perceived Ideal Self Image and Perceived Actual Self Image using Collins’ (1991) pictorial instrument scale of seven child body images that illustrate body weight from very thin to obese. The majority of students chose body images from the scale that depicted a healthy weight for both their Perceived Ideal Self Image and Perceived Actual Self Image. More boys than girls chose underweight as their Perceived Ideal Self Image. Thirty percent of the students were found to be overweight and 30 percent were at risk for being overweight. A small positive correlation between Perceived Actual Self Image and Body Mass Index was found.
Smoking and Depressive Symptoms in a College Population
Authors: Ridner S. Lee , Staten Ruth R. , Danner Fred W.
Published: July 2008

A number of studies have documented the relationship between smoking and depression in adolescent and adult populations. The purpose of this study was to examine the level of depressive symptoms among college-age smokers and to determine whether or not increases in cigarette use were associated with increases in the number of depressive symptoms. A nonexperimental cross-sectional design was used. Of the random sample ( N = 895), 28% were current smokers, and more than 26% of the total sample reported high levels of depressive symptoms. Current smokers were more likely to report an increased level of depressive symptoms than non-smokers were. Correlates of depressive symptoms included grade point average, marijuana use, and increased work hours. When controlling for these variables, the number of days smoked was predictive of depressive symptoms. School nurses have an important role in preventing smoking and treating smokers, as well as in preparing adolescents for the transition to college where many begin smoking.
Schools’ Capacity to Help Low-Income, Minority Children to Manage Asthma
Authors: Anderson Elizabeth W. , Valerio Melissa , Liu Manlan , Benet Dana Jones , Joseph Christine , Brown Randall , Clark Noreen M.
Published: July 2008

This article describes the challenges and strengths of asthma management in 14 low-income, predominantly African American urban elementary schools serving more than 5,000 students. Asthma prevalence was 24.5%. Teachers, school principals, parents, and children described how asthma was managed at school. Data from classmates of students with asthma showed that they had moderate to high levels of information about the disease. Data from teachers indicated the great need for practical instruction on how they might effectively support a child with asthma in the classroom and on the playground. Principals raised concerns about expectations for the functioning of school staff and implementation of school policies especially related to asthma emergencies. Parents reported a range of problems their children face at school. Data from children with asthma showed that 75% believed asthma affected their schoolwork. Findings from this study should be useful to school personnel, health providers, and others who assist children and their families to manage asthma at school. Data suggest that making school nursing services available is warranted, given the impact of asthma on the school community.
Evidence-Based Practice and School Nursing
Authors: Adams Susan , McCarthy Ann Marie
Published: July 2008

School nurses need to demonstrate that their practice is based on the best evidence available, which is usually data obtained from research. Evidence-based practice involves combining the best evidence available with nursing expertise and patient and family preferences to determine optimum care. Evidence-based practice guidelines are developed by carefully reviewing the available evidence on a topic and synthesizing this information into recommendations for practice. This article defines evidence-based practice and best evidence, describes the development of evidence-based practice guidelines, discusses factors that affect the use of research and evidence-based practice guidelines in school nursing, and reviews current sources of evidence-based practice guidelines for school nurses. Strategies that school nurses can use to incorporate evidence into their practice are discussed. One recommendation is that school nurses partner with nurse leaders and nurse researchers to develop evidence-based practice guidelines relevant to school nurse practice.
An Oral Health Education Program for Latino Immigrant Parents
Authors: Brown Ruth M. , Canham Daryl , Cureton Virginia Young
Published: July 2008

A high prevalence of dental caries in the pediatric population is a major health problem. At highest risk are low-income minority groups, including refugee and immigrant populations. Consequences of oral disease include pain, difficulty eating and speaking, poor school performance, and poor self-esteem. Parent involvement in oral health education is crucial. This program provided oral health education for Latino immigrant parents in a northern California school district. A pretest–posttest was administered to measure changes in oral health knowledge and reported oral health behaviors following two sessions of oral health education. This program provides a framework for school nurses who are in an ideal position to implement similar programs that address the oral health needs of the pediatric population, particularly those of the Latino immigrant community.
The Use of Antidepressants in School-Age Children
Authors: Brock Kelly , Nguyen Bich , Liu Nianci , Watkins Melissa , Reutzel Thomas
Published: July 2008

Approximately 5% of the pediatric population suffers from depression. Children suffering from depression should be treated first with some type of psychotherapy, cognitive therapy, and/or education. Pharmacotherapy (medications) should be used only as a last resort for those children suffering from severe, chronic, or recurring depression. The only antidepressant approved by the U.S. Food and Drug Administration for the treatment of depression in children is fluoxetine (Prozac), a selective serotonin reuptake inhibitor. In the school setting, children should be monitored closely upon the initiation of antidepressant therapy and changes in dosing or medication. They also should be monitored for side effects of the medication, response to therapy, and new signs of depression or worsening symptoms. After starting an antidepressant, children must be monitored closely for any changes in behavior, especially increased preoccupation with suicide. Any changes should be reported to the physician immediately for follow-up.
Victimization of Obese Adolescents
Authors: Robinson Sabrina
Published: July 2008

Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and teasing as a result of being overweight or obese. The victimization may be overt or relational. Obese adolescents are at risk of victimization, because their peers view them as different and undesirable. Although peer victimization occurs commonly among adolescents, obese adolescents are more susceptible than their average-weight peers. Because school nurses are often the first line of defense for obese adolescents, they are in an excellent position to identify forms of peer victimization and be prepared to intervene with the victims. School nurses can potentially preserve the psychosocial integrity of obese adolescents by promoting healthy peer interactions and experiences.
Understanding Qualitative Research: A School Nurse Perspective
Authors: Broussard Lisa
Published: July 2008

More school nurses are engaging in the generation of research, and their studies increasingly are using qualitative methods to describe various areas of practice. This article provides an overview of 4 major qualitative methods: ethnography, phenomenology, grounded theory, and historical research. Examples of school nursing research studies that have used these methods are included. Descriptions of other qualitative designs, ethical considerations, and issues of scientific rigor are also discussed.
Elementary School Nurses’ Perceptions of Student Bullying
Authors: Hendershot Candace , Dake Joseph A. , Price James H. , Lartey Grace K.
Published: July 2008

The aim of this study was to assess elementary school nurses’ perceptions of student bullying, actions when they encounter bullies or victims, and perceived level of preparation for dealing with this problem. School nurses identified the most common barriers to dealing with bullying, which included bullying taking place where the nurse is not supervising (49%), someone else in the school being more qualified to address bullying (41%), not having enough time (26%), and not being prepared to handle the problem (25%). Only 14% stated that there were no barriers to dealing with student bullying. School nurses believed that the most effective means to reduce school bullying were consistent discipline and improved supervision. However, these perceptions are not in line with current research, which indicates that the most effective method to reduce bullying is to create a whole-school atmosphere to prevent the problem from occurring.
Oppositional Defiant Disorder: Information for School Nurses
Authors: Barcalow Kelly
Published: July 2008

Oppositional defiant disorder, one of the disruptive behavior disorders, has far-reaching consequences for the individual, family, school, community, and society. Early recognition allows interventions geared toward promotion of prosocial behaviors, possibly halting progression to the more deviant conduct disorder. Awareness of this disorder and associated comorbidities is the first step that enables the school nurse to use assessment techniques and to assist in planning of interventions for the child. Children at risk often show tendencies toward oppositional defiant disorder as early as preschool. Interventions should be in place by the elementary school years to interrupt the pathways that may be difficult or impossible to change once adolescence begins. The school nurse can be instrumental in educating staff about risk factors, early associated behaviors, and referrals. Implementation of an individualized healthcare plan targets specific behaviors and provides a means of observing and documenting a child’s improvements.
Foregone Mental Health Care and Self-Reported Access Barriers Among Adolescents
Authors: Samargia Luzette A. , Saewyc Elizabeth M. , Elliott Barbara A.
Published: July 2008

Adolescents forego mental health care in spite of self-perceived needs for services; this presents a significant public health problem. Using data from the 2001 Adolescent Health Care Access Survey of 16-year-olds in Saint Louis County, Minnesota, we assessed barriers to mental health care among the 878 respondents who reported ever needing psychological or emotional counseling. Demographic characteristics were compared among those who had always, had sometimes, or had never received needed mental health care. Overall, 57% of the youths reported foregoing mental health care at least once. Girls and adolescents living with both parents were significantly more likely to have foregone care. Youths identified two common barriers to accessing care: “Thought or hoped the problem would go away” (50%) and “Didn’t want parents to know” (36%). School-based interventions should be sensitive to mental health needs, especially among girls and teens living in two-parent families.
Quality of Life in Adolescents With Type 1 Diabetes Who Participate in Diabetes Camp
Authors: Cheung Ruth , Cureton Virginia Young , Canham Daryl L.
Published: July 2008

Quality of life in adolescents with Type 1 diabetes is a growing area of interest in pediatric research. The complex diabetes regimen imposes challenges for an adolescent. Adolescents diagnosed with diabetes are a group that appears to be at risk for having a poor health-related quality of life. Although research supports the positive relationship of social support and well-being in adolescents, there are few studies discussing quality of life in adolescents that are based on the factor of social support. This study compared the quality of life in adolescents with Type 1 diabetes who have attended at least one diabetes camp to the quality of life of those who have never attended diabetes camp. Results provided evidence of the value of social support.
Adolescent Immunization: Challenges and Opportunities
Authors: Grace Judith A.
Published: July 2008

Immunization is one of the greatest public health achievements of the past century. Vaccines are responsible for the worldwide eradication of smallpox, the elimination of polio in the western hemisphere, and most recently the elimination of rubella as a public health threat in the United States. Childhood vaccination rates are at an all-time high, but immunization falls off dramatically during adolescence (ages 11–19). With increased attention being paid to adolescent health and the new vaccines available for adolescents, efforts to increase adolescent immunization rates are moving to the forefront. Improving adolescent immunization rates requires advocacy on the part of all health professionals. School nurses, whose mission is to enhance the well-being of adolescents, are in a unique position to work with students, parents, and local health professionals to improve the adolescent immunization rate.
Changes in Medications Administered in Schools
Authors: Mccarthy Ann Marie , Kelly Michael W. , Johnson Sheila , Roman Jaclyn , Zimmerman M. Bridget
Published: July 2008

The purpose of this descriptive, cross-sectional study was to determine if there have been changes in the type and number of attention deficit/hyperactivity disorder (AD/HD) medications administered in schools since the introduction of long-acting stimulants. A survey was sent to 1,000 school nurses randomly selected from the National Association of School Nurses membership, with 339 returned (34%). Between 2000 and 2003 the proportion of students receiving any prescription medication (2.9/100 vs. 1.0/100), methylphenidate (1.2 vs. 0.2), or amphetamine/dextroamphetamine (0.3/100 vs. 0.1/100) was significantly reduced (p < .0001). High school students took fewer prescription (p < .0001) and AD/HD medications (p < .0001), but more nonprescription medications than other students. A total of 163 different prescription medications and 28 nonprescription medications were administered during the typical school day. This study suggests that the use of long-acting stimulants has significantly reduced the number of prescription medications administered in schools. This reduction has been accompanied by a dramatic increase in the range of medications administered, making the medication administration process in schools more complex, not less.
Helping Teen Mothers Succeed
Authors: SmithBattle Lee
Published: July 2008

Because the success of teen mothers is enhanced by completing high school, school districts should give high priority to supporting teen mothers to remain in school and to graduate. This article reviews the literature on the educational attainment of these students, their school aspirations, and the policies affecting their education. Although teens often begin mothering with a range of educational and social disadvantages, many teen mothers recommit to school to enhance their future opportunities. Unfortunately, rising school aspirations among teen mothers often are undermined by competing demands and the lack of consistent family and school support. School nurses can support teen mothers’ aspirations and contribute to their long-term success by linking them to resources and advocating for policies and practices that promote high school graduation.
Encouraging Sun Safety for Children and Adolescents
Authors: Boe Kathy , Tillotson Elizabeth A.
Published: July 2008

The rise in the number of cases of skin cancers, both melanomas and nonmelanomas, has prompted increased awareness and educational efforts to limit sun exposure. Because 80% of lifetime sun exposure occurs before the age of 18, educating parents and adolescents to incorporate sun-protective behaviors into daily routines is particularly important. Education of parents is essential to establishing healthy behavior patterns in children. Educational interventions are recommended that encourage the following: using sunscreen, wearing hats with wide brims and clothing that blocks or absorbs ultraviolet rays, using sunglasses that block ultraviolet radiation, and seeking shade. Continued efforts are important through adolescence to maintain the established behaviors. School nurses are in a position to affect the health education curriculum, as well as school policies that promote sun safety behaviors.
Asthma Education for Rural School Nurses: Resources, Barriers, and Outcomes
Authors: Winkelstein Marilyn L. , Quartey Ruth , Pham Luu , Lewis-Boyer LaPricia , Lewis Cassia , Hill Kimberly , Butz Arlene
Published: July 2008

This paper describes a school-based asthma education program for rural elementary school nurses. The program was designed to teach school nurses in 7 rural counties in Maryland how to implement and to reinforce asthma management behaviors in children with asthma and their caregivers. Rural nurses who participated in this program increased their mean asthma knowledge scores more than nurses who did not take the program. The program also increased self-efficacy among intervention school nurses, but the difference in self-efficacy between intervention and control nurses was not statistically significant at follow-up. No effects on documentation or communication behaviors were noted. Only 25% of the nurses reported an interest in implementing future asthma educational programs for children with asthma. This study indicates the importance of understanding the unique characteristics of rural school nurses, the resources they need, and the barriers and challenges they face in their practice.
Advocating for a Harm-Minimization Approach to Drug Education in Australian Schools
Authors: Guzys Diana , Kendall Sharon
Published: July 2008

The concept of using a harm-minimization approach to drug education in Australian schools has existed in both national and state government policy documents for over two decades. However, this approach appears to be ineffectively and inconsistently incorporated within the curriculum. Harm minimization emphasizes strategies that reduce the harms associated with drug use and prevent related health and social problems. Traditional drug education programs that promote abstinence as the only option may not be realistic and appear to have had limited success. School nurses in the state of Victoria have a significant role in improving both the understanding and adoption of this approach through advocacy, education, and their understanding of evidence-based practice.
Conversion of School Nurse Policy and Procedure Manual to Electronic Format
Authors: Randall Joellyn , Knee Rachel , Galemore Cynthia
Published: July 2008

Policy and procedure manuals are essential to establishing standards of practice and ensuring quality of care to students and families. The Olathe District Schools (Kansas) Technology Department created the Virtual File Cabinet to provide online access to employee policies, school board policies, forms, and other documents. A task force of school nurses was formed to convert the nursing department’s policies, procedures, protocols, and forms from hard copy to electronic format and make them available on the district’s Virtual File Cabinet. Having the policy and procedure manuals in electronic format allows for quick access and ease in updating information, thereby guaranteeing the school nurses have access to the most current information. Cost savings were realized by reducing the amount of paper and staff time needed to copy, collate, and assemble materials.
Gender Differences In Extrafamilial Sexual Abuse Experiences Among Young Teens
Authors: Edinburgh Laurel , Saewyc Elizabeth , Levitt Carolyn
Published: July 2008

Extrafamilial sexual abuse experiences of young adolescents (ages 10–14), particularly young teen boys, are not well studied. This retrospective chart review study compared psychosocial correlates and victimization experiences between young adolescent girls ( n = 226) and boys ( n = 64) referred to a hospital child advocacy center. Several differences in risk behaviors and abuse experiences were found: Girls were more likely to have run away, to be truant from school, to report substance use, to have multiple perpetrators, and to have physical findings from the abuse. Boys were more likely to have a diagnosis of attention deficit disorder and to report anal penetration, and rarely disclosed abuse at the time of the incident. Peers were girls’ most common choice for disclosing abuse, whereas boys confided most often in their mothers or other adults. These findings suggest sexually abused young adolescent girls and boys need distinct, developmentally appropriate screening and care in school and health care settings.
Sex Parties: Female Teen Sexual Experimentation
Authors: Toscano Sharyl Eve
Published: July 2008

Adolescent participants in a study aimed at exploring the nature and characteristics of girls’ dating relationships revealed the phenomenon of sex parties. These teens defined a sex party as an opportunity to engage in sexual contact outside of typical dating relationships. Sexual activity could involve actual intercourse, but usually involved sex acts without vaginal intercourse. Data were collected through 22 semistructured interviews with female adolescents, ages 15–18. All the participants knew of sex parties, however, only a subgroup of these adolescents actually participated in activities loosely defined by teens as sex parties. Alcohol was common at these parties, but female teens asserted that they consumed alcohol willingly to relax, as opposed to being coerced to do so. Some teens expressed regret following participation in a sex party, although none reported sexual coercion or abuse.
Young People, Pornography, And Sexuality: Sources And Attitudes
Authors: Wallmyr Gudrun , Welin Catharina
Published: July 2008

The purpose of this study was to investigate the use of and attitudes among young people toward pornography and their sources of information about sexuality. Eight hundred and seventy-six young people ages 15–25 years (555 females and 321 males) who visited a youth center in Sweden for a period of 1 year answered a questionnaire about their use of pornography, their attitudes toward pornography, and sources of information about sexuality. Although most had seen pornographic movies, the youngest boys reported viewing the most pornography. The male participants reported that the most common reason they viewed pornography was to get aroused and to masturbate, whereas the female participants stated that they viewed pornography out of curiosity. The most frequent source of information about sexuality was peers. These results illustrate the importance of sex education to give factual information about sexuality and to counteract the messages about sexuality presented in pornography.
Knowledge of School Nurses in the U.K. Regarding Sexual Health Education
Authors: Westwood Jo , Mullan Barbara
Published: July 2008

In the U.K., a current government health strategy indicates that school nurses should be key contributors to sexual health education because they have access to the school-age population. However, there appears to be little research that investigates whether school nurses are the most appropriate health care professionals or indeed have sufficient knowledge to contribute to this topic in the schools. The purpose of this study was to examine the sexual health knowledge of school nurses, using a survey to assess school nurses employed in a large central region of the U.K. The results suggest that although their general knowledge of the topic was adequate, school nurses have insufficient knowledge to effectively teach about sexually transmitted infections or emergency contraception. This has implications for school nursing because it appears that school nurses may have inadequate knowledge about sexual health to contribute to sex education in schools.
A School-Based Approach to Early Identification and Management of Students with ADHD
Authors: Dang Michelle T. , Warrington Dawn , Tung Tan , Baker Dian , Pan Richard J.
Published: July 2008

Attention-deficit/hyperactivity disorder (ADHD) is one of the most challenging chronic conditions for children, families, schools, and physicians. Because symptoms of ADHD can be mistaken for other health conditions and misdiagnosis can occur, accurate diagnosis and treatment require comprehensive evaluation. This article introduces a school-based framework—ADHD Identification and Management in Schools (AIMS)—developed by a multidisciplinary team composed of a pediatrician, school nurses, and school psychologists that sought to improve communication between school personnel and physicians, standardize practice, and improve the quality of care for children with ADHD. The framework provides school nurses with an evidence-based, systematic method for early identification and management of children with ADHD.
An Audit of Medication Administration: A Glimpse Into School Health Offices
Authors: Canham Daryl L. , Bauer Laurie , Concepcion Michelle , Luong June , Peters Jill , Wilde Claudia
Published: July 2008

Many students require prescription and nonprescription medication to be administered during the school day for chronic and acute illnesses. School office staff members are typically delegated this task, yet these individuals are unlicensed assistive personnel without medical training. Five school nurses developed and participated in a medication audit providing a glimpse into the administration and management of medications in school health offices. The audit included 154 medications. Results of the audit showed a wide range of errors and discrepancies, including problems with transcription, physician orders or lack thereof, timing, documentation, and storage. Audit results highlight the importance of training in medication administration and management at schools. It also directs attention to view training not as a once-a-year event, but as a process. A process is needed to ensure and sustain the safe and accurate administration of medication. Towards this end, school nurses need to periodically evaluate school office staff, audit school medication records and documents, and conduct refresher classes throughout the school year.
Bereavement Support for Children
Authors: Auman Mary Jo
Published: July 2008

The death of a parent is one of the most significant and stressful events children can encounter. Surviving children may experience psychiatric problems and social dysfunction during their childhood and possibly throughout their adult lives. Children surviving a sibling’s death may develop behavioral problems, because no one can fill the emptiness that remains in their lives, especially if their relationship was close. It is vital to recognize the trauma experienced by children who have suffered the loss of a loved one. Adults need to know when a grieving child needs help. Literature supports the need for education and counseling for grieving children. School nurses can be instrumental in meeting these needs for school-age children by performing early, comprehensive assessments, educating school administration regarding the benefits of bereavement support, initiating appropriate referrals, and providing bereavement support.
Prevalence of Elevated Blood Pressure in Hispanic Versus Non-Hispanic 6th Graders
Authors: Tarlton Patricia A.
Published: July 2008

Blood pressure screening was conducted on 4,311 (Hispanic n = 763 [17.7%], White n = 2,566 [59.5%], African American n = 610 [14.1%], Asian n = 136 [3.2%], Multiracial n = 231 [5.4%], and Native American n = 5 [0.1%]) 6th-grade students enrolled in Seminole County, Florida, Public Schools from August to December 2005. Prevalence of obesity was 21% for the overall population, with Hispanics n = 218 (28.6%) having a greater prevalence than non-Hispanics n = 630 (19.0%). Following a second screening, overall prevalence of elevated blood pressure was 1.9%, with Hispanics at 2.6% versus 1.6% for non-Hispanics. This was found to be significant when Hispanics were further compared to the White population. However, when adjusted for obesity, elevated blood pressure was not significant for Hispanics. Results confirm the presence of elevated blood pressure and obesity in all population groups, with an elevated risk for both among the Hispanic population.
Development of the Massachusetts School Nurse Research Network (MASNRN): A Practice-Based Research Network to Improve the Quality of School Nursing Practice
Authors: Vessey Judith A. ,   the Founding Oversight Board Members of MASNRN
Published: July 2008

When school nurses embrace evidence-based practice (EBP), higher-quality care is provided to students, their families, and the larger community. Despite this, school nursing has been slow to embrace EBP. Practice-Based Research Networks (PBRNs), which capitalize on the combined strengths of clinicians and researchers to study clinical questions, are one approach to overcoming barriers towards advancing evidence-based practice (EBP) in school nursing. This article will briefly review EBP and PBRNs. The development of Massachusetts School Nurse Research Network (MASNRN), a PBRN designed to investigate health issues common across schools and to validate school nursing practice, will then be described. Details regarding MASNRN’s mission, governance, communications systems, staffing, and network maintenance and funding will be explicated. MASNRN can serve as a model for PBRN development within the broader school nursing community.
Evidence-Based Practice Guideline: Increasing Physical Activity in Schools—Kindergarten Through 8th Grade
Authors: Bagby Karen , Adams Susan
Published: July 2008

Because of the growing obesity epidemic across all age groups in the United States, interventions to increase physical activity and reduce sedentary behaviors have become a priority. Evidence is growing that interventions to increase physical activity and reduce sedentary behaviors have positive results and are generally inexpensive to implement. National and international health organizations are calling for a comprehensive approach for reducing obesity in children that includes increasing physical activity in the school setting. Although the call to increase activity levels in schools is clear, little guidance has been given to schools on specific methods to accomplish this task. This article provides an overview of an evidence-based guideline developed by a physical education teacher and a school nurse to provide inexpensive, easy-to-implement, effective strategies to increase physical activity in students. Tools are also included in the guideline to measure the effectiveness of the intervention.
Child Health Issues in New Zealand: An Overview
Authors: Simmons Darlene R.
Published: July 2008

International travel can provide the unique opportunity to experience other cultures. For nurses, it can also provide a window through which different health care structures and services can be viewed. Many similarities and differences can be found between the country visited and the United States in terms of health issues, nursing education, roles, and responsibilities. This article explores a number of ways health services are provided to school-age children in New Zealand. Nearly 20% of New Zealand’s population are native Maori people. Not only is cultural sensitivity in health service delivery a priority, but the Maori people are guaranteed participation in health care decisions by law. School nurses in the United States can benefit from examining the models of care used by New Zealand nurses for managing the health care needs of school-age children.
Emergency Management of Seizures in the School Setting
Authors: O’Dell Christine , O’Hara Kathryn , Kiel Sarah , McCullough Kathleen
Published: July 2008

Effective seizure management in the school setting is a critical issue for students with seizures, as well as their parents, classmates, and school personnel. The unpredictable nature of seizures and the potential outcomes of experiencing a seizure in school are sources of anxiety for students with seizures. The ability to respond appropriately to a seizure is of concern to parents and school personnel. Implementation of a seizure emergency treatment plan empowers school personnel to quickly treat the child. Diazepam rectal gel is commonly used in seizure emergency treatment plans. It is safe and effective in terminating seizures and reduces the time to treatment and the need for emergency department visits when used in the school setting, and can be administered by medical and delegated to trained nonmedical personnel. School nurses should be aware of the laws and professional recommendations that pertain to rectal medication administration in schools for optimal emergency seizure management.
School Nurses’ Experience With Administration of Rectal Diazepam Gel for Seizures
Authors: O’Dell Christine , O’Hara Kathryn
Published: July 2008

The purpose of this study was to determine school nurses’ knowledge of state and school district policies, their experience regarding the administration of rectal diazepam gel in the school, and the perceived benefits and barriers of providing this treatment. Four hundred nineteen nurses responded to a survey conducted during the National Association of School Nurses Annual Meeting. Seventy-one (18%) nurses surveyed had administered rectal diazepam gel in a school setting, while 54 (13%) nurses reported that either their state practice act or school district prohibited them from giving rectal medications in the school. Medication administration benefits, such as early intervention for treatment of acute seizure emergencies, were noted. Barriers were also identified, with lack of privacy as the most frequently listed. Scope of practice as it pertains to administering medication in the school and the extent to which delegation of duties can be used in the situation of administering rectal medication in a seizure emergency remain issues for school nurses.
Community-Acquired Methicillin-Resistant Staphylococcus aureus: Considerations for School Nurses
Authors: Alex Aniltta , Letizia MariJo
Published: July 2008

Methicillin-resistant Staphylococcus aureus (MRSA) is a disease-causing organism that has been present in hospital settings since the 1960s. However, a genetically distinct strain of MRSA, called community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), has emerged in recent years in community settings among healthy individuals. While this organism has been found to be less resistant to antibiotics, it is also more virulent and capable of causing a spectrum of illnesses. School nurses must be aware of the risk factors for this infection and understand its signs, symptoms, diagnostic testing, and management. With this knowledge, school nurses can help protect students, staff, and community members from this increasingly prevalent pathogen.
Is Acanthosis Nigricans a Reliable Indicator for Risk of Type 2 Diabetes?
Authors: Jones Lisa H. , Ficca Michelle
Published: July 2008

Acanthosis nigricans (AN) is a thickening and hyperpigmentation of the skin commonly found on the neck, axilla, or groin and is generally caused by hyperinsulinemia, a consequence of insulin resistance associated with obesity. Insulin resistance is a primary risk factor for the development of type 2 diabetes, hypercholesterolemia, and hypertension. Screening for acanthosis nigricans is controversial and not recommended by the Centers for Disease Control and Prevention; however, some states, such as Texas, are implementing AN screenings in schools to identify those children who are at highest risk for developing type 2 diabetes. With the current epidemics of obesity and diabetes, school nurses will see students in the health office with AN and should be knowledgeable about this skin condition and the association with hyperinsulinemia and obesity. The school nurse’s role is to educate and assist students and their families in seeking appropriate medical advice based on current knowledge of risk factors. This article will explore the controversy associated with screening for AN and make recommendations for school nursing practice.
Asthma Prevalence, Management, and Education in New York State Elementary Schools: A Survey of School Nurses
Authors: Kielb Christine , Lin Shao , Hwang Syni-an
Published: July 2008

A survey of school nurses was conducted in New York State elementary schools to assess asthma and asthma management in students. The survey contained questions about asthma morbidity, management and education, obstacles to management, and school indoor air quality. The reported prevalence of asthma among students was 8.5%. Of the students with asthma, 64% visited the health office, 26% were absent from school, 20% had physical limitations, and 7% needed urgent care. Only 28% had a written management plan at school, less than 25% of schools used asthma self-management programs, and obstacles to management included lack of time and funding. More than 25% rated school indoor air quality as “fair” or “poor.” Schools need to adopt key components of asthma management, and school nurses should be encouraged to work with others in the school setting to address indoor air quality problems that might be affecting health.
The Relationship Between the Use of Health Clinics in Rural Mississippi Schools and the CHIP-AE Adolescent Health Profile
Authors: Bradford Judith Young , O’Sullivan Patricia S.
Published: July 2008

School health clinics are one way to meet the objectives in Healthy People 2010 for adolescent health. To determine the relationship between adolescent health status and use of the school health clinics in four Mississippi high schools, the Child Health and Illness Profile–Adolescent Edition (CHIP-AE) was used. The CHIP-AE identifies health status, giving scores on resilience, comfort, risks, and satisfaction, resulting in health profiles. One hundred seventy-one 9th-graders participated in this descriptive study. Students with the highest discomfort and risk scores had no use of the school health clinic. Students with fair health profiles were the highest users of the school health clinic when compared to all other profiles. Of those students with very poor health status, 60% reported the school health clinic was their only source of health care. In this study, the term school health clinic refers to the health office staffed by a nurse without an advanced degree.
What School Nurses Need to Know About Cervical Cancer, HPV, and the New Vaccine
Authors: Ehrhardt Jeanie
Published: July 2008

At least 12,000 women are diagnosed with cervical cancer each year in the United States, accounting for at least 4,000 deaths. Worldwide, cervical cancer is the second most common type of cancer among women. The human papilloma virus (HPV) has been linked to at least 70% of all cervical cancer. HPV can be divided into 2 categories: (a) low risk, which is responsible for genital warts, and (b) high risk, which is responsible for cervical cancer. An effective new vaccine has been approved that will decrease the spread of infection caused by HPV, therefore decreasing the future incidence of cervical cancer and genital warts. Understanding the risks of acquiring HPV and the increased risk for cervical cancer may lead to enhanced vaccine acceptance.
Evaluating the Effectiveness of the Kids Living Fit™Program: A Comparative Study
Authors: Speroni Karen Gabel , Earley Cynthia , Atherton Martin
Published: July 2008

After-school programs can be implemented by school nurses to facilitate healthy lifestyle choices in children with the goal of decreasing obesity. Kids Living Fit™(KLF), an after-school program designed by community hospital nurses, was implemented in elementary schools and focused on best lifestyle choices regarding foods consumed and activities chosen for children in grades 2 through 5. Study measures included comparison of body mass index (BMI) percentiles for age and gender and waist circumference between two self-selected groups composing a total sample size of 185 participants: the KLF intervention group ( n =80) and the no-intervention/ contrast group ( n =105). The 12-week intervention included a weekly fitness program and monthly dietitian presentations. Participants completed food and activity diaries and wore pedometers. In pairwise comparisons, the KLF group had a significant decrease in BMI percentile between baseline and follow-up (−2.3%) compared with the contrast group. The KLF group also demonstrated a smaller increase in waist circumference than the contrast group.
A Follow-up Study of Former Student Health Advocates
Authors: Streng Nancy J.
Published: July 2008

Student health advocates (SHAs) are high school students who, under the supervision of the school nurse, provide health education and health promotion activities to other students via a peer education model. This 3-year follow-up study explored how the SHA experience influences career choice and attitudes of the participants. It also examined what motivates students to become SHAs, the benefits and drawbacks of SHA participation, how SHA involvement influenced career plans, and how SHAs perceive the role of the school nurse. Study results indicate that this innovative health education/promotion experience offered an opportunity for SHAs to express their interest in health and enhanced their sense of belonging, meaningful involvement, connection to learning, and caring relationships in the school setting.
The Role of Sugar-Sweetened Beverage Consumption in Adolescent Obesity: A Review of the Literature
Authors: Harrington Susan
Published: July 2008

Soft drink consumption has increased by 300% in the past 20 years, and 56–85% of children in school consume at least one soft drink daily. The odds ratio of becoming obese among children increases 1.6 times for each additional can or glass of sugar-sweetened drink consumed beyond their usual daily intake of the beverage. Soft drinks currently constitute the leading source of added sugars in the diet and exceed the U.S. Department of Agriculture’s recommended total sugar consumption for adolescents. With the increase in adolescent obesity and the concurrent increase in consumption of sugar-sweetened beverages (SSB), the assumption infers a relationship between the two variables. SSB, classified as high–glycemic index (GI) liquids, increase postprandial blood glucose levels and decrease insulin sensitivity. Additionally, high-GI drinks submit to a decreased satiety level and subsequent overeating. Low-GI beverages stimulate a delayed return of hunger, thereby prompting an increased flexibility in amounts and frequencies of servings. Single intervention manipulation, elimination, or marked reduction of SSB consumption may serve to decrease caloric intake, increase satiety levels, decrease tendencies towards insulin resistance, and simplify the process of weight management in this population.
L.I.F.E.: A School-Based Heart-Health Screening and Intervention Program
Authors: Northrup Karen L. , Cottrell Lesley A. , Wittberg Richard A.
Published: July 2008

This article describes the development and growth of Lifestyle Improvements in the Family Environment ( L.I.F.E.), a school-based heart-health screening and intervention program. The primary goals of L.I.F.E. through three rounds of grant funding remained constant: (a) to identify cardiovascular risk factors in students and their families and (b) to provide counseling, education, and opportunities to change lifestyle routines that contribute to those risk factors. The program began with direct ties to a university-based research program and grew with evidence-based successes and development of community partnerships. Waves of growth were influenced by capacity-building efforts, partnership development, and resource availability. School nurses managed the screening component and partnered with appropriate others in the intervention programming. School nurses are appropriately positioned to assist families as well as school and community partners in decreasing the incidence of obesity and promoting healthy lifestyle behaviors.