bluuebunny/crossref_metadata_2025 huggingface dataset:
Special Day Class Teachers’ Perceptions of the Role of the School Nurse
Authors: Leier Janice L. , Cureton Virginia Young , Canham Daryl L.
Published: July 2008

School nurses are on the front lines of health care in public schools. The integration of students’ health care needs as components of educational programs has become increasingly important as medically fragile children rely on school nurses to deliver or coordinate their health care services. The purpose of this descriptive study was to determine which school nurse services special day class teachers perceive as very important, important, somewhat important, or not important. Perceptions were surveyed via the School Nurse Services Data Collection Tool. The data were analyzed using percentages, mean values, and frequencies. The data were then aligned to match the role concepts set forth in the California Commission on Teacher Credentialing (CTC) standards for school nurse preparation. The findings of this survey suggested that most of the services provided by school nurses were rated as important or somewhat important.
Working With a Vietnamese Adolescent
Authors: Labun Evelyn
Published: July 2008

Every day nurses make practice decisions that are based on knowledge drawn from personal, cultural, and scientific sources. Nurses therefore practice from a particular perspective that involves culturally based personal, professional, and societal beliefs and values. Their practice, however, may involve clients whose beliefs and values are culturally different from their own and that of mainstream society. To deal effectively with competing demands in a multicultural society, nurses need to be aware of transcultural nursing concepts and how they influence ethical decision making. Using a problem-solving approach, this article analyzes the practice decisions made by a school nurse when working with a Vietnamese adolescent girl and her family. A case study is presented with background information about the Vietnamese culture, the refugee-immigrant experience, and nursing ethics. Suggestions are offered for future ethical problem solving.
Identification of Desired Outcomes for School Nursing Practice
Authors: Selekman Janice , Guilday Patricia
Published: July 2008

The Scope and Standards of Professional School Nursing Practice states that school nurses should evaluate the quality and effectiveness of their practice. School nurses have not yet identified and adopted outcomes by which this effectiveness can be measured. This study used focus groups during a national meeting of school nurse leaders to identify the desired outcomes that could be used to measure the efficacy of school nursing practice. Ten desired outcome themes were identified with numerous specific indicators as possible ways to measure the desired outcome in each theme. The student-, school-, and nurse-focused outcome themes were as follows: (a) increased student seat time, (b) receipt of first aid and acute care measures, (c) receipt of competent health-related interventions or skills, (d) meeting of the comprehensive needs of children with chronic conditions, (e) enhanced school health via wellness promotion and disease prevention measures, (f) referrals, (g) safe environment, (h) enhanced school health via community outreach, (i) cost-effective school nurse services, and (j) student, parent, and staff satisfaction. The school nurse participants were supportive of having potential outcomes identified and unanimously endorsed the findings at the conclusion of the study. They have provided a comprehensive framework from which evaluation tools can be developed to measure the efficacy of school nursing.
Design and Evaluation of SchoolhealthLink, a Web-Based Health Information Resource
Authors: Bachman Jean A. , Brennan Patricia Flatley , Patrick Timothy B.
Published: July 2008

SchoolhealthLink, a Web-based information service for Missouri school nurses, is a promising resource to reach school nurses isolated from traditional professional networks. It also may serve as an important adjunct to stay abreast of the latest health information. Using a strategy to identify the health information needs of school nurses and to test the site early in its development, this pilot study found school nurses reported SchoolhealthLink was an easy-to-use method to find high-quality, up-to-date information relevant to school nursing practice, was better than existing methods to access information, and could change the way they practiced. In order to continue to build SchoolhealthLink, a partnership with Barnes College of Nursing and the Missouri Association of School Nurses has been established to work together to continue to add health information resources useful to school nursing practice.
Prediction of Postpartum Social Support and Symptoms of Depression in Pregnant Adolescents: A Pilot Study
Authors: Logsdon M. Cynthia , Cross René , Williams Beverly , Simpson Theresa
Published: July 2008

Many pregnant adolescents remain in school, creating unique challenges for professionals to meet their educational and health needs. In this descriptive pilot study of pregnant adolescents ( n = 26), 68% demonstrated symptoms of depression as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). In addition, there was an expectation by the pregnant adolescent that postpartum social support received, as measured by the Postpartum Support Questionnaire, would be different from what is important to her. As an important part of the team, school nurses are uniquely positioned to screen pregnant adolescents for depression and to assist them in learning how to negotiate for the social support that is important to them.
A Multi-Factor Analysis of Job Satisfaction Among School Nurses
Authors: Foley Marcia , Lee Julie , Wilson Lori , Cureton Virginia Young , Canham Daryl
Published: July 2008

Although job satisfaction has been widely studied among registered nurses working in traditional health care settings, little is known about the job-related values and perceptions of nurses working in school systems. Job satisfaction is linked to lower levels of job-related stress, burnout, and career abandonment among nurses. This study evaluated the level of job satisfaction among a convenience sample of school nurses practicing in California. The Index of Work Satisfaction (IWS) was the instrument used. Although the sampled school nurses rated autonomy and interaction as the most important and satisfying factors contributing to job satisfaction, the overall findings indicated that school nurses are relatively dissatisfied with their jobs.
A Differentiated Practice Model for School Nursing
Authors: Keller Teresa , Ryberg Jacalyn Wickline
Published: July 2008

School nursing is notable for autonomous practice and independent decision-making. School nurses practice within a complex school health services environment that is subject to constant change, the influence of multiple stakeholders, and a chronic state of uncertain resources. Other professional challenges faced by school nurses are a lack of standardized entry education requirement, inadequate theoretical research with practice application, and expanding role responsibilities. Administrative restructuring of school nursing services using a differentiated practice model could be a method to address the challenges of school nurse practice. A model of differentiated school nursing practice is proposed as a starting point for the national school nurse audience to consider this alternative to the master's entry requirement. School nurse role responsibilities are divided among three levels of practitioners: generalist, master's prepared, and school nurse policy analyst. Each level features an increased scope of responsibility based on higher educational attainment. Research regarding how differentiated practice has been implemented in other health care settings is described. Implications for the implementation of differentiated practice in school health services are discussed, including the need for cooperation among stakeholders, possible cost considerations, and how school nurse education might be affected.
Bloodborne Infections: Should They Be Disclosed? Is Differential Treatment Necessary?
Authors: Kukka Christine
Published: July 2008

There are students and staff in many schools with hepatitis B, hepatitis C, or HIV infections. Should parents or guardians be expected to disclose students’ bloodborne infections to school officials? Can infected students play contact sports given the increased risk of blood spills? What type of response plan should schools develop in the event of a blood spill to protect student health and privacy? This article summarizes the policies and approaches that the federal government and medical, school nursing, teacher, and parent organizations have taken on these issues. It suggests strategies school nurses can employ to protect the civil rights, privacy, and health of all students and school staff.
Anger Expression and Blood Pressure in Adolescents
Authors: Starner Tamie M. , Peters Rosalind M.
Published: July 2008

The clinical significance of childhood hypertension is important as elevated pressures during childhood are found to follow a progressively increasing track into adulthood. Little work has been done to examine the relationship of emotions and emotional behavioral factors to the development of hypertension in children. Using the Roy Adaptation Model as a guide, this study investigated the relationship of anger expression and blood pressure (BP) among adolescents 16–18 years of age. Participants were 63 urban high school seniors. Measurements included the Anger Expression Inventory, a Demographic Questionnaire, and measures of systolic and diastolic blood pressure. Analysis revealed significant positive relationships between anger expression with blood pressure, and a significant inverse relationship between blood pressure and the control of anger for girls. No significant relationships between anger expression and blood pressure were noted for boys. The majority of students (53%) were found to have high normal or hypertensive blood pressure readings, putting them at increased cardiovascular risk.
Understanding the Culture of Chinese Children and Families
Authors: Cheung Ruth , Nelson Warren , Advincula Luzelle , Cureton Virginia Young , Canham Daryl L.
Published: July 2008

Providing appropriate health care to a client can be accomplished only in an environment that is sensitive to the cultural values and beliefs of the client. As the population of first-and second-generation Chinese immigrants increases in the United States, the need to develop culturally sensitive health care becomes significant. Chinese immigrants and their families have become an important part of American society, including the school setting. The school nurse, who regularly works with students and families, should work in a manner that allows Chinese immigrants to maintain their cultural values and beliefs, while providing appropriate care for the student. The Chinese culture is unique and holds values and beliefs that contrast with those of the Western culture. A school nurse who understands and incorporates the Chinese culture will be better able to develop a positive interaction with the family and make arrangements for culturally appropriate care.
Bipolar Disorder in School-Age Children
Authors: Olson Patricia M. , Pacheco Mary Rae
Published: July 2008

This article examines the individual components of bipolar disorder in children and the behaviors that can escalate as a result of misdiagnosis and treatment. The brain/behavior relationship in bipolar disorders can be affected by genetics, developmental failure, or environmental influences, which can cause an onset of dramatic mood swings and dysfunctional behavior. School is often the site where mental health disorders are observed when comparing behaviors with other children. Assessing the emotional, academic, and health needs of a student with a bipolar disorder is a critical step in designing effective interventions and school accommodations. Without appropriate medical, psychological, pharmaceutical, and academic interventions, a child is at risk for uncontrolled mania, depression, substance abuse, or suicide. The school nurse is part of the multidisciplinary team and plays a key role in facilitating case management to potentially reverse this possible negative trajectory. Successful case management provides children with bipolar disorder the opportunity to reach their academic potential.
What Are the Odds? Random Drug Testing of Students: Two Perspectives
Authors: Pohlman Katherine , Schwab Nadine
Published: July 2008

Companion articles explore random drug testing programs in schools. The first article addresses random drug testing of students from a legal perspective. It describes legal issues and current case law regarding drug testing programs in schools and commonly asked questions regarding these programs. The second article addresses random drug testing of students from a practice perspective. It explores arguments for and against random drug testing programs and the role of the school nurse in policy and procedure development.
Data Destruction
Authors: Bergren Martha Dewey , Murphy Elizabeth Ann , Bergren Martha Dewey
Published: July 2008

School nurses are caretakers of a vast amount of sensitive student and family health information. In schools, older computer hardware that previously stored education records is recycled for less demanding student and employee functions. Sensitive data must be adequately erased before electronic storage devices are reassigned or are discarded. State and federal laws must be considered when permanently destroying personally identifiable student information. To fulfill their ethical and legal responsibilities, school nurses must be aware of record retention and data destruction policies and procedures for both paper and electronic records.
Tooth Avulsion in the School Setting
Authors: Krause-Parello Cheryl A.
Published: July 2008

Tooth avulsions occur when a tooth is displaced from its socket. Tooth avulsions are common dental injuries that may occur before, during, or after school. Therefore, it is essential that school nurses be well prepared to intervene when such a dental emergency arises. It is also imperative that school nurses and school personnel are fully equipped to manage a tooth avulsion. Time is of the essence when attempting to save an avulsed tooth. The goal is to successfully reinsert the avulsed tooth and to preserve the periodontal ligament. The school nurse is responsible for implementing the appropriate actions needed to save the avulsed tooth.
The Use of Ergogenic Agents in High School Athletes
Authors: Rosenfield Charlene
Published: July 2008

Statistics reporting adolescent use of ergogenic agents are staggering. According to the Centers for Disease Control and Prevention Youth Risk Behavior Surveillance, 6.1% of students from grades 9 through 12 had taken illegal anabolic steroids without a prescription one or more times during their lifetime. Additionally, more adolescent athletes are using non–Food and Drug Administration-regulated herbal supplements that claim ergogenic benefits. Many athletes either are unaware of or do not consider the possible health risks caused by these agents. School-based programs for athletes may be successful in preventing the use of ergogenic agents by increasing knowledge about such agents and offering skills in critical thinking to improve decision-making skills.
Comparing the Number of Ill or Injured Students Who Are Released Early From School by School Nursing and Nonnursing Personnel
Authors: Wyman Linda L.
Published: July 2008

There is a growing demand for research linking specific educational services with positive student outcomes. Little empirical evidence exists to show that school nursing services improve student success. School attendance is one of many factors that has been associated with improved learning; school nurses can affect that factor. This study compared the number of students in a Midwest urban public school district who were dismissed from school early for illness or injury with and without interaction with a school nurse. A student sign-out and sign-in log identified the number of students who left school prior to the official dismissal time, and a school nurse activity log indicated the students who were dismissed early from school after contact with a school nurse. Analysis of these data indicates that 57% fewer students left school early with school nurse contact compared with those who left school early without such contact. The results of this study indicate school nurses may positively influence student school success by reducing avoidable early release from school for ill or injured students.
Handheld Computer Software for School Nurses
Authors: Bergren Martha Dewey , Murphy Elizabeth Ann
Published: July 2008

School nurses used computers in the 1980s, the Internet in the 1990s, and are embracing handheld computers in the first decade of the 21st century to improve their practice. The purpose of this article is to provide information about handheld computers and software applications that school nurses can use in day-to-day, emergency, and disaster situations. Handheld computers help school nurses to make decisions based on accurate and up-to-date information, and to practice evidence-based nursing. Evidence-based nursing is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise, and patient preferences.
Self-Mutilation in Adolescents
Authors: McDonald Catherine
Published: July 2008

Self-mutilation is not a new trend or phenomenon in adolescents. Self-mutilation can be divided into three categories: major, stereotypic, and moderate/superficial. Moderate/superficial self-mutilation is the most common type in adolescents and includes cutting, burning, and carving. School nurses are positioned to identify, to assist, and to educate adolescents who are self-mutilating, as well as those who may be at risk. A crucial intervention by school nurses is referral of students who are self-mutilating, because it is a gateway to treatment. Treatment, which includes therapy and medication, may be a difficult and lengthy process. The adolescent who self-mutilates may find the school environment difficult during treatment. School nurses must become educated about adolescent self-mutilation in order to care for those who engage in this behavior. Prevention of self-mutilation should focus on increasing coping mechanisms, facilitating decision-making strategies, encouraging positive relationships, and cultivating self-esteem.
The Use of Latex Gloves in the School Setting
Authors: Purcell Cathy Koeppen
Published: July 2008

In 1987, when the U.S. Centers for Disease Control and Prevention recommended the use of universal precautions in response to the HIV/AIDS epidemic, the demand for medical gloves dramatically increased. Unfortunately, the manufacturing techniques for the most widely-used gloves—natural rubber latex—also changed, in order to expedite production. These changes resulted in an increase in latex allergies, because excessive residual proteins that cause allergies remained on the gloves and became airborne with the gloves’ high level of powder. This allergy concern is especially relevant in the school setting where school nurses are not only concerned about their own well-being, but the well-being of the children in their care. Today, latex gloves are still the most widely used of any medical gloves, but they have much lower levels of protein and are available in low-or no-powder. This article examines whether the current latex gloves indeed reduce the allergenicity of the gloves and how allergy and barrier protection data can assist school nurses in making informed glove choices.
A Comparison of Patched HOTV Visual Acuity and Photoscreening
Authors: Leman Rachel , Clausen Michelle M. , Bates Janice , Stark Lee , Arnold Koni K. , Arnold Robert W.
Published: July 2008

Early detection of significant vision problems in children is a high priority for pediatricians and school nurses. Routine vision screening is a necessary part of that detection and has traditionally involved acuity charts. However, photoscreening in which “red eye” is elicited to show whether each eye is focusing may outperform routine acuity testing in pediatric offices and schools. This study compares portable acuity testing with photoscreening of preschoolers, kindergarteners, and 1st-graders in 21 elementary schools. School nurses performed enhanced patched acuity testing and two types of photoscreening in a portable tent. Nearly 1,700 children were screened during spring semester 2004, and 14% had confirmatory exams by community eye care professionals. The results indicate that one form of photoscreening using a Gateway DV-S20 digital camera is significantly more sensitive to children with significant vision problems, as well as being the most cost effective (85% specificity and only $0.11 per child). This suggests that the adaptation of photoscreening into a routine vision screening protocol would be beneficial for efficiently detecting vision problems that could lead to amblyopia.
NANDA Diagnoses, NIC Interventions, and NOC Outcomes used in an Electronic Health Record with Elementary School Children
Authors: Lunney Margaret
Published: July 2008

This is a report of a secondary analysis of data from a published quasi-experimental feasibility study of the effects of implementing diagnoses from North American Nursing Diagnosis Association International, interventions from the Nursing Interventions Classification, and outcomes from the Nursing Outcomes Classification (referred to as NNN) on nurses’ power and children's health outcomes. For this study, the NNN terms that were frequently used by nurses in the original study were identified through the nurses’ printed reports of health-related visits (N = 766) with 103 New York City children in the 4th and 5th grades in six schools. The findings indicate that a large majority of nurses’ efforts were focused on health promotion and management of risk states. Health problems such as pain and ineffective airway clearance were identified and were treated when present. Findings from this study can be combined with findings from previous studies to identify the diagnoses, interventions, and outcomes that are relevant for school settings. Use of the relevant NNN terms will provide data to support evidenced-based school nursing practice, education of school nurses, development of policies, and communication of the value of school nursing practice to stakeholders.
Development of a School Nursing Research Agenda in Florida: A Delphi Study
Authors: Gordon Shirley C. , Barry Charlotte D.
Published: July 2008

Research is important to the image, visibility, and viability of school nursing. Each state school nursing association should evaluate member commitment to school nursing research based on their unique set of financial, educational, and organizational resources. A 3-round Delphi study was conducted in which Florida school nurses identified research priorities. The 10 priority research topics were (a) obesity/nutrition, (b) role of the school nurse, (c) legal/ethical issues, (d) emergencies, (e) health education, (f) absenteeism/attendance, (g) diabetes and insulin, (h) injuries, (i) health services, and (j) asthma. These topics form the state research agenda and will be used to guide the development of multisite school nursing studies.
Teens’ Perceptions about Attention Deficit/Hyperactivity Disorder and Medications
Authors: Knipp Diana K.
Published: July 2008

This qualitative study describes teens’ perceptions about attention deficit/hyperactivity disorder (AD/HD) and medications. The four modes of adaptation of the Roy Adaptation Model were the framework for this study. Data were collected through semistructured interviews with 15 high school teens aged 14-17 with parent-reported AD/HD. An inductive analysis identified four themes: (1) physiologic (medication)—“Medications are a hassle, but they work”; (2) role function—“I do better in school when I take the meds”; (3) interdependence—”With meds things are better with my family, and friends don't know I am any different”; and (4) self-concept/group identity—“I'm just an everyday teenager, pretty much.” The composite main theme was, “Meds help me.” School nurses can use this information to guide interventions for families and teens with AD/HD and in working with health care providers, teachers, staff, and communities in a multidisciplinary effort toward an adaptive educational experience for teens.
School Health Nursing Services Role in Education: The No Child Left Behind Act of 2001
Authors: Costante Carol C.
Published: July 2008

Public Law 107–110, the No Child Left Behind Act of 2001, represents the most sweeping reauthorization of the Elementary and Secondary Education Act since it was enacted in 1965. The goal of the No Child Left Behind Act is to improve the academic achievement of all American students so that they all meet their own state’s standards for competence by 2014. The law focuses on closing the achievement gap that exists among the economically disadvantaged, those with limited English proficiency, racial/ethnic minorities, and students receiving special education services. The No Child Left Behind Act has created both support and controversy in education circles. Although the No Child Left Behind Act does not legislate the practice of school nursing, as professional staff working in schools, school nurses are affected indirectly by the heightened emphasis on accountability for achievement in public education. School nurses actively promote and support achievement for all students in specific ways and help to provide a safe school environment.
Lack of Follow-up Exams After Failed School Vision Screenings: An Investigation of Contributing Factors
Authors: Kimel Linda S.
Published: July 2008

Programs to facilitate professional eye exams after failed school vision screenings often are based on the assumption that funding and access to services are major obstacles to care. Despite such programs, many children do not receive professional exams. The purpose of this study was to identify additional barriers to follow-up eye care. School nurses in an urban, mid-western public school district identified elementary school students who had not received follow-up eye exams after failed school vision screenings. Parents of these students were interviewed during the summer to determine financial, logistical, social/family, and perceptual barriers to care. Family issues, parental perceptions of vision problems, and difficulty planning ahead were found to be significant factors. Strategies to increase follow-up compliance and recommendations for overcoming barriers to care were also identified.
No-Nit Policies in Schools: Time for Change
Authors: Sciscione Patricia , Krause-Parello Cheryl A.
Published: July 2008

No-nit policies that exist in many schools throughout the United States were established years ago based on fear and misinformation, rather than scientific evidence. Children who are found to have live lice are no more infectious on the day of diagnosis than they had been prior to the discovery. Transmission of head lice requires close personal contact, which is not common in the school setting. To date, no scientific literature exists to support the exclusion of children from school due to head lice infestation. Therefore, there is a need to develop updated school policies using research-based evidence to determine the best method of treating infestations while allowing children to remain in school.
Silent Victims: Children Exposed to Family Violence
Authors: Kolar Kathryn R. , Davey Debrynda
Published: July 2008

Annually an estimated 3 million or more children are exposed to acts of domestic violence between adults in their homes. These children are at risk for abuse themselves as well as other immediate and long-term problems, especially if they have been exposed to repeated episodes of domestic violence. Multiple behavioral manifestations, including anxiety, depression, and posttraumatic stress disorder, may be associated with violence exposure, and it is imperative that school nurses recognize these. All children should be screened for domestic violence exposure at regular intervals, and those who are at risk should have a more thorough health assessment. Planning for the safety of the child, nonoffending caregiver, and siblings and the school nurse involved in the situation is of utmost importance.
A Training Program for Unlicensed Assistive Personnel
Authors: Gursky Beverly S. , Ryser Barbara J.
Published: July 2008

In many school districts, school nurses are assigned multiple schools with responsibility for the health care needs of all students at those schools. Because they cannot be physically present at all sites simultaneously, it is necessary to delegate tasks to unlicensed assistive personnel (UAP). Educating and supervising UAP are critical steps in the delegation process. This article shows how one school district developed and implemented a training program for UAP using its school nursing staff.
Exploration of School Administrator Attitudes Regarding Do Not Resuscitate Policies in the School Setting
Authors: Hone-Warren Martha
Published: July 2008

Few school districts in the United States have policies relating to do not resuscitate (DNR) orders in the school setting. School administrators are the gatekeepers of policy development. Little is known about administrator attitudes related to DNR orders in the school setting. School nurses need to understand administrator attitudes in order to facilitate DNR policy development. This study explored the attitudes of 15 administrators about DNR orders in the school setting through structured interviews. Administrators were asked their attitudes about DNR orders in the school setting and about DNR policy implementation. The majority of administrators believed that DNR policies should not be developed for the school setting because of the emotions involved and lack of administrator knowledge related to DNR orders. The majority of administrators did agree that having a DNR policy would clarify how staff should respond to DNR orders at school.
North Carolina School Nurse Leadership Institute
Authors: Guttu Martha
Published: July 2008

Recognizing that school nurse leaders are essential to the development of school nurses, the North Carolina School Nurse Leadership Institute was developed to enable school nurse leaders to update and advance their leadership skills. The Institute was a collaborative endeavor between the North Carolina Department of Health and Human Services, Eastern Area Health Education Center, and East Carolina University School of Nursing. School nurse leaders were empowered to assume a role in public policy, and they were provided opportunities to network with leaders in other counties throughout the state. A combination of face-to-face and asynchronous discussion via the Internet was used to foster continuous rather than episodic learning. Participant evaluations were positive and indicated a significant increase in learning in key areas.
Sexual Behaviors and Drinking Patterns Among Middle School and High School Students in Southeastern North Carolina
Authors: Kim-Godwin Yeoun Soo , Clements Carrie , Bullers Susan , Maume Michael , Demski Elizabeth
Published: July 2008

Considering that current trends in sexual behavior and alcohol use among adolescents pose a significant public health risk, more research is needed in this area. Using a cross-sectional design, this study examined sex and alcohol behaviors among middle school and high school students in southeastern North Carolina. The findings suggested that there were strong associations between overall drinking patterns and sexual behaviors. Further analyses examined the effect of several demographic and behavioral factors on sexual experience and condom use for both middle and high school students. Alcohol, race, and age were significant determinants of sexual experience for all students while gender was significant for middle school students. None of the measured factors, including AIDS education, significantly increased condom use among sexually active students. The results suggested that sexuality and alcohol education methods and content should be reevaluated and should begin in or before middle school.
Secondhand Smoke Exposure in a Rural High School
Authors: Lee Kiyoung , Hahn Ellen J. , Riker Carol A. , Hoehne Amber , White Ashleigh , Greenwell Devin , Thompson Dyshel
Published: July 2008

Although federal law requires all public schools to be smoke free, lack of compliance with the smoke-free policy is commonly reported. The aims of this study were to describe the indoor fine-particle (PM2.5) air pollution in a rural high school and surrounding public venues. This cross-sectional, nonexperimental study was conducted in Monroe County, Kentucky (population of 11,756). Fine-particle concentrations were measured in the high school and 5 public venues using spectrometers. Because of illegal student smoking, PM2.5 concentrations were 19 times higher in the boys’ student restroom than the National Ambient Air Quality Standard for outdoor air (670 vs. 35 μg/m3). The staff restrooms adjacent to the student restroom where staff did not smoke also showed high PM2.5 levels. Average indoor air pollution in the public venues was 158 μg/m3. Strict enforcement of smoke-free school policy and cessation resources are needed to reduce secondhand smoke exposure. Collaborative school-community campaigns involving parents, students, mass media, and community organizations may be effective in reducing the harm caused by tobacco. Implications for school nurses are discussed.
Adolescents’ Attitudes About Obesity and What They Want in Obesity Prevention Programs
Authors: Wilson Louise F.
Published: July 2008

Obesity is a major pediatric public health problem. Adolescents are a priority population for intervention strategies. School nurses are in key positions to design intervention strategies to promote healthy lifestyles and prevent adolescent obesity in the students they serve. To design effective programs, school nurses need to know what components their students perceive as important. This study involved the development and administration of a questionnaire to middle school students to determine their attitudes about overweight/obesity and what they felt would work for them. Adolescents are willing to exercise more, to change eating habits to include more fruits and vegetables, drink more water, and eat less junk food. They are not willing to give up soda, video/computer games, and watching television to improve their health. School nurses can use this questionnaire to collect data that will assist in the development of effective programs for their students.
Effectiveness of Nutrition Education on Fast Food Choices in Adolescents
Authors: Allen Kelly N. , Taylor Julie Smith , Kuiper RuthAnne
Published: July 2008

Adolescent obesity has become a major health concern in the United States. An increased frequency of fast food restaurant dining is associated with higher intake of calories and calories from fat. The purpose of this study was to gain insight as to how food choices in a “simulated” fast food environment might be influenced by nutrition education in a group of adolescents. Ten adolescents were asked to choose food items from a fast food restaurant menu. Their chosen meals’ nutrition make-up (calories, fat, cholesterol, sodium, carbohydrates, protein, and fiber) was calculated. Following a 30-minute nutrition education session, participants were asked again to choose a meal from the same fast food menu. The nutrition make-up of the meal chosen postintervention was compared with the meal chosen before the education session. There was a statistically significant ( p <.05) difference in calories, fat, carbohydrate, and fiber content of the meals chosen postintervention. This short nutrition education intervention resulted in healthier fast food choices in this group of adolescents.
Anesthetic Considerations for Lung Transplantation
Authors: Baez Bernard , Castillo Maria
Published: July 2008

Lung transplantation is the definitive treatment for end-stage lung disease. The number of lung transplantations performed is limited by the number of donors available and is far outnumbered by the potential recipients on the waiting list. Advances in surgical methods, organ preservation, and immunosuppression have decreased the morbidity and mortality associated with this procedure during the last few decades. Specific anesthetic concerns are associated with lung transplantation, including careful preoperative assessment of pulmonary and cardiac function, adequate venous access and monitors, and ventilation techniques, such as 1-lung ventilation and lung-protective strategies to decrease the risks of reperfusion injury, barotrauma, and re-expansion pulmonary edema. Intraoperative transesophageal echocardiography, cardiopulmonary bypass, and inhaled nitric oxide can also be important tools for the anesthesiologist to optimize patient care during this challenging procedure.
Cowboy Capitalism
Authors: Stahl Geoff
Published: July 2008

This article draws on recent discussion regarding changes in city life by focusing on specific cultural spaces and social relations found in contemporary Berlin. “The Art of Ping Pong Country”—the union of ping pong and country music as a series of events bringing together artists, cultural entrepreneurs, and new media practitioners—highlights the temporal, social, spatial, and semiotic distinctions of the city's current scene, particularly as a manifestation of the overlapping contexts of work and play in a “culturalized economy.” Ping Pong Country is made up of a complex set of relationships that reveals the way artists and entrepreneurs in Berlin construct individual, group, and urban identities; how a particular relationship to flexible work patterns and urban lifestyles is negotiated; and how the city acquires and maintains its specific character and semantic force by evoking a particularly attractive structure of feeling as manifest in its deliberate “playfulness.”
Protecting axons in multiple sclerosis
Authors: Wilkins A , Scolding N
Published: July 2008

Typically patients with multiple sclerosis (MS) experience acute episodes of neurological dysfunction, which recover followed, at a later stage, by slow and insidious accumulation of disability (disease progression). Disease progression reflects axon damage and loss within the central nervous system. However, the precise mechanism of axon injury in MS is not clear. Inflammation occurring during acute relapses undoubtedly causes some degree of acute axon damage, but epidemiological data and treatment studies have suggested that inflammation alone is not the sole cause of axonopathy. Indeed, there appears to be dissociation between inflammation and disease progression once a certain level of clinical disability has been reached because immune suppression in patients who have established disease progression does not halt the slow decrease of function. The slow and insidious loss of neurological function that occurs during the progressive phase of the disease implies a degenerative process. Whether axon drop-out occurs at these later stages because of previous inflammatory damage to axons; because of low grade inflammation causing damage to already vulnerable demyelinated axons; because of loss of trophic environment for axons to survive; or as part of a completely independent neurodegenerative process is not clear. Understanding disease mechanisms involved in the axonopathy of MS allows for the development of rational therapies for disease progression.
Magnetic resonance imaging measures of brain and spinal cord atrophy correlate with clinical impairment in secondary progressive multiple sclerosis
Authors: Furby J , Hayton T , Anderson V , Altmann D , Brenner R , Chataway J , Hughes RAC , Smith KJ , Miller DH , Kapoor R
Published: July 2008

Background

Neuroaxonal loss is a pathological substrate of disability in progressive multiple sclerosis (MS) and can be estimated in vivo by measuring tissue atrophy on magnetic resonance imaging (MRI). While there is some evidence that brain atrophy correlates better with disability than T2 lesion load in secondary progressive MS, the clinical relevance of atrophy within specific regions of the central nervous system requires further evaluation.

Methods

Clinical and MRI examinations were performed in 117 subjects with secondary progressive MS. MRI analysis included measures of normalized brain volume (NBV), normalized grey matter (NGMV) and white matter volume (NWMV), central cerebral volume (CCV), spinal cord cross-sectional area (SCCA), and brain T2 and T1 lesion volume. Clinical assessments included the expanded disability status scale (EDSS) and MS functional composite (MSFC).

Results

All MRI measures correlated significantly with the MSFC score, with the strongest correlation being for the NBV ( r = 0.47; P < 0.001). NBV and SCCA were the only significant independent predictors of the MSFC score in a stepwise regression model containing all the MRI measures, and SCCA was the only MRI measure to show a significant association with the EDSS. While NGMV had stronger correlations with the clinical variables than NWMV, NBV was more correlated with clinical impairment than either measure.

Conclusions

This data suggests that measures of atrophy, particularly of the whole brain and spinal cord, are relevant and useful disease markers in secondary progressive MS.
Setting the agenda for multiple sclerosis rehabilitation research
Authors: Kraft GH , Johnson KL , Yorkston K , Amtmann D , Bamer A , Bombardier C , Ehde D , Fraser R , Starks H
Published: July 2008

Background

Recognizing the need for more evidence-based multiple sclerosis (MS) rehabilitation, in the mid-2000s several initiatives were undertaken to explore why there had been a paucity of such research and to determine strategies to reverse this pattern.

Expert-Opinion-Paper

In 2004 the National Multiple Sclerosis Society (NMSS) convened an expert opinion panel, reviewed evidence-based MS rehabilitation research, and published the paper on the web. It was concluded that much of the MS rehabilitation carried out was based on experience, with little research backing it up.

Increasing the Quality and Quantity of MS Rehabilitation Research

Largely as a result of the conclusions of the Expert-Opinion-Paper, the NMSS convened a conference of a large number of MS and rehabilitation experts in New York in May, 2005. This conference made many recommendations of ways to increase the quantity and quality of MS research.

State of the Science Conference

In September, 2006, a follow-up conference was held in Washington, D.C... This conference, primarily sponsored by the University of Washington Multiple Sclerosis Rehabilitation Research and Training Center (MS RRTC), focused on some of the under-studied “hidden” disabilities present in persons with MS. This paper discusses the details and recommendations of these latter two conferences.
Fitting Square Pegs into Round Holes: The Challenge of Coping with Attention-Deficit Hyperactivity Disorder
Authors: Gallichan Deanna J. , Curle Christine
Published: July 2008

This study aimed to further our understanding of young people's perspectives on attention-deficit hyperactivity disorder (ADHD), with particular reference to social context and coping. Twelve young people (aged 10 years 11 months to 17 years 4 months) took part in semi-structured interviews. These were transcribed verbatim and analysed using grounded theory to extract themes and link these into an over-arching model. The model suggested a reciprocal relationship between young people and their social context, with the challenges of ADHD formulated as a mismatch between the two; young people were like square pegs trying to fit into rigid round holes. This `vicious cycle' led young people to feel out of control and have low self-esteem. ADHD was experienced as less challenging when the environment was adaptable and flexible, and when young people experienced the support and acceptance of others. Such environments may motivate young people to make their own changes, and fostered a sense of agency and positive sense of self. The understanding of others and the willingness to adapt the environment to meet individual needs may ultimately benefit these young people's senses of agency and self-esteem.
Evaluation of a Targeted Cognitive-Behavioral Program for Children with Conduct Problems — The SNAP® Under 12 Outreach Project: Service Intensity, Age and Gender Effects on Short- and Long-Term Outcomes
Authors: Koegl Christopher J. , Farrington David P. , Augimeri Leena K. , Day David M.
Published: July 2008

This study tested the effectiveness of a multifaceted, cognitive-behavioral therapy (CBT) program for antisocial children — the SNAP® Under 12 Outreach Project (ORP) — in relation to age, sex and indices of treatment intensity. Study participants were 80 clinic-referred children (59 boys and 21 girls) aged 6—11 years assigned to one of the following groups: control (CG; n = 14) who did not receive the ORP, matched (MG; n = 50) who received the ORP, and experimental (EG; n = 16) who received an enhanced version of the ORP. Results indicated significant pre—post changes for the EG and MG for Child Behavior Checklist (CBCL)-measured delinquency and aggression, but no improvement for the CG. Positive relationships between the number of individual ORP components (e.g. number of children's CBT sessions) received and CBCL change scores were also found. Statistical associations tended to be larger for girls and older children (i.e. 10—11 years old) who may have been more cognitively advanced. Also, the number of children's CBT sessions predicted later convictions, even after controlling for prior CBCL delinquency scores. Findings from this study support the effectiveness of the ORP, but also highlight the need to take into account client characteristics when offering clinical treatment.
Use of oral tradition in archaeology: The case of Ajdovščina above Rodik, Slovenia
Authors: Hrobat Katja
Published: July 2008

This article addresses the potential of oral tradition (folklore) in the archaeological study of the past. It deals with oral traditions concerning landscape features in the area of the prehistoric and Roman site of Ajdovščina above Rodik, Slovenia. The palimpsest nature of modern landscapes can be regarded as a syncretic sum of past ways of life, land use, religious practices, and cults. In oral tradition concerning the ancient inhabitants of Ajdovščina, it is possible to discern the obscured memory of historical process. Certain sites, referred to in local oral tradition, mainly in the form of memories of religious practices performed there and of superstitions related to them, may well prove to be the remains of ancient sacred places. Methodological problems include identification of the generic and specific in oral tradition, the recognition of Christian intervention and/or censorship of ancient cults and beliefs, and the transposition and/or survival of elements of old ritual practices in popular beliefs. The aim of this article is to discuss the role of oral tradition linked to the landscape in the persistence of collective memory concerning historical circumstances and the survival and/or transformation of ancient cult or ritual sites and beliefs.
Fear and punishment in Sweden
Authors: Demker Marie , Towns Ann , Duus-Otterström Göran , Sebring Joakim
Published: July 2008

Sweden is often portrayed as a hold out from `penal populism', with a comparatively non-punitive population that prefers preventive and non-custodial sanctions to imprisonment. But while the Swedish public is still less punitive than many others, there is evidence that it has become more punitive, and less content with Swedish penal practice, over time. Trying to add to the understanding of the causes of toughening penal attitudes, we proceed to investigate the importance of media consumption for Swedish penal attitudes. We find a correlation between tabloid consumption and punitiveness. We end by a speculation that locates this finding in the wider context of an individualized, victim-centred discourse of crime.