School Health Care Research Articles

Does time matter? Exploring the relationship between interdependent teamwork and time allocation in Swedish interprofessional teams

This paper explores the relationship between time allocation on formal and informal forms of contact within interprofessional teams and an interdependent collaboration. Data were collected by a questionnaire including items on work organization, team climate and time allocation that was responded to by 226 professionals from 44 interprofessional teams. An additional sample of 139 professionals from 18 teams responded to the same questionnaire except for the item on time allocation. The teams worked within occupational health care, psychiatry, rehabilitation and school health care. On average, team members spent about 22% of their available work time on internal meetings/consultations and they perceived their collaboration as fairly interdependent. No correlation was found between, on the one hand, time invested in meetings and informal consultations within the team and, on the other hand, degree of team interdependence. Instead, interdependence was predicted by team climate, followed by manager coordination and self-regulation. However, there may be a lower limit: all 44 teams allocated at least about 10% of their work time to internal meetings and consultations. The results suggest three ways to strengthen interprofessional team collaboration – development of team climate and communication and more opportunity for both manager coordination and self-regulation.

Nordic adolescents’ school lunch patterns and their suggestions for making healthy choices at school easier

This article examines Nordic adolescents’ school lunch patterns and their perceptions of how making healthy choices at school could be easier. Analysis is based on a quantitative data-set collected between 2006 and 2007 as part of a Nordic research project. The sample of 1539 respondents consisted of 14–17year old adolescents from Finland, Sweden, Denmark, and Norway. The number of adolescents regularly eating either a packed lunch or a hot school lunch differed between countries and statistically significant differences were found between girls’ and boys’ school lunch patterns in the Swedish and Finnish data. Results suggest that adolescents have an understanding of what is healthy, but that school resources do not always support their ability to make healthy choices. Adolescents’ own suggestions for improvement imply that more attention should be paid to building a healthy school food environment. An important future challenge is trying to involve school health care personnel and aligning classroom activities more coherently with adolescents’ eating patterns during the school day.

Overweight and obesity in twenty‐year‐old Swedes in relation to birthweight and weight development during childhood

To describe the frequency of overweight and obesity from birth to 20 years of age and analyse weight at 20 years of age in relation to weight and weight development during early childhood and adolescence. A longitudinal, population-based study, which followed 496 children from birth to 20 years of age. Information about weight and height was collected from health records at child health centres and school health care. At 20 years of age, weight and height measurements were taken by one of the authors. At 20 years of age, 124 (25%) of the youth were obese or overweight. Of these youths, 60% had normal weight at 5.5 years. Of the teenagers who were overweight/obese at 15 years, 79% remained overweight/obese at 20 years of age. Out of the 124 overweight/obese at 20, 47% had normal weight at 15 years. [Corrections added after online publication on April 18, 2012: 'Out of the 124 obese at 20' has been changed to 'Out of the 124 overweight/obese at 20']. No relation was found between rapid weight gain during preschool age and overweight and obesity in 20-year-olds. The majority of those who were overweight/obese at 20 years of age were recruited after 5.5 years of age, and half of them in their late teens. Thus, during the preschool period, the entire population should be the target of primary prevention from overweight/obesity and, in the case of teenagers, prevention strategies should be developed for the whole population as well as treatment strategies for teenagers with established overweight/obesity.

NASN Position Statement

It is the position of the National Association of School Nurses that the registered professional school nurse is the leader in the school community to oversee school health policies and programs. The school nurse serves in a pivotal role to provide expertise and oversight for the provision of school health services and promotion of health education. Using clinical knowledge and judgment, the school nurse provides health care to students and staff, performs health screenings and coordinates referrals to the medical home or private healthcare provider. The school nurse serves as a liaison between school personnel, family, community and healthcare providers to advocate for health care and a healthy school environment (National Association of School Nurses/American Nurses Association [NASN/ANA], 2005).

A public school district's vending machine policy and changes over a 4-year period: Implementation of a national wellness policy

The school environment has been the focus of many health initiatives over the years as a means to address the childhood obesity crisis. The availability of low-nutrient, high-calorie foods and beverages to students via vending machines further exacerbates the issue of childhood obesity. However, a healthy overhaul of vending machines may also affect revenue on which schools have come to depend. This article describes the experience of one school district in changing the school environment, and the resulting impact on food and beverage vending machines. Observational study in Ann Arbor public schools. The contents and locations of vending machines were identified in 2003 and surveyed repeatedly in 2007. Overall revenues were also documented during this time period. Changes were observed in the contents of both food and beverage vending machines. Revenue in the form of commissions to the contracted companies and the school district decreased. Local and national wellness policy changes may have financial ramifications for school districts. In order to facilitate and sustain school environment change, all stakeholders, including teachers, administrators, students and healthcare providers, should collaborate and communicate on policy implementation, recognizing that change can have negative financial consequences as well as positive, healthier outcomes.

Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization.

BackgroundThe objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD).MethodsData were from the 2007 U.S. National Health Interview Survey (NHIS) and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ). Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics.ResultsOf the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3%) had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP), and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4). Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4).ConclusionsIn children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.

Early Childhood Overweight and Asthma and Allergic Sensitization at 8 Years of Age

Our aim was to examine the associations between high BMI and changes in BMI status during the first 7 years of life and asthma and allergic sensitization at age 8 years. A birth cohort of newborn infants was followed for 8 years. Repeated parental questionnaires provided information on environmental exposures and health outcomes. Information on height and weight during childhood was retrieved from preschool and school health care records. The analyses included the 2075 children for whom information was available on weight and height, as well as on asthma, at age 8 years. A high BMI (≥85th percentile) at age 1, 4, and/or 7 years was associated with an increased risk of asthma at age 8 years. However, no significant association was observed among children with high BMI at age 12 and/or 18 months (early age) or at age 4 years who developed a normal BMI by age 7 years. The risk was increased among children with high BMI at age 7 years, regardless of their earlier weight. Moreover, we observed an increased risk of sensitization to inhalant allergens among children with high BMI at age 7 years. Our study indicates that high BMI during the first 4 years does not increase the risk of asthma at school age among children who have developed a normal weight by age 7 years. However, high BMI at age 7 years is associated with an increased risk of asthma and sensitization to inhalant allergens.

Development and Psychometric Evaluation of a New Instrument for Measuring Sleep Length and Television and Computer Habits of Swedish School-Age Children

The aim was to develop a new instrument for measuring length of sleep as well as television and computer habits in school-age children. A questionnaire was constructed for use when children visit the school health care unit. Three aspects of the validity of the questionnaire were examined: its face validity, content validity, and construct validity. Test–retest reliability was assessed by giving the questionnaire twice, 2 weeks apart, to the respondents. The questionnaire was assessed as being reasonably valid, the test–retest results (n = 138) showing 90.4% of the estimates regarding bedtime on weeknights on the two survey occasions to lie within ± 30 min of each other, the test–retest agreement also being rather close (κ > .600) regarding both sleep and media habits. The instrument can be a valuable tool in a clinical setting, both for measuring sleep habits in a class and for discussing sleep with individual school children and their families.

To Screen or Not to Screen Women in Their 40s for Breast Cancer: Is Personalized Risk-Based Screening the Answer?

Editorials5 July 2011To Screen or Not to Screen Women in Their 40s for Breast Cancer: Is Personalized Risk-Based Screening the Answer?Jeanne S. Mandelblatt, MD, MPH, Natasha Stout, PhD, and Amy Trentham-Dietz, PhDJeanne S. Mandelblatt, MD, MPHFrom Lombardi Comprehensive Cancer Center, Washington, DC 20057; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215; and University of Wisconsin Carbone Cancer Center, Madison, WI 53792.Search for more papers by this author, Natasha Stout, PhDFrom Lombardi Comprehensive Cancer Center, Washington, DC 20057; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215; and University of Wisconsin Carbone Cancer Center, Madison, WI 53792.Search for more papers by this author, and Amy Trentham-Dietz, PhDFrom Lombardi Comprehensive Cancer Center, Washington, DC 20057; Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215; and University of Wisconsin Carbone Cancer Center, Madison, WI 53792.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-1-201107050-00008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail After decades of research and numerous consensus panels, guidelines on the use of screening mammography to detect breast cancer among women aged 40 to 49 years (1, 2) continue to generate controversy in the scientific community (3) and confusion in the public sector (4–6). The most recent update to screening mammography guidelines by the U.S. Preventive Services Task Force (2) was based on a synthesis of the clinical trial evidence about the balance of benefits and harms of screening for average-risk women and did not consider costs. They concluded that “there is moderate certainty that the net benefit [in terms ...

Evidence For Postpartum Depression Screening: The Authors Reply

Letters Health AffairsVol. 30, No. 6: Strategies For The ‘Decade Of Vaccines’ Evidence For Postpartum Depression Screening: The Authors ReplyKaty Backes Kozhimannil, Stephen B. Soumerai, and Haiden A. Huskamp Affiliations School of Public Health, University of Minnesota Minneapolis, Minnesota Harvard Medical School and Harvard Pilgrim Health Care Institute Boston, Massachusetts Harvard Medical School Boston, Massachusetts PUBLISHED:June 2011No Accesshttps://doi.org/10.1377/hlthaff.2011.0434AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View article"Evidence For Postpartum Depression Screening: The Authors Reply." Health Affairs, 30(6), p. 1217TOPICSDepression Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 June 2011 Information Project HOPE—The People-to-People Health Foundation, Inc. PDF download

Prediction of obesity from infancy to adolescence

To examine the development of childhood obesity and to determine the earliest age when estimating body mass using only weight and height data is associated with a corresponding estimate at the age of 15. Subjects included are all children born in 1991 in Östergötland County, Sweden. Weight and height data collected during regular check-ups at well-child centres and school health care assessments up to 15 years of age were assembled from health records. Correlations between childhood estimates of body mass and the body mass index (BMI) at 15 years of age were computed pairwise. Correlations with r > 0.5 were defined as reliably strong. Complete data were available for 3579 children (62%). Fewer girls (2.6%; C.I. 1.9-3.3) than boys (4.6%; C.I. 3.7-5.5) were obese at 15 years of age. Correlations with BMI at 15 years of age were strong (significantly higher than 0.5) from 5 years of age. Only 23% of girls and 8% of boys found to be obese at 5 years of age were of normal weight at the age of 15. From 5 years of age, point estimates of body mass using only weight and height data are strongly associated with BMI at the age of 15. More data sources are needed to predict weight trajectories in younger children.

High-Deductible Health Plans: The Authors Reply

Letters Health AffairsVol. 30, No. 4: Still Crossing The Quality Chasm High-Deductible Health Plans: The Authors ReplyAlison A. Galbraith, Dennis Ross-Degnan, and Meredith B. Rosenthal Affiliations Harvard Medical School and Harvard Pilgrim Health Care Institute Boston, Massachusetts Harvard School of Public Health Boston, Massachusetts PUBLISHED:April 2011No Accesshttps://doi.org/10.1377/hlthaff.2011.0307AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View article"High-Deductible Health Plans: The Authors Reply." Health Affairs, 30(4), p. 800TOPICSPremiumsOut-of-pocket expensesEconomic burdenCost reductionHigh-deductible health plansCosts and spending Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 April 2011 Information Project HOPE—The People-to-People Health Foundation, Inc. PDF download

A healthy school start - Parental support to promote healthy dietary habits and physical activity in children: Design and evaluation of a cluster-randomised intervention

BackgroundChildhood obesity is multi-factorial and determined to a large extent by dietary habits, physical activity and sedentary behaviours. Previous research has shown that school-based programmes are effective but that their effectiveness can be improved by including a parental component. At present, there is a lack of effective parental support programmes for improvement of diet and physical activity and prevention of obesity in children.Methods/DesignThis paper describes the rationale and design of a parental support programme to promote healthy dietary habits and physical activity in six-year-old children starting school. The study is performed in close collaboration with the school health care and is designed as a cluster-randomised controlled trial with a mixed methods approach. In total, 14 pre-school classes are included from a municipality in Stockholm county where there is large variation in socio-economic status between the families. The school classes are randomised to intervention (n = 7) and control (n = 7) groups including a total of 242 children. The intervention is based on social cognitive theory and consists of three main components: 1) a health information brochure; 2) two motivational interviewing sessions with the parents; and 3) teacher-led classroom activities with the children. The primary outcomes are physical activity in the children measured objectively by accelerometry, children's dietary and physical activity habits measured with a parent-proxy questionnaire and parents' self-efficacy measured by a questionnaire. Secondary outcomes are height, weight and waist circumference in the children. The duration of the intervention is six months and includes baseline, post intervention and six months follow-up measurements. Linear and logistic regression models will be used to analyse differences between intervention and control groups in the outcome variables. Mediator and moderator analysis will be performed. Participants will be interviewed.DiscussionThe results from this study will show if it is possible to promote a healthy lifestyle and a normal weight development among children from low-income districts with relatively limited efforts involving parents. Hopefully the study will provide new insights to the further development of effective programmes to prevent overweight and obesity in children.Trial registrationISRCTN: ISRCTN32750699

Health related quality of life in children and adolescents: Reliability and validity of the Norwegian version of KIDSCREEN-52 questionnaire, a cross sectional study

Background A number of health-related quality of life instruments for children and adolescents have been developed and used in European countries during recent years. However, few well-validated instruments have been translated into Norwegian. As part of a larger investigation about pain and health-related quality of life, the KIDSCREEN-52, a cross-cultural 10-scale questionnaire, was translated into Norwegian. The aim of this study was to examine psychometric properties of the first Norwegian version of KIDSCREEN, particularly reliability and construct validity. Methods A cross-sectional study was carried out, and a cluster sample of 20 randomly selected schools was drawn. The final study sample encompassed 1123 children and adolescents, aged 8–18 years. Internal consistency reliability was assessed using Cronbach's alpha. Construct validity was examined by confirmatory factor analysis, and by analysing whether the KIDSCREEN scales correlated with comparable KINDL scales, another health-related quality of life instrument. The analyses were conducted using SPSS (16.0) and Lisrel (8.7). Results The Cronbach's alpha value was above 0.80 for all KIDSCREEN scales, suggesting good internal consistency reliability for the instrument. Confirmatory factor analysis shows that most of the KIDSCREEN scales fit the data well. Fit statistics for the 10-factor model were satisfactory, although some scales displayed residual covariance. Several confirmatory factor analysis models were fitted to the data, and the model specified according to the 10-dimensional KIDSCREEN-52 measurement model with correlated first-order factors fitted the data well (RMSEA = 0.04; CFI = 0.99). The KIDSCREEN scales correlated sufficiently highly with comparable KINDL scales. Conclusions The results of the present study indicate that the Norwegian version of the KIDSCREEN-52 seems to work well in a Norwegian context, and is a valid and reliable generic health-related quality of life instrument. It is considered appropriate for screening in the public health area, for example, in school health care.

Journey to recovery: a teenagers inspirational story to “never give up”

An enviable life. That was how one would describe the life of an active, popular 16-year-old teenager from Rodney, Ontario, Canada. AJ Fordham participated in sports, raced cars at a...

Rate of Compliance with Hand Hygiene by Dental Healthcare Personnel (DHCP) within a Dentistry Healthcare First Aid Facility

To evaluate the compliance with the opportunities of hand hygiene by dentistry school healthcare professionals, as well as the higher choice products. Through direct observation, the oral healthcare team-professors, oral and maxillofacial surgery residents, graduation students-for daily care were monitored: before performing the first treatment of the shift, after snacks and meals, and after going to the bathroom (initial opportunities) as well as between patients' care, and after ending the shift (following opportunities). The professors' category profited 78.4% of all opportunities while residents and graduation students did not reach 50.0% of compliance. Statistically significant data (P</=.05) were seen between categories: professors and residents, professors and graduation students, and between genders within the residents' category. When opportunities were profited, the preferred choice for hand hygiene was water and soap (82.2%), followed by 70% alcohol (10.2%), and both (7.6%). Although gloves were worn in all procedures, we concluded that the hygiene compliance by these professionals was under the expectation.

Paediatric primary care in Europe: variation between countries

BackgroundAlthough it is known that differences in paediatric primary care (PPC) are found throughout Europe, little information exists as to where, how and who delivers this care. The aim of...

Critères de repérage précoce des enfants à risque de développer un surpoids

Health professionals who monitor the growth of children are also involved in the early detection of overweight. Appropriate tools are required for this purpose. The study sought to identify predictive markers of the development of subsequent overweight using a simple set of criteria. A consecutive cohort was composed of 1424 grade 4 children in Aquitaine, France, aged 8-9 years. Body mass index (BMI) was calculated during school health assessments at 8-9 years of age. Data from previous assessments at 3-4 and 5-6 years of age were also collected. Of the 189/1424 children (13.9 %) who were overweight according to the French national cut off for children aged 8-9 years, 67 (33.8 %) were already overweight at 3-4 years and 107 (54.1 %) at 5-6 years. Of the 134 (9.4 %) who were overweight at 5-6 years, 43.3 % were already overweight at 3-4 years and 79.9 % were overweight at 8-9 years. On the other hand, 76 of these 134 children (56.7 %) were not overweight at 3-4 years, so they had become overweight between the two assessments. The combination of the criterion "overweight at 3-4 years or 5-6 years" and "increase in BMI>1kg/m(2) between 3-4 years and 5-6 years" appears to be the best predictor of the risk of overweight at 8-9 years, with good sensitivity (75.3 %) and specificity (87.9 %). A predictive tool based on BMI changes between ages 3-4 years and 5-6 years could be used for the early detection of the risk of developing overweight and obesity. The tool is easy to use, especially for health care in schools. Furthermore, the present findings confirm the value of following up and managing children who are already overweight between the ages of 3 and 6 years.

C-C3-01: A Conditional Sequential Sampling Procedure for Drug Safety Surveillance

Lingling Li, PhD Lingling Li, PhD, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care

Clinical applicability of the World Health Organization Quality of Life Scale Brief Version (WHOQOL‐BREF) to mothers of children with asthma in Taiwan

This study examined the clinical applicability of the World Health Organization Quality of Life Scale brief version (WHOQOL-BREF) to mothers of children with asthma in Taiwan. The WHOQOL-BREF scale has been culturally adapted for Taiwan and applied to a variety of ill and healthy subjects in hospitals and the community and to the general population in the 2001 National Health Interview Survey in Taiwan. Its application to explore the QOL of mothers of children with asthma in Taiwan allows future cross-population comparisons. A cross-sectional survey. Internal consistency, test-retest reliability; content validity, criterion-related validity and discriminant validity were assessed. A total of 229 mothers participated in the study. The WHOQOL-BREF showed acceptable psychometric properties. Internal consistency of 0.63-0.84, content validity r = 0.39-0.65 (p < 0.01) and criterion-related validity r = 0.28-0.65 (p < 0.05) were reported. Discriminant validity was also found, especially in the domain of physical health. Issues of QOL for mothers, especially in the realm of physical health need more support and attention from health professionals. This study supports the clinical applicability of the WHOQOL-BREF scale as a measure of QOL of mothers of children with asthma. Future studies to compare the QOL measured by WHOQOL-BREF in female caregivers of children with other chronic health conditions are suggested. Our findings show that mothers are hardly ever free from the strains of the daily-care of an asthmatic and bear the uncertainties for the unending illness. The health care team is responsible for providing collaborative care approaches in hospital, home and school health care settings for children with asthma and their mothers.